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Barth M, Muharemovic A, Selig JI, Kröpil P, Lichtenberg A, Akhyari P. Nephropathy and Diabetes in Degenerative Aortic Valve Disease: A Role for Small Leucine-Rich Proteoglycans? Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725766] [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: 10/21/2022]
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2
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Schaarschmidt B, Boos D, Kröpil P, Kröpil P, Lanzman P, Fürst P, Thomas P. Endovaskuläre Therapie von akuten postoperativen Blutungen der Viszeralarterien mittels Stentgrafts: Effektivität und Komplikationen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B Schaarschmidt
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - D Boos
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf
| | - P Lanzman
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Fürst
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Thomas
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
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Boos J, Boos J, Kröpil P, Bethge O, Aissa J, Heinzler N, Antoch G, Thomas C. Genauigkeit der Berechnung von größenspezifischen Dosisabschätzungen (SSDE) aus dem wasseräquivalenten Durchmesser der Mittelschicht des CT Volumens. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Boos
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - J Boos
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - O Bethge
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - J Aissa
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - N Heinzler
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - G Antoch
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - C Thomas
- Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
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Aissa J, Sawicki L, Heusch P, Appel E, Kröpil P, Thomas C, Antoch G, Boos J. Abdominale Computertomografie (CT) zur Detektion von Body-Packing: Wie weit kann die Strahlendosis reduziert werden? ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Aissa
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - L Sawicki
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Heusch
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - E Appel
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - C Thomas
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - G Antoch
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - J Boos
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
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Appel E, Kröpil P, Aissa J, Heinzler N, Thomas C, Antoch G, Boos J. Die aktualisierten diagnostischen Referenzwerte (DRW) des Bundesamtes für Strahlenschutz: Einbettung in ein automatisches CT-Dosismanagementsystem und Auswirkungen auf die klinische Praxis. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- E Appel
- Universitätsklinikum Düsseldorf, Klinik für diagnostische und interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Universitätsklinikum Düsseldorf, Klinik für diagnostische und interventionelle Radiologie, Düsseldorf
| | - J Aissa
- Universitätsklinikum Düsseldorf, Klinik für diagnostische und interventionelle Radiologie, Düsseldorf
| | - N Heinzler
- Universitätsklinikum Düsseldorf, Klinik für diagnostische und interventionelle Radiologie, Düsseldorf
| | - C Thomas
- Universitätsklinikum Düsseldorf, Klinik für diagnostische und interventionelle Radiologie, Düsseldorf
| | - G Antoch
- Universitätsklinikum Düsseldorf, Klinik für diagnostische und interventionelle Radiologie, Düsseldorf
| | - J Boos
- Universitätsklinikum Düsseldorf, Klinik für diagnostische und interventionelle Radiologie, Düsseldorf
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Heinzler N, Kröpil P, Thomas C, Aissa J, Bethge O, Elisabeth A, Antoch G, Boos J. Implementierung sowie erste Ergebnisse einer automatischen größenkorrigierten Dosiserfassung bei CT-Untersuchungen mittels SSDE in der klinischen Routine eines Krankenhauses der Maximalversorgung. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N Heinzler
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
| | - C Thomas
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
| | - J Aissa
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
| | - O Bethge
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
| | - A Elisabeth
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
| | - G Antoch
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
| | - J Boos
- Universitätsklinikum Düsseldorf, Institut für diagnostische und interventionelle Radiologie, Düsseldorf
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Lanzman R, Dickmann C, Ljimani A, Aissa J, Schroeder T, Cadeddu R, Kröpil P, Antoch G, Heusch P. Evaluation von DNA-Doppelstrangbrüchen humaner Blutlymphozyten nach zerebralen MRT-Untersuchungen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R Lanzman
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - C Dickmann
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - A Ljimani
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - J Aissa
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - T Schroeder
- Universitätsklinikum Düsseldorf, Klinik für Hämatologie, Düsseldorf
| | - R Cadeddu
- Universitätsklinikum Düsseldorf, Klinik für Hämatologie, Düsseldorf
| | - P Kröpil
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - G Antoch
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Heusch
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
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Aissa J, Boos J, Sawicki L, Heinzler N, Kröpil P, Antoch G, Thomas C. Metallartefaktreduktion in der postoperativen Thorax CT: Evaluation von drei dezidierten iterativen Algorithmen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Aissa
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - J Boos
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - L Sawicki
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - N Heinzler
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - G Antoch
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - C Thomas
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
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Aissa J, Thomas C, Sawicki L, Caspers J, Kröpil P, Antoch G, Boos J. Computertomografie nach spinaler Instrumentierung: Evaluation zweier iterativer Algorithmen zur Metallartefaktreduktion. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Aissa
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - C Thomas
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - L Sawicki
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - J Caspers
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - P Kröpil
