@phdthesis{Krumma2024,
  author    = {Krumma, Judith Josefine Birgitta},
  title     = {Morphologie und bildgebende Ver{\"a}nderung in der Magnetresonanztomographie bei p{\"a}diatrischen Patienten/innen mit Rezidiven eines kranialen Ependymoms - Kohorte der Deutschen HIT- REZ Studie},
  doi       = {10.25972/OPUS-35149},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-351498},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {In dieser Arbeit wurde einerseits retrospektiv untersucht, wie sich supratentorielle und infratentorielle Ependymome bildmorphologisch unterscheiden, ob Lokalrezidive eines Ependymoms dessen Bildeigenschaften teilen und welche Art von Rezidiven im Verlauf auftreten k{\"o}nnen. Die von uns beschriebenen Bildcharakteristika der Ependymome decken sich zum gr{\"o}ßten Teil mit bereits ver{\"o}ffentlichten Studien. Supratentorielle Ependymome unterscheiden sich signifikant in ihrer Bildmorphologie im Vergleich zu Ependymome der hintern Sch{\"a}delgrube. Alle p{\"a}diatrischen Ependymompatienten/innen in unserem Kollektiv erkrankten an mindestens einem Rezidiv. Am h{\"a}ufigsten traten Lokalrezidive gefolgt von Meningeosen im ersten Rezidiv auf. Seltener fanden sich transiente postradiogene L{\"a}sionen, Diffuse intrinsische Ponsgliome und extraneurale Metastasen. Der bildmorphologische Vergleich, Primarius versus Lokalrezidiv ergab {\"u}berwiegend {\"a}hnliche bildgebende Eigenschaften vor allem im Signalverhalten, Tumorbegrenzung und KM-Aufnahme sowie KM anreichernder Tumoranteil. Die kranielle Meningeose pr{\"a}sentierte sich zum ersten Rezidivzeitpunkt different zum Prim{\"a}rtumor. Die extraneuralen Metastasen hatten bildcharakteristisch {\"A}hnlichkeiten zum Prim{\"a}rtumor. Bei der Bewertung neuer intraparenchymaler L{\"a}sionen sollte immer der zeitliche Zusammenhang zur letzten Therapie und damit m{\"o}gliche vor{\"u}bergehende postradiologischen Ver{\"a}nderungen ber{\"u}cksichtigt werden. Letztlich ist das p{\"a}diatrische Ependymom und Ependymomrezidiv ein komplexes und immer noch unvollst{\"a}ndiges erfasstes Krankheitsbild. Durch umfangreichere Studien und die Zusammenf{\"u}hrung dieser Ergebnisse k{\"o}nnte schlussendlich die Komplexit{\"a}t des Krankheitsbildes und somit die Therapieoptionen verbessert werden. Durch unsere Studie gelang einerseits die Beschreibung und der Vergleich des prim{\"a}ren Ependymoms bez{\"u}glich supra- und infratentorieller Lokalisation und andererseits gelang eine neuroradiologische Beschreibung von Ependymomrezidiven im Vergleich zum prim{\"a}ren Ependymom, wodurch in Zukunft die Nachsorge der Ependymomrezidive und die Therapieoptionen optimiert werden k{\"o}nnten.},
  subject      = {Ependymom},
  language  = {de}
}
@phdthesis{Feick2024,
  author    = {Feick, J{\"o}rn},
  title     = {Relevanz lokaler Blutgasparameter innerhalb des zerebralen Kollateralkreislaufs w{\"a}hrend akuter zerebraler Isch{\"a}mie},
  doi       = {10.25972/OPUS-35167},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-351678},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {St{\"o}rungen der Ionen- und Blutgas Hom{\"o}ostase mit Verschiebungen von Na+ und K+ in der regionalen Hypoxie sind ein Kennzeichen der experimentellen zerebralen Isch{\"a}mie, wurden aber in ihrer Bedeutung f{\"u}r Schlaganfallpatienten noch nicht hinreichend untersucht. Wir berichten {\"u}ber eine prospektive, humane Querschnittsstudie an 366 Schlaganfallpatienten, die mit einer endovaskul{\"a}ren Rekanalisation bei einem akuten LVO der vorderen Zirkulation zwischen dem 18.Dezember 2018 und dem 31.August 2020 behandelt wurden. Im Rahmen der vorliegenden Dissertationsarbeit wurden intraprozedural arterielle Blutgasproben (1ml) aus dem lokal isch{\"a}mischen Kollateralkreislauf und der intraindividuellen systemischen Referenzlokalisation in 51 Patienten gewonnen. Die Probengewinnung mit Hilfe eines Mikrokatheters erfolgte nach einem bereits ver{\"o}ffentlichten Protokoll. Diese Arbeit weist in der Perakutphase eines Großgef{\"a}ßverschlusses signifikant nach, dass der lokal isch{\"a}mische paO2 (-4,29\%, paO2isch{\"a}misch=185,3 mmHg vs. paO2systemisch=193,6mmHg; p=0,035) und die Konzentration von K+ (-5,49\%, K+isch{\"a}misch=3,44mmol/L vs. K+systemisch=3,64mmol/L; p=0,0081) signifikant reduziert war. Wir beobachteten, dass der Na+:K+-Quotient in der Kollateralzirkulation (+3,29\%; Na+:K+-Quotientisch{\"a}misch=41,74 vs. Na+:K+-Quotientsystemisch=40,38; p=0,0048) im Vergleich zur systemischen Zirkulation signifikant erh{\"o}ht war, w{\"a}hrend die Na+-Konzentration signifikant positiv mit einer Zunahme des Infarktausmaßes assoziiert war (r=0,42, p=0,0033). Wir fanden eine alkaline Tendenz des zerebralen pH (+0,14\%, pHisch{\"a}misch=7,38 vs. pHsystemisch=7,37, p=0,0019), mit einer zeitabh{\"a}ngigen Verschiebung in den azidotischen Bereich (r=-0,36, p=0,0549). Schlussfolgernd deuten unsere Ergebnisse darauf hin, dass die durch den Schlaganfall verursachten Ver{\"a}nderungen der zerebralen Sauerstoffversorgung, der Ionenzusammensetzung und des S{\"a}ure-Basen-Gleichgewichts dynamisch auftreten, w{\"a}hrend der okklusiven Isch{\"a}mie fortschreiten und mit der akuten Gewebesch{\"a}digung im Zusammenhang stehen. W{\"u}nschenswert sind weitere prospektive Studien, um die Ergebnisse valide zu reproduzieren.},
  subject      = {Schlaganfall},
  language  = {de}
}
@article{HaarmannVollmuthKollikowskietal.2023,
  author    = {Haarmann, Axel and Vollmuth, Christoph and Kollikowski, Alexander M. and Heuschmann, Peter U. and Pham, Mirko and Stoll, Guido and Neugebauer, Hermann and Schuhmann, Michael K.},
  title     = {Vasoactive soluble endoglin: a novel biomarker indicative of reperfusion after cerebral large-vessel occlusion},
  series = {Cells},
  volume    = {12},
  journal   = {Cells},
  number    = {2},
  issn      = {2073-4409},
  doi       = {10.3390/cells12020288},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304995},
  year      = {2023},
  abstract  = {Now that mechanical thrombectomy has substantially improved outcomes after large-vessel occlusion stroke in up to every second patient, futile reperfusion wherein successful recanalization is not followed by a favorable outcome is moving into focus. Unfortunately, blood-based biomarkers, which identify critical stages of hemodynamically compromised yet reperfused tissue, are lacking. We recently reported that hypoxia induces the expression of endoglin, a TGF-β co-receptor, in human brain endothelium in vitro. Subsequent reoxygenation resulted in shedding. Our cell model suggests that soluble endoglin compromises the brain endothelial barrier function. To evaluate soluble endoglin as a potential biomarker of reperfusion (-injury) we analyzed its concentration in 148 blood samples of patients with acute stroke due to large-vessel occlusion. In line with our in vitro data, systemic soluble endoglin concentrations were significantly higher in patients with successful recanalization, whereas hypoxia alone did not induce local endoglin shedding, as analyzed by intra-arterial samples from hypoxic vasculature. In patients with reperfusion, higher concentrations of soluble endoglin additionally indicated larger infarct volumes at admission. In summary, we give translational evidence that the sequence of hypoxia and subsequent reoxygenation triggers the release of vasoactive soluble endoglin in large-vessel occlusion stroke and can serve as a biomarker for severe ischemia with ensuing recanalization/reperfusion.},
  language  = {en}
}
@article{GuggenbergerVogtSongetal.2023,
  author    = {Guggenberger, Konstanze V. and Vogt, Marius L. and Song, Jae W. and Weng, Andreas M. and Fr{\"o}hlich, Matthias and Schmalzing, Marc and Venhoff, Nils and Hillenkamp, Jost and Pham, Mirko and Meckel, Stephan and Bley, Thorsten A.},
  title     = {Intraorbital findings in giant cell arteritis on black blood MRI},
  series = {European Radiology},
  volume    = {33},
  journal   = {European Radiology},
  number    = {4},
  doi       = {10.1007/s00330-022-09256-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324978},
  pages     = {2529-2535},
  year      = {2023},
