@article{SauerGoltzGassenmaieretal.2014,
  author    = {Sauer, Stephanie and Goltz, Jan P. and Gassenmaier, Tobias and Kunz, Andreas S. and Bley, Thorsten A. and Klein, Detlef and Petritsch, Bernhard},
  title     = {Partial Segmental Thrombosis of the Corpus Cavernosum (PSTCC) diagnosed by contrast-enhanced ultrasound: a case report},
  series = {BMC Urology},
  volume    = {14},
  journal   = {BMC Urology},
  number    = {100},
  doi       = {10.1186/1471-2490-14-100},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126495},
  year      = {2014},
  abstract  = {Background Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare disease predominantly occurring in young men. Cardinal symptoms are pain and perineal swelling. Although several risk factors are described in the literature, the exact etiology of penile thrombosis remains unclear in most cases. MRI or ultrasound (US) is usually used for diagnosing this condition. Case presentation We report a case of penile thrombosis after left-sided varicocele ligature in a young patient. The diagnosis was established using contrast-enhanced ultrasound (CEUS) and was confirmed by contrast-enhanced magnetic resonance imaging (ceMRI). Successful conservative treatment consisted of systemic anticoagulation using low molecular weight heparin and acetylsalicylic acid. Conclusion PSTCC is a rare condition in young men and appears with massive pain and perineal swelling. In case of suspected PSTCC utilization of CEUS may be of diagnostic benefit.},
  language  = {en}
}
@phdthesis{Klein2004,
  author    = {Klein, Detlef},
  title     = {Dynamische kontrastmittelunterst{\"u}tzte Ultraschalluntersuchung fokaler Leberraumforderungen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-15078},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2004},
  abstract  = {Ziel: Versuch der Definition von Lebertumoren mit quantitativem dynamischem kontrast-verst{\"a}rktem Ultraschall anhand der Beurteilung der Vaskularisation, wash-in, wash-out {\"u}ber einen definierten Zeitraum. Korrelation mit histologischen Befunden. Patienten und Methode: 42 Leberl{\"a}sionen in 39 Patienten wurden mittels „Contrast Harmonic Imaging" (CHI) {\"u}ber einen Zeitraum von 2 min nach einer Bolusinjektion von 10 ml Levovist® (300mg/ml, Schering AG, Berlin) untersucht. Die Untersuchungen wurden an einem Sonoline Elegra® (Siemens AG, Erlangen) mit einem frequenzvariablen 3,5 MHz Schallkopf durchgef{\"u}hrt. Das Kontrastmittelverhalten der Leberl{\"a}sionen wurde durch eine speziell f{\"u}r Ultraschallkontrastmittel entwickelte Software (Axius™ ACQ (Siemens, Issaquah, WA)) quantifiziert. Repr{\"a}sentative ROI wurden in das Zentrum der L{\"a}sion, {\"u}ber die gesamte L{\"a}sion, in normales Leberparenchym, sowie in repr{\"a}sentative Lebergef{\"a}ße (Leberarterie, Lebervene, Portalvene) gelegt. Die Kontrastmittelaufnahme der Leberl{\"a}sionen wurde unterteilt in arteriell, portal-ven{\"o}s oder ven{\"o}s. Des Weiteren erfolgte eine Unterteilung in hypovaskular, isovaskular und hypervaskular im Vergleich zum normalen Leberparenchym. Zus{\"a}tzlich wurde das Kontrastmittelverhalten innerhalb der L{\"a}sion beurteilt und unterteilt in zentrifugal, zentripetal, peripher und komplett. Alle Leberl{\"a}sionen wurden vor und nach Kontrastmittelgabe von vier im Ultraschall, CT und MRT erfahrenen Radiologen ausgewertet ohne Kenntnis der Patientendaten oder des histologischen Ergebnis. Das Diagnosekriterium maligne wurde mittels einer ROC-Analyse ausgewertet. Zus{\"a}tzlich wurden die durchschnittliche Sensitivit{\"a}t, Spezifit{\"a}t, sowie der positive und negative Vorhersagewert berechnet. Ergebnisse: Von 36 Raumforderungen lagen histologische Befunde vor. Histologisch ergaben sich 29 maligne L{\"a}sionen (HCC, n=11; CCC n=1; Lymphom, n=1, Metastasen, n=16) und 7 benigne L{\"a}sionen (H{\"a}mangiom, n=1; FNH, n=4, Adenom n=2). 4 FNH´s und 1 H{\"a}mangiom waren durch NUK, MRT und durch Langzeitkontrollen best{\"a}tigt. Die Auswertung der ROC-Analyse in Bezug auf das Kriterium maligne schwankte vor Kontrastmittelgabe zwischen 0,43 und 0,62 (Durchschnitt 0,57) und nach Kontrastmittelgabe zwischen 0,7 und 0,8 (Durchschnitt 0,75). Die durchschnittlichen Werte f{\"u}r die Sensitivit{\"a}t, Spezifit{\"a}t, negativer und positiver Vorhersagewert betrugen vor Kontrastmittelgabe 66\%, 26\%, 45\% und 73\% nach Kontrastmittelgabe 83\%, 49\%, 65\% und 82\%. Diskussion: Die Quantifizierung der verst{\"a}rkten Gef{\"a}ßdarstellung in Lebertumoren nach Bolus-Applikation eines Ultraschallkontrastmittels verbessert die Zuordnung zu einem malignen Prozess im Vergleich zum nativen Ultraschall. Um zuverl{\"a}ssigere Diagnosen stellen zu k{\"o}nnen ist eine Verbesserung der Auswertesoftware sowie die Ber{\"u}cksichtigung der neuen Generation von Ultraschallkontrastmitteln notwendig.},
  language  = {de}
}
@article{GlutschSchummerKneitzetal.2022,
  author    = {Glutsch, Valerie and Schummer, Patrick and Kneitz, Hermann and Gesierich, Anja and Goebeler, Matthias and Klein, Detlef and Posch, Christian and Gebhardt, Christoffer and Haferkamp, Sebastian and Zimmer, Lisa and Becker, J{\"u}rgen C and Leiter, Ulrike and Weichenthal, Michael and Schadendorf, Dirk and Ugurel, Selma and Schilling, Bastian},
