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Glemser PA, Rotkopf LT, Ziener CH, Beuthien-Baumann B, Weru V, Kopp-Schneider A, Schlemmer HP, Dimitrakopoulou-Strauss A, Sachpekidis C. Hybrid imaging with [ 68Ga]PSMA-11 PET-CT and PET-MRI in biochemically recurrent prostate cancer. Cancer Imaging 2022; 22:53. [PMID: 36138437 PMCID: PMC9502876 DOI: 10.1186/s40644-022-00489-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
AIM To compare [68Ga]PSMA-11 PET-CT, [68Ga]PSMA-11 PET-MRI and MRI in a cohort of prostate cancer (PCa) patients in biochemical recurrence after initial curative therapy. MATERIALS AND METHODS Fifty-three patients with biochemically recurrent PCa underwent whole-body [68Ga]PSMA-11 PET-CT 1 hour post-injection (p.i.) followed by [68Ga]PSMA-11 PET-MRI 2.5 hours p.i., including a multiparametric MRI pelvic protocol examination. Imaging data analysis consisted of visual (qualitative) evaluation of the PET-CT, PET-MRI and MRI scans, as well as semi-quantitative and quantitative analyses of the PET and MRI data, including calculation of the parameters standardized uptake value (SUV) and apparent diffusion coefficient (ADC) derived from the PCa lesions. Association analysis was performed between imaging and clinical data, including PSA level and Gleason score. The results were considered significant for p-values less than 0.05 (p < 0.05). RESULTS The hybrid imaging modalities [68Ga]PSMA-11 PET-CT and PET-MRI were positive in more patients than MRI alone. In particular, PET-CT detected lesions suggestive of PCa relapse in 34/53 (64.2%), PET-MRI in 36/53 (67.9%) and MRI in 23/53 patients (43.4%). While no significant differences in lesion detection rate were observed between PET-CT and PET-MRI, the latter was particularly efficient in detection of local recurrences in the prostate bed mainly due to the contribution of the MRI part of the modality. Association analysis revealed a statistically significant increase in the probability of a positive scan with increasing PSA levels for all imaging modalities. Accordingly, there was no significant association between scan positivity rate and Gleason score for any imaging modality. No significant correlation was observed between SUV and ADC values in lymph node metastases. CONCLUSION [68Ga]PSMA-11 PET-CT and PET-MRI provide equally good detection rates for PCa recurrence, both outperforming stand-alone MRI.
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Affiliation(s)
- P A Glemser
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L T Rotkopf
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Medical Faculty, Ruprecht-Karls-University Heidelberg, 69120, Heidelberg, Germany
| | - C H Ziener
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - B Beuthien-Baumann
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - V Weru
- Department of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Kopp-Schneider
- Department of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H P Schlemmer
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Dimitrakopoulou-Strauss
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210, Heidelberg, Germany
| | - C Sachpekidis
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210, Heidelberg, Germany.
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2
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Rotkopf LT, Buschle LR, Schlemmer HP, Ziener CH. Influence of diffusion on transverse relaxation rates and phases of an ensemble of magnetic spheres. J Magn Reson 2022; 341:107259. [PMID: 35779309 DOI: 10.1016/j.jmr.2022.107259] [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] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/30/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
In quantitative susceptibility mapping, the tissue susceptibility is determined from the magnitude and phase of the gradient echo signal, which is influenced by the interplay of complex susceptibility and diffusion effect. Herein, we analytically analyze the influence of diffusion on magnitude and phase images generated by randomly arranged magnetic spheres as a model of intracerebral iron depositions. We demonstrate that both gradient and spin echo relaxation rate constants have a strong and nonlinear dependence on diffusion strength and give empirical formulas for magnitude and phase. This may be used in the future to improve QSM processing methods. In addition, we show that, in theory, combined acquisitions of gradient and spin echo can be used to determine the dimension of the magnetic spheres and the diffusion strength.
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Affiliation(s)
- L T Rotkopf
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany; Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - L R Buschle
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany
| | - H-P Schlemmer
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany
| | - C H Ziener
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany.
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3
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Wehrse E, Klein L, Rotkopf LT, Stiller W, Finke M, Echner G, Glowa C, Heinze S, Ziener CH, Schlemmer HP, Kachelrieß M, Sawall S. Ultrahigh resolution whole body photon counting computed tomography as a novel versatile tool for translational research from mouse to man. Z Med Phys 2022:S0939-3889(22)00066-6. [PMID: 35868888 DOI: 10.1016/j.zemedi.2022.06.002] [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: 04/11/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 11/19/2022]
Abstract
X-ray computed tomography (CT) is a cardinal tool in clinical practice. It provides cross-sectional images within seconds. The recent introduction of clinical photon-counting CT allowed for an increase in spatial resolution by more than a factor of two resulting in a pixel size in the center of rotation of about 150 µm. This level of spatial resolution is in the order of dedicated preclinical micro-CT systems. However so far, the need for different dedicated clinical and preclinical systems often hinders the rapid translation of early research results to applications in men. This drawback might be overcome by ultra-high resolution (UHR) clinical photon-counting CT unifying preclinical and clinical research capabilities in a single machine. Herein, the prototype of a clinical UHR PCD CT (SOMATOM CounT, Siemens Healthineers, Forchheim, Germany) was used. The system comprises a conventional energy-integrating detector (EID) and a novel photon-counting detector (PCD). While the EID provides a pixel size of 0.6 mm in the centre of rotation, the PCD provides a pixel size of 0.25 mm. Additionally, it provides a quantification of photon energies by sorting them into up to four distinct energy bins. This acquisition of multi-energy data allows for a multitude of applications, e.g. pseudo-monochromatic imaging. In particular, we examine the relation between spatial resolution, image noise and administered radiation dose for a multitude of use-cases. These cases include ultra-high resolution and multi-energy acquisitions of mice administered with a prototype bismuth-based contrast agent (nanoPET Pharma, Berlin, Germany) as well as larger animals and actual patients. The clinical EID provides a spatial resolution of about 9 lp/cm (modulation transfer function at 10%, MTF10%) while UHR allows for the acquisition of images with up to 16 lp/cm allowing for the visualization of all relevant anatomical structures in preclinical and clinical specimen. The spectral capabilities of the system enable a variety of applications previously not available in preclinical research such as pseudo-monochromatic images. Clinical ultra-high resolution photon-counting CT has the potential to unify preclinical and clinical research on a single system enabling versatile imaging of specimens and individuals ranging from mice to man.
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Affiliation(s)
- E Wehrse
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - L Klein
- Department of Physics and Astronomy, Heidelberg University, Heidelberg, Germany; Division of X-ray Imaging and CT, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L T Rotkopf
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - W Stiller
- Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Heidelberg, Germany
| | - M Finke
- Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Heidelberg, Germany
| | - G Echner
- Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
| | - C Glowa
- Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiation Oncology and Radiotherapy, University Hospital Heidelberg, Heidelberg, Germany; Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
| | - S Heinze
- Institute of Forensic and Traffic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - C H Ziener
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H-P Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Kachelrieß
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; Division of X-ray Imaging and CT, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Sawall
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; Division of X-ray Imaging and CT, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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4
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Abstract
We are in the middle of a digital revolution in medicine. This raises the question of whether subjects such as radiology, which is superficially concerned with the interpretation of images, will be particularly changed by this revolution. In particular, it should be discussed whether in the future the completion of initially simpler, then more complex image analysis tasks by computer systems may lead to a reduced need for radiologists. What distinguishes radiology in particular is its key position between advanced technology and medical care. This article discusses that not only radiology but every medical discipline will be affected by innovations due to the digital revolution, and that a redefinition of medical specialties focusing on imaging and visual interpretation makes sense and that the arrival of artificial intelligence (AI) in radiology is to be welcomed in the context of ever larger amounts of image data-to at all be able to handle the increasing amount of image data in the future at the current number of radiologists. In this respect, the balance between research and teaching in comparison to patient care is more difficult to maintain in the academic environment. AI can help improve efficiency and balance in the areas mentioned. With regard to specialist training, information technology topics are expected to be integrated into the radiological curriculum. Radiology acts as a pioneer designing the entry of AI into medicine. It is to be expected that by the time radiologists can be substantially replaced by AI, the replacement of human contributions in other medical and non-medical fields will also be well advanced.