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - G Antoch
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
| | - J Boos
- Universitätsklinikum Düsseldorf, Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf
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Aissa J, Thomas C, Sawicki LM, Caspers J, Kröpil P, Antoch G, Boos J. Iterative metal artefact reduction in CT: can dedicated algorithms improve image quality after spinal instrumentation? Clin Radiol 2017; 72:428.e7-428.e12. [PMID: 28065638 DOI: 10.1016/j.crad.2016.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 11/15/2022]
Abstract
AIM To investigate the value of dedicated computed tomography (CT) iterative metal artefact reduction (iMAR) algorithms in patients after spinal instrumentation. MATERIALS AND METHODS Post-surgical spinal CT images of 24 patients performed between March 2015 and July 2016 were retrospectively included. Images were reconstructed with standard weighted filtered back projection (WFBP) and with two dedicated iMAR algorithms (iMAR-Algo1, adjusted to spinal instrumentations and iMAR-Algo2, adjusted to large metallic hip implants) using a medium smooth kernel (B30f) and a sharp kernel (B70f). Frequencies of density changes were quantified to assess objective image quality. Image quality was rated subjectively by evaluating the visibility of critical anatomical structures including the central canal, the spinal cord, neural foramina, and vertebral bone. RESULTS Both iMAR algorithms significantly reduced artefacts from metal compared with WFBP (p<0.0001). Results of subjective image analysis showed that both iMAR algorithms led to an improvement in visualisation of soft-tissue structures (median iMAR-Algo1=3; interquartile range [IQR]:1.5-3; iMAR-Algo2=4; IQR: 3.5-4) and bone structures (iMAR-Algo1=3; IQR:3-4; iMAR-Algo2=4; IQR:4-5) compared to WFBP (soft tissue: median 2; IQR: 0.5-2 and bone structures: median 2; IQR: 1-3; p<0.0001). Compared with iMAR-Algo1, objective artefact reduction and subjective visualisation of soft-tissue and bone structures were improved with iMAR-Algo2 (p<0.0001). CONCLUSION Both iMAR algorithms reduced artefacts compared with WFBP, however, the iMAR algorithm with dedicated settings for large metallic implants was superior to the algorithm specifically adjusted to spinal implants.
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Affiliation(s)
- J Aissa
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany.
| | - C Thomas
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany
| | - L M Sawicki
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany
| | - J Caspers
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany
| | - P Kröpil
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany
| | - G Antoch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany
| | - J Boos
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany
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Boos J, Meineke A, Bethge O, Antoch G, Kröpil P. Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives. ROFO-FORTSCHR RONTG 2016; 188:443-50. [DOI: 10.1055/s-0041-109514] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- J. Boos
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States
| | - A. Meineke
- Cerner Healthcare Services, Idstein, Germany
| | - O. Bethge
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - G. Antoch
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - P. Kröpil
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
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12
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Aissa J, Boos J, Rubbert C, Caspers J, Thomas C, Kröpil P, Antoch G, Miese F. Optimierung der Dosisexposition im Rahmen des Body-Packer-Screenings: Bildqualität und diagnostische Akzeptanz eines 80 kV low dose Protokolls mit automatischer Röhrenstrommodulation. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Lanzman R, Wessalowski R, Mils O, Thomas C, Boos J, Antoch G, Kröpil P. Evaluation der CT-gesteuerten Thermosondenanlage für das Monitoring der Hyperthermie-Behandlung pädiatrischer Malignome. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Boos J, Meineke A, Rubbert C, Heusch P, Lanzman R, Aissa J, Antoch G, Kröpil P. Cloud-Based CT Dose Monitoring using the DICOM-Structured Report: Fully Automated Analysis in Regard to National Diagnostic Reference Levels. ROFO-FORTSCHR RONTG 2015; 188:288-94. [PMID: 26632871 DOI: 10.1055/s-0041-108059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To implement automated CT dose data monitoring using the DICOM-Structured Report (DICOM-SR) in order to monitor dose-related CT data in regard to national diagnostic reference levels (DRLs). MATERIALS AND METHODS We used a novel in-house co-developed software tool based on the DICOM-SR to automatically monitor dose-related data from CT examinations. The DICOM-SR for each CT examination performed between 09/2011 and 03/2015 was automatically anonymized and sent from the CT scanners to a cloud server. Data was automatically analyzed in accordance with body region, patient age and corresponding DRL for volumetric computed tomography dose index (CTDIvol) and dose length product (DLP). RESULTS Data of 36,523 examinations (131,527 scan series) performed on three different CT scanners and one PET/CT were analyzed. The overall mean CTDIvol and DLP were 51.3% and 52.8% of the national DRLs, respectively. CTDIvol and DLP reached 43.8% and 43.1% for abdominal CT (n=10,590), 66.6% and 69.6% for cranial CT (n=16,098) and 37.8% and 44.0% for chest CT (n=10,387) of the compared national DRLs, respectively. Overall, the CTDIvol exceeded national DRLs in 1.9% of the examinations, while the DLP exceeded national DRLs in 2.9% of the examinations. Between different CT protocols of the same body region, radiation exposure varied up to 50% of the DRLs. CONCLUSION The implemented cloud-based CT dose monitoring based on the DICOM-SR enables automated benchmarking in regard to national DRLs. Overall the local dose exposure from CT reached approximately 50% of these DRLs indicating that DRL actualization as well as protocol-specific DRLs are desirable. The cloud-based approach enables multi-center dose monitoring and offers great potential to further optimize radiation exposure in radiological departments. KEY POINTS • The newly developed software based on the DICOM-Structured Report enables large-scale cloud-based CT dose monitoring • The implemented software solution enables automated benchmarking in regard to national DRLs • The local radiation exposure from CT reached approximately 50 % of the national DRLs • The cloud-based approach offers great potential for multi-center dose analysis.
