@article{FriedrichSchneiderBuerkleinetal.2023,
  author    = {Friedrich, Maximilian U. and Schneider, Erich and Buerklein, Miriam and Taeger, Johannes and Hartig, Johannes and Volkmann, Jens and Peach, Robert and Zeller, Daniel},
  title     = {Smartphone video nystagmography using convolutional neural networks: ConVNG},
  series = {Journal of Neurology},
  volume    = {270},
  journal   = {Journal of Neurology},
  number    = {5},
  doi       = {10.1007/s00415-022-11493-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324526},
  pages     = {2518-2530},
  year      = {2023},
  abstract  = {Background Eye movement abnormalities are commonplace in neurological disorders. However, unaided eye movement assessments lack granularity. Although videooculography (VOG) improves diagnostic accuracy, resource intensiveness precludes its broad use. To bridge this care gap, we here validate a framework for smartphone video-based nystagmography capitalizing on recent computer vision advances. Methods A convolutional neural network was fine-tuned for pupil tracking using > 550 annotated frames: ConVNG. In a cross-sectional approach, slow-phase velocity of optokinetic nystagmus was calculated in 10 subjects using ConVNG and VOG. Equivalence of accuracy and precision was assessed using the "two one-sample t-test" (TOST) and Bayesian interval-null approaches. ConVNG was systematically compared to OpenFace and MediaPipe as computer vision (CV) benchmarks for gaze estimation. Results ConVNG tracking accuracy reached 9-15\% of an average pupil diameter. In a fully independent clinical video dataset, ConVNG robustly detected pupil keypoints (median prediction confidence 0.85). SPV measurement accuracy was equivalent to VOG (TOST p < 0.017; Bayes factors (BF) > 24). ConVNG, but not MediaPipe, achieved equivalence to VOG in all SPV calculations. Median precision was 0.30°/s for ConVNG, 0.7°/s for MediaPipe and 0.12°/s for VOG. ConVNG precision was significantly higher than MediaPipe in vertical planes, but both algorithms' precision was inferior to VOG. Conclusions ConVNG enables offline smartphone video nystagmography with an accuracy comparable to VOG and significantly higher precision than MediaPipe, a benchmark computer vision application for gaze estimation. This serves as a blueprint for highly accessible tools with potential to accelerate progress toward precise and personalized Medicine.},
  language  = {en}
}
@article{NoyaletIlgenBuerkleinetal.2022,
  author    = {Noyalet, Laurent and Ilgen, Lukas and B{\"u}rklein, Miriam and Shehata-Dieler, Wafaa and Taeger, Johannes and Hagen, Rudolf and Neun, Tilmann and Zabler, Simon and Althoff, Daniel and Rak, Kristen},
  title     = {Vestibular aqueduct morphology and Meniere's disease - development of the vestibular aqueduct score by 3D analysis},
  series = {Frontiers in Surgery},
  volume    = {9},
  journal   = {Frontiers in Surgery},
  issn      = {2296-875X},
  doi       = {10.3389/fsurg.2022.747517},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-312893},
  year      = {2022},
  abstract  = {Improved radiological examinations with newly developed 3D models may increase understanding of Meniere's disease (MD). The morphology and course of the vestibular aqueduct (VA) in the temporal bone might be related to the severity of MD. The presented study explored, if the VA of MD and non-MD patients can be grouped relative to its angle to the semicircular canals (SCC) and length using a 3D model. Scans of temporal bone specimens (TBS) were performed using micro-CT and micro flat panel volume computed tomography (mfpVCT). Furthermore, scans were carried out in patients and TBS by computed tomography (CT). The angle between the VA and the three SCC, as well as the length of the VA were measured. From these data, a 3D model was constructed to develop the vestibular aqueduct score (VAS). Using different imaging modalities it was demonstrated that angle measurements of the VA are reliable and can be effectively used for detailed diagnostic investigation. To test the clinical relevance, the VAS was applied on MD and on non-MD patients. Length and angle values from MD patients differed from non-MD patients. In MD patients, significantly higher numbers of VAs could be assigned to a distinct group of the VAS. In addition, it was tested, whether the outcome of a treatment option for MD can be correlated to the VAS.},
  language  = {en}
}
@article{MuellerGraffIlgenSchendzielorzetal.2022,
  author    = {M{\"u}ller-Graff, Franz-Tassilo and Ilgen, Lukas and Schendzielorz, Philipp and Voelker, Johannes and Taeger, Johannes and Kurz, Anja and Hagen, Rudolf and Neun, Tilmann and Rak, Kristen},
  title     = {Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation},
  series = {European Archives of Oto-Rhino-Laryngology},
  volume    = {279},
  journal   = {European Archives of Oto-Rhino-Laryngology},
  number    = {5},
  issn      = {1434-4726},
  doi       = {10.1007/s00405-021-06924-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266798},
  pages     = {2309-2319},
  year      = {2022},
