1
|
Grunz JP, Kunz AS, Paul MM, Luetkens KS, Huflage H, Conrads N, Ergün S, Weber T, Herbst M, Herold S, Bley TA, Patzer TS. Postoperative Extremity Tomosynthesis-A Superimposition-Free Alternative to Standard Radiography? Invest Radiol 2024:00004424-990000000-00215. [PMID: 38709665 DOI: 10.1097/rli.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
RATIONALE AND OBJECTIVES This study investigates the performance of tomosynthesis in the presence of osteosynthetic implants, aiming to overcome superimposition-induced limitations in conventional radiograms. MATERIALS AND METHODS After surgical fracture induction and subsequent osteosynthesis, 8 cadaveric fracture models (wrist, metacarpus, ankle, metatarsus) were scanned with the prototypical tomosynthesis mode of a multiuse x-ray system. Tomosynthesis protocols at 60, 80, and 116 kV (sweep angle 10°, 13 FPS) were compared with standard radiograms. Five radiologists independently rated diagnostic assessability based on an equidistant 7-point scale focusing on fracture delineation, intra-articular screw placement, and implant positioning. The intraclass correlation coefficient (ICC) was calculated to analyze interrater agreement. RESULTS Radiation dose in radiography was 0.48 ± 0.26 dGy·cm2 versus 0.12 ± 0.01, 0.36 ± 0.02, and 1.95 ± 0.11 dGy·cm2 for tomosynthesis scans at 60, 80, and 116 kV. Delineation of fracture lines was superior for 80/116 kV tomosynthesis compared with radiograms (P ≤ 0.003). Assessability of intra-articular screw placement was deemed favorable for all tomosynthesis protocols (P ≤ 0.004), whereas superiority for evaluation of implant positioning could not be ascertained (all P's ≥ 0.599). Diagnostic confidence was higher for 80/116 kV tomosynthesis versus radiograms and 60 kV tomosynthesis (P ≤ 0.002). Interrater agreement was good for fracture delineation (ICC, 0.803; 95% confidence interval [CI], 0.598-0.904), intra-articular screw placement (ICC, 0.802; 95% CI, 0.599-0.903), implant positioning (ICC, 0.855; 95% CI, 0.729-0.926), and diagnostic confidence (ICC, 0.842; 95% CI, 0.556-0.934). CONCLUSIONS In the postoperative workup of extremity fractures, tomosynthesis allows for superior assessment of fracture lines and intra-articular screw positioning with greater diagnostic confidence at radiation doses comparable to conventional radiograms.
Collapse
Affiliation(s)
- Jan-Peter Grunz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany (J.-P.G., A.S.K., K.S.L., H.H., N.C., T.A.B., T.S.P.); Department of Orthopedic Trauma, Hand, Plastic, and Reconstructive Surgery, University Hospital Würzburg, Würzburg, Germany (M.M.P.); Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany (S.E.); and X-ray Products-Research and Development, Siemens Healthineers AG, Forchheim, Germany (T.W., M.H., S.H.)
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Yuki K, Vallon M, Ding J, Rada CC, Tang AT, Vilches-Moure JG, McCormick AK, Echeverri MFH, Alwahabi S, Braunger BM, Ergün S, Kahn ML, Kuo CJ. GPR124 regulates murine brain embryonic angiogenesis and BBB formation by an intracellular domain-independent mechanism. Development 2024:dev.202794. [PMID: 38682276 DOI: 10.1242/dev.202794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/18/2024] [Indexed: 05/01/2024]
Abstract
The GPR124/RECK/WNT7 pathway is an essential regulator of CNS angiogenesis and blood-brain barrier (BBB) function. GPR124, a brain endothelial adhesion 7-pass transmembrane protein, associates with RECK, which binds and stabilizes newly synthesized WNT7, which is transferred to Frizzled (FZD) to initiate canonical b-catenin signaling. GPR124 remains enigmatic; while its extracellular domain (ECD) is essential, the poorly conserved intracellular domain (ICD) appears variably required in mammals versus zebrafish, potentially via adaptor protein bridging of GPR124/FZD ICDs. GPR124 ICD deletion impairs zebrafish angiogenesis, but paradoxically retains WNT7 signaling upon mammalian transfection. We thus investigated GPR124 ICD function by mouse deletion (Gpr124ΔC). Despite inefficiently expressed GPR124ΔC protein, Gpr124ΔC/ΔC mice could be born with normal cerebral cortex angiogenesis, versus Gpr124-/- embryonic lethality, forebrain avascularity and hemorrhage. Gpr124ΔC/ΔC vascular phenotypes were restricted to sporadic ganglionic eminence angiogenic defects, attributable to impaired GPR124ΔC protein expression. Further, Gpr124ΔC and recombinant GPR124 ECD rescued WNT7 signaling in culture upon brain endothelial Gpr124 knockdown. Thus, in mice, GPR124-regulated CNS forebrain angiogenesis and BBB function is exerted by ICD-independent functionality, extending the signaling mechanisms used by adhesion 7-pass transmembrane receptors.
Collapse
Affiliation(s)
- Kanako Yuki
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mario Vallon
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Wuerzburg, 97070 Wuerzburg, Germany
| | - Jie Ding
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Cara C Rada
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alan T Tang
- Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - José G Vilches-Moure
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Aaron K McCormick
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Maria F Henao Echeverri
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Samira Alwahabi
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Barbara M Braunger
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Wuerzburg, 97070 Wuerzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Wuerzburg, 97070 Wuerzburg, Germany
| | - Mark L Kahn
- Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Calvin J Kuo
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
3
|
Feldle P, Grunz JP, Huflage H, Kunz AS, Ergün S, Afat S, Gruschwitz P, Görtz L, Pennig L, Bley TA, Conrads N. Influence of helical pitch and gantry rotation time on image quality and file size in ultrahigh-resolution photon-counting detector CT. Sci Rep 2024; 14:9358. [PMID: 38653758 DOI: 10.1038/s41598-024-59729-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
The goal of this experimental study was to quantify the influence of helical pitch and gantry rotation time on image quality and file size in ultrahigh-resolution photon-counting CT (UHR-PCCT). Cervical and lumbar spine, pelvis, and upper legs of two fresh-frozen cadaveric specimens were subjected to nine dose-matched UHR-PCCT scan protocols employing a collimation of 120 × 0.2 mm with varying pitch (0.3/1.0/1.2) and rotation time (0.25/0.5/1.0 s). Image quality was analyzed independently by five radiologists and further substantiated by placing normed regions of interest to record mean signal attenuation and noise. Effective mAs, CT dose index (CTDIvol), size-specific dose estimate (SSDE), scan duration, and raw data file size were compared. Regardless of anatomical region, no significant difference was ascertained for CTDIvol (p ≥ 0.204) and SSDE (p ≥ 0.240) among protocols. While exam duration differed substantially (all p ≤ 0.016), the lowest scan time was recorded for high-pitch protocols (4.3 ± 1.0 s) and the highest for low-pitch protocols (43.6 ± 15.4 s). The combination of high helical pitch and short gantry rotation times produced the lowest perceived image quality (intraclass correlation coefficient 0.866; 95% confidence interval 0.807-0.910; p < 0.001) and highest noise. Raw data size increased with acquisition time (15.4 ± 5.0 to 235.0 ± 83.5 GByte; p ≤ 0.013). Rotation time and pitch factor have considerable influence on image quality in UHR-PCCT and must therefore be chosen deliberately for different musculoskeletal imaging tasks. In examinations with long acquisition times, raw data size increases considerably, consequently limiting clinical applicability for larger scan volumes.
Collapse
Affiliation(s)
- Philipp Feldle
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, 97080, Wuerzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, 97080, Wuerzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, 97080, Wuerzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, 97080, Wuerzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Wuerzburg, Koellikerstraße 6, 97070, Wuerzburg, Germany
| | - Saif Afat
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str 3, 72076, Tuebingen, Germany
| | - Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, 97080, Wuerzburg, Germany
| | - Lukas Görtz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Lenhard Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, 97080, Wuerzburg, Germany
| | - Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, 97080, Wuerzburg, Germany.
| |
Collapse
|
4
|
Hartung V, Gruschwitz P, Huflage H, Augustin AM, Kleefeldt F, Peter D, Lichthardt S, Ergün S, Bley TA, Grunz JP, Petritsch B. Photon-Counting Detector CT for Femoral Stent Imaging in an Extracorporeally Perfused Human Cadaveric Model. Invest Radiol 2024; 59:320-327. [PMID: 37812470 DOI: 10.1097/rli.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND AND AIMS This study aims to compare the performance of first-generation dual-source photon-counting detector computed tomography (PCD-CT) to third-generation dual-source energy-integrating detector (EID-CT) regarding stent imaging in the femoral arterial runoff. METHODS Continuous extracorporeal perfusion was established in 1 human cadaver using an inguinal and infragenicular access and peristaltic pump. Seven peripheral stents were implanted into both superior femoral arteries by means of percutaneous angioplasty. Radiation dose-equivalent CT angiographies (high-/medium-/low-dose: 10/5/3 mGy) with constant tube voltage of 120 kVp, matching iterative reconstruction algorithm levels, and convolution kernels were used both with PCD-CT and EID-CT. In-stent lumen visibility, luminal and in-stent attenuation as well as contrast-to-noise ratio (CNR) were assessed via region of interest and diameter measurements. Results were compared using analyses of variance and regression analyses. RESULTS Maximum in-stent lumen visibility achieved with PCD-CT was 94.48% ± 2.62%. The PCD-CT protocol with the lowest lumen visibility (BV40: 78.93% ± 4.67%) performed equal to the EID-CT protocol with the best lumen visibility (BV59: 79.49% ± 2.64%, P > 0.999). Photon-counting detector CT yielded superior CNR compared with EID-CT regardless of kernel and dose level ( P < 0.001). Maximum CNR was 48.8 ± 17.4 in PCD-CT versus 31.28 ± 5.7 in EID-CT (both BV40, high-dose). The theoretical dose reduction potential of PCD-CT over EID-CT was established at 88% (BV40), 83% (BV48/49), and 73% (BV59/60), respectively. In-stent attenuation was not significantly different from luminal attenuation outside stents in any protocol. CONCLUSIONS With superior lumen visibility and CNR, PCD-CT allowed for noticeable dose reduction over EID-CT while maintaining image quality in a continuously perfused human cadaveric model.
Collapse
Affiliation(s)
- Viktor Hartung
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany (V.H., P.G., H.H., A.M.A., T.A.B., J.-P.G., B.M.W.P.); Institute of Anatomy and Cell Biology, Julius-Maximilians University Würzburg, Würzburg, Germany (F.K., S.E.); and Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, Center of Operative Medicine, University Hospital of Würzburg, Würzburg, Germany (D.P., S.L.)
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Huflage H, Hendel R, Kunz AS, Ergün S, Afat S, Petri N, Hartung V, Gruschwitz P, Bley TA, Grunz JP. Investigating the Small Pixel Effect in Ultra-High Resolution Photon-Counting CT of the Lung. Invest Radiol 2024; 59:293-297. [PMID: 37552040 DOI: 10.1097/rli.0000000000001013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
OBJECTIVES The aim of this study was to investigate potential benefits of ultra-high resolution (UHR) over standard resolution scan mode in ultra-low dose photon-counting detector CT (PCD-CT) of the lung. MATERIALS AND METHODS Six cadaveric specimens were examined with 5 dose settings using tin prefiltration, each in UHR (120 × 0.2 mm) and standard mode (144 × 0.4 mm), on a first-generation PCD-CT scanner. Image quality was evaluated quantitatively by noise comparisons in the trachea and both main bronchi. In addition, 16 readers (14 radiologists and 2 internal medicine physicians) independently completed a browser-based pairwise forced-choice comparison task for assessment of subjective image quality. The Kendall rank coefficient ( W ) was calculated to assess interrater agreement, and Pearson's correlation coefficient ( r ) was used to analyze the relationship between noise measurements and image quality rankings. RESULTS Across all dose levels, image noise in UHR mode was lower than in standard mode for scan protocols matched by CTDI vol ( P < 0.001). UHR examinations exhibited noise levels comparable to the next higher dose setting in standard mode ( P ≥ 0.275). Subjective ranking of protocols based on 5760 pairwise tests showed high interrater agreement ( W = 0.99; P ≤ 0.001) with UHR images being preferred by readers in the majority of comparisons. Irrespective of scan mode, a substantial indirect correlation was observed between image noise and subjective image quality ranking ( r = -0.97; P ≤ 0.001). CONCLUSIONS In PCD-CT of the lung, UHR scan mode reduces image noise considerably over standard resolution acquisition. Originating from the smaller detector element size in fan direction, the small pixel effect allows for superior image quality in ultra-low dose examinations with considerable potential for radiation dose reduction.
Collapse
Affiliation(s)
- Henner Huflage
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany (H.H., R.H., A.S., V.H., P.G., T.A., J.-P.G.); Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany (S.E.); Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany (S.A.); and Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (N.P.)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Conrads N, Kunz AS, Huflage H, Patzer TS, Luetkens KS, Ergün S, Herbst M, Herold S, Weber T, Bley TA, Grunz JP. Upright Tomosynthesis of the Lumbar Spine. Acad Radiol 2024; 31:1472-1479. [PMID: 37730493 DOI: 10.1016/j.acra.2023.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/11/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023]
Abstract
RATIONALE AND OBJECTIVES This experimental study investigates the potential of lumbar spine tomosynthesis to offset the traditional limitations of radiographic and computed tomography imaging, that is, superimposition of anatomy and disregard of physiological load-bearing. MATERIALS AND METHODS A gantry-free twin robotic scanner was used to obtain lateral radiographs and tomosyntheses of the lumbar spine under weight-bearing conditions in eight body donors. Tomosynthesis protocols varied in terms of sweep angle (20 versus 40°), scan time (2.4 versus 4.8 seconds), and framerate (16 versus 30 fps). Image quality and vertebral endplate assessability were evaluated by five radiologists with 4-8 years of skeletal imaging experience. Aiming to identify potential diagnostic deterioration near the scan volume margins, readers additionally determined the craniocaudal extent of clinically acceptable image quality. RESULTS Tomosynthesis scans effectuated a substantial dose reduction compared to standard radiographs (3.8 ± 0.2 to 15.4 ± 0.8 dGy*cm2 versus 77.7 ± 34.8 dGy*cm2; p ≤ 0.021). Diagnostic image quality and endplate assessability were deemed highest for the 30 fps wide-angle tomosynthesis protocol with good to excellent interrater reliability (intraclass correlation coefficients: 0.846 and 0.946). Accordingly, the craniocaudal extent of acceptable image quality was substantially larger compared to radiography (26.9 versus 18.9 cm; p < 0.001), whereas no significant difference was ascertained for the tomosynthesis protocols with 16 fps (15.3-22.1 cm; all p ≥ 0.058). CONCLUSION Combining minimal radiation dose with superimposition-free visualization, 30 fps wide-angle tomosynthesis superseded radiography in all evaluated aspects. With superior diagnostic assessability despite significant dose reduction, load-bearing tomosynthesis appears promising as an alternative for first-line lumbar spine imaging in the future.
Collapse
Affiliation(s)
- Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany (N.C., A.S.K., H.H., T.S.P., K.S.L., T.A.B., J.-P.G.)
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany (N.C., A.S.K., H.H., T.S.P., K.S.L., T.A.B., J.-P.G.)
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany (N.C., A.S.K., H.H., T.S.P., K.S.L., T.A.B., J.-P.G.)
| | - Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany (N.C., A.S.K., H.H., T.S.P., K.S.L., T.A.B., J.-P.G.)
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany (N.C., A.S.K., H.H., T.S.P., K.S.L., T.A.B., J.-P.G.)
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany (S.E.)
| | - Magdalena Herbst
- X-ray Products - Research & Development, Siemens Healthineers, Forchheim, Germany (M.H., S.H., T.W.)
| | - Sophia Herold
- X-ray Products - Research & Development, Siemens Healthineers, Forchheim, Germany (M.H., S.H., T.W.)
| | - Thomas Weber
- X-ray Products - Research & Development, Siemens Healthineers, Forchheim, Germany (M.H., S.H., T.W.)
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany (N.C., A.S.K., H.H., T.S.P., K.S.L., T.A.B., J.-P.G.)