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Affiliation(s)
- J. Boos
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - A. Meineke
- Cerner Health Services, Idstein, Germany
| | - C. Rubbert
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - P. Heusch
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - R. Lanzman
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - J. Aissa
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - G. Antoch
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - P. Kröpil
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
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Lanzman R, Müller-Lutz A, Liersch P, Heusch P, Weller J, Kröpil P, Antoch G, Wittsack H. Dynamische EKG-getriggerte DWI der Nieren: Erfassung von Diffusionsparametern über den gesamten Herzzyklus. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551435] [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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16
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Boos J, Meineke A, Lanzman R, Bethge O, Heusch P, Aissa J, Antoch G, Kröpil P. Cloud-basiertes Monitoring von CT-Dosisdaten mithilfe des DICOM-Structured Report (DICOM-SR): Analyse im Hinblick auf nationale Referenzwerte. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551369] [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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17
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Boos J, Aissa J, Lanzman R, Heusch P, Schimmöller L, Antoch G, Kröpil P. CT-Angiografie der Aorta mit 80 kV in Kombination mit iterativer Rekonstruktion: Beurteilung von Bildqualität und Strahlendosis. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550977] [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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Abstract
The Essex-Lopresti injury (ELI) of the forearm is a rare and serious condition which is often overlooked, leading to a poor outcome. The purpose of this retrospective case study was to establish whether early surgery can give good medium-term results. From a group of 295 patients with a fracture of the radial head, 12 patients were diagnosed with ELI on MRI which confirmed injury to the interosseous membrane (IOM) and ligament (IOL). They were treated by reduction and temporary Kirschner (K)-wire stabilisation of the distal radioulnar joint (DRUJ). In addition, eight patients had a radial head replacement, and two a radial head reconstruction. All patients were examined clinically and radiologically 59 months (25 to 90) after surgery when the mean Mayo Modified Wrist Score (MMWS) was 88.4 (78 to 94), the mean Mayo Elbow Performance Scores (MEPS) 86.7 (77 to 95) and the mean disabilities of arm, shoulder and hand (DASH) score 20.5 (16 to 31): all of these indicate a good outcome. In case of a high index of suspicion for ELI in patients with a radial head fracture, we recommend the following: confirmation of IOM and IOL injury with an early MRI scan; early surgery with reduction and temporary K-wire stabilisation of the DRUJ; preservation of the radial head if at all possible or replacement if not, and functional bracing in supination. This will increase the prospect of a good result, and avoid the complications of a missed diagnosis and the difficulties of late treatment.
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Affiliation(s)
- J P Grassmann
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Hakimi
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - S V Gehrmann
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Betsch
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - P Kröpil
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Wild
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - J Windolf
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - P Jungbluth
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
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Schimmöller L, Quentin M, Arsov C, Hiester A, Kröpil P, Rabenalt R, Albers P, Antoch G, Blondin D. Predictive power of the ESUR scoring system for prostate cancer diagnosis verified with targeted MR-guided in-bore biopsy. Eur J Radiol 2014; 83:2103-2108. [PMID: 25241051 DOI: 10.1016/j.ejrad.2014.08.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/03/2014] [Accepted: 08/07/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE This study evaluates the diagnostic value of the ESUR scoring system (PI-RADS) regarding prostate cancer detection using MR-guided in-bore biopsies (IB-GB) as the reference standard. METHODS 566 lesions in 235 consecutive patients (65.7 ± 7.9 years, PSA 9.9 ± 8.5 ng/ml) with a multiparametric (mp)-MRI (T2WI, DWI, DCE) of the prostate at 3T were scored using the PI-RADS scoring system. PI-RADS single (PSsingle), summed (PSsum), and overall (PSoverall) scores were determined. All lesions were histologically verified by IB-GB. RESULTS Lesions with a PSsum below 9 contained no prostate cancer (PCa) with Gleason score (GS) ≥ 4+3=7. A PSsum of 13-15 (PSoverall V) resulted in 87.8% (n=108) in PCa and in 42.3% (n=52) in GS ≥ 4+3=7. Transition zone (TZ) lesions with a PSsum of 13-15 (PSoverall V) resulted in 76.3% (n=36) in PCa and in 26.3% (n=10) in GS ≥ 4+3=7, whereas for peripheral zone (PZ) lesions cancer detection rate at this score was 92.9% (n=79) and 49.4% (n=42) for GS ≥ 4+3=7. Using a threshold of PSsum ≥ 10, sensitivity was 86.0%, and negative predictive value (NPV) was 86.2%. For higher grade PCa sensitivity was 98.6%, and NPV was 99.5%. CONCLUSION A PSsum below 9 excluded a higher grade PCa, whereas lesions with a PSsum ≥ 13 (PSoverall V) represented in 88% PCa, and in 42% higher grade PCa. The PSsum or PSoverall demonstrated a better diagnostic value for PZ lesions with higher detection rates for higher grade PCa compared to TZ lesions.