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Affiliation(s)
- David Bonekamp
- Abteilung für Radiologie (E010), Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
| | - H-P Schlemmer
- Abteilung für Radiologie (E010), Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
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5
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Rotkopf LT, Wehrse E, Kampf T, Vogel P, Schlemmer HP, Ziener CH. Spin echo formation in muscle tissue. Phys Rev E 2021; 104:034419. [PMID: 34654209 DOI: 10.1103/physreve.104.034419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/13/2021] [Indexed: 11/07/2022]
Abstract
Determination of the spin echo signal evolution and of transverse relaxation rates is of high importance for microstructural modeling of muscle tissue in magnetic resonance imaging. So far, numerically exact solutions for the NMR signal dynamics in muscle tissue models have been reported only for the gradient echo free induction decay, with spin echo problems usually solved by approximate methods. In this work, we modeled the spin echo signal numerically exact by discretizing the radial dimension of the Bloch-Torrey equation and expanding the angular dependency in terms of even Chebyshev polynomials. This allows us to express the time dependence of the local magnetization as a closed-form matrix expression. Using this method, we were able to accurately capture the spin echo local and total magnetization dynamics. The obtained transverse relaxation rates showed a high concordance with random walker and finite-element simulations. We could demonstrate that in cases of smaller diffusion coefficients, the commonly used strong collision approximation significantly underestimates the true value considerably. Instead, the limiting behavior in this regime is correctly described either by the full solution or by the slow diffusion approximation. Experimentally measured transverse relaxation rates of a mouse limb muscle showed an angular dependence in accordance with the theoretical prediction.
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Affiliation(s)
- L T Rotkopf
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany.,Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - E Wehrse
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany.,Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Department of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany.,Würzburg University Hospital, Department of Neuroradiology, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - P Vogel
- University of Würzburg, Department of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany
| | - H-P Schlemmer
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany
| | - C H Ziener
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany
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6
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Sawall S, Klein L, Wehrse E, Rotkopf LT, Amato C, Maier J, Schlemmer HP, Ziener CH, Heinze S, Kachelrieß M. Threshold-dependent iodine imaging and spectral separation in a whole-body photon-counting CT system. Eur Radiol 2021; 31:6631-6639. [PMID: 33713171 PMCID: PMC8379121 DOI: 10.1007/s00330-021-07786-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/20/2021] [Accepted: 02/12/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To evaluate the dual-energy (DE) performance and spectral separation with respect to iodine imaging in a photon-counting CT (PCCT) and compare it to dual-source CT (DSCT) DE imaging. METHODS A semi-anthropomorphic phantom extendable with fat rings equipped with iodine vials is measured in an experimental PCCT. The system comprises a PC detector with two energy bins (20 keV, T) and (T, eU) with threshold T and tube voltage U. Measurements using the PCCT are performed at all available tube voltages (80 to 140 kV) and threshold settings (50-90 keV). Further measurements are performed using a conventional energy-integrating DSCT. Spectral separation is quantified as the relative contrast media ratio R between the energy bins and low/high images. Image noise and dose-normalized contrast-to-noise ratio (CNRD) are evaluated in resulting iodine images. All results are validated in a post-mortem angiography study. RESULTS R of the PC detector varies between 1.2 and 2.6 and increases with higher thresholds and higher tube voltage. Reference R of the EI DSCT is found as 2.20 on average overall phantoms. Maximum CNRD in iodine images is found for T = 60/65/70/70 keV for 80/100/120/140 kV. The highest CNRD of the PCCT is obtained using 140 kV and is decreasing with decreasing tube voltage. All results could be confirmed in the post-mortem angiography study. CONCLUSION Intrinsically acquired DE data are able to provide iodine images similar to conventional DSCT. However, PCCT thresholds should be chosen with respect to tube voltage to maximize image quality in retrospectively derived image sets. KEY POINTS • Photon-counting CT allows for the computation of iodine images with similar quality compared to conventional dual-source dual-energy CT. • Thresholds should be chosen as a function of the tube voltage to maximize iodine contrast-to-noise ratio in derived image sets. • Image quality of retrospectively computed image sets can be maximized using optimized threshold settings.
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Affiliation(s)
- S Sawall
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. .,Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.
| | - L Klein
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Department of Physics and Astronomy, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 226, 69120, Heidelberg, Germany
| | - E Wehrse
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.,Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - L T Rotkopf
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.,Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - C Amato
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - J Maier
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - H-P Schlemmer
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.,Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - C H Ziener
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.,Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Heinze
- Institute of Forensic and Traffic Medicine, University Hospital Heidelberg, Voßstraße 2, 69115, Heidelberg, Germany
| | - M Kachelrieß
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Medical Faculty, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
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7
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Abstract
In the last few years, the early diagnosis of prostate cancer has continued to shift from systematic biopsies to multiparametric MRI (mpMRI)-guided/MRI-transrectal ultrasound (TRUS) fusion biopsies and guidelines are already reflecting these changes. While MRI-TRUS fusion biopsies have already resulted in significant improvements in diagnostic sensitivity and, thus, correct diagnosis of clinically significant prostate cancer (sPC), its use to avoid biopsies in certain men is still controversial. Optimal use of mpMRI requires a high degree of reader expertise due to the difficulty of image interpretation and poses the problem of training sufficient numbers of radiologists while demand is increasing. Recently, artificial intelligence (AI) has been utilized to create fully automatic analysis tools for interpretation of mpMRI of the prostate, rivaling the performance of clinical radiologist interpretation in retrospective research studies, demonstrating the promising potential of AI for diagnostic prostate MRI in the future. This article will provide an overview of machine and deep learning and its application in mpMRI of the prostate for early diagnosis of prostate cancer.
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Affiliation(s)
- D Bonekamp
- Abteilung für Radiologie (E010), Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
| | - H-P Schlemmer
- Abteilung für Radiologie (E010), Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
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8
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Kurz FT, Buschle LR, Rotkopf LT, Herzog FS, Sterzik A, Schlemmer HP, Kampf T, Bendszus M, Heiland S, Ziener CH. Dependence of the frequency distribution around a sphere on the voxel orientation. Z Med Phys 2021; 31:403-419. [PMID: 33750628 DOI: 10.1016/j.zemedi.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 11/29/2022]
Abstract
Microscopically small magnetic field inhomogeneities within an external static magnetic field cause a free induction decay in magnetic resonance imaging that generally exhibits two transverse components that are usually summarized to a complex entity. The Fourier transform of the complex-valued free induction decay is the purely real and positive-valued frequency distribution which allows an easy interpretation of the underlying dephasing mechanism. Typically, the frequency distribution inside a cubic voxel as caused by a spherical magnetic field inhomogeneity is determined by a histogram technique in terms of subdivision of the whole voxel into smaller subvoxels. A faster and more accurate computation is achieved by analytical expressions for the frequency distribution that are derived in this work. In contrast to the usually assumed simplified case of a spherical voxel, we also consider the tilt angles of the cubic voxel to the external magnetic field. The typical asymmetric form of the frequency distribution is reproduced and analyzed for the more realistic case of a cubic voxel. We observe a splitting of frequency distribution peaks for increasing tilt of the cubic voxel against the direction of the external magnetic field in analogy to the case for dephasing around cylindrical, vessel-like objects inside cubic voxels. These results are of value, e.g., for the analysis of susceptibility-weighted images or in quantitative susceptibility imaging since the reconstruction of these images is performed in cubic-shaped voxels.
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Affiliation(s)
- F T Kurz
- Heidelberg University Hospital, Dept. of Neuroradiology, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; German Cancer Research Center, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - L R Buschle
- German Cancer Research Center, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University, Faculty of Physics and Astronomy, INF 227, 69120 Heidelberg, Germany
| | - L T Rotkopf
- German Cancer Research Center, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - F S Herzog
- German Cancer Research Center, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University, Faculty of Physics and Astronomy, INF 227, 69120 Heidelberg, Germany
| | - A Sterzik
- German Cancer Research Center, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University, Faculty of Physics and Astronomy, INF 227, 69120 Heidelberg, Germany
| | - H-P Schlemmer
- German Cancer Research Center, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Dept. of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany; Würzburg University Hospital, Dept. of Neuroradiology, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - M Bendszus
- Heidelberg University Hospital, Dept. of Neuroradiology, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - S Heiland
- Heidelberg University Hospital, Dept. of Neuroradiology, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - C H Ziener
- Heidelberg University Hospital, Dept. of Neuroradiology, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; German Cancer Research Center, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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Wehrse E, Klein L, Rotkopf LT, Wagner WL, Uhrig M, Heußel CP, Ziener CH, Delorme S, Heinze S, Kachelrieß M, Schlemmer HP, Sawall S. Photon-counting detectors in computed tomography: from quantum physics to clinical practice. Radiologe 2021; 61:1-10. [PMID: 33598788 DOI: 10.1007/s00117-021-00812-8] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 12/19/2022]
Abstract
Over the last decade, a fundamentally new type of computed tomography (CT) detectors has proved its superior capabilities in both physical and preclinical evaluations and is now approaching the stage of clinical practice. These detectors are able to discriminate single photons and quantify their energy and are hence called photon-counting detectors. Among the promising benefits of this technology are improved radiation dose efficiency, increased contrast-to-noise ratio, reduced metal artifacts, improved spatial resolution, simultaneous multi-energy acquisitions, and the prospect of multi-phase imaging within a single acquisition using multiple contrast agents. Taking the conventional energy-integrating detectors as a reference, the authors demonstrate the technical principles of this new technology and provide phantom and patient images acquired by a whole-body photon-counting CT. These images serve as a basis for discussing the potential future of clinical CT.