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany (N.C., A.S.K., H.H., T.S.P., K.S.L., T.A.B., J.-P.G.).
| |
Collapse
|
7
|
Patzer TS, Kunz AS, Huflage H, Conrads N, Luetkens KS, Pannenbecker P, Ergün S, Herbst M, Herold S, Weber T, Bley TA, Grunz JP. Tomosynthesis of the Appendicular Skeleton on a Twin Robotic X-ray System: A Cadaveric Fracture Study. Acad Radiol 2024:S1076-6332(24)00090-4. [PMID: 38448327 DOI: 10.1016/j.acra.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024]
Abstract
RATIONALE AND OBJECTIVES Aiming to offset image quality limitations in radiographs due to superimposition, this study investigates the diagnostic potential of appendicular skeleton tomosynthesis. MATERIALS AND METHODS Eight cadaveric extremities (four hands and feet) were examined employing the prototypical tomosynthesis mode of a twin robotic X-ray scanner. 12 protocols with varying sweep angles (10, 20 vs. 40°), frame rates (13 vs. 26 fps), and tube voltages (60 vs. 80 kV) were compared to radiographs. Four radiologists separately evaluated cortical and trabecular bone visualization and fracture patterns. Interreader reliability was assessed based on the intraclass correlation coefficient (ICC). RESULTS Radiation dose in radiography was 0.59 ± 0.20 dGy * cm2 versus 0.11 ± 0.00 to 2.46 ± 0.17 dGy * cm2 for tomosynthesis. Cortical bone display was inferior for radiographs compared to 40° and 20° tomosynthesis. Best results were ascertained for the 80 kV/40°/26 fps protocol. Trabecular bone depiction was also superior in tomosynthesis (p ≤ 0.009) and best with the 80 kV/10°/26 fps setting. Interreader reliability was moderate for cortical bone display (ICC 0.521, 95% confidence interval 0.356-0.641) and good for trabecular bone (0.759, 0.697-0.810). Diagnostic accuracy for articular involvement and multifragment situations was higher in tomosynthesis (93.8-100%/92.2-100%) vs. radiography (85.9%/82.8%.). Diagnostic confidence was also better in tomosynthesis (p ≤ 0.003). CONCLUSION Compared to radiography, tomosynthesis allows for superior assessability of cortical and trabecular bone and fracture morphology, especially at high framerates. Operating on a multipurpose X-ray system, tomosynthesis of the appendicular skeleton can be performed without additional scanner hardware.
Collapse
Affiliation(s)
- Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Pauline Pannenbecker
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Magdalena Herbst
- X-ray Products - Research & Development, Siemens Healthineers AG, Siemensstraße 3, 91301 Forchheim, Germany
| | - Sophia Herold
- X-ray Products - Research & Development, Siemens Healthineers AG, Siemensstraße 3, 91301 Forchheim, Germany
| | - Thomas Weber
- X-ray Products - Research & Development, Siemens Healthineers AG, Siemensstraße 3, 91301 Forchheim, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| |
Collapse
|
8
|
Feldle P, Grunz JP, Kunz AS, Pannenbecker P, Patzer TS, Pichlmeier S, Sauer ST, Hendel R, Ergün S, Bley TA, Huflage H. Influence of spectral shaping and tube voltage modulation in ultralow-dose computed tomography of the abdomen. BMC Med Imaging 2024; 24:49. [PMID: 38395772 PMCID: PMC10893640 DOI: 10.1186/s12880-024-01228-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
PURPOSE Unenhanced abdominal CT constitutes the diagnostic standard of care in suspected urolithiasis. Aiming to identify potential for radiation dose reduction in this frequent imaging task, this experimental study compares the effect of spectral shaping and tube voltage modulation on image quality. METHODS Using a third-generation dual-source CT, eight cadaveric specimens were scanned with varying tube voltage settings with and without tin filter application (Sn 150, Sn 100, 120, 100, and 80 kVp) at three dose levels (3 mGy: standard; 1 mGy: low; 0.5 mGy: ultralow). Image quality was assessed quantitatively by calculation of signal-to-noise ratios (SNR) for various tissues (spleen, kidney, trabecular bone, fat) and subjectively by three independent radiologists based on a seven-point rating scale (7 = excellent; 1 = very poor). RESULTS Irrespective of dose level, Sn 100 kVp resulted in the highest SNR of all tube voltage settings. In direct comparison to Sn 150 kVp, superior SNR was ascertained for spleen (p ≤ 0.004) and kidney tissue (p ≤ 0.009). In ultralow-dose scans, subjective image quality of Sn 100 kVp (median score 3; interquartile range 3-3) was higher compared with conventional imaging at 120 kVp (2; 2-2), 100 kVp (1; 1-2), and 80 kVp (1; 1-1) (all p < 0.001). Indicated by an intraclass correlation coefficient of 0.945 (95% confidence interval: 0.927-0.960), interrater reliability was excellent. CONCLUSIONS In abdominal CT with maximised dose reduction, tin prefiltration at 100 kVp allows for superior image quality over Sn 150 kVp and conventional imaging without spectral shaping.
Collapse
Affiliation(s)
- Philipp Feldle
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Pauline Pannenbecker
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Svenja Pichlmeier
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Stephanie Tina Sauer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Robin Hendel
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
| |
Collapse
|
9
|
Huflage H, Hendel R, Woznicki P, Conrads N, Feldle P, Patzer TS, Ergün S, Bley TA, Kunz AS, Grunz JP. The Small Pixel Effect in Ultra-High-Resolution Photon-Counting CT of the Lumbar Spine. Invest Radiol 2024:00004424-990000000-00197. [PMID: 38329822 DOI: 10.1097/rli.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Image acquisition in ultra-high-resolution (UHR) scan mode does not impose a dose penalty in photon-counting CT (PCCT). This study aims to investigate the dose saving potential of using UHR instead of standard-resolution PCCT for lumbar spine imaging. MATERIALS AND METHODS Eight cadaveric specimens were examined with 7 dose levels (5-35 mGy) each in UHR (120 × 0.2 mm) and standard-resolution acquisition mode (144 × 0.4 mm) on a first-generation PCCT scanner. The UHR images were reconstructed with 3 dedicated bone kernels (Br68 [spatial frequency at 10% of the modulation transfer function 14.5 line pairs/cm], Br76 [21.0], and Br84 [27.9]), standard-resolution images with Br68 and Br76. Using automatic segmentation, contrast-to-noise ratios (CNRs) were established for lumbar vertebrae and psoas muscle tissue. In addition, image quality was assessed subjectively by 19 independent readers (15 radiologists, 4 surgeons) using a browser-based forced choice comparison tool totaling 16,974 performed pairwise tests. Pearson's correlation coefficient ( r ) was used to analyze the relationship between CNR and subjective image quality rankings, and Kendall W was calculated to assess interrater agreement. RESULTS Irrespective of radiation exposure level, CNR was higher in UHR datasets than in standard-resolution images postprocessed with the same reconstruction parameters. The use of sharper convolution kernels entailed lower CNR but higher subjective image quality depending on radiation dose. Subjective assessment revealed high interrater agreement ( W = 0.86; P < 0.001) with UHR images being preferred by readers in the majority of comparisons on each dose level. Substantial correlation was ascertained between CNR and the subjective image quality ranking (all r 's ≥ 0.95; P < 0.001). CONCLUSIONS In PCCT of the lumbar spine, UHR mode's smaller pixel size facilitates a considerable CNR increase over standard-resolution imaging, which can either be used for dose reduction or higher spatial resolution depending on the selected convolution kernel.
Collapse
Affiliation(s)
- Henner Huflage
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany (H.H., R.H., P.W., N.C., P.F., T.S., T.A.B., A.S.K., J.-P.G.); and Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany (S.E.)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Hartung V, Augustin AM, Grunz JP, Huflage H, Hennes JL, Kleefeldt F, Ergün S, Peter D, Lichthardt S, Bley TA, Gruschwitz P. Training for endovascular therapy of acute arterial disease and procedure-related complication: An extracorporeally-perfused human cadaver model study. PLoS One 2024; 19:e0297800. [PMID: 38330071 PMCID: PMC10852297 DOI: 10.1371/journal.pone.0297800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/12/2024] [Indexed: 02/10/2024] Open
Abstract
PURPOSE The aim of this study was to evaluate the usability of a recently developed extracorporeally-perfused cadaver model for training the angiographic management of acute arterial diseases and periprocedural complications that may occur during endovascular therapy of the lower extremity arterial runoff. MATERIALS AND METHODS Continuous extracorporeal perfusion was established in three fresh-frozen body donors via inguinal and infragenicular access. Using digital subtraction angiography for guidance, both arterial embolization (e.g., embolization using coils, vascular plugs, particles, and liquid embolic agents) and endovascular recanalization procedures (e.g., manual aspiration or balloon-assisted embolectomy) as well as various embolism protection devices were tested. Furthermore, the management of complications during percutaneous transluminal angioplasty, such as vessel dissection and rupture, were exercised by implantation of endovascular dissection repair system or covered stents. Interventions were performed by two board-certified interventional radiologists and one resident with only limited angiographic experience. RESULTS Stable extracorporeal perfusion was successfully established on both thighs of all three body donors. Digital subtraction angiography could be performed reliably and resulted in realistic artery depiction. The model allowed for repeatable training of endovascular recanalization and arterial embolization procedures with typical tactile feedback in a controlled environment. Furthermore, the handling of more complex angiographic devices could be exercised. Whereas procedural success was be ascertained for most endovascular interventions, thrombectomies procedures were not feasible in some cases due to the lack of inherent coagulation. CONCLUSION The presented perfusion model is suitable for practicing time-critical endovascular interventions in the lower extremity runoff under realistic but controlled conditions.
Collapse
Affiliation(s)
- Viktor Hartung
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Anne Marie Augustin
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Jan-Lucca Hennes
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Florian Kleefeldt
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Dominik Peter
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Sven Lichthardt
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| |
Collapse
|
11
|
Rani A, Ergün S, Karnati S, Jha HC. Understanding the link between neurotropic viruses, BBB permeability, and MS pathogenesis. J Neurovirol 2024; 30:22-38. [PMID: 38189894 DOI: 10.1007/s13365-023-01190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/04/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024]
Abstract
Neurotropic viruses can infiltrate the CNS by crossing the blood-brain barrier (BBB) through various mechanisms including paracellular, transcellular, and "Trojan horse" mechanisms during leukocyte diapedesis. These viruses belong to several families, including retroviruses; human immunodeficiency virus type 1 (HIV-1), flaviviruses; Japanese encephalitis (JEV); and herpesviruses; herpes simplex virus type 1 (HSV-1), Epstein-Barr virus (EBV), and mouse adenovirus 1 (MAV-1). For entering the brain, viral proteins act upon the tight junctions (TJs) between the brain microvascular endothelial cells (BMECs). For instance, HIV-1 proteins, such as glycoprotein 120, Nef, Vpr, and Tat, disrupt the BBB and generate a neurotoxic effect. Recombinant-Tat triggers amendments in the BBB by decreasing expression of the TJ proteins such as claudin-1, claudin-5, and zona occludens-1 (ZO-1). Thus, the breaching of BBB has been reported in myriad of neurological diseases including multiple sclerosis (MS). Neurotropic viruses also exhibit molecular mimicry with several myelin sheath proteins, i.e., antibodies against EBV nuclear antigen 1 (EBNA1) aa411-426 cross-react with MBP and EBNA1 aa385-420 was found to be associated with MS risk haplotype HLA-DRB1*150. Notably, myelin protein epitopes (PLP139-151, MOG35-55, and MBP87-99) are being used to generate model systems for MS such as experimental autoimmune encephalomyelitis (EAE) to understand the disease mechanism and therapeutics. Viruses like Theiler's murine encephalomyelitis virus (TMEV) are also commonly used to generate EAE. Altogether, this review provide insights into the viruses' association with BBB leakiness and MS along with possible mechanistic details which could potentially use for therapeutics.
Collapse
Affiliation(s)
- Annu Rani
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, 97070, Germany
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, 97070, Germany
| | - Hem Chandra Jha
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India.
| |
Collapse
|
12
|
Janz A, Walz K, Cirnu A, Surjanto J, Urlaub D, Leskien M, Kohlhaas M, Nickel A, Brand T, Nose N, Wörsdörfer P, Wagner N, Higuchi T, Maack C, Dudek J, Lorenz K, Klopocki E, Ergün S, Duff HJ, Gerull B. Mutations in DNAJC19 cause altered mitochondrial structure and increased mitochondrial respiration in human iPSC-derived cardiomyocytes. Mol Metab 2024; 79:101859. [PMID: 38142971 PMCID: PMC10792641 DOI: 10.1016/j.molmet.2023.101859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/06/2023] [Accepted: 12/20/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Dilated cardiomyopathy with ataxia (DCMA) is an autosomal recessive disorder arising from truncating mutations in DNAJC19, which encodes an inner mitochondrial membrane protein. Clinical features include an early onset, often life-threatening, cardiomyopathy associated with other metabolic features. Here, we aim to understand the metabolic and pathophysiological mechanisms of mutant DNAJC19 for the development of cardiomyopathy. METHODS We generated induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) of two affected siblings with DCMA and a gene-edited truncation variant (tv) of DNAJC19 which all lack the conserved DnaJ interaction domain. The mutant iPSC-CMs and their respective control cells were subjected to various analyses, including assessments of morphology, metabolic function, and physiological consequences such as Ca2+ kinetics, contractility, and arrhythmic potential. Validation of respiration analysis was done in a gene-edited HeLa cell line (DNAJC19tvHeLa). RESULTS Structural analyses revealed mitochondrial fragmentation and abnormal cristae formation associated with an overall reduced mitochondrial protein expression in mutant iPSC-CMs. Morphological alterations were associated with higher oxygen consumption rates (OCRs) in all three mutant iPSC-CMs, indicating higher electron transport chain activity to meet cellular ATP demands. Additionally, increased extracellular acidification rates suggested an increase in overall metabolic flux, while radioactive tracer uptake studies revealed decreased fatty acid uptake and utilization of glucose. Mutant iPSC-CMs also showed increased reactive oxygen species (ROS) and an elevated mitochondrial membrane potential. Increased mitochondrial respiration with pyruvate and malate as substrates was observed in mutant DNAJC19tv HeLa cells in addition to an upregulation of respiratory chain complexes, while cellular ATP-levels remain the same. Moreover, mitochondrial alterations were associated with increased beating frequencies, elevated diastolic Ca2+ concentrations, reduced sarcomere shortening and an increased beat-to-beat rate variability in mutant cell lines in response to β-adrenergic stimulation. CONCLUSIONS Loss of the DnaJ domain disturbs cardiac mitochondrial structure with abnormal cristae formation and leads to mitochondrial dysfunction, suggesting that DNAJC19 plays an essential role in mitochondrial morphogenesis and biogenesis. Moreover, increased mitochondrial respiration, altered substrate utilization, increased ROS production and abnormal Ca2+ kinetics provide insights into the pathogenesis of DCMA-related cardiomyopathy.