  abstract  = {Objective Blindness is a feared complication of giant cell arteritis (GCA). However, the spectrum of pathologic orbital imaging findings on magnetic resonance imaging (MRI) in GCA is not well understood. In this study, we assess inflammatory changes of intraorbital structures on black blood MRI (BB-MRI) in patients with GCA compared to age-matched controls. Methods In this multicenter case-control study, 106 subjects underwent BB-MRI. Fifty-six patients with clinically or histologically diagnosed GCA and 50 age-matched controls without clinical or laboratory evidence of vasculitis were included. All individuals were imaged on a 3-T MR scanner with a post-contrast compressed-sensing (CS) T1-weighted sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) BB-MRI sequence. Imaging results were correlated with available clinical symptoms. Results Eighteen of 56 GCA patients (32\%) showed inflammatory changes of at least one of the intraorbital structures. The most common finding was enhancement of at least one of the optic nerve sheaths (N = 13, 72\%). Vessel wall enhancement of the ophthalmic artery was unilateral in 8 and bilateral in 3 patients. Enhancement of the optic nerve was observed in one patient. There was no significant correlation between imaging features of inflammation and clinically reported orbital symptoms (p = 0.10). None of the age-matched control patients showed any inflammatory changes of intraorbital structures. Conclusions BB-MRI revealed inflammatory findings in the orbits in up to 32\% of patients with GCA. Optic nerve sheath enhancement was the most common intraorbital inflammatory change on BB-MRI. MRI findings were independent of clinically reported orbital symptoms. Key Points • Up to 32\% of GCA patients shows signs of inflammation of intraorbital structures on BB-MRI. • Enhancement of the optic nerve sheath is the most common intraorbital finding in GCA patients on BB-MRI. • Features of inflammation of intraorbital structures are independent of clinically reported symptoms.},
  language  = {en}
}
@article{GoepfertTraubSelletal.2023,
  author    = {G{\"o}pfert, Dennis and Traub, Jan and Sell, Roxane and Homola, Gy{\"o}rgy A. and Vogt, Marius and Pham, Mirko and Frantz, Stefan and St{\"o}rk, Stefan and Stoll, Guido and Frey, Anna},
  title     = {Profiles of cognitive impairment in chronic heart failure—A cluster analytic approach},
  series = {Frontiers in Human Neuroscience},
  volume    = {17},
  journal   = {Frontiers in Human Neuroscience},
  doi       = {10.3389/fnhum.2023.1126553},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-313429},
  year      = {2023},
  abstract  = {Background Cognitive impairment is a major comorbidity in patients with chronic heart failure (HF) with a wide range of phenotypes. In this study, we aimed to identify and compare different clusters of cognitive deficits. Methods The prospective cohort study "Cognition.Matters-HF" recruited 147 chronic HF patients (aged 64.5 ± 10.8 years; 16.2\% female) of any etiology. All patients underwent extensive neuropsychological testing. We performed a hierarchical cluster analysis of the cognitive domains, such as intensity of attention, visual/verbal memory, and executive function. Generated clusters were compared exploratively with respect to the results of cardiological, neurological, and neuroradiological examinations without correction for multiple testing. Results Dendrogram and the scree plot suggested three distinct cognitive profiles: In the first cluster, 42 patients (28.6\%) performed without any deficits in all domains. Exclusively, the intensity of attention deficits was seen in the second cluster, including 55 patients (37.4\%). A third cluster with 50 patients (34.0\%) was characterized by deficits in all cognitive domains. Age (p = 0.163) and typical clinical markers of chronic HF, such as ejection fraction (p = 0.222), 6-min walking test distance (p = 0.138), NT-proBNP (p = 0.364), and New York Heart Association class (p = 0.868) did not differ between clusters. However, we observed that women (p = 0.012) and patients with previous cardiac valve surgery (p = 0.005) prevailed in the "global deficits" cluster and the "no deficits" group had a lower prevalence of underlying arterial hypertension (p = 0.029). Total brain volume (p = 0.017) was smaller in the global deficit cluster, and serum levels of glial fibrillary acidic protein were increased (p = 0.048). Conclusion Apart from cognitively healthy and globally impaired HF patients, we identified a group with deficits only in the intensity of attention. Women and patients with previous cardiac valve surgery are at risk for global cognitive impairment when suffering HF and could benefit from special multimodal treatment addressing the psychosocial condition.},
  language  = {en}
}
@article{LehriederZapantisPhametal.2023,
  author    = {Lehrieder, Dominik and Zapantis, Nikolaos and Pham, Mirko and Schuhmann, Michael Klaus and Haarmann, Axel},