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Affiliation(s)
- E Wehrse
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
| | - L Klein
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
| | - L T Rotkopf
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - W L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
| | - M Uhrig
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - C P Heußel
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
- Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| | - C H Ziener
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Delorme
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Heinze
- Institute of Forensic and Traffic Medicine, University Hospital Heidelberg, Voßstraße 2, 69115, Heidelberg, Germany
| | - M Kachelrieß
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
| | - H-P Schlemmer
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Sawall
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
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10
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Wehrse E, Sawall S, Klein L, Glemser P, Delorme S, Schlemmer HP, Kachelrieß M, Uhrig M, Ziener CH, Rotkopf LT. Potential of ultra-high-resolution photon-counting CT of bone metastases: initial experiences in breast cancer patients. NPJ Breast Cancer 2021; 7:3. [PMID: 33398008 PMCID: PMC7782694 DOI: 10.1038/s41523-020-00207-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 11/12/2020] [Indexed: 01/01/2023] Open
Abstract
Conventional CT scanners use energy-integrating detectors (EIDs). Photon-counting detector (PCD) computed tomography (CT) utilizes a CT detector technology based on smaller detector pixels capable of counting single photons and in addition discriminating their energy. Goal of this study was to explore the potential of higher spatial resolution for imaging of bone metastases. Four female patients with histologically confirmed breast cancer and bone metastases were included between July and October 2019. All patients underwent conventional EID CT scans followed by a high resolution non-contrast experimental PCD CT scan. Ultra-high resolution (UHR) reconstruction kernels were used to reconstruct axial slices with voxel sizes of 0.3 mm × 0.3 mm (inplane) × 1 mm (z-direction). Four radiologists blinded for patient identity assessed the images and compared the quality to conventional CT using a qualitative Likert scale. In this case series, we present images of bone metastases in breast cancer patients using an experimental PCD CT scanner and ultra-high-resolution kernels. A tendency to both a smaller inter-reader variability in the structural assessment of lesion sizes and in the readers' opinion to an improved visualization of lesion margins and content was observed. In conclusion, while further studies are warranted, PCD CT has a high potential for therapy monitoring in breast cancer.
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Affiliation(s)
- E Wehrse
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany.
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
| | - S Sawall
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
| | - L Klein
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
| | - P Glemser
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - S Delorme
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - H-P Schlemmer
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - M Kachelrieß
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
| | - M Uhrig
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - C H Ziener
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - L T Rotkopf
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
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11
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Wagner WL, Hellbach K, Fiedler MO, Salg GA, Wehrse E, Ziener CH, Merle U, Eckert C, Weber TF, Stiller W, Wielpütz MO, Dullin C, Kenngott HG, Schlemmer HP, Weigand MA, Schirmacher P, Longerich T, Kauczor HU, Kommoss FKF, Schwab C. [Microvascular changes in COVID-19]. Radiologe 2020; 60:934-942. [PMID: 32857175 PMCID: PMC7453182 DOI: 10.1007/s00117-020-00743-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 01/30/2023]
Abstract
BACKGROUND Clinically, coronavirus disease 2019 (COVID-19) is associated with a wide range of symptoms, which can range from mild complaints of an upper respiratory infection to life-threatening hypoxic respiratory insufficiency and multiorgan failure. OBJECTIVE The initially identified pulmonary damage patterns, such as diffuse alveolar damage in acute lung failure, are accompanied by new findings that draw a more complex scenario. These include microvascular involvement and a wide range of associated pathologies of multiple organ systems. A back-scaling of microstructural vascular changes is possible via targeted correlation of pathological autopsy results with radiological imaging. MATERIAL AND METHODS Radiological and pathological correlation as well as microradiological imaging to investigate microvascular involvement in fatal COVID-19. RESULTS The cases of two COVID-19 patients are presented. Patient 1 showed a relative hypoperfusion in lung regions that did not have typical COVID-19 infiltrates; the targeted post-mortem correlation also showed subtle signs of microvascular damage even in these lung sections. Patient 2 showed both radiologically and pathologically advanced typical COVID-19 destruction of lung structures and the case illustrates the damage patterns of the blood-air barrier. The perfusion deficit of the intestinal wall shown in computed tomography of patient 2 could not ultimately clearly be microscopically attributed to intestinal microvascular damage. CONCLUSION In addition to microvascular thrombosis, our results indicate a functional pulmonary vasodysregulation as part of the pathophysiology during the vascular phase of COVID-19. The clinical relevance of autopsies and the integration of radiological imaging findings into histopathological injury patterns must be emphasized for a better understanding of COVID-19.
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Affiliation(s)
- W L Wagner
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
| | - K Hellbach
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M O Fiedler
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - G A Salg
- Neue Technologien und Datenwissenschaften/3D-Biodruck Einheit, Klinik für Allgemein‑, Viszeral-, und Transplantationschirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - E Wehrse
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
- Medizinische Fakultät, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
| | - C H Ziener
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - U Merle
- Klinik für Gastroenterologie, Infektionen, Vergiftungen, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Eckert
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T F Weber
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - W Stiller
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M O Wielpütz
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Dullin
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - H G Kenngott
- Neue Technologien und Datenwissenschaften/3D-Biodruck Einheit, Klinik für Allgemein‑, Viszeral-, und Transplantationschirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - H-P Schlemmer
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - M A Weigand
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- TI Biobank, Deutsches Zentrum für Infektionsforschung (DZIF), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T Longerich
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - H-U Kauczor
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - F K-F Kommoss
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Schwab
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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12
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Bostel T, Dreher C, Wollschläger D, Mayer A, König F, Bickelhaupt S, Schlemmer HP, Huber PE, Sterzing F, Bäumer P, Debus J, Nicolay NH. Exploring MR regression patterns in rectal cancer during neoadjuvant radiochemotherapy with daily T2- and diffusion-weighted MRI. Radiat Oncol 2020; 15:171. [PMID: 32653003 PMCID: PMC7353746 DOI: 10.1186/s13014-020-01613-4] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 07/03/2020] [Indexed: 12/15/2022] Open
Abstract
Background To date, only limited magnetic resonance imaging (MRI) data are available concerning tumor regression during neoadjuvant radiochemotherapy (RCT) of rectal cancer patients, which is a prerequisite for adaptive radiotherapy (RT) concepts. This exploratory study prospectively evaluated daily fractional MRI during neoadjuvant treatment to analyze the predictive value of MR biomarkers for treatment response. Methods Locally advanced rectal cancer patients were examined with daily MRI during neoadjuvant RCT. Contouring of the tumor volume was performed for each MRI scan by using T2- and diffusion-weighted-imaging (DWI)-sequences. The daily apparent-diffusion coefficient (ADC) was calculated. Volumetric and functional tumor changes during RCT were analyzed and correlated with the pathological response after surgical resection. Results In total, 171 MRI scans of eight patients were analyzed regarding anatomical and functional dynamics during RCT. Pathological complete response (pCR) could be achieved in four patients, and four patients had a pathological partial response (pPR) following neoadjuvant treatment. T2- and DWI-based volumetry proved to be statistically significant in terms of therapeutic response, and volumetric thresholds at week two and week four during RCT were defined for the prediction of pCR. In contrast, the average tumor ADC values widely overlapped between both response groups during RCT and appeared inadequate to predict treatment response in our patient cohort. Conclusion This prospective exploratory study supports the hypothesis that MRI may be able to predict pCR of rectal cancers early during neoadjuvant RCT. Our data therefore provide a useful template to tailor future MR-guided adaptive treatment concepts.
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Affiliation(s)
- T Bostel
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. .,Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - C Dreher
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - D Wollschläger
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Obere Zahlbacher Strasse 69, 55131, Mainz, Germany
| | - A Mayer
- Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - F König
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Bickelhaupt
- Division of Medical Imaging and Radiology - Cancer Prevention, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Maximiliansplatz 2, 91054, Erlangen, Germany
| | - H P Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - P E Huber
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - F Sterzing
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Radiation Oncology, Kempten Clinic, Robert-Weixler-Strasse 50, 87439, Kempten, Germany
| | - P Bäumer
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,dia.log, Altoetting Center for Radiology, Vinzenz-von-Paul-Strasse 10, 84503, Altoetting, Germany
| | - J Debus
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - N H Nicolay
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. .,Department of Radiation Oncology, University of Freiburg Medical Center, Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
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13
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Paech D, Kuder TA, Roßmanith C, Griebe M, Eisele P, Platten M, Ladd ME, Schlemmer HP, Gass A, Szabo K. What remains after transient global amnesia (TGA)? An ultra-high field 7 T magnetic resonance imaging study of the hippocampus. Eur J Neurol 2019; 27:406-409. [PMID: 31573112 DOI: 10.1111/ene.14099] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 04/29/2019] [Revised: 08/10/2019] [Accepted: 09/27/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to study whether ultra-high field 7 T magnetic resonance imaging (MRI) can demonstrate chronic focal defects in the hippocampus corresponding to the former acute diffusion-weighted imaging (DWI) lesions and to assess chronic T2-hyperintense hippocampal lesion load in transient global amnesia (TGA) patients. METHODS Follow-up of 7 T MRI of the hippocampus was performed in 13 patients with documented hippocampal DWI lesions (detected via 3 T MRI) after acute TGA. The location of the DWI lesions was transformed to 7 T T2 images after data co-registration. Additionally, the T2-hyperintense lesion load was estimated in each patient and compared with that of 13 healthy controls. RESULTS Magnetic resonance imaging (7 T) was performed after a median of 4 months. No structural abnormality at the site of the previous TGA lesion was observed in any case. None of the controls showed DWI lesions. There was no significant difference between patients and controls concerning the number (P = 0.67) or volume (P = 0.45) of T2-hyperintense hippocampal lesions. CONCLUSIONS Diffusion-weighted imaging lesions in patients with TGA do not provoke any visible sequelae and do not result in hippocampal cavities. The occurrence of incidental hippocampal T2 lesions after TGA is not more frequent than in controls.