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Affiliation(s)
- L Schimmöller
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - M Quentin
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - C Arsov
- Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - A Hiester
- Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - P Kröpil
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - R Rabenalt
- Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - P Albers
- Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - G Antoch
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
| | - D Blondin
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
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Schimmöller L, Lanzman R, Dietrich S, Boos J, Heusch P, Miese F, Antoch G, Kröpil P. Evaluation of automated attenuation-based tube potential selection in combination with organ-specific dose reduction for contrast-enhanced chest CT examinations. Clin Radiol 2014; 69:721-6. [DOI: 10.1016/j.crad.2014.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/10/2014] [Accepted: 02/24/2014] [Indexed: 12/28/2022]
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Kröpil P, Lanzman RS, Aissa J, Krix M, Antoch G, Kröpil P. Dosisreduktion in der pulmonalen CT-Angiografie – Evaluation des Konzepts „hohe Jodeinbringrate – geringe mAs“. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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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Aissa J, Kohlmeier A, Rubbert C, Kröpil P, Hohn U, Antoch G, Miese F. Die diagnostische Wertigkeit des CT-Localizers bei dem Bodypacking im Vergleich mit der vollständigen low-dose Abdomen CT. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372824] [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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Schleich C, Christian B, Nowak C, Kröpil P, Lanzman R, Wittsack HJ, Sewerin P, Aissa J, Schneider M, Ostendorf B, Scherer A, Antoch G, Miese F. Vergleich zwischen vermindertem Glykosaminoglykangehalt im Gelenkknorpel und Entzündungsaktivität der Synovia bei rheumatoider Arthritis. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373325] [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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Lanzman RS, Boos J, Klee D, Schaper J, Schimmöller L, Heusch P, Klasen-Sansone J, Antoch G, Kröpil P. Einfluss von organspezifischer Dosisreduktion auf die Bildqualität pädiatrischer CT-Thorax-Untersuchungen. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373110] [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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Haase M, Riester A, Kröpil P, Hahner S, Degenhart C, Willenberg HS, Reincke M. Adrenal vein sampling under mineralocorticoid receptor antagonistic therapy. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372082] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kröpil P, Bigdeli AH, Nagel HD, Antoch G, Cohnen M. Impact of increasing levels of advanced iterative reconstruction on image quality in low-dose cardiac CT angiography. ROFO-FORTSCHR RONTG 2014; 186:567-75. [PMID: 24458375 DOI: 10.1055/s-0033-1356074] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate the effects of an advanced iterative reconstruction (IR) technique on subjective and objective image quality (IQ) in low-dose cardiac CT angiography (CCTA). MATERIALS AND METHODS 30 datasets of prospectively triggered "step-and-shoot" CCTA scans acquired on a 256-slice CT scanner with optimized exposure settings were processed on a prototype IR system using filtered back-projection (FBP) and 4 levels of advanced IR (iDose4, Philips) providing incremental rates of IR (level 2, 4, 6, 7). In addition, the effects of different reconstruction kernels (semi-smooth [CB], standard with edge-enhancement [XCB]) and a "multi-resolution" feature [MR] to preserve the noise power spectrum were evaluated resulting in a total of n = 480 image sets. Contrast-to-noise ratios (CNR) were computed from regions of interest at 9 coronary locations. The subjective IQ was rated on a 4-point-scale with "classic" image appearance and noise-related artifacts as main criteria. RESULTS At an effective dose of 1.7 ± 0.7 mSv, the CNR significantly improved with every increasing level of IR (range: 14.2 - 27.8; p < 0.001) with the best objective IQ at the highest level of IR (level 7). The subjective IQ, however, was rated best at the medium level of IR (level 4) with minimal artifacts and a more "classic" image appearance when compared to higher IR levels. The XCB kernel provided better subjective ratings than CB (p < 0.05) and the MR feature further increased the IQ at a high level of IR. CONCLUSION The objective IQ of low-dose CCTA progressively improves with an increasing level of IR. The best subjective IQ, however, is reached at medium levels of IR combined with an edge-enhancing kernel allowing for preservation of a "classic" image appearance suggesting application in the clinical routine. KEY POINTS • iterative reconstruction (IR) improves image quality in low-dose coronary CTA• objective image quality (CNR) enhances with increasing level of IR• best subjective image quality is reached at medium level of IR• "multi-resolution" algorithm further improves image quality at a higher level of IR.