  title     = {Treating seronegative neuromyelitis optica spectrum disorder with inebilizumab: a case report},
  series = {Frontiers in Neurology},
  volume    = {14},
  journal   = {Frontiers in Neurology},
  doi       = {10.3389/fneur.2023.1297341},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-354031},
  year      = {2023},
  abstract  = {Background Neuromyelitis optica spectrum disorder (NMOSD) is a devastating inflammatory disease of the central nervous system that is often severely disabling from the outset. The lack of pathognomonic aquaporin 4 (AQP4) antibodies in seronegative NMOSD not only hinders early diagnosis, but also limits therapeutic options, in contrast to AQP4 antibody-positive NMOSD, where the therapeutic landscape has recently evolved massively. Case presentation We report a 56-year-old woman with bilateral optic neuritis and longitudinally extensive myelitis as the index events of a seronegative NMOSD, who was successfully treated with inebilizumab. Conclusion Treatment with inebilizumab may be considered in aggressive seronegative NMOSD. Whether broader CD19-directed B cell depletion is more effective than treatment with rituximab remains elusive.},
  language  = {en}
}
@article{StebaniBlaimerZableretal.2023,
  author    = {Stebani, Jannik and Blaimer, Martin and Zabler, Simon and Neun, Tilmann and Pelt, Dani{\"e}l M. and Rak, Kristen},
  title     = {Towards fully automated inner ear analysis with deep-learning-based joint segmentation and landmark detection framework},
  series = {Scientific Reports},
  volume    = {13},
  journal   = {Scientific Reports},
  doi       = {10.1038/s41598-023-45466-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357411},
  year      = {2023},
  abstract  = {Automated analysis of the inner ear anatomy in radiological data instead of time-consuming manual assessment is a worthwhile goal that could facilitate preoperative planning and clinical research. We propose a framework encompassing joint semantic segmentation of the inner ear and anatomical landmark detection of helicotrema, oval and round window. A fully automated pipeline with a single, dual-headed volumetric 3D U-Net was implemented, trained and evaluated using manually labeled in-house datasets from cadaveric specimen (N = 43) and clinical practice (N = 9). The model robustness was further evaluated on three independent open-source datasets (N = 23 + 7 + 17 scans) consisting of cadaveric specimen scans. For the in-house datasets, Dice scores of 0.97 and 0.94, intersection-over-union scores of 0.94 and 0.89 and average Hausdorf distances of 0.065 and 0.14 voxel units were achieved. The landmark localization task was performed automatically with an average localization error of 3.3 and 5.2 voxel units. A robust, albeit reduced performance could be attained for the catalogue of three open-source datasets. Results of the ablation studies with 43 mono-parametric variations of the basal architecture and training protocol provided task-optimal parameters for both categories. Ablation studies against single-task variants of the basal architecture showed a clear performance beneft of coupling landmark localization with segmentation and a dataset-dependent performance impact on segmentation ability.},
  language  = {en}
}
@article{VogelRueckertGreineretal.2023,
  author    = {Vogel, P. and R{\"u}ckert, M. A. and Greiner, C. and G{\"u}nther, J. and Reichl, T. and Kampf, T. and Bley, T. A. and Behr, V. C. and Herz, S.},
  title     = {iMPI: portable human-sized magnetic particle imaging scanner for real-time endovascular interventions},
  series = {Scientific Reports},
  volume    = {13},
  journal   = {Scientific Reports},
  doi       = {10.1038/s41598-023-37351-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357794},
  year      = {2023},