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Affiliation(s)
- D Paech
- Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - T A Kuder
- Medical Physics in Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - C Roßmanith
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Griebe
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - P Eisele
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Platten
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M E Ladd
- Medical Physics in Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany.,Faculty of Physics and Astronomy and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - H-P Schlemmer
- Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - A Gass
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - K Szabo
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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14
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Ziener CH, Kampf T, Schlemmer HP, Buschle LR. Spin echoes: full numerical solution and breakdown of approximative solutions. J Phys Condens Matter 2019; 31:155101. [PMID: 30641507 DOI: 10.1088/1361-648x/aafe21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The spin echo signal from vessels in Krogh's capillary model as well in the random distribution vessel model are studied by numerically solving the Bloch-Torrey equation. A comparison is made with the Gaussian local phase approximation, the Gaussian phase approximation and the strong-collision approximation. Differences between the Gaussian local phase approximation and the Gaussian phase approximation are explained. In the intermediate diffusion regime, the full numerical solution shows oscillations which are absent in any of the approximate solutions. In the limit of large diffusion coefficients, where the approximations become exact, the signal shows a linear-exponential decay governed by a single parameter. The features of the exact numerical solution can be explained by an analytically solvable discrete two-level model. There is a one-to-one correspondence between the different diffusion regimes and the three cases of the damped harmonic oscillator.
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Affiliation(s)
- C H Ziener
- German Cancer Research Center DKFZ, E010 Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. University Hospital Heidelberg, Neuroradiology, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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15
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Schlemmer HP. [New reserach center for imaging and radiation oncology at the German Cancer Research Center in Heidelberg : Interview with Prof. Dr. med. Dipl. Phys. Heinz-Peter Schlemmer]. Radiologe 2019; 59:467-470. [PMID: 30859235 DOI: 10.1007/s00117-019-0510-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H-P Schlemmer
- Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
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16
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Buschle LR, Kurz FT, Kampf T, Schlemmer HP, Ziener CH. Spin dephasing around randomly distributed vessels. J Magn Reson 2019; 299:12-20. [PMID: 30529850 DOI: 10.1016/j.jmr.2018.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 06/09/2023]
Abstract
We analyze the gradient echo signal in the presence of blood vessel networks. Both, diffusion and susceptibility effects are analytically emphasized within the Bloch-Torrey equation. Solving this equation, we present the first exact description of the local magnetization around a single vessel. This allows us to deduce the gradient echo signal of parallel vessels randomly distributed in a plane, which is valid for arbitrary mean vessel diameters in the range of physiological relevant blood volume fractions. Thus, the results are potentially relevant for gradient echo measurements of blood vessel networks with arbitrary vessel size.
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Affiliation(s)
- L R Buschle
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; Heidelberg University, Faculty of Physics and Astronomy, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany
| | - F T Kurz
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Department of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany; Würzburg University Hospital, Department of Neuroradiology, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - H P Schlemmer
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - C H Ziener
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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17
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Ziener CH, Kampf T, Kurz FT, Schlemmer HP, Buschle LR. Pseudo-diffusion effects in lung MRI. J Magn Reson 2019; 299:1-11. [PMID: 30529849 DOI: 10.1016/j.jmr.2018.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 06/09/2023]
Abstract
Magnetic resonance imaging of lung tissue is strongly influenced by susceptibility effects between spin-bearing water molecules and air-filled alveoli. The measured lineshape, however, also depends on the interplay between susceptibility effects and blood-flow around alveoli that can be approximated as pseudo-diffusion. Both effects are quantitatively described by the Bloch-Torrey-equation, which was so far only solved for dephasing on the alveolar surface. In this work, we extend this model to the whole range of physiological relevant air volume fractions. The results agree very well with in vivo measurements in human lung tissue.
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Affiliation(s)
- C H Ziener
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Department of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany; Würzburg University Hospital, Department of Neuroradiology, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - F T Kurz
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - H P Schlemmer
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - L R Buschle
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; Heidelberg University, Faculty of Physics and Astronomy, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany.
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18
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Bonekamp D, Wolf MB, Roethke MC, Pahernik S, Hadaschik BA, Hatiboglu G, Kuru TH, Popeneciu IV, Chin JL, Billia M, Relle J, Hafron J, Nandalur KR, Staruch RM, Burtnyk M, Hohenfellner M, Schlemmer HP. Twelve-month prostate volume reduction after MRI-guided transurethral ultrasound ablation of the prostate. Eur Radiol 2018; 29:299-308. [PMID: 29943185 DOI: 10.1007/s00330-018-5584-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 01/08/2018] [Revised: 05/08/2018] [Accepted: 06/01/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To quantitatively assess 12-month prostate volume (PV) reduction based on T2-weighted MRI and immediate post-treatment contrast-enhanced MRI non-perfused volume (NPV), and to compare measurements with predictions of acute and delayed ablation volumes based on MR-thermometry (MR-t), in a central radiology review of the Phase I clinical trial of MRI-guided transurethral ultrasound ablation (TULSA) in patients with localized prostate cancer. MATERIALS AND METHODS Treatment day MRI and 12-month follow-up MRI and biopsy were available for central radiology review in 29 of 30 patients from the published institutional review board-approved, prospective, multi-centre, single-arm Phase I clinical trial of TULSA. Viable PV at 12 months was measured as the remaining PV on T2-weighted MRI, less 12-month NPV, scaled by the fraction of fibrosis in 12-month biopsy cores. Reduction of viable PV was compared to predictions based on the fraction of the prostate covered by the MR-t derived acute thermal ablation volume (ATAV, 55°C isotherm), delayed thermal ablation volume (DTAV, 240 cumulative equivalent minutes at 43°C thermal dose isocontour) and treatment-day NPV. We also report linear and volumetric comparisons between metrics. RESULTS After TULSA, the median 12-month reduction in viable PV was 88%. DTAV predicted a reduction of 90%. Treatment day NPV predicted only 53% volume reduction, and underestimated ATAV and DTAV by 36% and 51%. CONCLUSION Quantitative volumetry of the TULSA phase I MR and biopsy data identifies DTAV (240 CEM43 thermal dose boundary) as a useful predictor of viable prostate tissue reduction at 12 months. Immediate post-treatment NPV underestimates tissue ablation. KEY POINTS • MRI-guided transurethral ultrasound ablation (TULSA) achieved an 88% reduction of viable prostate tissue volume at 12 months, in excellent agreement with expectation from thermal dose calculations. • Non-perfused volume on immediate post-treatment contrast-enhanced MRI represents only 64% of the acute thermal ablation volume (ATAV), and reports only 60% (53% instead of 88% achieved) of the reduction in viable prostate tissue volume at 12 months. • MR-thermometry-based predictions of 12-month prostate volume reduction based on 240 cumulative equivalent minute thermal dose volume are in excellent agreement with reduction in viable prostate tissue volume measured on pre- and 12-month post-treatment T2w-MRI.