Collapse
Affiliation(s)
- Anna Janz
- Comprehensive Heart Failure Center, Department of Cardiovascular Genetics, University Hospital Würzburg, Würzburg, Germany
| | - Katharina Walz
- Comprehensive Heart Failure Center, Department of Cardiovascular Genetics, University Hospital Würzburg, Würzburg, Germany
| | - Alexandra Cirnu
- Comprehensive Heart Failure Center, Department of Cardiovascular Genetics, University Hospital Würzburg, Würzburg, Germany
| | - Jessica Surjanto
- Comprehensive Heart Failure Center, Department of Cardiovascular Genetics, University Hospital Würzburg, Würzburg, Germany
| | - Daniela Urlaub
- Comprehensive Heart Failure Center, Department of Cardiovascular Genetics, University Hospital Würzburg, Würzburg, Germany
| | - Miriam Leskien
- Comprehensive Heart Failure Center, Department of Cardiovascular Genetics, University Hospital Würzburg, Würzburg, Germany
| | - Michael Kohlhaas
- Comprehensive Heart Failure Center, Department of Translational Research, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Nickel
- Comprehensive Heart Failure Center, Department of Translational Research, University Hospital Würzburg, Würzburg, Germany
| | - Theresa Brand
- Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg, Germany
| | - Naoko Nose
- Comprehensive Heart Failure Center, Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Philipp Wörsdörfer
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Nicole Wagner
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Takahiro Higuchi
- Comprehensive Heart Failure Center, Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Christoph Maack
- Comprehensive Heart Failure Center, Department of Translational Research, University Hospital Würzburg, Würzburg, Germany; Department of Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Jan Dudek
- Comprehensive Heart Failure Center, Department of Translational Research, University Hospital Würzburg, Würzburg, Germany
| | - Kristina Lorenz
- Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg, Germany; Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., Dortmund, Germany
| | - Eva Klopocki
- Institute for Human Genetics, Biocenter, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Henry J Duff
- Department of Cardiac Sciences and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Brenda Gerull
- Comprehensive Heart Failure Center, Department of Cardiovascular Genetics, University Hospital Würzburg, Würzburg, Germany; Department of Medicine I, University Hospital Würzburg, Würzburg, Germany; Department of Cardiac Sciences and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| |
Collapse
|
13
|
Gruschwitz P, Hartung V, Ergün S, Peter D, Lichthardt S, Huflage H, Hendel R, Pannenbecker P, Augustin AM, Kunz AS, Feldle P, Bley TA, Grunz JP. Comparison of ultrahigh and standard resolution photon-counting CT angiography of the femoral arteries in a continuously perfused in vitro model. Eur Radiol Exp 2023; 7:83. [PMID: 38110729 PMCID: PMC10728414 DOI: 10.1186/s41747-023-00398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/17/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND With the emergence of photon-counting CT, ultrahigh-resolution (UHR) imaging can be performed without dose penalty. This study aims to directly compare the image quality of UHR and standard resolution (SR) scan mode in femoral artery angiographies. METHODS After establishing continuous extracorporeal perfusion in four fresh-frozen cadaveric specimens, photon-counting CT angiographies were performed with a radiation dose of 5 mGy and tube voltage of 120 kV in both SR and UHR mode. Images were reconstructed with dedicated convolution kernels (soft: Body-vascular (Bv)48; sharp: Bv60; ultrasharp: Bv76). Six radiologists evaluated the image quality by means of a pairwise forced-choice comparison tool. Kendall's concordance coefficient (W) was calculated to quantify interrater agreement. Image quality was further assessed by measuring intraluminal attenuation and image noise as well as by calculating signal-to-noise ratio (SNR) and contrast-to-noise ratios (CNR). RESULTS UHR yielded lower noise than SR for identical reconstructions with kernels ≥ Bv60 (p < 0.001). UHR scans exhibited lower intraluminal attenuation compared to SR (Bv60: 406.4 ± 25.1 versus 418.1 ± 30.1 HU; p < 0.001). Irrespective of scan mode, SNR and CNR decreased while noise increased with sharper kernels but UHR scans were objectively superior to SR nonetheless (Bv60: SNR 25.9 ± 6.4 versus 20.9 ± 5.3; CNR 22.7 ± 5.8 versus 18.4 ± 4.8; p < 0.001). Notably, UHR scans were preferred in subjective assessment when images were reconstructed with the ultrasharp Bv76 kernel, whereas SR was rated superior for Bv60. Interrater agreement was high (W = 0.935). CONCLUSIONS Combinations of UHR scan mode and ultrasharp convolution kernel are able to exploit the full image quality potential in photon-counting CT angiography of the femoral arteries. RELEVANCE STATEMENT The UHR scan mode offers improved image quality and may increase diagnostic accuracy in CT angiography of the peripheral arterial runoff when optimized reconstruction parameters are chosen. KEY POINTS • UHR photon-counting CT improves image quality in combination with ultrasharp convolution kernels. • UHR datasets display lower image noise compared with identically reconstructed standard resolution scans. • Scans in UHR mode show decreased intraluminal attenuation compared with standard resolution imaging.
Collapse
Affiliation(s)
- Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany.
| | - Viktor Hartung
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Dominik Peter
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Sven Lichthardt
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Robin Hendel
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Pauline Pannenbecker
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Anne Marie Augustin
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Philipp Feldle
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| |
Collapse
|
14
|
Rajendran R, Rajendran V, Böttiger G, Stadelmann C, Shirvanchi K, von Au L, Bhushan S, Wallendszus N, Schunin D, Westbrock V, Liebisch G, Ergün S, Karnati S, Berghoff M. The small molecule fibroblast growth factor receptor inhibitor infigratinib exerts anti-inflammatory effects and remyelination in a model of multiple sclerosis. Br J Pharmacol 2023; 180:2989-3007. [PMID: 37400950 DOI: 10.1111/bph.16186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Fibroblast growth factors and receptors (FGFR) have been shown to modulate inflammation and neurodegeneration in multiple sclerosis (MS). The selective FGFR inhibitor infigratinib has been shown to be effective in cancer models. Here, we investigate the effects of infigratinib on prevention and suppression of first clinical episodes of myelin oligodendrocyte glycoprotein (MOG)35-55 -induced experimental autoimmune encephalomyelitis (EAE) in mice. EXPERIMENTAL APPROACH The FGFR inhibitor infigratinib was given over 10 days from the time of experimental autoimmune encephalomyelitis induction or the onset of symptoms. The effects of infigratinib on proliferation, cytotoxicity and FGFR signalling proteins were studied in lymphocyte cell lines and microglial cells. KEY RESULTS Administration of infigratinib prevented by 40% and inhibited by 65% first clinical episodes of the induced experimental autoimmune encephalomyelitis. In the spinal cord, infiltration of lymphocytes and macrophages/microglia, destruction of myelin and axons were reduced by infigratinib. Infigratinib enhanced the maturation of oligodendrocytes and increased remyelination. In addition, infigratinib resulted in an increase of myelin proteins and a decrease in remyelination inhibitors. Further, lipids associated with neurodegeneration such as lysophosphatidylcholine and ceramide were decreased as were proliferation of T cells and microglial cells. CONCLUSION AND IMPLICATIONS This proof of concept study demonstrates the therapeutic potential of targeting FGFRs in a disease model of multiple sclerosis. Application of oral infigratinib resulted in anti-inflammatory and remyelinating effects. Thus, infigratinib may have the potential to slow disease progression or even to improve the disabling symptoms of multiple sclerosis.
Collapse
Affiliation(s)
- Ranjithkumar Rajendran
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Vinothkumar Rajendran
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Gregor Böttiger
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Christine Stadelmann
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Kian Shirvanchi
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Laureen von Au
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Sudhanshu Bhushan
- Institute for Anatomy and Cell Biology, University of Giessen, Giessen, Germany
| | - Natascha Wallendszus
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Darja Schunin
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Victor Westbrock
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Gerhard Liebisch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Martin Berghoff
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| |
Collapse
|
15
|
Götz L, Rueckschloss U, Balk G, Pfeiffer V, Ergün S, Kleefeldt F. The role of carcinoembryonic antigen-related cell adhesion molecule 1 in cancer. Front Immunol 2023; 14:1295232. [PMID: 38077351 PMCID: PMC10704240 DOI: 10.3389/fimmu.2023.1295232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
The Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1), also known as CD66a, is a member of the immunoglobulin superfamily. CEACAM1 was shown to be a prognostic marker in patients suffering from cancer. In this review, we summarize pre-clinical and clinical evidence linking CEACAM1 to tumorigenicity and cancer progression. Furthermore, we discuss potential CEACAM1-based mechanisms that may affect cancer biology.
Collapse
Affiliation(s)
- Lisa Götz
- Institute of Anatomy and Cell Biology, Julius‐Maximilians‐University Würzburg, Würzburg, Germany
| | - Uwe Rueckschloss
- Institute of Anatomy and Cell Biology, Julius‐Maximilians‐University Würzburg, Würzburg, Germany
| | - Gözde Balk
- Institute of Anatomy and Cell Biology, Julius‐Maximilians‐University Würzburg, Würzburg, Germany
| | - Verena Pfeiffer
- Institute of Anatomy and Cell Biology, Julius‐Maximilians‐University Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius‐Maximilians‐University Würzburg, Würzburg, Germany
| | - Florian Kleefeldt
- Institute of Anatomy and Cell Biology, Julius‐Maximilians‐University Würzburg, Würzburg, Germany
- Harvard Stem Cell Institute, Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, United States
| |
Collapse
|
16
|
Gruschwitz P, Hartung V, Kleefeldt F, Ergün S, Huflage H, Peter D, Hendel R, Patzer TS, Pannenbecker P, Kuhl PJ, Bley TA, Petritsch B, Grunz JP. Photon-Counting Versus Energy-Integrating Detector CT Angiography of the Lower Extremity in a Human Cadaveric Model With Continuous Extracorporeal Perfusion. Invest Radiol 2023; 58:740-745. [PMID: 37185253 DOI: 10.1097/rli.0000000000000982] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES Detailed visualization of the arterial runoff is mandatory for the assessment of peripheral arterial occlusive disease. This study aims to compare the performance of a first-generation photon-counting detector computed tomography (PCD-CT) to a third-generation energy-integrating detector CT (EID-CT). MATERIALS AND METHODS Computed tomography angiographies of 8 upper leg arterial runoffs were performed on human cadaveric models with continuous extracorporeal perfusion. For both PCD-CT and EID-CT, radiation dose-equivalent 120 kVp acquisition protocols (low-/medium-/high-dose: CTDI Vol = 3/5/10 mGy) were used. All scans were performed with standard collimation (PCD-CT: 144 × 0.4 mm; EID-CT: 96 × 0.6 mm), a pitch factor of 0.4, and a gantry rotation time of 1.0 second. Reformatting of data included the use of comparable vascular kernels (Bv 48/49), a slice thickness and increment of 1.0 mm, and a field of view of 150 × 150 mm. Eight radiologists evaluated image quality independently using a browser-based pairwise forced-choice comparison setup. Kendall concordance coefficient ( W ) was calculated to estimate interrater agreement. Signal-to-noise ratio and contrast-to-noise ratio (CNR) were compared based on 1-way analyses of variance and linear regression analysis. RESULTS Low-dose PCD-CT achieved superior signal-to-noise ratio/CNR values compared with high-dose EID-CT ( P < 0.001). Linear regression analysis suggested that an EID-CT scan with a CTDI Vol of at least 15.5 mGy was required to match the CNR value of low-dose PCD-CT. Intraluminal contrast attenuation was higher in PCD-CT than EID-CT, irrespective of dose level (415.0 ± 31.9 HU vs 329.2 ± 29.4 HU; P < 0.001). Subjective image quality of low-dose PCD-CT was considered superior to high-dose EID-CT ( P < 0.001). Interrater agreement was high ( W = 0.989). CONCLUSIONS Using cadaveric models with continuous extracorporeal perfusion allows for intraindividual image quality comparisons between PCD-CT and EID-CT on variable dose levels. With superior luminal contrast attenuation and denoising in angiographies of the peripheral arterial runoff, PCD-CT displayed potential for radiation saving of up to 83% compared with EID-CT.
Collapse
Affiliation(s)
- Philipp Gruschwitz
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Viktor Hartung
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | | | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg
| | - Henner Huflage
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Dominik Peter
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Robin Hendel
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Theresa Sophie Patzer
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Pauline Pannenbecker
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Philipp Josef Kuhl
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Thorsten Alexander Bley
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Bernhard Petritsch
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| | - Jan-Peter Grunz
- From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg
| |
Collapse
|
17
|
Patzer TS, Kunz AS, Huflage H, Luetkens KS, Conrads N, Pannenbecker P, Jakuscheit A, Reppenhagen S, Ergün S, Bley TA, Grunz JP. Rotational alignment of the lower extremity in the presence of total knee endoprosthesis: Reproducibility of torsion analyses using ultra-low-dose photon-counting CT. Eur J Radiol 2023; 167:111055. [PMID: 37632998 DOI: 10.1016/j.ejrad.2023.111055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/25/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE Leg torsion analysis can provide valuable information in symptomatic patients after total knee arthroplasty. However, extensive beam-hardening and photon-starvation artifacts limit diagnostic assessability and dose reduction potential. For this study, we investigated the reproducibility of rotational measurements in ultra-low-dose photon-counting CT with spectral shaping via tin prefiltration. MATERIAL AND METHODS Employing a first-generation photon-counting CT, eight cadaveric specimens were examined with an established three-level scan protocol (hip: Sn 140, knee: Sn 100, ankle: Sn 100 kVp). In three body donors with unilateral knee endoprostheses, additional modified settings were applied (Sn 140 kVp at knee level). Protocols were executed with three dose levels (hip-knee-ankle, high-quality: 5.0-3.0-2.0 mGy, low-dose: 0.80-0.30-0.26 mGy, ultra-low-dose: 0.25-0.06-0.06 mGy). Six radiologists performed torsion analyses, additionally reporting their diagnostic confidence. Intraclass correlation coefficients (ICC) were calculated to assess interrater reliability. RESULTS No significant differences were ascertained for femoral (p = 0.330), tibial (p = 0.177), and overall leg rotation measurements (p = 0.358) among high-quality, low-dose, and ultra-low-dose protocols. Interrater reliability was excellent for torsion of the femur (ICC 0.915, 95% confidence interval 0.871-0.947), tibia (0.960, 0.938-0.976), and overall leg (0.967, 0.945-0.981). In specimens with total knee endoprostheses, absolute rotational measurements were unaffected by dose level and tube voltage despite superior diagnostic confidence on the ipsilateral and contralateral sides with modified settings (p < 0.001). CONCLUSIONS Combining the advantages of photon-counting CT and spectral shaping, reliable leg torsion analyses are feasible with ultra-low radiation exposure even in the presence of total knee endoprostheses.
Collapse
Affiliation(s)
- Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Pauline Pannenbecker
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Axel Jakuscheit
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Würzburg, Brettreichstrasse 11, 97074 Würzburg, Germany
| | - Stephan Reppenhagen
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Würzburg, Brettreichstrasse 11, 97074 Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| |
Collapse
|
18
|
Madrahimov N, Mutsenko V, Natanov R, Radaković D, Klapproth A, Hassan M, Rosenfeldt M, Kleefeldt F, Aleksic I, Ergün S, Otto C, Leyh RG, Bening C. Multiorgan recovery in a cadaver body using mild hypothermic ECMO treatment in a murine model. Intensive Care Med Exp 2023; 11:46. [PMID: 37537415 PMCID: PMC10400742 DOI: 10.1186/s40635-023-00534-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Transplant candidates on the waiting list are increasingly challenged by the lack of organs. Most of the organs can only be kept viable within very limited timeframes (e.g., mere 4-6 h for heart and lungs exposed to refrigeration temperatures ex vivo). Donation after circulatory death (DCD) using extracorporeal membrane oxygenation (ECMO) can significantly enlarge the donor pool, organ yield per donor, and shelf life. Nevertheless, clinical attempts to recover organs for transplantation after uncontrolled DCD are extremely complex and hardly reproducible. Therefore, as a preliminary strategy to fulfill this task, experimental protocols using feasible animal models are highly warranted. The primary aim of the study was to develop a model of ECMO-based cadaver organ recovery in mice. Our model mimics uncontrolled organ donation after an "out-of-hospital" sudden unexpected death with subsequent "in-hospital" cadaver management post-mortem. The secondary aim was to assess blood gas parameters, cardiac activity as well as overall organ state. The study protocol included post-mortem heparin-streptokinase administration 10 min after confirmed death induced by cervical dislocation under full anesthesia. After cannulation, veno-arterial ECMO (V-A ECMO) was started 1 h after death and continued for 2 h under mild hypothermic conditions followed by organ harvest. Pressure- and flow-controlled oxygenated blood-based reperfusion of a cadaver body was accompanied by blood gas analysis (BGA), electrocardiography, and histological evaluation of ischemia-reperfusion injury. For the first time, we designed and implemented, a not yet reported, miniaturized murine hemodialysis circuit for the treatment of severe hyperkalemia and metabolic acidosis post-mortem. RESULTS BGA parameters confirmed profound ischemia typical for cadavers and incompatible with normal physiology, including extremely low blood pH, profound negative base excess, and enormously high levels of lactate. Two hours after ECMO implantation, blood pH values of a cadaver body restored from < 6.5 to 7.3 ± 0.05, pCO2 was lowered from > 130 to 41.7 ± 10.5 mmHg, sO2, base excess, and HCO3 were all elevated from below detection thresholds to 99.5 ± 0.6%, - 4 ± 6.2 and 22.0 ± 6.0 mmol/L, respectively (Student T test, p < 0.05). A substantial decrease in hyperlactatemia (from > 20 to 10.5 ± 1.7 mmol/L) and hyperkalemia (from > 9 to 6.9 ± 1.0 mmol/L) was observed when hemodialysis was implemented. On balance, the first signs of regained heart activity appeared on average 10 min after ECMO initiation without cardioplegia or any inotropic and vasopressor support. This was followed by restoration of myocardial contractility with a heart rate of up to 200 beats per minute (bpm) as detected by an electrocardiogram (ECG). Histological examinations revealed no evidence of heart injury 3 h post-mortem, whereas shock-specific morphological changes relevant to acute death and consequent cardiac/circulatory arrest were observed in the lungs, liver, and kidney of both control and ECMO-treated cadaver mice. CONCLUSIONS Thus, our model represents a promising approach to facilitate studying perspectives of cadaveric multiorgan recovery for transplantation. Moreover, it opens new possibilities for cadaver organ treatment to extend and potentiate donation and, hence, contribute to solving the organ shortage dilemma.