  abstract  = {Minimally invasive endovascular interventions have become an important tool for the treatment of cardiovascular diseases such as ischemic heart disease, peripheral artery disease, and stroke. X-ray fluoroscopy and digital subtraction angiography are used to precisely guide these procedures, but they are associated with radiation exposure for patients and clinical staff. Magnetic Particle Imaging (MPI) is an emerging imaging technology using time-varying magnetic fields combined with magnetic nanoparticle tracers for fast and highly sensitive imaging. In recent years, basic experiments have shown that MPI has great potential for cardiovascular applications. However, commercially available MPI scanners were too large and expensive and had a small field of view (FOV) designed for rodents, which limited further translational research. The first human-sized MPI scanner designed specifically for brain imaging showed promising results but had limitations in gradient strength, acquisition time and portability. Here, we present a portable interventional MPI (iMPI) system dedicated for real-time endovascular interventions free of ionizing radiation. It uses a novel field generator approach with a very large FOV and an application-oriented open design enabling hybrid approaches with conventional X-ray-based angiography. The feasibility of a real-time iMPI-guided percutaneous transluminal angioplasty (PTA) is shown in a realistic dynamic human-sized leg model.},
  language  = {en}
}
@article{GuggenbergerBleyVogtetal.2022,
  author    = {Guggenberger, Konstanze V. and Bley, Thorsten A. and Vogt, Marius L. and Urbach, Horst and Meckel, Stephan},
  title     = {High-Resolution Black Blood Vessel Wall Imaging in COVID-19 Encephalopathy-Is it Really Endotheliitis?},
  series = {Clinical Neuroradiology},
  volume    = {32},
  journal   = {Clinical Neuroradiology},
  number    = {1},
  doi       = {10.1007/s00062-021-01109-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264794},
  pages     = {295-296},
  year      = {2022},
  abstract  = {No abstract available.},
  language  = {en}
}
@article{VogtKollikowskiWeidneretal.2022,
  author    = {Vogt, Marius L. and Kollikowski, Alexander M. and Weidner, Franziska and Strinitz, Marc and Feick, J{\"o}rn and Essig, Fabian and Neugebauer, Herrmann and Haeusler, Karl Georg and Pham, Mirko and Maerz, Alexander},
  title     = {Safety and Effectiveness of the New Generation APERIO® Hybrid Stent-retriever Device in Large Vessel Occlusion Stroke},
  series = {Clinical Neuroradiology},
  volume    = {32},
  journal   = {Clinical Neuroradiology},
  number    = {1},
  doi       = {10.1007/s00062-021-01122-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264817},
  pages     = {141-151},
  year      = {2022},
  abstract  = {Background It is unknown whether technological advancement of stent-retriever devices influences typical observational indicators of safety or effectiveness. Methods Observational retrospective study of APERIO® (AP) vs. new generation APERIO® Hybrid (APH) (Acandis®, Pforzheim, Germany) stent-retriever device (01/2019-09/2020) for mechanical thrombectomy (MT) in large vessel occlusion (LVO) stroke. Primary effectiveness endpoint was successful recanalization eTICI (expanded Thrombolysis In Cerebral Ischemia) ≥ 2b67, primary safety endpoint was occurrence of hemorrhagic complications after MT. Secondary outcome measures were time from groin puncture to first pass and successful reperfusion, and the total number of passes needed to achieve the final recanalization result. Results A total of 298 patients with LVO stroke who were treated by MT matched the inclusion criteria: 148 patients (49.7\%) treated with AP vs. 150 patients (50.3\%) treated with new generation APH. Successful recanalization was not statistically different between both groups: 75.7\% for AP vs. 79.3\% for APH; p = 0.450. Postinterventional hemorrhagic complications and particularly subarachnoid hemorrhage as the entity possibly associated with stent-retriever device type was significantly less frequent in the group treated with the APH: 29.7\% for AP and 16.0\% for APH; p = 0.005; however, rates of symptomatic hemorrhage with clinical deterioration and in domo mortality were not statistically different. Neither the median number of stent-retriever passages needed to achieve final recanalization, time from groin puncture to first pass, time from groin puncture to final recanalization nor the number of cases in which successful recanalization could only be achieved by using a different stent-retriever as bail-out device differed between both groups. Conclusion In the specific example of the APERIO® stent-retriever device, we observed that further technological developments of the new generation device were not associated with disadvantages with respect to typical observational indicators of safety or effectiveness.},
  language  = {en}
}