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Affiliation(s)
- P Kröpil
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Düsseldorf
| | - A H Bigdeli
- Institute of Clinical Radiology, Städtische Kliniken Neuss Lukaskrankenhaus GmbH, Neuss
| | - H D Nagel
- Science & Technology for Radiology, Dr. HD Nagel, Buchholz
| | - G Antoch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Düsseldorf
| | - M Cohnen
- Institute of Clinical Radiology, Städtische Kliniken Neuss Lukaskrankenhaus GmbH, Neuss
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Jungbluth P, Hakimi AR, Grassmann JP, Schneppendahl J, Betsch M, Kröpil P, Thelen S, Sager M, Herten M, Wild M, Windolf J, Hakimi M. The early phase influence of bone marrow concentrate on metaphyseal bone healing. Injury 2013; 44:1285-94. [PMID: 23684350 DOI: 10.1016/j.injury.2013.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/30/2013] [Accepted: 04/14/2013] [Indexed: 02/02/2023]
Abstract
Bone marrow concentrate (BMC) contains high densities of progenitor cells. Therefore, in critical size defects BMC may have the potency to support bone healing. The aim of this study was to investigate the effect of BMC in combination with calcium phosphate granules (CPG) on bone defect healing in a metaphyseal long bone defect in mini-pigs. A metaphyseal critical-size bone defect at the proximal tibia of 24 mini-pigs was filled with CPG combined with BMC, CPG solely (control group) or with an autograft. Radiological and histomorphometrical evaluations after 6 weeks (42 days) showed significantly more bone formation in the BMC group in the central area of the defect zone and the cortical defect zone compared to the CPG group. At the same time the resorption rate of CPG increased significantly in the BMC group. Nevertheless, compared to the BMC group the autograft group showed a significantly higher new bone formation radiologically and histomorphometrically. In BMC the count of mononuclear cells was significantly higher compared to the bone marrow aspirate (3.5-fold). The mesenchymal progenitor cell characteristics of the cells in BMC were confirmed by flow cytometry. Cells from BMC created significantly larger colonies of alkaline phosphatase-positive colony forming units (CFU-ALP) (4.4-fold) compared to cells from bone marrow aspirate. Nevertheless, even in the BMC group complete osseous bridging was only detectable in isolated instances of the bone defects. Within the limitations of this study the BMC+CPG composite promotes bone regeneration in the early phase of bone healing significantly better than the isolated application of CPG. However, the addition of BMC does not lead to a solid fusion of the defect in the early phase of bone healing an still does not represent an equal alternative to autologous bone.
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Affiliation(s)
- P Jungbluth
- Heinrich Heine University Hospital Duesseldorf, Department of Trauma and Handsurgery, Moorenstr. 5, 40225 Duesseldorf, Germany
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Kröpil P, Schimmöller L, Dietrich S, Heusch P, Aissa J, Antoch G, Lanzman RS. Evaluation einer automatischen Röhrenspannungsselektion in Kombination mit organspezifischer Dosisreduktion in der klinischen Thorax-CT. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346332] [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: 10/26/2022]
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Kröpil P, Heusch P, Schimmöller L, Miese F, Dietrich S, Antoch G, Lanzman RS. Automatische schwächungsbasierte Röhrenspannungsselektion in der Abdomen-CT: Einfluss auf Bildqualität und Dosis. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346303] [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: 10/26/2022]
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Lanzman RS, Blondin D, Heusch P, Martirosian P, Aissa J, BIlk P, Zenginli H, Kröpil P, Antoch G, Wittsack HJ. Funktionelle Bildgebung von Transplantatnieren mittels Arterial Spin Labeling (ASL) MRT bei 1.5T und 3T: Ergebnisse bei 105 Patienten. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346488] [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: 10/26/2022]
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Aissa J, Blondin D, Schmitt P, Kröpil P, Heusch P, Klasen-Sansone J, Miese F, Antoch G, Lanzman RS. Kontrastmittel-freie, EKG-getriggerte Quiescent-Interval Single-Shot MR Angiografie (QISS-MRA) der Becken- und Beinarterien: Vergleich mit der Digitalen Subtraktionsangiografie (DSA). ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346255] [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: 10/26/2022]
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Lanzman RS, SChimmöller L, Heusch P, Dietrich S, Miese F, Aissa J, Heusner TA, Antoch G, Kröpil P. Einfluss von organspezifischer Dosisreduktion auf die Bildqualität der CT Angiografie der Kopf- und Halsgefäße. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346524] [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: 10/26/2022]