Collapse
Affiliation(s)
- Nodir Madrahimov
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany.
| | - Vitalii Mutsenko
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Ruslan Natanov
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Dejan Radaković
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - André Klapproth
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Mohamed Hassan
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Mathias Rosenfeldt
- Institute for Pathology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Florian Kleefeldt
- Institute of Anatomy and Cell Biology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Ivan Aleksic
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Christoph Otto
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Rainer G Leyh
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Constanze Bening
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| |
Collapse
|
19
|
Feldle P, Grunz JP, Kunz AS, Patzer TS, Huflage H, Hendel R, Luetkens KS, Ergün S, Bley TA, Conrads N. Weight-bearing gantry-free cone-beam CT of the lumbar spine: Image quality analysis and dose efficiency. Eur J Radiol 2023; 165:110951. [PMID: 37379623 DOI: 10.1016/j.ejrad.2023.110951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE The effect of static forces under load limits the prognostic value of lumbar spine CT in a horizontal position. Using a gantry-free scanner architecture, this study was designed to assess the feasibility of weight-bearing cone-beam CT (CBCT) of the lumbar spine and to establish the most dose-effective combination of scan parameters. METHODS Eight formalin-fixated cadaveric specimens were examined with a gantry-free CBCT system in upright position with the aid of a dedicated positioning backstop. Cadavers were scanned with eight combinations of tube voltage (102 or 117 kV), detector entrance dose level (high or low), and frame rates (16 or 30 fps). Five radiologists independently analyzed datasets for overall image quality and posterior wall assessability. Additionally, image noise and signal-to-noise ratio (SNR) were compared based on region-of-interest (ROI) measurements in the gluteal muscles. RESULTS Radiation dose ranged from 6.8 ± 1.6 (117 kV, dose level low, 16 fps) to 24.3 ± 6.3 mGy (102 kV, dose level high, 30 fps). Both image quality and posterior wall assessability were favored with 30 over 16 fps (all p ≤ 0.008). In contrast, both tube voltage (all p > 0.999) and dose level (all p > 0.096) did not significantly impact reader assessment. Image noise decreased considerably with higher frame rates (all p ≤ 0.040), while SNR ranged from 0.56 ± 0.03 to 1.11 ± 0.30 without a significant difference between scan protocols (all p ≥ 0.060). CONCLUSIONS Employing an optimized scan protocol, weight-bearing gantry-free CBCT of the lumbar spine allows for diagnostic imaging at reasonable radiation dose.
Collapse
Affiliation(s)
- Philipp Feldle
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Robin Hendel
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| |
Collapse
|
20
|
Gruschwitz P, Hartung V, Kleefeldt F, Ergün S, Lichthardt S, Huflage H, Hendel R, Kunz AS, Pannenbecker P, Kuhl PJ, Augustin AM, Bley TA, Petritsch B, Grunz JP. Standardized assessment of vascular reconstruction kernels in photon-counting CT angiographies of the leg using a continuous extracorporeal perfusion model. Sci Rep 2023; 13:12109. [PMID: 37495759 PMCID: PMC10372012 DOI: 10.1038/s41598-023-39063-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
This study evaluated the influence of different vascular reconstruction kernels on the image quality of CT angiographies of the lower extremity runoff using a 1st-generation photon-counting-detector CT (PCD-CT) compared with dose-matched examinations on a 3rd-generation energy-integrating-detector CT (EID-CT). Inducing continuous extracorporeal perfusion in a human cadaveric model, we performed CT angiographies of eight upper leg arterial runoffs with radiation dose-equivalent 120 kVp acquisition protocols (CTDIvol 5 mGy). Reconstructions were executed with different vascular kernels, matching the individual modulation transfer functions between scanners. Signal-to-noise-ratios (SNR) and contrast-to-noise-ratios (CNR) were computed to assess objective image quality. Six radiologists evaluated image quality subjectively using a forced-choice pairwise comparison tool. Interrater agreement was determined by calculating Kendall's concordance coefficient (W). The intraluminal attenuation of PCD-CT images was significantly higher than of EID-CT (414.7 ± 27.3 HU vs. 329.3 ± 24.5 HU; p < 0.001). Using comparable kernels, image noise with PCD-CT was significantly lower than with EID-CT (p ≤ 0.044). Correspondingly, SNR and CNR were approximately twofold higher for PCD-CT (p < 0.001). Increasing the spatial frequency for PCD-CT reconstructions by one level resulted in similar metrics compared to EID-CT (CNRfat; EID-CT Bv49: 21.7 ± 3.7 versus PCD-CT Bv60: 21.4 ± 3.5). Overall image quality of PCD-CTA achieved ratings superior to EID-CTA irrespective of the used reconstruction kernels (best: PCD-CT Bv60; worst: EID-CT Bv40; p < 0.001). Interrater agreement was good (W = 0.78). Concluding, PCD-CT offers superior intraluminal attenuation, SNR, and CNR compared to EID-CT in angiographies of the upper leg arterial runoff. Combined with improved subjective image quality, PCD-CT facilitates the use of sharper convolution kernels and ultimately bears the potential of improved vascular structure assessability.
Collapse
Affiliation(s)
- Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| | - Viktor Hartung
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Florian Kleefeldt
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Sven Lichthardt
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Robin Hendel
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Pauline Pannenbecker
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Philipp Josef Kuhl
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Anne Marie Augustin
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Bernhard Petritsch
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| |
Collapse
|
21
|
Elsner C, Kunz AS, Wagner N, Huflage H, Hübner S, Luetkens KS, Bley TA, Schmitt R, Ergün S, Grunz JP. MRI-Based Evaluation of the Flexor Digitorum Superficialis Anatomy: Investigating the Prevalence and Morphometry of the "Chiasma Antebrachii". Diagnostics (Basel) 2023; 13:2406. [PMID: 37510150 PMCID: PMC10378300 DOI: 10.3390/diagnostics13142406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Recent dissection studies resulted in the introduction of the term "chiasma antebrachii", which represents an intersection of the flexor digitorum superficialis (FDS) tendons for digits 2 and 3 in the distal third of the forearm. This retrospective investigation aimed to provide an MRI-based morphologic analysis of the chiasma antebrachii. In 89 patients (41 women, 39.3 ± 21.3 years), MRI examinations of the forearm (2010-2021) were reviewed by two radiologists, who evaluated all studies for the presence and length of the chiasma as well as its distance from the distal radioulnar and elbow joint. The chiasma antebrachii was identified in the distal third of the forearm in 88 patients (98.9%), while one intersection was located more proximally in the middle part. The chiasma had a median length of 28 mm (interquartile range: 24-35 mm). Its distances to the distal radioulnar and elbow joint were 16 mm (8-25 mm) and 215 mm (187-227 mm), respectively. T1-weighted post-contrast sequences were found to be superior to T2- or proton-density-weighted sequences in 71 cases (79.8%). To conclude, the chiasma antebrachii is part of the standard FDS anatomy. Knowledge of its morphology is important, e.g., in targeted injections of therapeutics or reconstructive surgery.
Collapse
Affiliation(s)
- Clara Elsner
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Nicole Wagner
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Stefan Hübner
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Rainer Schmitt
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
- Department of Radiology, University Hospital, LMU Munich, Ziemessenstraße 6, 80336 Munich, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| |
Collapse
|
22
|
Luetkens KS, Grunz JP, Kunz AS, Huflage H, Weißenberger M, Hartung V, Patzer TS, Gruschwitz P, Ergün S, Bley TA, Feldle P. Ultra-High-Resolution Photon-Counting Detector CT Arthrography of the Ankle: A Feasibility Study. Diagnostics (Basel) 2023; 13:2201. [PMID: 37443595 DOI: 10.3390/diagnostics13132201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/13/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
This study was designed to investigate the image quality of ultra-high-resolution ankle arthrography employing a photon-counting detector CT. Bilateral arthrograms were acquired in four cadaveric specimens with full-dose (10 mGy) and low-dose (3 mGy) scan protocols. Three convolution kernels with different spatial frequencies were utilized for image reconstruction (ρ50; Br98: 39.0, Br84: 22.6, Br76: 16.5 lp/cm). Seven radiologists subjectively assessed the image quality regarding the depiction of bone, hyaline cartilage, and ligaments. An additional quantitative assessment comprised the measurement of noise and the computation of contrast-to-noise ratios (CNR). While an optimal depiction of bone tissue was achieved with the ultra-sharp Br98 kernel (S ≤ 0.043), the visualization of cartilage improved with lower modulation transfer functions at each dose level (p ≤ 0.014). The interrater reliability ranged from good to excellent for all assessed tissues (intraclass correlation coefficient ≥ 0.805). The noise levels in subcutaneous fat decreased with reduced spatial frequency (p < 0.001). Notably, the low-dose Br76 matched the CNR of the full-dose Br84 (p > 0.999) and superseded Br98 (p < 0.001) in all tissues. Based on the reported results, a photon-counting detector CT arthrography of the ankle with an ultra-high-resolution collimation offers stellar image quality and tissue assessability, improving the evaluation of miniscule anatomical structures. While bone depiction was superior in combination with an ultra-sharp convolution kernel, soft tissue evaluation benefited from employing a lower spatial frequency.
Collapse
Affiliation(s)
- Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Manuel Weißenberger
- Department of Orthopaedic Surgery, University of Würzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074 Würzburg, Germany
| | - Viktor Hartung
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Philipp Feldle
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| |
Collapse
|
23
|
Gruschwitz P, Hartung V, Kleefeldt F, Peter D, Lichthardt S, Huflage H, Grunz JP, Augustin AM, Ergün S, Bley TA, Petritsch B. Continuous extracorporeal femoral perfusion model for intravascular ultrasound, computed tomography and digital subtraction angiography. PLoS One 2023; 18:e0285810. [PMID: 37220113 DOI: 10.1371/journal.pone.0285810] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/02/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVES We developed a novel human cadaveric perfusion model with continuous extracorporeal femoral perfusion suitable for performing intra-individual comparison studies, training of interventional procedures and preclinical testing of endovascular devices. Objective of this study was to introduce the techniques and evaluate the feasibility for realistic computed tomography angiography (CTA), digital subtraction angiography (DSA) including vascular interventions, and intravascular ultrasound (IVUS). METHODS The establishment of the extracorporeal perfusion was attempted using one formalin-fixed and five fresh-frozen human cadavers. In all specimens, the common femoral and popliteal arteries were prepared, introducer sheaths inserted, and perfusion established by a peristaltic pump. Subsequently, we performed CTA and bilateral DSA in five cadavers and IVUS on both legs of four donors. Examination time without unintentional interruption was measured both with and without non-contrast planning CT. Percutaneous transluminal angioplasty and stenting was performed by two interventional radiologists on nine extremities (five donors) using a broad spectrum of different intravascular devices. RESULTS The perfusion of the upper leg arteries was successfully established in all fresh-frozen but not in the formalin-fixed cadaver. The experimental setup generated a stable circulation in each procedure (ten upper legs) for a period of more than six hours. Images acquired with CT, DSA and IVUS offered a realistic impression and enabled the sufficient visualization of all examined vessel segments. Arterial cannulating, percutaneous transluminal angioplasty as well as stent deployment were feasible in a way that is comparable to a vascular intervention in vivo. The perfusion model allowed for introduction and testing of previously not used devices. CONCLUSIONS The continuous femoral perfusion model can be established with moderate effort, works stable, and is utilizable for medical imaging of the peripheral arterial system using CTA, DSA and IVUS. Therefore, it appears suitable for research studies, developing skills in interventional procedures and testing of new or unfamiliar vascular devices.
Collapse
Affiliation(s)
- Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Viktor Hartung
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Florian Kleefeldt
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Dominik Peter
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Sven Lichthardt
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Anne Marie Augustin
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Bernhard Petritsch
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| |
Collapse
|
24
|
Patzer TS, Kunz AS, Huflage H, Luetkens KS, Conrads N, Gruschwitz P, Pannenbecker P, Ergün S, Bley TA, Grunz JP. Quantitative and qualitative image quality assessment in shoulder examinations with a first-generation photon-counting detector CT. Sci Rep 2023; 13:8226. [PMID: 37217553 DOI: 10.1038/s41598-023-35367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
Photon-counting detector (PCD) CT allows for ultra-high-resolution (UHR) examinations of the shoulder without requiring an additional post-patient comb filter to narrow the detector aperture. This study was designed to compare the PCD performance with a high-end energy-integrating detector (EID) CT. Sixteen cadaveric shoulders were examined with both scanners using dose-matched 120 kVp acquisition protocols (low-dose/full-dose: CTDIvol = 5.0/10.0 mGy). Specimens were scanned in UHR mode with the PCD-CT, whereas EID-CT examinations were conducted in accordance with the clinical standard as "non-UHR". Reconstruction of EID data employed the sharpest kernel available for standard-resolution scans (ρ50 = 12.3 lp/cm), while PCD data were reconstructed with both a comparable kernel (11.8 lp/cm) and a sharper dedicated bone kernel (16.5 lp/cm). Six radiologists with 2-9 years of experience in musculoskeletal imaging rated image quality subjectively. Interrater agreement was analyzed by calculation of the intraclass correlation coefficient in a two-way random effects model. Quantitative analyses comprised noise recording and calculating signal-to-noise ratios based on attenuation measurements in bone and soft tissue. Subjective image quality was higher in UHR-PCD-CT than in EID-CT and non-UHR-PCD-CT datasets (all p < 0.001). While low-dose UHR-PCD-CT was considered superior to full-dose non-UHR studies on either scanner (all p < 0.001), ratings of low-dose non-UHR-PCD-CT and full-dose EID-CT examinations did not differ (p > 0.99). Interrater reliability was moderate, indicated by a single measures intraclass correlation coefficient of 0.66 (95% confidence interval: 0.58-0.73; p < 0.001). Image noise was lowest and signal-to-noise ratios were highest in non-UHR-PCD-CT reconstructions at either dose level (p < 0.001). This investigation demonstrates that superior depiction of trabecular microstructure and considerable denoising can be realized without additional radiation dose by employing a PCD for shoulder CT imaging. Allowing for UHR scans without dose penalty, PCD-CT appears as a promising alternative to EID-CT for shoulder trauma assessment in clinical routine.