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Affiliation(s)
- David Bonekamp
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - M B Wolf
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - M C Roethke
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Pahernik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - B A Hadaschik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - G Hatiboglu
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - T H Kuru
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - I V Popeneciu
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - J L Chin
- Department of Urology, University of Western Ontario (UWO), London Health Sciences Center, Victoria Hospital, London, ON, Canada
| | - M Billia
- Department of Urology, University of Western Ontario (UWO), London Health Sciences Center, Victoria Hospital, London, ON, Canada
| | - J Relle
- Department of Urology, Beaumont Health System, Royal Oak, MI, USA
| | - J Hafron
- Department of Urology, Beaumont Health System, Royal Oak, MI, USA
| | - K R Nandalur
- Department of Radiology, Beaumont Health System, Royal Oak, MI, USA
| | - R M Staruch
- Clinical Science, Profound Medical Inc., Toronto, ON, Canada
| | - M Burtnyk
- Clinical Science, Profound Medical Inc., Toronto, ON, Canada
| | - M Hohenfellner
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - H-P Schlemmer
- Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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19
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Franz T, von Hardenberg J, Blana A, Cash H, Baumunk D, Salomon G, Hadaschik B, Henkel T, Herrmann J, Kahmann F, Köhrmann KU, Köllermann J, Kruck S, Liehr UB, Machtens S, Peters I, Radtke JP, Roosen A, Schlemmer HP, Sentker L, Wendler JJ, Witzsch U, Stolzenburg JU, Schostak M, Ganzer R. [MRI/TRUS fusion-guided prostate biopsy : Value in the context of focal therapy]. Urologe A 2017; 56:208-216. [PMID: 27844131 DOI: 10.1007/s00120-016-0268-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Several systems for MRI/TRUS fusion-guided biopsy of the prostate are commercially available. Many studies have shown superiority of fusion systems for tumor detection and diagnostic quality compared to random biopsy. The benefit of fusion systems in focal therapy of prostate cancer (PC) is less clear. OBJECTIVES Critical considerations of fusion systems for planning and monitoring of focal therapy of PC were investigated. MATERIALS AND METHODS A systematic literature review of available fusion systems for the period 2013-5/2016 was performed. A checklist of technical details, suitability for special anatomic situations and suitability for focal therapy was established by the German working group for focal therapy (Arbeitskreis fokale und Mikrotherapie). RESULTS Eight fusion systems were considered (Artemis™, BioJet, BiopSee®, iSR´obot™ Mona Lisa, Hitachi HI-RVS, UroNav and Urostation®). Differences were found for biopsy mode (transrectal, perineal, both), fusion mode (elastic or rigid), navigation (image-based, electromagnetic sensor-based or mechanical sensor-based) and space requirements. DISCUSSION Several consensus groups recommend fusion systems for focal therapy. Useful features are "needle tracking" and compatibility between fusion system and treatment device (available for Artemis™, BiopSee® and Urostation® with Focal One®; BiopSee®, Hitachi HI-RVS with NanoKnife®; BioJet, BiopSee® with cryoablation, brachytherapy). CONCLUSIONS There are a few studies for treatment planning. However, studies on treatment monitoring after focal therapy are missing.
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Affiliation(s)
- T Franz
- Klinik und Poliklinik für Urologie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - J von Hardenberg
- Klinik für Urologie, Universitätsmedizin Mannheim der Universität Heidelberg, Mannheim, Deutschland
| | - A Blana
- Klinik für Urologie und Kinderurologie, Klinikum Fürth, Fürth, Deutschland
| | - H Cash
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - D Baumunk
- Universitätsklinik für Urologie und Kinderurologie, Universität Magdeburg, Magdeburg, Deutschland
| | - G Salomon
- Martini-Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - B Hadaschik
- Urologische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T Henkel
- Praxis Urologie Britz, Berlin, Deutschland
| | - J Herrmann
- Klinik für Urologie, Universitätsmedizin Mannheim der Universität Heidelberg, Mannheim, Deutschland
| | - F Kahmann
- Praxis Urologie Britz, Berlin, Deutschland
| | - K-U Köhrmann
- Abteilung für Urologie, Theresienkrankenhaus Mannheim, Mannheim, Deutschland
| | - J Köllermann
- Institut für Pathologie, Sana Klinikum Offenbach, Offenbach, Deutschland
| | - S Kruck
- Klinik für Urologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - U-B Liehr
- Universitätsklinik für Urologie und Kinderurologie, Universität Magdeburg, Magdeburg, Deutschland
| | - S Machtens
- Klinik für Urologie, Marien-Krankenhaus, Bergisch Gladbach, Deutschland
| | - I Peters
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - J P Radtke
- Urologische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - A Roosen
- Klinik für Urologie, Augusta-Kranken-Anstalt GmbH, Bochum, Deutschland
| | - H-P Schlemmer
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum Heidelberg, Heidelberg, Deutschland
| | - L Sentker
- Zentrum f. Urologie Sinsheim/Walldorf/Wiesloch, Sinsheim, Deutschland
| | - J J Wendler
- Universitätsklinik für Urologie und Kinderurologie, Universität Magdeburg, Magdeburg, Deutschland
| | - U Witzsch
- Klinik für Urologie und Kinderurologie, Klinikum Nordwest, Frankfurt am Main, Deutschland
| | - J-U Stolzenburg
- Klinik und Poliklinik für Urologie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - M Schostak
- Universitätsklinik für Urologie und Kinderurologie, Universität Magdeburg, Magdeburg, Deutschland
| | - R Ganzer
- Klinik und Poliklinik für Urologie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland.
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20
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Kesch C, Radtke JP, Distler F, Boxler S, Klein T, Hüttenbrink C, Hees K, Roth W, Roethke M, Schlemmer HP, Hohenfellner M, Hadaschik BA. [Multiparametric MRI and MRI-TRUS fusion biopsy in patients with prior negative prostate biopsy]. Urologe A 2017; 55:1071-7. [PMID: 27168038 DOI: 10.1007/s00120-016-0093-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Multiparametric MRI (mpMRI) plays an increasingly important role in prostate cancer (PCa) diagnostics and is recommended in men with previously negative TRUS biopsy. The optimal biopsy method after mpMRI is under discussion. OBJECTIVE Prospective, PIRADS- and START-conform analysis of the relevance of mpMRI and MRI-TRUS fusion biopsy in patients with prior negative TRUS biopsy and comparison of the detection rates of fusion-targeted biopsies (tB) and systematic transperineal saturation biopsies (sB). MATERIALS AND METHODS Between 10/2012 and 09/2015, 287 patients with prior negative TRUS biopsy underwent mpMRI and software-assisted, rigid MRI-TRUS fusion biopsy. In addition to and strictly separated from sB (median cores n = 24), tB (median cores per patient n = 4, per lesion n = 3) were performed in case of suspicious MRI lesions (PIRADS ≥ 2). Both biopsy methods were compared by using McNemar's test. RESULTS Of the 287 patients, 148 (52 %) had positive biopsies. Of these, 108/287 (38 %) had significant PCa (Gleason Score [GS] = 3 + 3 and PSA ≥ 10 ng/ml or GS ≥ 3 + 4) and again 43/287 (15 %) had a GS ≥ 4 + 3 PCa. sB failed to diagnose 8/148 PCa (5.4 %) and 6/108 significant PCa (5.5 %), whereas tB failed to diagnose 48 (32.4 %) PCa (p < 0.0001) and 22 (20.4 %) significant PCa (p = 0.0046). Of the PCa missed by tB, 11 had a GS ≥ 3 + 4 and 5 of these a GS = 4 + 3. On a per patient basis, MRI failed to detect 5 significant PCa, whereby 17 of the significant PCa were missed by fusion-targeted cores alone. CONCLUSIONS In men with unsuspicious MRI (PIRADS < 3), there is a 11 % risk of significant PCa. In case of suspicious MRI lesions, the combination of both biopsy approaches offers maximum tumor detection.
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Affiliation(s)
- C Kesch
- Urologische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
| | - J P Radtke
- Urologische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.,Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - F Distler
- Urologische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - S Boxler
- Universitätsklinik für Urologie, Universität Bern, Bern, Schweiz
| | - T Klein
- Urologische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - C Hüttenbrink
- Urologische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - K Hees
- Institut für Medizinische Biometrie und Informatik, Heidelberg, Deutschland
| | - W Roth
- Pathologisches Institut der Universität Heidelberg, Universität Heidelberg, Heidelberg, Deutschland
| | - M Roethke
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - H P Schlemmer
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - M Hohenfellner
- Urologische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - B A Hadaschik
- Urologische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
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21
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Buschle LR, Kurz FT, Kampf T, Wagner WL, Duerr J, Stiller W, Konietzke P, Wünnemann F, Mall MA, Wielpütz MO, Schlemmer HP, Ziener CH. Dephasing and diffusion on the alveolar surface. Phys Rev E 2017; 95:022415. [PMID: 28297921 DOI: 10.1103/physreve.95.022415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Indexed: 06/06/2023]
Abstract
We propose a surface model of spin dephasing in lung tissue that includes both susceptibility and diffusion effects to provide a closed-form solution of the Bloch-Torrey equation on the alveolar surface. The nonlocal susceptibility effects of the model are validated against numerical simulations of spin dephasing in a realistic lung tissue geometry acquired from synchotron-based μCT data sets of mouse lung tissue, and against simulations in the well-known Wigner-Seitz model geometry. The free induction decay is obtained in dependence on microscopic tissue parameters and agrees very well with in vivo lung measurements at 1.5 Tesla to allow a quantification of the local mean alveolar radius. Our results are therefore potentially relevant for the clinical diagnosis and therapy of pulmonary diseases.