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Schek J, Kröpil P, Witte I, Heusch P, Klasen-Sansone J, Macht S, Antoch G, Lanzman RS. Prognostischer Stellenwert hyperdenser Nebennieren in der kontrastmittelverstärkten Polytrauma-CT. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346438] [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: 10/26/2022]
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Schimmöller L, Lanzman RS, Heusch P, Dietrich S, Miese F, Aissa J, Heusner TA, Antoch G, Kröpil P. Impact of organ-specific dose reduction on the image quality of head and neck CT angiography. Eur Radiol 2013; 23:1503-9. [PMID: 23300039 DOI: 10.1007/s00330-012-2750-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 11/15/2012] [Accepted: 11/19/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Organ-specific dose reduction (OSDR) algorithms can reduce radiation on radiosensitive organs up to 59 %. This study evaluates the influence of a new OSDR algorithm on image quality of head and neck computed tomographic angiography (CTA) in clinical routine. METHODS Sixty-two consecutive patients (68 ± 13 years) were randomised into two groups and imaged using 128-row multidetector CT. Group A (n = 31) underwent conventional CTA and group B (n = 31) CTA with a novel OSDR algorithm. Subjective and objective image quality were statistically compared. Subjective image quality was rated on a five-point scale. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated with region-of-interest measurements. RESULTS The SNR of the common carotid artery and middle cerebral artery was 53.6 ± 22.7 and 43.3 ± 15.3 (group A) versus 54.1 ± 20.5 and 46.2 ± 14.6 (group B). The CNR was 40.0 ± 19.3 and 29.7 ± 12.0 (group A) compared with 40.7 ± 16.8 and 32.9 ± 10.9 (group B), respectively. Subjective image quality was excellent in both groups (mean score 4.4 ± 0.7 versus 4.4 ± 0.6). Differences between the two groups were not significant. CONCLUSIONS The novel OSDR algorithm does not compromise image quality of head and neck CTA. Its application can be recommended for CTA in clinical routine to protect the thyroid gland and ocular lenses from unnecessary high radiation. KEY POINTS • Organ-specific dose reduction (OSDR) can significantly reduce radiation exposure during CT • OSDR does not compromise image quality of head and neck CTA • OSDR can significantly lower the risk of radiation damage to sensitive organs • OSDR can easily be applied in routine clinical practice.
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Affiliation(s)
- L Schimmöller
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany
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Schimmöller L, Lehwald N, Antoch G, Kröpil P. Polyostotische Knochenveränderungen mit assoziierten intramuskulären Weichteiltumoren. Radiologe 2012; 52:934-6. [DOI: 10.1007/s00117-012-2355-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kroepil F, Schauer M, Raffel AM, Kröpil P, Eisenberger CF, Knoefel WT. Treatment of early and delayed esophageal perforation. Indian J Surg 2012; 75:469-72. [PMID: 24465104 DOI: 10.1007/s12262-012-0539-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 05/31/2012] [Indexed: 12/19/2022] Open
Abstract
Esophageal perforations are life threatening emergencies associated with high morbidity and mortality. We report on 22 consecutive patients (age 20-86; 13 female and 9 male) with an oesophageal perforation treated at the university hospital Duesseldorf. The patients' charts were reviewed and follow-up was completed for all patients until demission, healed reconstruction or death. Patients' history, clinical presentation, time interval to surgical presentation, and treatment modality were recorded and correlated with patients' outcome. Six esophageal perforations were due to a Boerhaave-syndrome, eleven caused by endoscopic perforation, two after osteosynthesis of the cervical spine and three foreign body induced. In 7 patients a primary local suture was performed, in 4 cases a supplemental muscle flap was interposed, and 7 patients underwent an oesophageal resection. Four patients were treated without surgery (three esophageal stent implantations, one conservative treatment). Eleven patients (50 %) were presented within 24 h of perforation, and 11 patients (50 %) afterwards. Time delay correlates with survival. In 17 (80.9 %) cases a surgical sufficient reconstruction could be achieved. One (4.7 %) patient is waiting for reconstruction after esophagectomy. Four (18.2 %) patients died. A small subset of patients can be treated conservatively by stenting of the Esophagus, if the patient presents early. In the majority of patients a primary repair (muscle flap etc.) can be performed with good prognosis. If the patient presents delayed with extensive necrosis or mediastinitis, oesophagectomy and secondary repair is the only treatment option with high mortality.