Collapse
Affiliation(s)
- Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Pauline Pannenbecker
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstr. 6, 97070, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| |
Collapse
|
25
|
Schreiber LM, Lohr D, Baltes S, Vogel U, Elabyad IA, Bille M, Reiter T, Kosmala A, Gassenmaier T, Stefanescu MR, Kollmann A, Aures J, Schnitter F, Pali M, Ueda Y, Williams T, Christa M, Hofmann U, Bauer W, Gerull B, Zernecke A, Ergün S, Terekhov M. Ultra-high field cardiac MRI in large animals and humans for translational cardiovascular research. Front Cardiovasc Med 2023; 10:1068390. [PMID: 37255709 PMCID: PMC10225557 DOI: 10.3389/fcvm.2023.1068390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/04/2023] [Indexed: 06/01/2023] Open
Abstract
A key step in translational cardiovascular research is the use of large animal models to better understand normal and abnormal physiology, to test drugs or interventions, or to perform studies which would be considered unethical in human subjects. Ultrahigh field magnetic resonance imaging (UHF-MRI) at 7 T field strength is becoming increasingly available for imaging of the heart and, when compared to clinically established field strengths, promises better image quality and image information content, more precise functional analysis, potentially new image contrasts, and as all in-vivo imaging techniques, a reduction of the number of animals per study because of the possibility to scan every animal repeatedly. We present here a solution to the dual use problem of whole-body UHF-MRI systems, which are typically installed in clinical environments, to both UHF-MRI in large animals and humans. Moreover, we provide evidence that in such a research infrastructure UHF-MRI, and ideally combined with a standard small-bore UHF-MRI system, can contribute to a variety of spatial scales in translational cardiovascular research: from cardiac organoids, Zebra fish and rodent hearts to large animal models such as pigs and humans. We present pilot data from serial CINE, late gadolinium enhancement, and susceptibility weighted UHF-MRI in a myocardial infarction model over eight weeks. In 14 pigs which were delivered from a breeding facility in a national SARS-CoV-2 hotspot, we found no infection in the incoming pigs. Human scanning using CINE and phase contrast flow measurements provided good image quality of the left and right ventricle. Agreement of functional analysis between CINE and phase contrast MRI was excellent. MRI in arrested hearts or excised vascular tissue for MRI-based histologic imaging, structural imaging of myofiber and vascular smooth muscle cell architecture using high-resolution diffusion tensor imaging, and UHF-MRI for monitoring free radicals as a surrogate for MRI of reactive oxygen species in studies of oxidative stress are demonstrated. We conclude that UHF-MRI has the potential to become an important precision imaging modality in translational cardiovascular research.
Collapse
Affiliation(s)
- Laura M. Schreiber
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - David Lohr
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Steffen Baltes
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ulrich Vogel
- Institute for Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany
| | - Ibrahim A. Elabyad
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Maya Bille
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Theresa Reiter
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Aleksander Kosmala
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Tobias Gassenmaier
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Maria R. Stefanescu
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Alena Kollmann
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Julia Aures
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Florian Schnitter
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Mihaela Pali
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| | - Yuichiro Ueda
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Wuerzburg, Germany
| | - Tatiana Williams
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center Wuerzburg, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Martin Christa
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ulrich Hofmann
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Wolfgang Bauer
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Brenda Gerull
- Department of Internal Medicine I/Cardiology, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center Wuerzburg, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Alma Zernecke
- Institute of Experimental Biomedicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Wuerzburg, Germany
| | - Maxim Terekhov
- Department of Cardiovascular Imaging and Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, Germany
| |
Collapse
|
26
|
Patzer TS, Kunz AS, Huflage H, Conrads N, Luetkens KS, Pannenbecker P, Paul MM, Ergün S, Bley TA, Grunz JP. Ultrahigh-Resolution Photon-Counting CT in Cadaveric Fracture Models: Spatial Frequency Is Not Everything. Diagnostics (Basel) 2023; 13:diagnostics13101677. [PMID: 37238160 DOI: 10.3390/diagnostics13101677] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
In this study, the impact of reconstruction sharpness on the visualization of the appendicular skeleton in ultrahigh-resolution (UHR) photon-counting detector (PCD) CT was investigated. Sixteen cadaveric extremities (eight fractured) were examined with a standardized 120 kVp scan protocol (CTDIvol 10 mGy). Images were reconstructed with the sharpest non-UHR kernel (Br76) and all available UHR kernels (Br80 to Br96). Seven radiologists evaluated image quality and fracture assessability. Interrater agreement was assessed with the intraclass correlation coefficient. For quantitative comparisons, signal-to-noise-ratios (SNRs) were calculated. Subjective image quality was best for Br84 (median 1, interquartile range 1-3; p ≤ 0.003). Regarding fracture assessability, no significant difference was ascertained between Br76, Br80 and Br84 (p > 0.999), with inferior ratings for all sharper kernels (p < 0.001). Interrater agreement for image quality (0.795, 0.732-0.848; p < 0.001) and fracture assessability (0.880; 0.842-0.911; p < 0.001) was good. SNR was highest for Br76 (3.4, 3.0-3.9) with no significant difference to Br80 and Br84 (p > 0.999). Br76 and Br80 produced higher SNRs than all kernels sharper than Br84 (p ≤ 0.026). In conclusion, PCD-CT reconstructions with a moderate UHR kernel offer superior image quality for visualizing the appendicular skeleton. Fracture assessability benefits from sharp non-UHR and moderate UHR kernels, while ultra-sharp reconstructions incur augmented image noise.
Collapse
Affiliation(s)
- Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Pauline Pannenbecker
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Mila Marie Paul
- Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| |
Collapse
|
27
|
Rockel AF, Wagner N, Spenger P, Ergün S, Wörsdörfer P. Neuro-mesodermal assembloids recapitulate aspects of peripheral nervous system development in vitro. Stem Cell Reports 2023; 18:1155-1165. [PMID: 37084722 DOI: 10.1016/j.stemcr.2023.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/23/2023] Open
Abstract
Here we describe a novel neuro-mesodermal assembloid model that recapitulates aspects of peripheral nervous system (PNS) development such as neural crest cell (NCC) induction, migration, and sensory as well as sympathetic ganglion formation. The ganglia send projections to the mesodermal as well as neural compartment. Axons in the mesodermal part are associated with Schwann cells. In addition, peripheral ganglia and nerve fibers interact with a co-developing vascular plexus, forming a neurovascular niche. Finally, developing sensory ganglia show response to capsaicin indicating their functionality. The presented assembloid model could help to uncover mechanisms of human NCC induction, delamination, migration, and PNS development. Moreover, the model could be used for toxicity screenings or drug testing. The co-development of mesodermal and neuroectodermal tissues and a vascular plexus along with a PNS allows us to investigate the crosstalk between neuroectoderm and mesoderm and between peripheral neurons/neuroblasts and endothelial cells.
Collapse
Affiliation(s)
- Anna F Rockel
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Nicole Wagner
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Peter Spenger
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Philipp Wörsdörfer
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.
| |
Collapse
|
28
|
Ascheid D, Baumann M, Funke C, Volz J, Pinnecker J, Friedrich M, Höhn M, Nandigama R, Ergün S, Nieswandt B, Heinze KG, Henke E. Image-based modeling of vascular organization to evaluate anti-angiogenic therapy. Biol Direct 2023; 18:10. [PMID: 36922848 PMCID: PMC10018970 DOI: 10.1186/s13062-023-00365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
In tumor therapy anti-angiogenic approaches have the potential to increase the efficacy of a wide variety of subsequently or co-administered agents, possibly by improving or normalizing the defective tumor vasculature. Successful implementation of the concept of vascular normalization under anti-angiogenic therapy, however, mandates a detailed understanding of key characteristics and a respective scoring metric that defines an improved vasculature and thus a successful attempt. Here, we show that beyond commonly used parameters such as vessel patency and maturation, anti-angiogenic approaches largely benefit if the complex vascular network with its vessel interconnections is both qualitatively and quantitatively assessed. To gain such deeper insight the organization of vascular networks, we introduce a multi-parametric evaluation of high-resolution angiographic images based on light-sheet fluorescence microscopy images of tumors. We first could pinpoint key correlations between vessel length, straightness and diameter to describe the regular, functional and organized structure observed under physiological conditions. We found that vascular networks from experimental tumors diverted from those in healthy organs, demonstrating the dysfunctionality of the tumor vasculature not only on the level of the individual vessel but also in terms of inadequate organization into larger structures. These parameters proofed effective in scoring the degree of disorganization in different tumor entities, and more importantly in grading a potential reversal under treatment with therapeutic agents. The presented vascular network analysis will support vascular normalization assessment and future optimization of anti-angiogenic therapy.
Collapse
Affiliation(s)
- David Ascheid
- Institute of Anatomy and Cell Biology, Universität Würzburg, Koellikerstrasse 6, 97070, Würzburg, Germany
| | - Magdalena Baumann
- Institute of Anatomy and Cell Biology, Universität Würzburg, Koellikerstrasse 6, 97070, Würzburg, Germany
| | - Caroline Funke
- Institute of Anatomy and Cell Biology, Universität Würzburg, Koellikerstrasse 6, 97070, Würzburg, Germany
| | - Julia Volz
- Institute of Experimental Biomedicine I, Universitätsklinikum Würzburg, Würzburg, Germany
- Rudolf Virchow Center for Integrative and Translational Bioimaging, Universität Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany
| | - Jürgen Pinnecker
- Rudolf Virchow Center for Integrative and Translational Bioimaging, Universität Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany
| | - Mike Friedrich
- Rudolf Virchow Center for Integrative and Translational Bioimaging, Universität Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany
| | - Marie Höhn
- Institute of Anatomy and Cell Biology, Universität Würzburg, Koellikerstrasse 6, 97070, Würzburg, Germany
| | - Rajender Nandigama
- Institute of Anatomy and Cell Biology, Universität Würzburg, Koellikerstrasse 6, 97070, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Universität Würzburg, Koellikerstrasse 6, 97070, Würzburg, Germany
| | - Bernhard Nieswandt
- Institute of Experimental Biomedicine I, Universitätsklinikum Würzburg, Würzburg, Germany
- Rudolf Virchow Center for Integrative and Translational Bioimaging, Universität Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany
| | - Katrin G Heinze
- Rudolf Virchow Center for Integrative and Translational Bioimaging, Universität Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany.
| | - Erik Henke
- Institute of Anatomy and Cell Biology, Universität Würzburg, Koellikerstrasse 6, 97070, Würzburg, Germany.
- Graduate School for Life Sciences, Universität Würzburg, Würzburg, Germany.
| |
Collapse
|
29
|
Conrads N, Grunz JP, Huflage H, Luetkens KS, Feldle P, Pennig L, Ergün S, Alexander Bley T, Petritsch B, Kunz AS. Ultrahigh-resolution computed tomography of the cervical spine without dose penalty employing a cadmium-telluride photon-counting detector. Eur J Radiol 2023; 160:110718. [PMID: 36731400 DOI: 10.1016/j.ejrad.2023.110718] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 01/28/2023]
Abstract
PURPOSE This cadaveric study compared image quality between a third-generation dual-source CT scanner with energy-integrating detector technology (EID) and a first-generation CT system employing a photon-counting detector (PCD) for the cervical spine in ultrahigh-resolution mode. METHODS The cervical spine of eight formalin-fixed full-body cadaveric specimens was scanned with both CT systems using 140 kVp scan protocols matched for CTDIvol (full-dose; low-dose; ultralow-dose; 10 mGy; 3 mGy; 1 mGy). Images were reconstructed with 1 mm slice thickness and 0.5 mm increment. Three radiologists rated overall subjective image quality based on an equidistant five-point scale with the intraclass correlation coefficient (ICC) calculated for assessment of interobserver reliability. Contrast-to-noise ratios were calculated individually for bone (CNRbone) and muscle tissue (CNRmuscle) to provide objective criteria of image analysis. RESULTS Subjective image quality, as well as CNRbone, and CNRmuscle were each superior for PCD-CT compared to EID-CT among dose-matched scan protocol pairs (all p < 0.05). Between full-dose EID-CT and low-dose PCD-CT, subjective image quality was equal (p = 0.903), while superior quantitative results regarding the latter were ascertained (both p < 0.001). Similarly, objective analysis determined higher CNRbone, and CNRmuscle in ultralow-dose PCD-CT compared to low-dose EID-CT (both p < 0.001), while readers considered the image quality of the respective studies comparable (p > 0.99). Interobserver reliability was good, denoted by an ICC of 0.861 (95 % confidence interval: 0.788 - 0.914; p < 0.001). CONCLUSIONS In cervical spine examinations, both subjective and objective image quality of PCD-CT were superior to EID-CT in comparison of scan protocols with corresponding dose levels, suggesting potential for significantly reducing the radiation exposure without compromising image quality.
Collapse
Affiliation(s)
- Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Philipp Feldle
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Lenhard Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Bernhard Petritsch
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| |
Collapse
|
30
|
Indari O, Ergün S, Karnati S, Chandra Jha H. Herpesviral interplay with peroxisome: An underexplored viral niche. Genes Dis 2023. [DOI: 10.1016/j.gendis.2023.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
|
31
|
Chen R, Buchmann S, Kroth A, Arias-Loza AP, Kohlhaas M, Wagner N, Grüner G, Nickel A, Cirnu A, Williams T, Maack C, Ergün S, Frantz S, Gerull B. Mechanistic Insights of the LEMD2 p.L13R Mutation and Its Role in Cardiomyopathy. Circ Res 2023; 132:e43-e58. [PMID: 36656972 DOI: 10.1161/circresaha.122.321929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Nuclear envelope proteins play an important role in the pathogenesis of hereditary cardiomyopathies. Recently, a new form of arrhythmic cardiomyopathy caused by a homozygous mutation (p.L13R) in the inner nuclear membrane protein LEMD2 was discovered. The aim was to unravel the molecular mechanisms of mutant LEMD2 in the pathogenesis of cardiomyopathy. METHODS We generated a Lemd2 p.L13R knock-in mouse model and a corresponding cell model via CRISPR/Cas9 technology and investigated the cardiac phenotype as well as cellular and subcellular mechanisms of nuclear membrane rupture and repair. RESULTS Knock-in mice developed a cardiomyopathy with predominantly endocardial fibrosis, left ventricular dilatation, and systolic dysfunction. Electrocardiograms displayed pronounced ventricular arrhythmias and conduction disease. A key finding of knock-in cardiomyocytes on ultrastructural level was a significant increase in nuclear membrane invaginations and decreased nuclear circularity. Furthermore, increased DNA damage and premature senescence were detected as the underlying cause of fibrotic and inflammatory remodeling. As the p.L13R mutation is located in the Lap2/Emerin/Man1 (LEM)-domain, we observed a disrupted interaction between mutant LEMD2 and BAF (barrier-to-autointegration factor), which is required to initiate the nuclear envelope rupture repair process. To mimic increased mechanical stress with subsequent nuclear envelope ruptures, we investigated mutant HeLa-cells upon electrical stimulation and increased stiffness. Here, we demonstrated impaired nuclear envelope rupture repair capacity, subsequent cytoplasmic leakage of the DNA repair factor KU80 along with increased DNA damage, and recruitment of the cGAS (cyclic GMP-AMP synthase) to the nuclear membrane and micronuclei. CONCLUSIONS We show for the first time that the Lemd2 p.L13R mutation in mice recapitulates human dilated cardiomyopathy with fibrosis and severe ventricular arrhythmias. Impaired nuclear envelope rupture repair capacity resulted in increased DNA damage and activation of the cGAS/STING/IFN pathway, promoting premature senescence. Hence, LEMD2 is a new player inthe disease group of laminopathies.
Collapse
Affiliation(s)
- Ruping Chen
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center (R.C., S.B., A.K., G.G., A.C., T.W., B.G.), University Hospital Würzburg, Germany
- Department of Medicine I (R.C., T.W., C.M., S.F., B.G.), University Hospital Würzburg, Germany
| | - Simone Buchmann
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center (R.C., S.B., A.K., G.G., A.C., T.W., B.G.), University Hospital Würzburg, Germany
| | - Amos Kroth
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center (R.C., S.B., A.K., G.G., A.C., T.W., B.G.), University Hospital Würzburg, Germany
| | - Anahi-Paula Arias-Loza
- Department of Nuclear Medicine, Comprehensive Heart Failure Center (A.-P.A.-L.), University Hospital Würzburg, Germany
| | - Michael Kohlhaas
- Department of Translational Research, Comprehensive Heart Failure Center (M.K., A.N., C.M.), University Hospital Würzburg, Germany
| | - Nicole Wagner
- Institute of Anatomy and Cell Biology, University of Würzburg, Germany (N.W., S.E.)
| | - Gianna Grüner
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center (R.C., S.B., A.K., G.G., A.C., T.W., B.G.), University Hospital Würzburg, Germany
| | - Alexander Nickel
- Department of Translational Research, Comprehensive Heart Failure Center (M.K., A.N., C.M.), University Hospital Würzburg, Germany
| | - Alexandra Cirnu
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center (R.C., S.B., A.K., G.G., A.C., T.W., B.G.), University Hospital Würzburg, Germany
| | - Tatjana Williams
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center (R.C., S.B., A.K., G.G., A.C., T.W., B.G.), University Hospital Würzburg, Germany
- Department of Medicine I (R.C., T.W., C.M., S.F., B.G.), University Hospital Würzburg, Germany
| | - Christoph Maack
- Department of Medicine I (R.C., T.W., C.M., S.F., B.G.), University Hospital Würzburg, Germany
- Department of Translational Research, Comprehensive Heart Failure Center (M.K., A.N., C.M.), University Hospital Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Germany (N.W., S.E.)
| | - Stefan Frantz
- Department of Medicine I (R.C., T.W., C.M., S.F., B.G.), University Hospital Würzburg, Germany
- Comprehensive Heart Failure Center (S.F.), University Hospital Würzburg, Germany
| | - Brenda Gerull
- Department of Cardiovascular Genetics, Comprehensive Heart Failure Center (R.C., S.B., A.K., G.G., A.C., T.W., B.G.), University Hospital Würzburg, Germany
- Department of Medicine I (R.C., T.W., C.M., S.F., B.G.), University Hospital Würzburg, Germany
| |
Collapse
|
32
|
Abstract
Peroxisomes are central metabolic organelles whose maturation and function depend on efficient and accurate targeting of peroxisomal membrane proteins (PMPs). Ultrastructural imaging of the PMPs is a quite difficult task as it requires high spatial and temporal resolution. Further, the spatial resolution of conventional light microscopy is limited due to the diffraction of light. However, recent methodological developments in super resolution microscopy showed us to access the nanoscale regimes spatially allowing to elucidate the membrane structures of cell organelles. In this chapter, we present protocols used in our laboratory for the super-resolution imaging of the peroxisomal membrane protein 14 (PEX14p) by direct stochastic optical reconstruction microscopy (dSTORM).