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Affiliation(s)
- L R Buschle
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - F T Kurz
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Department of Experimental Physics 5, Am Hubland, 97074 Würzburg, Germany
| | - W L Wagner
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - J Duerr
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- University of Heidelberg, Department of Translational Pulmonology, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - W Stiller
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - P Konietzke
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - F Wünnemann
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - M A Mall
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- University of Heidelberg, Department of Translational Pulmonology, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - M O Wielpütz
- University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - H P Schlemmer
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - C H Ziener
- German Cancer Research Center - DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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22
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Freitag MT, Bickelhaupt S, Ziener C, Meier-Hein K, Radtke JP, Mosebach J, Kuder TA, Schlemmer HP, Laun FB. [Selected clinically established and scientific techniques of diffusion-weighted MRI. In the context of imaging in oncology]. Radiologe 2016; 56:137-47. [PMID: 26801187 DOI: 10.1007/s00117-015-0066-6] [Citation(s) in RCA: 16] [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] [Indexed: 01/26/2023]
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) technique that was established in the clinical routine primarily for the detection of brain ischemia. In the past 15 years its clinical use has been extended to oncological radiology, as tumor and metastases can be depicted in DWI due to their hypercellular nature. PRINCIPLES The basis of DWI is the Stejskal-Tanner experiment. The diffusion properties of tissue can be visualized after acquisition of at least two diffusion-weighted series using echo planar imaging and a specific sequence of gradient pulses. CLINICAL APPLICATIONS The use of DWI in prostate MRI was reported to be one of the first established applications that found its way into internationally recognized clinical guidelines of the European Society of Urological Radiology (ESUR) and the prostate imaging reporting and data system (PI-RADS) scale. Due to recently reported high specificity and negative predictive values of 94% and 92%, respectively, its regular use for breast MRI is expected in the near future. Furthermore, DWI can also reliably be used for whole-body imaging in patients with multiple myeloma or for measuring the extent of bone metastases. OUTLOOK New techniques in DWI, such as intravoxel incoherent motion imaging, diffusion kurtosis imaging and histogram-based analyses represent promising approaches to achieve a more quantitative evaluation for tumor detection and therapy response.
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Affiliation(s)
- M T Freitag
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
| | - S Bickelhaupt
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - C Ziener
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - K Meier-Hein
- Abteilung für medizinische Informatik, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - J P Radtke
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.,Abteilung für Urologie, Universitätsklinik Heidelberg, Heidelberg, Deutschland
| | - J Mosebach
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - T-A Kuder
- Abteilung für Medizinische Physik in der Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - H-P Schlemmer
- Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - F B Laun
- Abteilung für Medizinische Physik in der Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
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23
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Zondervan PJ, Wagstaff PGK, Desai MM, de Bruin DM, Fraga AF, Hadaschik BA, Köllermann J, Liehr UB, Pahernik SA, Schlemmer HP, Wendler JJ, Algaba F, de la Rosette JJMCH, Laguna Pes MP. Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project. World J Urol 2016; 34:1657-1665. [PMID: 27106492 PMCID: PMC5114314 DOI: 10.1007/s00345-016-1828-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 02/26/2016] [Accepted: 04/04/2016] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To establish consensus on follow-up (FU) after focal therapy (FT) in renal masses. To formulate recommendations to aid in clinical practice and research. METHODS Key topics and questions for consensus were identified from a systematic literature research. A Web-based questionnaire was distributed among participants selected based on their contribution to the literature and/or known expertise. Three rounds according to the Delphi method were performed online. Final discussion was conducted during the "8th International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer" among an international multidisciplinary expert panel. RESULTS Sixty-two participants completed all three rounds of the online questionnaire. The panel recommended a minimum follow-up of 5 years, preferably extended to 10 years. The first FU was recommended at 3 months, with at least two imaging studies in the first year. Imaging was recommended biannually during the second year and annually thereafter. The panel recommended FU by means of CT scan with slice thickness ≤3 mm (at least three phases with excretory phase if suspicion of collecting system involvement) or mpMRI. Annual checkup for pulmonary metastasis by CT thorax was advised. Outside study protocols, biopsy during follow-up should only be performed in case of suspicion of residual/persistent disease or radiological recurrence. CONCLUSIONS The consensus led to clear FU recommendations after FT of renal masses supported by a multidisciplinary expert panel. In spite of the low level of evidence, these recommendations can guide clinicians and create uniformity in the follow-up practice and for clinical research purposes.
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Affiliation(s)
- P J Zondervan
- Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands.
| | - P G K Wagstaff
- Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands
| | - M M Desai
- Department of Urology, Keck School of Medicine USC, Los Angeles, CA, USA
| | - D M de Bruin
- Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands
- Department of Biomedical Engineering and Physics, AMC University Hospital, Amsterdam, The Netherlands
| | - A F Fraga
- Department of Urology, Centro Hospitalar do Porto, Porto, Portugal
| | - B A Hadaschik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - J Köllermann
- Department of Pathology, Sana Klinikum Offenbach, Offenbach, Germany
| | - U B Liehr
- Department of Urology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - S A Pahernik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - H P Schlemmer
- Department of Urology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - J J Wendler
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - F Algaba
- Department of Pathology, Fundació Puigvert, Barcelona, Spain
| | - J J M C H de la Rosette
- Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands
| | - M P Laguna Pes
- Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands
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24
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Kurz FT, Buschle LR, Kampf T, Zhang K, Schlemmer HP, Heiland S, Bendszus M, Ziener CH. Spin dephasing in a magnetic dipole field around large capillaries: Approximative and exact results. J Magn Reson 2016; 273:83-97. [PMID: 27794269 DOI: 10.1016/j.jmr.2016.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 06/06/2023]
Abstract
We present an analytical solution of the Bloch-Torrey equation for local spin dephasing in the magnetic dipole field around a capillary and for ensembles of capillaries, and adapt this solution for the study of spin dephasing around large capillaries. In addition, we provide a rigorous mathematical derivation of the slow diffusion approximation for the spin-bearing particles that is used in this regime. We further show that, in analogy to the local magnetization, the transverse magnetization of one MR imaging voxel in the regime of static dephasing (where diffusion effects are not considered) is merely the first term of a series expansion that constitutes the signal in the slow diffusion approximation. Theoretical results are in agreement with experimental data for capillaries in rat muscle at 7T.
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Affiliation(s)
- F T Kurz
- Heidelberg University Hospital, INF 400, D-69120 Heidelberg, Germany; German Cancer Research Center, INF 280, D-69120 Heidelberg, Germany.
| | - L R Buschle
- German Cancer Research Center, INF 280, D-69120 Heidelberg, Germany
| | - T Kampf
- University of Würzburg, Am Hubland, D-97074 Würzburg, Germany
| | - K Zhang
- German Cancer Research Center, INF 280, D-69120 Heidelberg, Germany
| | - H P Schlemmer
- German Cancer Research Center, INF 280, D-69120 Heidelberg, Germany
| | - S Heiland
- Heidelberg University Hospital, INF 400, D-69120 Heidelberg, Germany
| | - M Bendszus
- Heidelberg University Hospital, INF 400, D-69120 Heidelberg, Germany
| | - C H Ziener
- Heidelberg University Hospital, INF 400, D-69120 Heidelberg, Germany; German Cancer Research Center, INF 280, D-69120 Heidelberg, Germany
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25
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Giesel FL, Sterzing F, Schlemmer HP, Holland-Letz T, Mier W, Rius M, Afshar-Oromieh A, Kopka K, Debus J, Haberkorn U, Kratochwil C. Intra-individual comparison of (68)Ga-PSMA-11-PET/CT and multi-parametric MR for imaging of primary prostate cancer. Eur J Nucl Med Mol Imaging 2016; 43:1400-6. [PMID: 26971788 PMCID: PMC4906063 DOI: 10.1007/s00259-016-3346-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [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: 11/17/2015] [Accepted: 02/16/2016] [Indexed: 12/01/2022]
Abstract
Purpose Multi-parametric magnetic resonance imaging (MP-MRI) is currently the most comprehensive work up for non-invasive primary tumor staging of prostate cancer (PCa). Prostate-specific membrane antigen (PSMA)-Positron emission tomography–computed tomography (PET/CT) is presented to be a highly promising new technique for N- and M-staging in recurrent PCa-patients. The actual investigation analyses the potential of 68Ga-PSMA11-PET/CT to assess the extent of primary prostate cancer by intra-individual comparison to MP-MRI. Methods In a retrospective study, ten patients with primary PCa underwent MP-MRI and PSMA-PET/CT for initial staging. All tumors were proven histopathological by biopsy. Image analysis was done in a quantitative (SUVmax) and qualitative (blinded read) fashion based on PI-RADS. The PI-RADS schema was then translated into a 3D-matrix and the euclidian distance of this coordinate system was used to quantify the extend of agreement. Results Both MP-MRI and PSMA-PET/CT presented a good allocation of the PCa, which was also in concordance to the tumor location validated in eight-segment resolution by biopsy. An Isocontour of 50 % SUVmax in PSMA-PET resulted in visually concordant tumor extension in comparison to MP-MRI (T2w and DWI). For 89.4 % of sections containing a tumor according to MP-MRI, the tumor was also identified in total or near-total agreement (euclidian distance ≤1) by PSMA-PET. Vice versa for 96.8 % of the sections identified as tumor bearing by PSMA-PET the tumor was also found in total or near-total agreement by MP-MRI. Conclusions PSMA-PET/CT and MP-MRI correlated well with regard to tumor allocation in patients with a high pre-test probability for large tumors. Further research will be needed to evaluate its value in challenging situation such as prostatitis or after repeated negative biopsies.