  title     = {Ipilimumab plus nivolumab in avelumab-refractory Merkel cell carcinoma: a multicenter study of the prospective skin cancer registry ADOREG},
  series = {Journal for ImmunoTherapy of Cancer},
  volume    = {10},
  journal   = {Journal for ImmunoTherapy of Cancer},
  number    = {11},
  issn      = {2051-1426},
  doi       = {10.1136/jitc-2022-005930},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304613},
  year      = {2022},
  abstract  = {Merkel cell carcinoma is a rare, highly aggressive skin cancer with neuroendocrine differentiation. Immune checkpoint inhibition has significantly improved treatment outcomes in metastatic disease with response rates to programmed cell death protein 1/programmed cell death 1 ligand 1 (PD-1/PD-L1) inhibition of up to 62\%. However, primary and secondary resistance to PD-1/PD-L1 inhibition remains a so far unsolved clinical challenge since effective and safe treatment options for these patients are lacking.Fourteen patients with advanced (non-resectable stage III or stage IV, Union international contre le cancer 2017) Merkel cell carcinoma with primary resistance to the PD-L1 inhibitor avelumab receiving subsequent therapy (second or later line) with ipilimumab plus nivolumab (IPI/NIVO) were identified in the prospective multicenter skin cancer registry ADOREG. Five of these 14 patients were reported previously and were included in this analysis with additional follow-up. Overall response rate, progression-free survival (PFS), overall survival (OS) and adverse events were analyzed.All 14 patients received avelumab as first-line treatment. Thereof, 12 patients had shown primary resistance with progressive disease in the first tumor assessment, while two patients had initially experienced a short-lived stabilization (stable disease). Six patients had at least one systemic treatment in between avelumab and IPI/NIVO. In total, 7 patients responded to IPI/NIVO (overall response rate 50\%), and response was ongoing in 4 responders at last follow-up. After a median follow-up of 18.85 months, median PFS was 5.07 months (95\% CI 2.43—not available (NA)), and median OS was not reached. PFS rates at 12 months and 24 months were 42.9\% and 26.8 \%, respectively. The OS rate at 36 months was 64.3\%. Only 3 (21\%) patients did not receive all 4 cycles of IPI/NIVO due to immune-related adverse events.In this multicenter evaluation, we observed high response rates, a durable benefit and promising OS rates after treatment with later-line combined IPI/NIVO. In conclusion, our patient cohort supports our prior findings with an encouraging activity of second-line or later-line IPI/NIVO in patients with anti-PD-L1-refractory Merkel cell carcinoma.},
  language  = {en}
}
@article{GilbertKleinWengetal.2017,
  author    = {Gilbert, Fabian and Klein, Detlef and Weng, Andreas Max and K{\"o}stler, Herbert and Schmitz, Benedikt and Schmalzl, Jonas and B{\"o}hm, Dirk},
  title     = {Supraspinatus muscle elasticity measured with real time shear wave ultrasound elastography correlates with MRI spectroscopic measured amount of fatty degeneration},
  series = {BMC Muscoskeletal Disorders},
  volume    = {18},
  journal   = {BMC Muscoskeletal Disorders},
  number    = {549},
  doi       = {10.1186/s12891-017-1911-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159378},
  year      = {2017},
  abstract  = {Background: Fatty Degeneration (FD) of the rotator cuff muscles influences functional and anatomical outcome after rotator cuff repair. The MRI based estimation of fatty degeneration is the gold standard. There is some evidence that Ultrasound elastography (EUS) can detect local differences of tissue stiffness in muscles and tendons. Shear-wave elastography (SWE) was evaluated to determine the extent to which shear wave velocity was associated with measures of fatty degeneration. MRI-spectroscopic fat measurement was used as a reference to quantify the amount of fat in the muscle belly. Methods: Forty-two patients underwent SWE of the supraspinatus muscles at its thickest diameter. After ultrasound evaluation an MRI-spectroscopic fat measurement of the supraspinatus muscle was performed using the SPLASH-technique. A gel filled capsule was used to locate the measured area in the MRI. The values of shear wave velocity (SWV) measured with SWE and spectroscopic fat measurement were correlated statistically using Pearson's correlation test. Results: Correlation of the fat amount measured with MRI-spectroscopy and the SWV measured with SWE was ρ =0.82. Spectroscopic measured fat ratio of the supraspinatus muscle ranged from 0\% to 77.41\% and SWV from 1.59 m/s to 5.32 m/s. In 4 patients no sufficient SWE could be performed, these individuals showed a larger diameter of the overlying soft tissue. SWV measured with SWE showed a good correlation with MRI spectroscopic fat amount of the supraspinatus muscle. Conclusion: These preliminary data suggest that SWE may be a sufficient tool in detecting and estimating the amount of fatty degeneration in the supraspinatus muscle in real time. Large overlying soft tissue may be a limitation in performing sufficient EUS.},
  language  = {en}
}