Collapse
Affiliation(s)
- Teresa Klein
- Department of Biotechnology and Biophysics, Biocenter, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Markus Sauer
- Department of Biotechnology and Biophysics, Biocenter, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Wurzburg, Würzburg, Germany
| | | |
Collapse
|
33
|
Behera A, Biswas M, Ergün S, Karnati S, Sonawane A. Detection of Peroxisomal Proteins During Mycobacterial Infection. Methods Mol Biol 2023; 2643:123-134. [PMID: 36952182 DOI: 10.1007/978-1-0716-3048-8_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Peroxisomes are ubiquitous organelles with essential roles in lipid and reactive oxygen species (ROS) metabolism. They are involved in modulating the immune responses during microbial infection, thus having major impact on several bacterial and viral infectious diseases including tuberculosis. Intracellular pathogens such as Mycobacterium tuberculosis (M. tb) employ various strategies to suppress the host oxidative stress mechanisms to avoid killing by the host. Peroxisome-mediated ROS balance is crucial for innate immune responses to M. tb. Therefore, peroxisomes represent promising targets for host-directed therapeutics to tuberculosis. Here, we present protocols used in our laboratory for the culture of M. tb and detection of peroxisomal proteins in M. tb infected macrophages.
Collapse
Affiliation(s)
- Ananyaashree Behera
- School of Biotechnology, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Mainak Biswas
- School of Biotechnology, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Avinash Sonawane
- School of Biotechnology, KIIT Deemed to be University, Bhubaneswar, Odisha, India.
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Madhya Pradesh, India.
| |
Collapse
|
34
|
Huflage H, Grunz JP, Kunz AS, Patzer TS, Sauer ST, Christner SA, Petritsch B, Ergün S, Bley TA, Luetkens KS. Potential of employing a quantum iterative reconstruction algorithm for ultra-high-resolution photon-counting detector CT of the hip. Radiography (Lond) 2023; 29:44-49. [PMID: 36274316 DOI: 10.1016/j.radi.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION This study investigated the image quality of a new quantum iterative reconstruction algorithm (QIR) for high resolution photon-counting CT of the hip. METHODS Using a first-generation photon-counting CT scanner, five cadaveric specimens were examined with ultra-high-resolution protocols matched for radiation dose. Images were post-processed with a sharp convolution kernel and five different strength levels of iterative reconstruction (QIR 0 - QIR 4). Subjective image quality was rated independently by three radiologists on a five-point scale. Intraclass correlation coefficients (ICC) were computed for assessing interrater agreement. Objective image quality was evaluated by means of contrast-to-noise-ratios (CNR) in bone and muscle tissue. RESULTS For osseous tissue, subjective image quality was rated best for QIR 2 reformatting (median 5 [interquartile range 5-5]). Contrarily, for soft tissue, QIR 4 received the highest ratings among compared strength levels (3 [3-4]). Both ICCbone (0.805; 95% confidence interval 0.711-0.877; p < 0.001) and ICCmuscle (0.885; 0.824-0.929; p < 0.001) suggested good interrater agreement. CNR in bone and muscle tissue increased with ascending strength levels of iterative reconstruction with the highest results recorded for QIR 4 (CNRbone 29.43 ± 2.61; CNRmuscle 8.09 ± 0.77) and lowest results without QIR (CNRbone 3.90 ± 0.29; CNRmuscle 1.07 ± 0.07) (all p < 0.001). CONCLUSION Reconstructing photon-counting CT data with an intermediate QIR strength level appears optimal for assessment of osseous tissue, whereas soft tissue analysis benefitted from applying the highest strength level available. IMPLICATIONS FOR PRACTICE Quantum iterative reconstruction technique can enhance image quality by significantly reducing noise and improving CNR in ultra-high resolution CT imaging of the hip.
Collapse
Affiliation(s)
- H Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - J-P Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - A S Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - T S Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - S T Sauer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - S A Christner
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - B Petritsch
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - S Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.
| | - T A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - K S Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| |
Collapse
|
35
|
Indari O, Rani A, Baral B, Ergün S, Bala K, Karnati S, Jha HC. Modulation of peroxisomal compartment by Epstein-Barr virus. Microb Pathog 2023; 174:105946. [PMID: 36526038 DOI: 10.1016/j.micpath.2022.105946] [Citation(s) in RCA: 2] [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: 08/12/2022] [Revised: 11/29/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
Viruses utilize clever strategies of interacting with various cellular factors, to remodel an organelle function, for the establishment of successful infection. In recent decades, numerous studies revealed the exploitation of the peroxisomal compartment by viruses. Epstein-Barr virus (EBV) is a ubiquitous virus linked with various cancers and neurological disorders. Till now, there is no report regarding the impacts of EBV infection on peroxisomal compartment. Therefore, we investigate the modulation of peroxisomal proteins in EBV transformed cell lines and during acute EBV infection. EBV positive Burkitt lymphoma cells of different origins as EBV transformed cells along with EBV negative Burkitt lymphoma cells as a control were used in this study. For acute EBV infection experiments, we infected peripheral blood mononuclear cells with EBV for three days. Thereafter, analyzed the gene expression patterns of peroxisomal proteins using qPCR. In addition, quantification of lipid content was performed by using fluorescence microscopy and biochemical assay. Our results revealed that, the peroxisomal proteins were distinctly regulated in EBV transformed cells and during acute EBV infection. Interestingly, PEX19 was significantly upregulated in EBV infected cells. Further, in correlation with the altered expression of peroxisomes proteins involved in lipid metabolism, the EBV transformed cells showed lower lipid abundance. Conversely, the lipid levels were increased during acute EBV infection. Our study highlights the importance of investigating the manipulation of the peroxisomal compartment by putting forward various differentially expressed proteins upon EBV infection. This study provides a base for further investigation to delve deeper into EBV and peroxisomal interactions. The future research in this direction could provide involvement of novel signaling pathways to understand molecular changes during EBV mediated pathologies.
Collapse
Affiliation(s)
- Omkar Indari
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Indore, 453552, India
| | - Annu Rani
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Indore, 453552, India
| | - Budhadev Baral
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Indore, 453552, India
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, 97070, Germany
| | - Kiran Bala
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Indore, 453552, India
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, 97070, Germany.
| | - Hem Chandra Jha
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Indore, 453552, India.
| |
Collapse
|
36
|
Jordan MC, Bröer D, Fischer C, Heilig P, Gilbert F, Hölscher-Doht S, Kalogirou C, Popp K, Grunz JP, Huflage H, Jakubietz RG, Ergün S, Meffert RH. Development and preclinical evaluation of a cable-clamp fixation device for a disrupted pubic symphysis. Commun Med (Lond) 2022; 2:164. [PMID: 36550296 PMCID: PMC9780275 DOI: 10.1038/s43856-022-00227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Traumatic separation of the pubic symphysis can destabilize the pelvis and require surgical fixation to reduce symphyseal gapping. The traditional approach involves open reduction and the implantation of a steel symphyseal plate (SP) on the pubic bone to hold the reposition. Despite its widespread use, SP-fixation is often associated with implant failure caused by screw loosening or breakage. METHODS To address the need for a more reliable surgical intervention, we developed and tested two titanium cable-clamp implants. The cable served as tensioning device while the clamp secured the cable to the bone. The first implant design included a steel cable anterior to the pubic symphysis to simplify its placement outside the pelvis, and the second design included a cable encircling the pubic symphysis to stabilize the anterior pelvic ring. Using highly reproducible synthetic bone models and a limited number of cadaver specimens, we performed a comprehensive biomechanical study of implant stability and evaluated surgical feasibility. RESULTS We were able to demonstrate that the cable-clamp implants provide stability equivalent to that of a traditional SP-fixation but without the same risks of implant failure. We also provide detailed ex vivo evaluations of the safety and feasibility of a trans-obturator surgical approach required for those kind of fixation. CONCLUSION We propose that the developed cable-clamp fixation devices may be of clinical value in treating pubic symphysis separation.
Collapse
Affiliation(s)
- Martin C Jordan
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| | - David Bröer
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Christian Fischer
- Headmade Materials, Langhausstraße 9, 97294, Unterpleichfeld, Germany
| | - Philipp Heilig
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Fabian Gilbert
- Center of Musculoskeletal Medicine, University Hospital LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Stefanie Hölscher-Doht
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Charis Kalogirou
- Department of Urology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Kevin Popp
- Additive Manufacturing Research Unit, SKZ Technology Center, Friedrich-Bergius-Ring 22, 97076, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Henner Huflage
- Department of Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Rafael G Jakubietz
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy, Julius-Maximilians-University Würzburg, Koellikerstraße 6, 97070, Würzburg, Germany
| | - Rainer H Meffert
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| |
Collapse
|
37
|
Grunz JP, Petritsch B, Luetkens KS, Kunz AS, Lennartz S, Ergün S, Bley TA, Huflage H. Ultra-Low-Dose Photon-Counting CT Imaging of the Paranasal Sinus With Tin Prefiltration: How Low Can We Go? Invest Radiol 2022; 57:728-733. [PMID: 35703452 DOI: 10.1097/rli.0000000000000887] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In this study, we compared photon-counting detector computed tomography (PCD-CT) and energy-integrating detector computed tomography (EID-CT) for ultra-low-dose paranasal sinus examinations with employed tin prefiltration. The goal of our investigation was to define the most dose-effective scan protocols for diagnostic assessment of midface trauma, preoperative sinonasal anatomy, and acute rhinosinusitis. MATERIALS AND METHODS Five cadaveric heads were examined with the standard-resolution scan mode of both CT systems using a tube potential of 100 kV and tin prefiltration for 7 dose-equivalent scan protocols (CTDI vol = 4.16-0.15 mGy) and 2 additional ultra-low-dose protocols exclusively feasible on the PCD-CT scanner (0.10 and 0.08 mGy). After applying comparable iterative reconstruction algorithms, image quality was subjectively assessed by 4 radiologists. The intraclass correlation coefficient was calculated to estimate the agreement among readers. Image noise was quantified in standardized regions of interest to establish an additional quantitative criterion of image quality. RESULTS The most dose-effective scan protocols for diagnostic imaging of midface trauma (PCD-CT: 1.24 mGy; EID-CT: 2.05 mGy), preoperative sinonasal anatomy (PCD-CT: 0.20 mGy; EID-CT: 0.40 mGy), and acute rhinosinusitis (PCD-CT: 0.08 mGy; EID-CT: 0.15 mGy) required less radiation exposure on the PCD-CT system ( P < 0.050). Despite higher image noise, ultra-low-dose PCD-CT studies (0.08 and 0.10 mGy) were considered suitable for inflammation-focused imaging, offering lower-dose penalties than EID-CT studies. Interobserver reliability for subjective image quality was excellent (intraclass correlation coefficient, 0.90; 95% confidence interval, 0.88-0.93; P < 0.001). CONCLUSIONS In paranasal sinus imaging with tin prefiltration, the PCD-CT allowed for superior image quality compared with high-end EID-CT. Assessment of paranasal sinuses with an ultra-low radiation exposure of 0.08 mGy was deemed adequate, suggesting substantial dose reduction potential for clinical routine, for example, in the diagnostic workup of patients with rhinosinusitis.
Collapse
Affiliation(s)
- Jan-Peter Grunz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg
| | - Bernhard Petritsch
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg
| | | | - Andreas Steven Kunz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg
| | - Simon Lennartz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Thorsten Alexander Bley
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg
| | - Henner Huflage
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg
| |
Collapse
|
38
|
Elsner C, Ergün S, Wagner N. Biogenesis and release of endothelial extracellular vesicles: morphological aspects. Ann Anat 2022; 245:152006. [PMID: 36183939 DOI: 10.1016/j.aanat.2022.152006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/25/2022] [Accepted: 08/12/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cell-cell communication through extracellular vesicles (EVs) including exosomes, microvesicles and apoptotic bodies has been shown to be important in physiological homoeostasis as well as pathological processes such as atherosclerosis. However, while the cellular machinery controlling EV formation and composition has been studied during the past decade, less is known about the morphological process of their formation and release. METHODS Using different electron microscopic approaches including transmission-, scanning-, immun-, and serial block face electron microscopy we studied the morphogenetic events of EV formation and release. We analysed the different steps of EV formation and release in cultured myocardial endothelial (MyEnd) and aortic endothelial (AoEnd) cell lines under serum starvation and under inflammatory conditions. RESULTS We show that in a narrow time frame, the number of active cells and microvesicle (MV) producing cells increased in dependence of time spent in cultivation and additional stimulation by TNF-α. However, MV secretion was a highly heterogeneous process which couldn´t be seen in all cells cultivated under the same conditions. Release of MVs could be observed all over the cells' surface with no preferred release site. While no single specific microscopic approach applied was sufficient to provide a comprehensive analysis of EV biogenesis, we show that the limitations of one technique could be compensated by the qualities of the respective other applied techniques, thus enabling us to provide a detailed ultrastructural analysis of MV and exosome biogenesis. Surprisingly, exosome release in endothelial cells occurred via a yet undescribed process indicating that MVBs were incorporated into a novel distinct cellular compartment covered by fenestrated endothelium before exosome release. Lastly, we could show that TNF-α stimulation of AoEnd cells leads not only to the upregulation of CD44 in parental cells, but also to incorporation of CD44 into the membranes of generated MVs and exosomes. CONCLUSIONS Taken together, our data contribute to a better understanding of biogenesis and release of EVs. We conclude that under inflammatory conditions, EVs can mediate the transfer of CD44 from endothelial cells to target cells at distant sites including vessel wall cells and this could be a mechanism by which MVs may change the and thus contribute to the development and progression of atherosclerotic lesions.