  abstract  = {Purpose For further improvements in cochlear implantation, the measurement of the cochlear duct length (CDL) and the determination of the electrode contact position (ECP) are increasingly in the focus of clinical research. Usually, these items were investigated by multislice computed tomography (MSCT). The determination of ECP was only possible by research programs so far. Flat-panel volume computed tomography (fpVCT) and its secondary reconstructions (fpVCT\(_{SECO}\)) allow for high spatial resolution for the visualization of the temporal bone structures. Using a newly developed surgical planning software that enables the evaluation of CDL and the determination of postoperative ECP, this study aimed to investigate the combination of fpVCT and otological planning software to improve the implementation of an anatomically based cochlear implantation. Methods Cochlear measurements were performed utilizing surgical planning software in imaging data (MSCT, fpVCT and fpVCT\(_{SECO}\)) of patients with and without implanted electrodes. Results Measurement of the CDL by the use of an otological planning software was highly reliable using fpVCT\(_{SECO}\) with a lower variance between the respective measurements compared to MSCT. The determination of the inter-electrode-distance (IED) between the ECP was improved in fpVCT\(_{SECO}\) compared to MSCT. Conclusion The combination of fpVCT\(_{SECO}\) and otological planning software permits a simplified and more reliable analysis of the cochlea in the pre- and postoperative setting. The combination of both systems will enable further progress in the development of an anatomically based cochlear implantation.},
  language  = {en}
}
@article{TaegerMuellerGraffLukasetal.2021,
  author    = {Taeger, Johannes and M{\"u}ller-Graff, Franz-Tassilo and Lukas, Ilgen and Schendzielorz, Philipp and Hagen, Rudolf and Neun, Tilman and Rak, Kristen},
  title     = {Cochlear duct length measurements in computed tomography and magnetic resonance imaging using newly developed techniques},
  series = {OTO Open},
  volume    = {5},
  journal   = {OTO Open},
  number    = {3},
  doi       = {10.1177/2473974X211045312},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-263922},
  pages     = {1-8},
  year      = {2021},
  abstract  = {Objective Growing interest in measuring the cochlear duct length (CDL) has emerged, since it can influence the selection of cochlear implant electrodes. Currently the measurements are performed with ionized radiation imaging. Only a few studies have explored CDL measurements in magnetic resonance imaging (MRI). Therefore, the presented study aims to fill this gap by estimating CDL in MRI and comparing it with multislice computed tomography (CT). Study Design Retrospective data analyses of 42 cochleae. Setting Tertiary care medical center. Methods Diameter (A value) and width (B value) of the cochlea were measured in HOROS software. The CDL and the 2-turn length were determined by the elliptic circular approximation (ECA). In addition, the CDL, the 2-turn length, and the angular length were determined via HOROS software by the multiplanar reconstruction (MPR) method. Results CDL values were significantly shorter in MRI by MPR (d = 1.38 mm, P < .001) but not by ECA. Similar 2-turn length measurements were significantly lower in MRI by MPR (d = 1.67 mm) and ECA (d = 1.19 mm, both P < .001). In contrast, angular length was significantly higher in MRI (d = 26.79°, P < .001). When the values were set in relation to the frequencies of the cochlea, no clinically relevant differences were estimated (58 Hz at 28-mm CDL). Conclusion In the presented study, CDL was investigated in CT and MRI by using different approaches. Since no clinically relevant differences were found, diagnostics with radiation may be omitted prior to cochlear implantation; thus, a concept of radiation-free cochlear implantation could be established.},
  language  = {en}
}
@article{TaegerMuellerGraffNeunetal.2021,
  author    = {Taeger, Johannes and M{\"u}ller-Graff, Franz-Tassilo and Neun, Tilmann and K{\"o}ping, Maria and Schendzielorz, Philipp and Hagen, Rudolf and Rak, Kristen},
  title     = {Highly precise navigation at the lateral skull base by the combination of flat-panel volume CT and electromagnetic navigation},
  series = {Science Progress},
  volume    = {104},
  journal   = {Science Progress},
  number    = {3},
  issn      = {2047-7163},
  doi       = {10.1177/00368504211032090},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-250268},
  year      = {2021},
  abstract  = {This study aimed to evaluate the feasibility and accuracy of electromagnetic navigation at the lateral skull base in combination with flat panel volume computed tomography (fpVCT) datasets. A mastoidectomy and a posterior tympanotomy were performed on 10 samples of fresh frozen temporal bones. For registration, four self-drilling titanium screws were applied as fiducial markers. Multi-slice computed tomography (MSCT; 600 µm), conventional flat panel volume computed tomography (fpVCT; 466 µm), micro-fpVCT (197 µm) and secondary reconstructed fpVCT (100 µM) scans were performed and data were loaded into the navigation system. The resulting fiducial registration error (FRE) was analysed, and control of the navigation accuracy was performed. The registration process was very quick and reliable with the screws as fiducials. Compared to using the MSCT data, the micro-fpVCT data led to significantly lower FRE values, whereas conventional fpVCT and secondary reconstructed fpVCT data had no advantage in terms of accuracy. For all imaging modalities, there was no relevant visual deviation when targeting defined anatomical points with a navigation probe. fpVCT data are very well suited for electromagnetic navigation at the lateral skull base. The use of titanium screws as fiducial markers turned out to be ideal for comparing different imaging methods. A further evaluation of this approach by a clinical trial is required.},
  language  = {en}
}