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Affiliation(s)
- F Kroepil
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - M Schauer
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - A M Raffel
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - P Kröpil
- Department of Diagnostic and Interventional Radiology, University of Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - C F Eisenberger
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - W T Knoefel
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
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Klasen J, Blondin D, Schmitt P, Bi X, Sansone R, Wittsack HJ, Kröpil P, Quentin M, Kuhlemann J, Miese F, Heiss C, Kelm M, Antoch G, Lanzman R. Nonenhanced ECG-gated quiescent-interval single-shot MRA (QISS-MRA) of the lower extremities: Comparison with contrast-enhanced MRA. Clin Radiol 2012; 67:441-6. [DOI: 10.1016/j.crad.2011.10.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 10/09/2011] [Accepted: 10/12/2011] [Indexed: 12/01/2022]
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Buchbender S, Obenauer S, Hepp S, Buchbender C, Miese FR, Wittsack HJ, Kröpil P, Blondin D, Janni W, Antoch G, Lanzman RS. Arterial spin labeling (ASL) MRT zur Perfusionsquantifizierung in der Mamma-MRT: eine Machbarkeitsstudie. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311301] [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: 10/28/2022]
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Kröpil P, Nagel HD, Bigdeli AH, Heusch P, Pentang G, Antoch G, Cohnen M. Objektive und subjektive Bildqualität bei verschiedenen Stufen iterativer Rekonstruktionen in der Niedrigdosis-Cardio-CT. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311330] [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: 10/28/2022]
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Lanzman RS, Kröpil P, Schmitt P, Wittsack HJ, Orzechowski D, Schek J, Miese FR, Buchbender C, Turowski B, Antoch G, Blondin D. Kontrastmittelfreie, EKG-getriggerte 4D Steady-State Free Precession MR Angiographie (4D SSFP MRA) der zerebralen Arterien: Vergleich bei 1.5T und 3T. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311230] [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: 10/28/2022]
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Kröpil P, Bigdeli AH, Nagel HD, Andersen K, Lanzman RS, Antoch G, Cohnen M. Auswirkungen iterativer Rekonstruktionstechnik der 4. Generation auf die objektive Bildqualität in der Niedrigdosis-Cardio-CT. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311331] [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: 10/28/2022]
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Lanzman RS, Ljimani A, Blondin D, Martirosian P, Zgoura P, Heusch P, Kröpil P, Miese FR, Antoch G, Wittsack HJ. Arterial Spin Labeling (ASL) Perfusionsbildgebung von Transplantatnieren bei 3T. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311290] [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: 10/28/2022]
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Kröpil P, Riegger C, Rubbert C, Lanzman RS, Miese FR, Hakimi AR, Jungbluth P, Becker J, Hakimi M, Antoch G, Scherer A. Quantitative Messung der Knochendefektheilung mittels Digitaler Volumentomographie (DVT) am Tiermodell. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311295] [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: 10/28/2022]
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Heusch P, Kröpil P, Buchbender C, Heusner TA, Lanzman RS, Antoch G, Fürst G. Teilkörperdosis der Augenlinse des Untersuchers bei CT-gesteuerten Interventionen: erste Ergebnisse. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311075] [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: 10/28/2022]
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Scherer A, Kröpil P, Heusch P, Buchbender C, Sewerin P, Blondin D, Lanzman RS, Miese F, Ostendorf B, Bölke E, Mödder U, Antoch G. [Case-based interactive PACS learning: introduction of a new concept for radiological education of students]. Radiologe 2012; 51:969-70, 973-7. [PMID: 22033604 DOI: 10.1007/s00117-011-2241-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE Medical curricula are currently being reformed in order to establish superordinated learning objectives, including, e.g., diagnostic, therapeutic and preventive competences. This requires a shifting from traditional teaching methods towards interactive and case-based teaching concepts. Conceptions, initial experiences and student evaluations of a novel radiological course Co-operative Learning In Clinical Radiology (CLICR) are presented in this article. MATERIALS AND METHODS A novel radiological teaching course (CLICR course), which combines different innovative teaching elements, was established and integrated into the medical curriculum. Radiological case vignettes were created for three clinical teaching modules. By using a PC with PACS (Picture Archiving and Communication System) access, web-based databases and the CASUS platform, a problem-oriented, case-based and independent way of learning was supported as an adjunct to the well established radiological courses and lectures. Student evaluations of the novel CLICR course and the radiological block course were compared. RESULTS Student evaluations of the novel CLICR course were significantly better compared to the conventional radiological block course. Of the participating students 52% gave the highest rating for the novel CLICR course concerning the endpoint overall satisfaction as compared to 3% of students for the conventional block course. The innovative interactive concept of the course and the opportunity to use a web-based database were favorably accepted by the students. Of the students 95% rated the novel course concept as a substantial gain for the medical curriculum and 95% also commented that interactive working with the PACS and a web-based database (82%) promoted learning and understanding. CONCLUSION Interactive, case-based teaching concepts such as the presented CLICR course are considered by both students and teachers as useful extensions to the radiological course program. These concepts fit well into competence-oriented curricula.
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Affiliation(s)
- A Scherer
- Institut für Diagnostische und Interventionelle Radiologie, Heinrich-Heine-Universität, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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Kröpil P, Nagel HD, Andersen K, Bigdeli AH, Heusch P, Pentang G, Antoch G, Cohnen M. Wie beeinflussen verschiedenen Stufen iterativer Rekonstruktionen die objektive und subjektive Bildqualität in der Niedrigdosis-Kardio-CT? ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300911] [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: 10/14/2022]
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Hofer M, Kamper L, Miese F, Kröpil P, Naujoks C, Handschel J, Heussen N. Quality indicators for the development and didactics of ultrasound courses in continuing medical education. Ultraschall Med 2012; 33:68-75. [PMID: 21894600 DOI: 10.1055/s-0031-1281649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE Based on evaluation data from participant feedback, a concept was to be developed for introductory abdominal ultrasound courses lasting several days. This approach was to be developed incrementally with the intent of maximizing the learning effect per time. MATERIALS AND METHODS This concept has been modified annually over several years based on the findings of educational research and the scores on final examinations in OSCE format. It has been modified with the aid of detailed questionnaires completed by approximately 2000 participating physicians and has thus undergone incremental optimization. RESULTS Analysis of the most recent 1005 questionnaires has shown that participants recommend a modular course design with only brief lectures on theory (average optimal duration of 20 min., SD 9.6 min.). These should alternate with longer practical "hands-on" ultrasound exercises (60 - 90 min., accounting for at least 50 - 60 % of the course time), consolidating drawing exercises, and breaks. 51 % of the physicians specified 5 participants as the ideal group size for practical exercises, while 43 % specified only 4. The discussion presents 10 specific quality indicators for efficient ultrasound courses. It elucidates the feasibility and logistical prerequisites of this model, and compares it with other basic course concepts. Furthermore, this article presents a model for an evaluation covering the course concept and tutors as well as discussing a training program for tutors including a cost analysis. CONCLUSION In summary, the participants estimate the course design to represent a mature concept that has demonstrated its feasibility and broad acceptance among physicians in CME.