Collapse
Affiliation(s)
- Clara Elsner
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Germany
| | - Nicole Wagner
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Germany.
| |
Collapse
|
39
|
Kunz AS, Patzer TS, Grunz JP, Luetkens KS, Hartung V, Hendel R, Fieber T, Genest F, Ergün S, Bley TA, Huflage H. Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system. Sci Rep 2022; 12:15549. [PMID: 36114270 PMCID: PMC9481547 DOI: 10.1038/s41598-022-19978-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
Cone-beam computed tomography (CBCT) has been shown to be a powerful tool for 3D imaging of the appendicular skeleton, allowing for detailed visualization of bone microarchitecture. This study was designed to compare artifacts in the presence of osteosynthetic implants between CBCT and multidetector computed tomography (MDCT) in cadaveric wrist scans. A total of 32 scan protocols with varying tube potential and current were employed: both conventional CBCT and MDCT studies were included with tube voltage ranging from 60 to 140 kVp as well as additional MDCT protocols with dedicated spectral shaping via tin prefiltration. Irrespective of scanner type, all examinations were conducted in ultra-high-resolution (UHR) scan mode. For reconstruction of UHR-CBCT scans an additional iterative metal artifact reduction algorithm was employed, an image correction tool which cannot be used in combination with UHR-MDCT. To compare applied radiation doses between both scanners, the volume computed tomography dose index for a 16 cm phantom (CTDIvol) was evaluated. Images were assessed regarding subjective and objective image quality. Without automatic tube current modulation or tube potential control, radiation doses ranged between 1.3 mGy (with 70 kVp and 50.0 effective mAs) and 75.2 mGy (with 140 kVp and 383.0 effective mAs) in UHR-MDCT. Using the pulsed image acquisition method of the CBCT scanner, CTDIvol ranged between 2.3 mGy (with 60 kVp and 0.6 mean mAs per pulse) and 61.0 mGy (with 133 kVp and 2.5 mean mAs per pulse). In essence, all UHR-CBCT protocols employing a tube potential of 80 kVp or more were found to provide superior overall image quality and artifact reduction compared to UHR-MDCT (all p < .050). Interrater reliability of seven radiologists regarding image quality was substantial for tissue assessment and moderate for artifact assessment with Fleiss kappa of 0.652 (95% confidence interval 0.618-0.686; p < 0.001) and 0.570 (95% confidence interval 0.535-0.606; p < 0.001), respectively. Our results demonstrate that the UHR-CBCT scan mode of a twin robotic X-ray system facilitates excellent visualization of the appendicular skeleton in the presence of metal implants. Achievable image quality and artifact reduction are superior to dose-comparable UHR-MDCT and even MDCT protocols employing spectral shaping with tin prefiltration do not achieve the same level of artifact reduction in adjacent soft tissue.
Collapse
Affiliation(s)
- Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
| | - Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Viktor Hartung
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Robin Hendel
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Tabea Fieber
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Franca Genest
- Orthopedic Clinic König-Ludwig-Haus, Julius-Maximilians-Universität Würzburg, Brettreichstr. 11, 97070, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstr. 6, 97070, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| |
Collapse
|
40
|
Luetkens KS, Grunz JP, Paul MM, Huflage H, Conrads N, Patzer TS, Gruschwitz P, Ergün S, Bley TA, Kunz AS. One-stop-shop CT arthrography of the wrist without subject repositioning by means of gantry-free cone-beam CT. Sci Rep 2022; 12:14422. [PMID: 36002544 PMCID: PMC9402709 DOI: 10.1038/s41598-022-18395-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Modern cone-beam CT systems are capable of ultra-high-resolution 3D imaging in addition to conventional radiography and fluoroscopy. The combination of various imaging functions in a multi-use setup is particularly appealing for musculoskeletal interventions, such as CBCT arthrography (CBCTA). With this study, we aimed to investigate the feasibility of CBCTA of the wrist in a “one-stop-shop” approach with a gantry-free twin robotic scanner that does not require repositioning of subjects. Additionally, the image quality of CBCTA was compared to subsequent arthrograms on a high-end multidetector CT (MDCTA). Fourteen cadaveric wrists received CBCTA with four acquisition protocols. Specimens were then transferred to the CT suite for additional MDCTA. Dose indices ranged between 14.3 mGy (120 kVp/100 effective mAs; full-dose) and 1.0 mGy (70 kVp/41 effective mAs; ultra-low-dose) for MDCTA and between 17.4 mGy (80 kVp/2.5 mAs per pulse; full-dose) and 1.2 mGy (60 kVp/0.5 mAs per pulse; ultra-low-dose) for CBCTA. Subjective image quality assessment for bone, cartilage and ligamentous tissue was performed by seven radiologists. The interrater reliability was assessed by calculation of the intraclass correlation coefficient (ICC) based on a two-way random effects model. Overall image quality of most CBCTA was deemed suitable for diagnostic use in contrast to a considerable amount of non-diagnostic MDCTA examinations (38.8%). The depiction of bone, cartilage and ligaments in MDCTA with any form of dose reduction was inferior to any CBCTA scan with at least 0.6 mAs per pulse (all p < 0.001). Full-dose MDCTA and low-dose CBCTA were of equal quality for bone tissue visualization (p = 0.326), whereas CBCTA allowed for better depiction of ligaments and cartilage (both p < 0.001), despite merely one third of radiation exposure (MDCTA–14.3 mGy vs. CBCTA–4.5 mGy). Moderate to good interrater reliability was ascertained for the assessment all tissues (ICC 0.689–0.756). Overall median examination time for CBCTA was 5.4 min (4.8–7.2 min). This work demonstrates that substantial dose reduction can be achieved in CT arthrography of the wrist while maintaining diagnostic image quality by employing the cone-beam CT mode of a twin robotic X-ray system. The ability of the multi-use X-ray system to switch between fluoroscopy mode and 3D imaging allows for “one-stop-shop” CBCTA in minimal examination time without the need for repositioning.
Collapse
Affiliation(s)
- Karsten Sebastian Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Mila Marie Paul
- Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Nora Conrads
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Theresa Sophie Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Philipp Gruschwitz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstr. 6, 97070, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Andreas Steven Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| |
Collapse
|
41
|
Shityakov S, Nagai M, Ergün S, Braunger BM, Förster CY. The Protective Effects of Neurotrophins and MicroRNA in Diabetic Retinopathy, Nephropathy and Heart Failure via Regulating Endothelial Function. Biomolecules 2022; 12:biom12081113. [PMID: 36009007 PMCID: PMC9405668 DOI: 10.3390/biom12081113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 12/15/2022] Open
Abstract
Diabetes mellitus is a common disease affecting more than 537 million adults worldwide. The microvascular complications that occur during the course of the disease are widespread and affect a variety of organ systems in the body. Diabetic retinopathy is one of the most common long-term complications, which include, amongst others, endothelial dysfunction, and thus, alterations in the blood-retinal barrier (BRB). This particularly restrictive physiological barrier is important for maintaining the neuroretina as a privileged site in the body by controlling the inflow and outflow of fluid, nutrients, metabolic end products, ions, and proteins. In addition, people with diabetic retinopathy (DR) have been shown to be at increased risk for systemic vascular complications, including subclinical and clinical stroke, coronary heart disease, heart failure, and nephropathy. DR is, therefore, considered an independent predictor of heart failure. In the present review, the effects of diabetes on the retina, heart, and kidneys are described. In addition, a putative common microRNA signature in diabetic retinopathy, nephropathy, and heart failure is discussed, which may be used in the future as a biomarker to better monitor disease progression. Finally, the use of miRNA, targeted neurotrophin delivery, and nanoparticles as novel therapeutic strategies is highlighted.
Collapse
Affiliation(s)
- Sergey Shityakov
- Division of Chemoinformatics, Infochemistry Scientific Center, Lomonosova Street 9, 191002 Saint-Petersburg, Russia
| | - Michiaki Nagai
- Department of Cardiology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Aaskita-ku, Hiroshima 731-0293, Japan
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, 97070 Würzburg, Germany
| | - Barbara M. Braunger
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, 97070 Würzburg, Germany
- Correspondence: (B.M.B.); (C.Y.F.)
| | - Carola Y. Förster
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg University, 97080 Würzburg, Germany
- Correspondence: (B.M.B.); (C.Y.F.)
| |
Collapse
|
42
|
Huflage H, Grunz JP, Hackenbroch C, Halt D, Luetkens KS, Alfred Schmidt AM, Patzer TS, Ergün S, Bley TA, Kunz AS. Metal artefact reduction in low-dose computed tomography: Benefits of tin prefiltration versus postprocessing of dual-energy datasets over conventional CT imaging. Radiography (Lond) 2022; 28:690-696. [PMID: 35728278 DOI: 10.1016/j.radi.2022.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the potential for metal artefact reduction in low-dose multidetector CT as these pose a frequent challenge in clinical routine. Investigations focused on whether spectral shaping via tin prefiltration, virtual monoenergetic imaging or virtual blend imaging (VBI) offers superior image quality in comparison with conventional CT imaging. METHODS Using a third-generation dual-source CT scanner, two cadaveric specimens with different metal implants (dental, cervical spine, hip, knee) were examined with acquisition protocols matched for radiation dose with regards to tube voltage and current. In order to allow for precise comparison, and due to the relatively short scan lengths, automatic tube current modulation was disabled. Specifically, the following scan protocals were examined: conventional CT protocols (100/120 kVp), tin prefiltration (Sn 100/Sn 150 kVp), VBI and virtual monoenergetic imaging (VME 100/120/150 keV). Mean attenuation and image noise were measured in hyperdense and hypodense artefacts, in artefact-impaired and artefact-free soft tissue. Subjective image quality was rated independently by three radiologists. RESULTS Objectively, Sn 150 kVp allowed for the best reduction of hyperdense streak artefacts (p < 0.001), while VME 150 keV and Sn 150 kVp protocols facilitated equally good reduction of hypodense artefacts (p = 0.173). Artefact-impaired soft tissue attenuation was lowest in Sn 150 kVp protocols (p ≤ 0.011), whereas all VME showed significantly less image noise compared to conventional or tin-filtered protocols (p ≤ 0.001). Subjective assessment favoured Sn 150 kVp regarding hyperdense streak artefacts and delineation of cortical bone (p ≤ 0.005). The intraclass correlation coefficient was 0.776 (95% confidence interval: 0.712-0.831; p < 0.001) indicating good interrater reliability. CONCLUSION In the presence of metal implants in our cadaveric study, tin prefiltration with 150 kVp offers superior artefact reduction for low-dose CT imaging of osseous tissue compared with virtual monoenergetic images of dual-energy datasets. The delineation of cortical boundaries seems to benefit particularly from spectral shaping. IMPLICATIONS FOR PRACTICE Low-dose CT imaging of osseous tissue in combination with tin prefiltration allows for superior metal artefact reduction when compared to virtual monoenergetic images of dual-energy datasets. Employing this technique ought to be considered in daily routine when metal implants are present within the scan volume as findings suggest it allows for radiation dose reduction and facilitates diagnosis relevant to further treatment.
Collapse
Affiliation(s)
- H Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - J-P Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - C Hackenbroch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
| | - D Halt
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany.
| | - K S Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - A M Alfred Schmidt
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - T S Patzer
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - S Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.
| | - T A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - A S Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| |
Collapse
|
43
|
Eckenstaler R, Ripperger A, Hauke M, Braun H, Ergün S, Schwedhelm E, Benndorf RA. Thromboxane A 2 receptor activation via G α13-RhoA/C-ROCK-LIMK2-dependent signal transduction inhibits angiogenic sprouting of human endothelial cells. Biochem Pharmacol 2022; 201:115069. [PMID: 35525325 DOI: 10.1016/j.bcp.2022.115069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/13/2022]
Abstract
We could previously show that thromboxane A2 receptor (TP) activation inhibits the angiogenic capacity of human endothelial cells, but the underlying mechanisms remained unclear. Therefore, the aim of this study was to elucidate TP signal transduction pathways relevant to angiogenic sprouting of human endothelial cells. To clarify this matter, we used RNAi-mediated gene silencing as well as pharmacological inhibition of potential TP downstream targets in human umbilical vein endothelial cells (HUVEC) and VEGF-induced angiogenic sprouting of HUVEC spheroids in vitro as a functional read-out. In this experimental set-up, the TP agonist U-46619 completely blocked VEGF-induced angiogenic sprouting of HUVEC spheroids. Moreover, in live-cell analyses TP activation induced endothelial cell contraction, sprout retraction as well as endothelial cell tension and focal adhesion dysregulation of HUVEC. These effects were reversed by pharmacological TP inhibition or TP knockdown. Moreover, we identified a TP-Gα13-RhoA/C-ROCK-LIMK2-dependent signal transduction pathway to be relevant for U-46619-induced inhibition of VEGF-mediated HUVEC sprouting. In line with these results, U-46619-mediated TP activation potently induced RhoA and RhoC activity in live HUVEC as measured by FRET biosensors. Interestingly, pharmacological inhibition of ROCK and LIMK2 also normalized U-46619-induced endothelial cell tension and focal adhesion dysregulation of HUVEC. In summary, our work reveals mechanisms by which the TP may disturb angiogenic endothelial function in disease states associated with sustained endothelial TP activation.
Collapse
Affiliation(s)
- Robert Eckenstaler
- Martin-Luther-University Halle-Wittenberg, Department of Clinical Pharmacy and Pharmacotherapy, Halle (Saale), Germany
| | - Anne Ripperger
- Martin-Luther-University Halle-Wittenberg, Department of Clinical Pharmacy and Pharmacotherapy, Halle (Saale), Germany
| | - Michael Hauke
- Martin-Luther-University Halle-Wittenberg, Department of Clinical Pharmacy and Pharmacotherapy, Halle (Saale), Germany
| | - Heike Braun
- Martin-Luther-University Halle-Wittenberg, Department of Clinical Pharmacy and Pharmacotherapy, Halle (Saale), Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Würzburg, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf A Benndorf
- Martin-Luther-University Halle-Wittenberg, Department of Clinical Pharmacy and Pharmacotherapy, Halle (Saale), Germany.
| |
Collapse
|
44
|
Karnati S, Guntas G, Rajendran R, Shityakov S, Höring M, Liebisch G, Kosanovic D, Ergün S, Nagai M, Förster CY. Quantitative Lipidomic Analysis of Takotsubo Syndrome Patients' Serum. Front Cardiovasc Med 2022; 9:797154. [PMID: 35514439 PMCID: PMC9062978 DOI: 10.3389/fcvm.2022.797154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Takotsubo syndrome (TTS), also known as the transient left ventricular apical ballooning syndrome, is in contemporary times known as novel acute cardiac syndrome. It is characterized by transient left ventricular apical akinesis and hyperkinesis of the basal left ventricular portions. Although the precise etiology of TTS is unknown, events like the sudden release of stress hormones, such as the catecholamines and the increased inflammatory status might be plausible causes leading to the cardiovascular pathologies. Recent studies have highlighted that an imbalance in lipid accumulation might promote a deviant immune response as observed in TTS. However, there is no information on comprehensive profiling of serum lipids of TTS patients. Therefore, we investigated a detailed quantitative lipid analysis of TTS patients using ES-MSI. Our results showed significant differences in the majority of lipid species composition in the TTS patients compared to the control group. Furthermore, the computational analyses presented was able to link the altered lipids to the pro-inflammatory cytokines and disseminate possible mechanistic pathways involving TNFα and IL-6. Taken together, our study provides an extensive quantitative lipidome of TTS patients, which may provide a valuable Pre-diagnostic tool. This would facilitate the elucidation of the underlying mechanisms of the disease and to prevent the development of TTS in the future.
Collapse
Affiliation(s)
- Srikanth Karnati
- University of Würzburg, Institute of Anatomy and Cell Biology, Würzburg, Germany
- *Correspondence: Srikanth Karnati
| | - Gulcan Guntas
- Department of Biochemistry, Medical Faculty, Atilim University, Ankara, Turkey
| | - Ranjithkumar Rajendran
- Experimental Neurology, Department of Neurology, Justus Liebig University, Giessen, Germany
| | - Sergey Shityakov
- Infochemistry Scientific Center, Laboratory of Chemoinformatics, ITMO University, Saint-Petersburg, Russia
| | - Marcus Höring
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - Gerhard Liebisch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - Djuro Kosanovic
- Department of Pulmonology, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Süleyman Ergün
- University of Würzburg, Institute of Anatomy and Cell Biology, Würzburg, Germany
| | - Michiaki Nagai
- Hiroshima City Asa Hospital, Department of Cardiology, Hiroshima, Japan
| | - Carola Y. Förster
- University of Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany
- Carola Y. Förster
| |
Collapse
|
45
|
Eckenstaler R, Ripperger A, Hauke M, Petermann M, Hemkemeyer SA, Schwedhelm E, Ergün S, Frye M, Werz O, Koeberle A, Braun H, Benndorf RA. A Thromboxane A 2 Receptor-Driven COX-2-Dependent Feedback Loop That Affects Endothelial Homeostasis and Angiogenesis. Arterioscler Thromb Vasc Biol 2022; 42:444-461. [PMID: 35236104 PMCID: PMC8939709 DOI: 10.1161/atvbaha.121.317380] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND TP (thromboxane A2 receptor) plays an eminent role in the pathophysiology of endothelial dysfunction and cardiovascular disease. Moreover, its expression is reported to increase in the intimal layer of blood vessels of cardiovascular high-risk individuals. Yet it is unknown, whether TP upregulation per se has the potential to affect the homeostasis of the vascular endothelium. METHODS We combined global transcriptome analysis, lipid mediator profiling, functional cell analyses, and in vivo angiogenesis assays to study the effects of endothelial TP overexpression or knockdown/knockout on the angiogenic capacity of endothelial cells in vitro and in vivo. RESULTS Here we report that endothelial TP expression induces COX-2 (cyclooxygenase-2) in a Gi/o- and Gq/11-dependent manner, thereby promoting its own activation via the auto/paracrine release of TP agonists, such as PGH2 (prostaglandin H2) or prostaglandin F2 but not TxA2 (thromboxane A2). TP overexpression induces endothelial cell tension and aberrant cell morphology, affects focal adhesion dynamics, and inhibits the angiogenic capacity of human endothelial cells in vitro and in vivo, whereas TP knockdown or endothelial-specific TP knockout exerts opposing effects. Consequently, this TP-dependent feedback loop is disrupted by pharmacological TP or COX-2 inhibition and by genetic reconstitution of PGH2-metabolizing prostacyclin synthase even in the absence of functional prostacyclin receptor expression. CONCLUSIONS Our work uncovers a TP-driven COX-2-dependent feedback loop and important effector mechanisms that directly link TP upregulation to angiostatic TP signaling in endothelial cells. By these previously unrecognized mechanisms, pathological endothelial upregulation of the TP could directly foster endothelial dysfunction, microvascular rarefaction, and systemic hypertension even in the absence of exogenous sources of TP agonists.