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Affiliation(s)
- F L Giesel
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany.
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany.
| | - F Sterzing
- Department of RadioOncology, University Hospital Heidelberg, Heidelberg, Germany
| | - H P Schlemmer
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Holland-Letz
- Department of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - W Mier
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - M Rius
- Institute of Transuranium Elements, European Commission (EC), Karlsruhe, Germany
| | - A Afshar-Oromieh
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany
| | - K Kopka
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J Debus
- Department of RadioOncology, University Hospital Heidelberg, Heidelberg, Germany
| | - U Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany
| | - C Kratochwil
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany
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Simons D, Kachelrieß M, Schlemmer HP. Dual-energy CT in oncology: technical principles and clinical prospects. Cancer Imaging 2015. [PMCID: PMC4601760 DOI: 10.1186/1470-7330-15-s1-p51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Glemser PA, Krauskopf A, Simons D, Schlemmer HP, Yen K. [Clinical forensic imaging. Detection and documentation of internal injuries in living victims of violence]. Radiologe 2015; 55:901-14. [PMID: 26443330 DOI: 10.1007/s00117-015-0021-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
External examination of the body surface with documentation of all visible findings can still be regarded as the status quo of clinical forensic injury assessment. It is obvious that internal findings cannot be detected using this technique. For obtaining such findings accessible well-established radiological techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI) should be used. Especially MRI with no damaging radiation exposure for the examined person allows the detection of internal soft tissue and organ damage and offers a great potential regarding new techniques for allowing insights into tissue composition and function. Furthermore, imaging data collected in clinical institutions before the patient was transferred to the department of legal medicine will play a major role in the future. Although these data were obtained based on a different approach, they provide excellent and recent information on injuries in the respective (current) case und can therefore be of high value for the forensic expertise.
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Affiliation(s)
- P A Glemser
- Abteilung Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
| | - A Krauskopf
- Institut für Rechtsmedizin und Verkehrsmedizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - D Simons
- Abteilung Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - H P Schlemmer
- Abteilung Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - K Yen
- Institut für Rechtsmedizin und Verkehrsmedizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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Tesdorff J, Simons D, Schlemmer HP. Structured reporting of metastatic disease for improving communication in comprehensive cancer centers- a feasibility study. Cancer Imaging 2015. [PMCID: PMC4601120 DOI: 10.1186/1470-7330-15-s1-p30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Radtke JP, Schwab C, Wolf MB, Freitag MT, Alt C, Kesch C, Popeneciu IV, Huettenbrink C, Bergstraesser-Gasch C, Klein T, Duensing S, Roth S, Schlemmer HP, Roethke M, Hohenfellner M, Hadaschik B. Multiparametric magnetic resonance tomography and MRI/TRUS-fusion-biopsy for index lesion detection: correlation with radical prostatectomy specimen. Cancer Imaging 2015. [PMCID: PMC4601104 DOI: 10.1186/1470-7330-15-s1-s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Mosebach J, Sachpekidis C, Hillengass J, Haberkorn U, Dimitrakopoulou-Strauss A, Schlemmer HP, Delorme S. Comparison of functional imaging in multiple myeloma patients: Indication for hybrid-imaging with PET/MRI? Cancer Imaging 2015. [PMCID: PMC4601840 DOI: 10.1186/1470-7330-15-s1-s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hansen J, Wielpütz MO, Pahn G, Schlemmer HP, Kauczor HU, Stiller W. Quantitative dual-energy computed tomography (DECT) imaging: Evaluation of system performance regarding iodine quantification accuracy. Pneumologie 2015. [DOI: 10.1055/s-0035-1556644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wolf MB, Roethke M, Pahernik S, Hadaschik B, Kuru T, Popeneciu IV, Hatiboglu G, Chin J, Billia M, Relle J, Hafron J, Nandalur K, Burtnyk M, Schlemmer HP. Localised prostate cancer treated with MRI-guided transurethral ultrasound ablation: phase I trial results. Cancer Imaging 2014. [PMCID: PMC4242781 DOI: 10.1186/1470-7330-14-s1-s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Hillengass J, Stoll J, Zechmann CM, Kunz C, Wagner B, Heiss C, Sumkauskaite M, Moehler TM, Schlemmer HP, Goldschmidt H, Delorme S. The application of Gadopentate-Dimeneglumin has no impact on progression free and overall survival as well as renal function in patients with monoclonal plasma cell disorders if general precautions are taken. Eur Radiol 2014; 25:745-50. [PMID: 25358594 DOI: 10.1007/s00330-014-3458-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 08/22/2014] [Accepted: 09/29/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The current analysis investigated the prognostic significance of gadopentetate dimeglumine on survival and renal function in patients with monoclonal plasma cell disorders. METHODS In this study 263 patients who had received gadopentetate dimeglumine within a prospective trial investigating dynamic contrast-enhanced magnetic resonance imaging (MRI) were compared with 335 patients who had undergone routine, unenhanced MRI. RESULTS We found no significant prognostic impact of the application of contrast agent on progression-free survival in patients with either monoclonal gammopathy of undetermined significance, smouldering or symptomatic myeloma and no significant prognostic impact on overall survival in patients with symptomatic myeloma. Since renal impairment is a frequent complication of myeloma, and decreased renal function is associated with a higher risk of complications in patients receiving contrast agents, we evaluated the impact of contrast agent on renal function after 1 year. In the present analysis the only significant adverse impact on kidney function occurred in symptomatic myeloma patients who already had impaired renal parameters at baseline. Here, the renal function did not recover during therapy, whereas it did so in patients with normal or only slightly impaired renal function. CONCLUSION If general recommendations are adhered to, gadopentetate dimeglumine can be safely applied in patients with monoclonal plasma cell disease.
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Affiliation(s)
- J Hillengass
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany,
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Fard N, Rezaei N, Emmami G, Saffari A, Golriz M, Mehrabi A, Schlemmer HP, Delorme S. Evaluation of hepatic flow changes in early stages after extended hepatectomy by contrast enhanced ultrasound. Cancer Imaging 2014. [PMCID: PMC4242768 DOI: 10.1186/1470-7330-14-s1-p35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- N Fard
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
| | - N Rezaei
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
| | - G Emmami
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
| | - A Saffari
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
| | - M Golriz
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
| | - A Mehrabi
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
| | - H-P Schlemmer
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
| | - S Delorme
- German Cancer Research Center, Department of Surgery, Heidelberg University, Germany
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Mosebach J, Sachpekidis C, Fard N, Wilhelm T, Wilhelm M, Hillengass J, Dimitrakopoulou-Strauss A, Schlemmer HP, Delorme S. Characterization of multiple myeloma osseous lesions and diffuse infiltration pattern by 18F-FDG-PET/CT, static MRI and diffusion-weighted MR Imaging (DWI-MRI): a comparative multimodality imaging study. Cancer Imaging 2014. [PMCID: PMC4242677 DOI: 10.1186/1470-7330-14-s1-p33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kurz FT, Schlemmer HP, Heiland S, Bendszus M, Ziener CH. Quantitative magnetic resonance imaging of microvascular changes in KHT sarcoma. Cancer Imaging 2014. [PMCID: PMC4242431 DOI: 10.1186/1470-7330-14-s1-p13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sedlaczek O, Wiedemann C, Gruellich C, Klingmüller U, Kauczor HU, Schlemmer HP. Alteration of MR-DWI/ADC before and 24h after induction of chemotherapy in patients with lung cancer. Cancer Imaging 2014. [PMCID: PMC4242758 DOI: 10.1186/1470-7330-14-s1-p34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Uhrig M, Simons D, Ganten M, Hassel J, Schlemmer HP. Dual-energy CT for therapy monitoring: histogram analyses of iodine maps reveal typical pattern of enhancement. Cancer Imaging 2014. [PMCID: PMC4241994 DOI: 10.1186/1470-7330-14-s1-p17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Maier-Hein L, Groch A, Bartoli A, Bodenstedt S, Boissonnat G, Chang PL, Clancy NT, Elson DS, Haase S, Heim E, Hornegger J, Jannin P, Kenngott H, Kilgus T, Müller-Stich B, Oladokun D, Röhl S, Dos Santos TR, Schlemmer HP, Seitel A, Speidel S, Wagner M, Stoyanov D. Comparative validation of single-shot optical techniques for laparoscopic 3-D surface reconstruction. IEEE Trans Med Imaging 2014; 33:1913-1930. [PMID: 24876109 DOI: 10.1109/tmi.2014.2325607] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Intra-operative imaging techniques for obtaining the shape and morphology of soft-tissue surfaces in vivo are a key enabling technology for advanced surgical systems. Different optical techniques for 3-D surface reconstruction in laparoscopy have been proposed, however, so far no quantitative and comparative validation has been performed. Furthermore, robustness of the methods to clinically important factors like smoke or bleeding has not yet been assessed. To address these issues, we have formed a joint international initiative with the aim of validating different state-of-the-art passive and active reconstruction methods in a comparative manner. In this comprehensive in vitro study, we investigated reconstruction accuracy using different organs with various shape and texture and also tested reconstruction robustness with respect to a number of factors like the pose of the endoscope as well as the amount of blood or smoke present in the scene. The study suggests complementary advantages of the different techniques with respect to accuracy, robustness, point density, hardware complexity and computation time. While reconstruction accuracy under ideal conditions was generally high, robustness is a remaining issue to be addressed. Future work should include sensor fusion and in vivo validation studies in a specific clinical context. To trigger further research in surface reconstruction, stereoscopic data of the study will be made publically available at www.open-CAS.com upon publication of the paper.