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Affiliation(s)
- M Hofer
- AG Medizindidaktik, Univ.-Klinikum, Moorenstrasse 5, Düsseldorf, Germany.
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Kröpil F, Schauer M, Raffel A, Kröpil P, Topp SA, Eisenberger CF, Knoefel WT. Arteria Lienalis Switch als Salvage Procedure zur Rekonstruktion der Arteria hepatica bei Arrosionsblutung nach Pankreaseingriffen. Zentralbl Chir 2011. [DOI: 10.1055/s-0031-1289056] [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: 10/16/2022]
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Lanzman RS, Kröpil P, Schmitt P, Wittsack HJ, Orzechowski D, Kuhlemann J, Buchbender C, Miese FR, Antoch G, Blondin D. Nonenhanced ECG-gated time-resolved 4D steady-state free precession (SSFP) MR angiography (MRA) of cerebral arteries: comparison at 1.5T and 3T. Eur J Radiol 2011; 81:e531-5. [PMID: 21726972 DOI: 10.1016/j.ejrad.2011.06.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare image quality of nonenhanced time-resolved 4D steady-state free precession MR angiography (4D SSFP MRA) of cerebral arteries at 1.5T and 3T. MATERIALS AND METHODS 12 healthy subjects (mean age 29.4±6.9 years) were studied at both 1.5T and 3T. Two different positions of the acquisition slab were evaluated; in one acquisition the imaging slab included the carotid siphon ("S(low)"), in the other acquisition the imaging slab was placed superior to the carotid siphon ("S(high)"). Subjective image quality of cerebral arteries was assessed independently by two readers on a 4-point scale. Relative Signal-to-Noise-Ratio (SNR) was determined for the M1 segment of the middle cerebral artery. RESULTS Subjective image quality of the anterior cerebral artery (segments A1, A2) was significantly higher at 1.5T as compared to 3T, while 3T provided significantly higher image quality for segment P3 of the posterior cerebral artery. For the middle cerebral artery (segments M1-M3), image quality was significantly higher at 1.5T than at 3T when the carotid siphon was included in the acquisition slab ("S(low)"), while no significant difference was found between 1.5T and 3T with "S(high)". Relative SNR was significantly higher at 1.5T (23.1±5.1) as compared to 3T (12.1±7.8) for "S(low)" and significantly higher at 3T (29.8±5.9) than at 1.5T (24.2±3.6) for "S(high)". CONCLUSION Our results indicate that 4D SSFP MRA should preferably be performed at 1.5T with inclusion of the carotid siphon in the acquisition slab, which might be required for the assessment of intracranial collateral flow.
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Affiliation(s)
- R S Lanzman
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Moorenstr. 5, 40225 Düsseldorf, Germany.
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Quentin M, Kröpil P, Steiner S, Lanzman RS, Blondin D, Miese F, Choy G, Abbara S, Scherer A. [Prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT scans]. Radiologe 2011; 51:59-64. [PMID: 20967410 DOI: 10.1007/s00117-010-2071-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT. PATIENTS AND METHODS Non-ECG-gated chest CT examinations of 300 patients were retrospectively analyzed for incidental cardiac findings. Subsequently, these findings were evaluated for their clinical relevance by a cardiologist. RESULTS A total of 107 out of 300 examined patients had 174 incidental cardiac findings including coronary calcification (90), aortic/mitral valve calcification (42), iatrogenic changes (23), pericardial effusion (6), dilatation of the heart (4), myocardial changes (3), thrombus in the left ventricle (2), constrictive pericarditis (2) and atrial myxoma (1). Of the cardiac findings 51% were described in the written report and in 53 out of the 107 patients the cardiac findings were unknown. Newly detected incidental findings from 8 patients were rated as clinically significant: pericardial effusion (4), constrictive pericarditis (1), thrombus in the left ventricle (1), atrial myxoma (1) and dilatation of the heart (1). CONCLUSION Incidental cardiac findings are frequent in non-ECG-gated chest CT and may have a high clinical relevance.
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Affiliation(s)
- M Quentin
- Institut für Radiologie, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
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