Collapse
Affiliation(s)
- Robert Eckenstaler
- Department of Clinical Pharmacy and Pharmacotherapy, Institute of Pharmacy, Martin-Luther-University Halle-Wittenberg, Germany (R.E., A.R., M.H., M.P., H.B., R.A.B.)
| | - Anne Ripperger
- Department of Clinical Pharmacy and Pharmacotherapy, Institute of Pharmacy, Martin-Luther-University Halle-Wittenberg, Germany (R.E., A.R., M.H., M.P., H.B., R.A.B.)
| | - Michael Hauke
- Department of Clinical Pharmacy and Pharmacotherapy, Institute of Pharmacy, Martin-Luther-University Halle-Wittenberg, Germany (R.E., A.R., M.H., M.P., H.B., R.A.B.)
| | - Markus Petermann
- Department of Clinical Pharmacy and Pharmacotherapy, Institute of Pharmacy, Martin-Luther-University Halle-Wittenberg, Germany (R.E., A.R., M.H., M.P., H.B., R.A.B.)
| | - Sandra A Hemkemeyer
- Institute of Clinical Chemistry and Laboratory Medicine (S.A.H., M.F.), University Medical Center Hamburg-Eppendorf, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology (E.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Germany (S.E.)
| | - Maike Frye
- Institute of Clinical Chemistry and Laboratory Medicine (S.A.H., M.F.), University Medical Center Hamburg-Eppendorf, Germany
| | - Oliver Werz
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Germany (O.W., A.K.)
| | - Andreas Koeberle
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Germany (O.W., A.K.).,Michael Popp Institute and Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria (A.K.)
| | - Heike Braun
- Department of Clinical Pharmacy and Pharmacotherapy, Institute of Pharmacy, Martin-Luther-University Halle-Wittenberg, Germany (R.E., A.R., M.H., M.P., H.B., R.A.B.)
| | - Ralf A Benndorf
- Department of Clinical Pharmacy and Pharmacotherapy, Institute of Pharmacy, Martin-Luther-University Halle-Wittenberg, Germany (R.E., A.R., M.H., M.P., H.B., R.A.B.)
| |
Collapse
|
46
|
Grunz JP, Huflage H, Heidenreich JF, Ergün S, Petersilka M, Allmendinger T, Bley TA, Petritsch B. Image Quality Assessment for Clinical Cadmium Telluride-Based Photon-Counting Computed Tomography Detector in Cadaveric Wrist Imaging. Invest Radiol 2021; 56:785-790. [PMID: 33882030 DOI: 10.1097/rli.0000000000000789] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Detailed visualization of bone microarchitecture is essential for assessment of wrist fractures in computed tomography (CT). This study aims to evaluate the imaging performance of a CT system with clinical cadmium telluride-based photon-counting detector (PCD-CT) compared with a third-generation dual-source CT scanner with energy-integrating detector technology (EID-CT). MATERIALS AND METHODS Both CT systems were used for the examination of 8 cadaveric wrists with radiation dose equivalent scan protocols (low-/standard-/full-dose imaging: CTDIvol = 1.50/5.80/8.67 mGy). All wrists were scanned with 2 different operating modes of the photon-counting CT (standard-resolution and ultra-high-resolution). After reformatting with comparable reconstruction parameters and convolution kernels, subjective evaluation of image quality was performed by 3 radiologists on a 7-point scale. For estimation of interrater reliability, we report the intraclass correlation coefficient (absolute agreement, 2-way random-effects model). Signal-to-noise and contrast-to-noise ratios were calculated to provide semiquantitative assessment of image quality. RESULTS Subjective image quality of standard-dose PCD-CT examinations in ultra-high-resolution mode was superior compared with full-dose PCD-CT in standard-resolution mode (P = 0.016) and full-dose EID-CT (P = 0.040). No difference was ascertained between low-dose PCD-CT in ultra-high-resolution mode and standard-dose scans with either PCD-CT in standard-resolution mode (P = 0.108) or EID-CT (P = 0.470). Observer evaluation of standard-resolution PCD-CT and EID-CT delivered similar results in full- and standard-dose scans (P = 0.248/0.509). Intraclass correlation coefficient was 0.876 (95% confidence interval, 0.744-0.925; P < 0.001), indicating good reliability. Between dose equivalent studies, signal-to-noise and contrast-to-noise ratios were substantially higher in photon-counting CT examinations (all P's < 0.001). CONCLUSIONS Superior visualization of fine anatomy is feasible with the clinical photon-counting CT system in cadaveric wrist scans. The ultra-high-resolution scan mode suggests potential for considerable dose reduction over energy-integrating dual-source CT.
Collapse
Affiliation(s)
- Jan-Peter Grunz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg
| | - Henner Huflage
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg
| | | | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg
| | - Martin Petersilka
- Computed Tomography-Research and Development, Siemens Healthcare GmbH, Forchheim, Germany
| | - Thomas Allmendinger
- Computed Tomography-Research and Development, Siemens Healthcare GmbH, Forchheim, Germany
| | - Thorsten Alexander Bley
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg
| | - Bernhard Petritsch
- From the Department of Diagnostic and Interventional Radiology, University Hospital Würzburg
| |
Collapse
|
47
|
Luetkens KS, Huflage H, Kunz AS, Ritschl L, Herbst M, Kappler S, Ergün S, Goertz L, Pennig L, Bley TA, Gassenmaier T, Grunz JP. The effect of tin prefiltration on extremity cone-beam CT imaging with a twin robotic X-ray system. Radiography (Lond) 2021; 28:433-439. [PMID: 34716089 DOI: 10.1016/j.radi.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/13/2021] [Accepted: 10/09/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION While tin prefiltration is established in various CT applications, its value in extremity cone-beam CT relative to optimized spectra has not been thoroughly assessed thus far. This study aims to investigate the effect of tin filters in extremity cone-beam CT with a twin-robotic X-ray system. METHODS Wrist, elbow and ankle joints of two cadaveric specimens were examined in a laboratory setup with different combinations of prefiltration (copper, tin), tube voltage and current-time product. Image quality was assessed subjectively by five radiologists with Fleiss' kappa being computed to measure interrater agreement. To provide a semiquantitative criterion for image quality, contrast-to-noise ratios (CNR) were compared for standardized regions of interest. Volume CT dose indices were calculated for a 16 cm polymethylmethacrylate phantom. RESULTS Radiation dose ranged from 17.4 mGy in the clinical standard protocol without tin filter to as low as 0.7 mGy with tin prefiltration. Image quality ratings and CNR for tin-filtered scans with 100 kV were lower than for 80 kV studies with copper prefiltration despite higher dose (11.2 and 5.6 vs. 4.5 mGy; p < 0.001). No difference was ascertained between 100 kV scans with tin filtration and 60 kV copper-filtered scans with 75% dose reduction (subjective: p = 0.101; CNR: p = 0.706). Fleiss' kappa of 0.597 (95% confidence interval 0.567-0.626; p < 0.001) indicated moderate interrater agreement. CONCLUSION Considerable dose reduction is feasible with tin prefiltration, however, the twin-robotic X-ray system's low-dose potential for extremity 3D imaging is maximized with a dedicated low-kilovolt scan protocol in situations without extensive beam-hardening artifacts. IMPLICATIONS FOR PRACTICE Low-kilovolt imaging with copper prefiltration provides a superior trade-off between dose reduction and image quality compared to tin-filtered cone-beam CT scan protocols with higher tube voltage.
Collapse
Affiliation(s)
- K S Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - H Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - A S Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - L Ritschl
- X-ray Products - Research & Development, Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany.
| | - M Herbst
- X-ray Products - Research & Development, Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany.
| | - S Kappler
- X-ray Products - Research & Development, Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany.
| | - S Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.
| | - L Goertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
| | - L Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
| | - T A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - T Gassenmaier
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - J-P Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| |
Collapse
|
48
|
Dogan L, Scheuring R, Wagner N, Ueda Y, Schmidt S, Wörsdörfer P, Groll J, Ergün S. Human iPSC-derived mesodermal progenitor cells preserve their vasculogenesis potential after extrusion and form hierarchically organized blood vessels. Biofabrication 2021; 13. [PMID: 34521078 DOI: 10.1088/1758-5090/ac26ac] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/14/2021] [Indexed: 12/29/2022]
Abstract
Post-fabrication formation of a proper vasculature remains an unresolved challenge in bioprinting. Established strategies focus on the supply of the fabricated structure with nutrients and oxygen and either rely on the mere formation of a channel system using fugitive inks or additionally use mature endothelial cells and/or peri-endothelial cells such as smooth muscle cells for the formation of blood vesselsin vitro.Functional vessels, however, exhibit a hierarchical organization and multilayered wall structure that is important for their function. Human induced pluripotent stem cell-derived mesodermal progenitor cells (hiMPCs) have been shown to possess the capacity to form blood vesselsin vitro, but have so far not been assessed for their applicability in bioprinting processes. Here, we demonstrate that hiMPCs, after formulation into an alginate/collagen type I bioink and subsequent extrusion, retain their ability to give rise to the formation of complex vessels that display a hierarchical network in a process that mimics the embryonic steps of vessel formation during vasculogenesis. Histological evaluations at different time points of extrusion revealed the initial formation of spheres, followed by lumen formation and further structural maturation as evidenced by building a multilayered vessel wall and a vascular network. These findings are supported by immunostainings for endothelial and peri-endothelial cell markers as well as electron microscopic analyses at the ultrastructural level. Moreover, endothelial cells in capillary-like vessel structures deposited a basement membrane-like matrix at the basal side between the vessel wall and the alginate-collagen matrix. After transplantation of the printed constructs into the chicken chorioallantoic membrane (CAM) the printed vessels connected to the CAM blood vessels and get perfusedin vivo. These results evidence the applicability and great potential of hiMPCs for the bioprinting of vascular structures mimicking the basic morphogenetic steps ofde novovessel formation during embryogenesis.
Collapse
Affiliation(s)
- Leyla Dogan
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Ruben Scheuring
- Chair for Functional Materials for Medicine and Dentistry at the Institute for Functional Materials and Biofabrication (IFB) and Bavarian Polymer Institute (BPI), University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Nicole Wagner
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Yuichiro Ueda
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Sven Schmidt
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Philipp Wörsdörfer
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| | - Jürgen Groll
- Chair for Functional Materials for Medicine and Dentistry at the Institute for Functional Materials and Biofabrication (IFB) and Bavarian Polymer Institute (BPI), University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University of Würzburg, Koellikerstr. 6, 97070 Würzburg, Germany
| |
Collapse
|
49
|
Schlecht A, Vallon M, Wagner N, Ergün S, Braunger BM. TGFβ-Neurotrophin Interactions in Heart, Retina, and Brain. Biomolecules 2021; 11:biom11091360. [PMID: 34572573 PMCID: PMC8464756 DOI: 10.3390/biom11091360] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 12/13/2022] Open
Abstract
Ischemic insults to the heart and brain, i.e., myocardial and cerebral infarction, respectively, are amongst the leading causes of death worldwide. While there are therapeutic options to allow reperfusion of ischemic myocardial and brain tissue by reopening obstructed vessels, mitigating primary tissue damage, post-infarction inflammation and tissue remodeling can lead to secondary tissue damage. Similarly, ischemia in retinal tissue is the driving force in the progression of neovascular eye diseases such as diabetic retinopathy (DR) and age-related macular degeneration (AMD), which eventually lead to functional blindness, if left untreated. Intriguingly, the easily observable retinal blood vessels can be used as a window to the heart and brain to allow judgement of microvascular damages in diseases such as diabetes or hypertension. The complex neuronal and endocrine interactions between heart, retina and brain have also been appreciated in myocardial infarction, ischemic stroke, and retinal diseases. To describe the intimate relationship between the individual tissues, we use the terms heart-brain and brain-retina axis in this review and focus on the role of transforming growth factor β (TGFβ) and neurotrophins in regulation of these axes under physiologic and pathologic conditions. Moreover, we particularly discuss their roles in inflammation and repair following ischemic/neovascular insults. As there is evidence that TGFβ signaling has the potential to regulate expression of neurotrophins, it is tempting to speculate, and is discussed here, that cross-talk between TGFβ and neurotrophin signaling protects cells from harmful and/or damaging events in the heart, retina, and brain.
Collapse
|
50
|
Rattila S, Kleefeldt F, Ballesteros A, Beltrame JS, L Ribeiro M, Ergün S, Dveksler G. Pro-angiogenic effects of pregnancy-specific glycoproteins in endothelial and extravillous trophoblast cells. Reproduction 2021; 160:737-750. [PMID: 33065549 DOI: 10.1530/rep-20-0169] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/20/2020] [Indexed: 01/23/2023]
Abstract
We previously reported that binding to heparan sulfate (HS) is required for the ability of the placentally secreted pregnancy-specific glycoprotein 1 (PSG1) to induce endothelial tubulogenesis. PSG1 is composed of four immunoglobulin-like domains but which domains of the protein bind to HS remains unknown. To analyze the interaction of PSG1 with HS, we generated several recombinant proteins, including the individual domains, chimeric proteins between two PSG1 domains, and mutants. Using flow cytometric and surface plasmon resonance studies, we determined that the B2 domain of PSG1 binds to HS and that the positively charged amino acids encompassed between amino acids 43-59 are required for this interaction. Furthermore, we showed that the B2 domain of PSG1 is required for the increase in the formation of tubes by endothelial cells (EC) including a human endometrial EC line and two extravillous trophoblast (EVT) cell lines and for the pro-angiogenic activity of PSG1 observed in an aortic ring assay. PSG1 enhanced the migration of ECs while it increased the expression of matrix metalloproteinase-2 in EVTs, indicating that the pro-angiogenic effect of PSG1 on these two cell types may be mediated by different mechanisms. Despite differences in amino acid sequence, we observed that all human PSGs bound to HS proteoglycans and confirmed that at least two other members of the family, PSG6 and PSG9, induce tube formation. These findings contribute to a better understanding of the pro-angiogenic activity of human PSGs and strongly suggest conservation of this function among all PSG family members.
Collapse
Affiliation(s)
- Shemona Rattila
- Department of Pathology, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| | - Florian Kleefeldt
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Angela Ballesteros
- Molecular Physiology and Biophysics Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Jimena S Beltrame
- Laboratory of Physiology and Pharmacology of Reproduction, Centre for Pharmacological and Botanical Studies (CONICET - School of Medicine, University of Buenos Aires), Buenos Aires, Argentina
| | - Maria L Ribeiro
- Laboratory of Physiology and Pharmacology of Reproduction, Centre for Pharmacological and Botanical Studies (CONICET - School of Medicine, University of Buenos Aires), Buenos Aires, Argentina
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Gabriela Dveksler
- Department of Pathology, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| |
Collapse
|