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Kickingereder P, Sahm F, Wiestler B, Roethke M, Heiland S, Schlemmer HP, Wick W, von Deimling A, Bendszus M, Radbruch A. Evaluation of microvascular permeability with dynamic contrast-enhanced MRI for the differentiation of primary CNS lymphoma and glioblastoma: radiologic-pathologic correlation. AJNR Am J Neuroradiol 2014; 35:1503-8. [PMID: 24722313 DOI: 10.3174/ajnr.a3915] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE Dynamic contrast-enhanced MR imaging can provide in vivo assessment of the microvasculature in intracranial tumors. The aim of the present study was to evaluate the diagnostic performance of dynamic contrast-enhanced MR imaging derived vascular permeability parameters, including the volume transfer constant, the volume of extravascular extracellular space, and the flux rate constant between the extravascular extracellular space and plasma, for the differentiation of primary CNS lymphoma and glioblastoma. MATERIALS AND METHODS Sixty glioblastomas and 11 primary central nervous system lymphomas were included. Pretreatment T1-weighted dynamic contrast-enhanced MR imaging with a 3D T1-weighted spoiled gradient-echo sequence was performed on a 3T MR imaging scanner. Perfusion parameters (volume transfer constant, the volume of extravascular extracellular space, and the flux rate constant) were measured on the basis of the Tofts-Kernmode model. The Mann-Whitney U test and receiver operating characteristic analysis were used to compare those parameters between primary central nervous system lymphoma and glioblastoma. Histopathologic correlation of dynamic contrast-enhanced MR imaging findings was performed by using reticulin staining and CD31 immunohistochemistry. RESULTS Median volume transfer constant and flux rate constant values were significantly higher in primary central nervous system lymphoma (0.145 ± 0.057 and 0.396 ± 0.088) than in glioblastoma (0.064 ± 0.021 and 0.230 ± 0.058) (P < .001, respectively). Median volume of extravascular extracellular space values did not differ significantly between primary central nervous system lymphoma (0.434 ± 0.165) and glioblastoma (0.319 ± 0.107). On receiver operating characteristic analysis, volume transfer constant had the best discriminative value for differentiating primary central nervous system lymphoma and glioblastoma (threshold, 0.093; sensitivity, 90.9%; specificity, 95.0%). Histopathologic evaluation revealed intact vascular integrity in glioblastoma despite endothelial proliferation, whereas primary central nervous system lymphoma demonstrated destroyed vessel architecture, thereby promoting vascular disintegrity. CONCLUSIONS Primary central nervous system lymphoma demonstrated significantly higher volume transfer constant and flux rate constant values compared with glioblastoma, implying a higher vascular permeability in primary central nervous system lymphoma. These findings confirm initial observations from perfusion CT and dynamic contrast-enhanced MR imaging studies, correlating with underlying histopathologic features, and may be useful in distinguishing primary central nervous system lymphoma from glioblastoma.
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Affiliation(s)
- P Kickingereder
- From the Departments of Neuroradiology (P.K., S.H., M.B., A.R.)
| | - F Sahm
- Neuropathology (F.S., A.v.D.)German Cancer Consortium, Clinical Cooperation Unit Neuropathology (F.S., A.v.D.)
| | - B Wiestler
- Neuro-oncology (B.W., W.W.), Neurology Clinic, University of Heidelberg Medical Center, Heidelberg, GermanyClinical Cooperation Unit Neuro-oncology (B.W., W.W.)
| | - M Roethke
- Department of Radiology (M.R., H.-P.S., A.R.), German Cancer Research Center, Heidelberg, Germany
| | - S Heiland
- From the Departments of Neuroradiology (P.K., S.H., M.B., A.R.)
| | - H-P Schlemmer
- Department of Radiology (M.R., H.-P.S., A.R.), German Cancer Research Center, Heidelberg, Germany
| | - W Wick
- Neuro-oncology (B.W., W.W.), Neurology Clinic, University of Heidelberg Medical Center, Heidelberg, GermanyClinical Cooperation Unit Neuro-oncology (B.W., W.W.)
| | - A von Deimling
- Neuropathology (F.S., A.v.D.)German Cancer Consortium, Clinical Cooperation Unit Neuropathology (F.S., A.v.D.)
| | - M Bendszus
- From the Departments of Neuroradiology (P.K., S.H., M.B., A.R.)
| | - A Radbruch
- From the Departments of Neuroradiology (P.K., S.H., M.B., A.R.)Department of Radiology (M.R., H.-P.S., A.R.), German Cancer Research Center, Heidelberg, Germany
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Antoch G, Barkhausen J, Düber C, Epsch R, Heindel W, Krombach G, Maintz D, Schlemmer HP, Schönberg S, Wigge P. White paper: clinical studies in radiology. ROFO-FORTSCHR RONTG 2014; 186:451-7. [PMID: 24764210 DOI: 10.1055/s-0034-1366394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- G Antoch
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Düsseldorf, Düsseldorf
| | - J Barkhausen
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum S-H Campus Lübeck, Lübeck
| | - C Düber
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Mainz, Mainz
| | | | - W Heindel
- Institut für Klinische Radiologie, Universitätsklinikum Münster, Münster
| | - G Krombach
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Giessen und Marburg GmbH, Giessen
| | - D Maintz
- Institut und Poliklinik für Radiologische Diagnostik, Uniklinik Köln, Köln
| | | | - S Schönberg
- Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Mannheim
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Radbruch A, Paech D, Windschuh J, Meissner JE, Schlemmer HP, Bachert P, Ladd M, Bendszus M. Three-dimensional Chemical Exchange Saturation Transfer (CEST) Imaging at 7 Tesla in Glioblastoma Patients. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kurz F, Kampf T, Heiland S, Bendszus M, Schlemmer HP, Ziener C. T2 Spin-Echo-Relaxation von magnetisch markierten Zellen und Eisenoxid-Agglomerationen. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kurz F, Kampf T, Heiland S, Bendszus M, Schlemmer HP, Ziener C. Variation der CPMG Inter-Echo-Zeit und Quantifizierung von Kapillardurchmesser in Muskelgewebe. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Simons D, Uhrig M, Sassenberg A, Breithaupt M, Berger M, Yen K, Schlemmer HP. Experimentelle 7 Tesla MRT basierte innovative Blutungsdetektion in der Rechtsmedizin. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kueres R, Flach B, Kuntz J, Schlemmer HP, Kachelrieß M, Bartling S. Entwicklung der 4D (3D + Zeit) Interventionsführung mittels Kegelstrahl-CT für Organbereiche mit physiologischer Bewegung. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schlemmer HP. Prä-interventionelle Prostata-Diagnostik (Zertifizierung: Modul C/D Spezialkurs). ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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49
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Schlemmer HP. Methoden des radiologischen Therapiemonitorings: WHO, RECIST, Choi usw. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
CLINICAL/METHODICAL ISSUE A present goal is to improve detection and staging of prostate cancer using innovative imaging technology such as PET/MRI. STANDARD RADIOLOGICAL METHODS The modality of choice for detection of prostate cancer is multiparametric MRI. Furthermore, PET/CT is used, in particular, for the detection and staging of distant metastases and recurrent disease. For assessment of bone metastases, the method most commonly used is bone scintigraphy. METHODICAL INNOVATIONS The development of a simultaneous hybrid PET/MRI system is the last great "fusion" of the known cross-sectional image modalities. In addition, synthesis of new, innovative tracers such as (18)F-FACBC or (68)Ga-PSMA allows more specific detection of prostate cancer. PERFORMANCE Hybrid PET/MRI imaging has the potential to replace conventional imaging techniques in the future. ACHIEVEMENTS The method is just starting the broad application. Clinical studies must be expanded in order to substantiate the additional value of the method. PRACTICAL RECOMMENDATIONS Currently, there is still a low distribution situation, since it is a new and cost-intensive method. At the same time, there is still no consistent solution for reimbursement. The importance in practice first rises by clarifying the payment situation and further demonstration of the method's benefit by larger studies.
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Affiliation(s)
- M C Röthke
- Abteilung für onkologische Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg, Deutschland.
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