@phdthesis{Herz2012, author = {Herz, Stefan}, title = {Dynamische Ver{\"a}nderungen der Homing-Rezeptor-Expression humaner T-Zellen im peripheren Blut}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-93907}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2012}, abstract = {Dieses Projekt soll zur Entwicklung eines Bluttests beitragen, um bei allogen stammzelltransplantierten (allo-SZT) Patienten eine drohende akute Graft-versus-Host Disease (aGVHD) vorhersagen und von einer Infektionskomplikation unterscheiden zu k{\"o}nnen. Die aGVHD und opportunistische Infektionen, wie etwa eine Zytomegalievirus- Infektion, stellen die Hauptrisiken der allo-SZT dar. Eine durch einen pr{\"a}diktiven Test verbesserte Vorhersage bzw. Differenzierung dieser beiden schweren omplikationen k{\"o}nnte zu einem breiteren Einsatz der allo-SZT f{\"u}hren. Eine Reihe von Erkenntnissen lassen die Vermutung zu, dass bestimmte Homing- Rezeptoren auf T-Zellen im peripheren Blut als Marker zur Vorhersage und Differenzierung zwischen einer aGVHD und Infektionskomplikationen dienen k{\"o}nnten. So wurde in Mausmodellen gezeigt, dass die Pathogenese der aGVHD ein streng zeitlich regulierter und organspezifischer Immunprozess ist. Alloreaktive T-Zellen m{\"u}ssen bestimmte Homing-Rezeptoren exprimieren, um in die Zielorgane der aGVHD (Gastrointestinaltrakt, Leber und Haut) einwandern zu k{\"o}nnen. Die Immunreaktion auf eine Infektion setzt ebenfalls voraus, dass in der adaptiven Immunantwort T-Zellen organ- und entz{\"u}ndungsspezifische Homing-Rezeptoren exprimieren. Eine zentrale Voraussetzung f{\"u}r einen prospektiven klinischen Test mit allo-SZT Patienten ist die Kenntnis der physiologischen Bandbreite der Oberfl{\"a}chenmarker auf T-Lymphozyten in Gesunden, um diese von pathophysiologischen Ver{\"a}nderungen unterscheiden zu k{\"o}nnen. Ziel dieser Arbeit war es daher, eine effiziente und zuverl{\"a}ssige Methode zu entwickeln, um das Homing-Rezeptor-Profil von humanen T-Zellen im peripheren Blut analysieren zu k{\"o}nnen. Dazu wurde ein urchflusszytometrie-Test mit 25 Oberfl{\"a}chenmarkern etabliert, die eine Rolle in der Pathogenese der aGVHD und bei Infektionen spielen k{\"o}nnten. Mit diesem Test wurde die Expression der Oberfl{\"a}chenmarker von 21 gesunden Probanden an 8 Zeitpunkten {\"u}ber einen Zeitraum von 3 Wochen analysiert. Die untersuchten Oberfl{\"a}chenmarker lassen sich dabei entsprechend ihrer Expressionsmuster in drei Kategorien einteilen, n{\"a}mlich (I) zeitlich stabile niedrige, (II) zeitlich stabile hohe und (III) dynamisch schwankende Expression. Aufbauend auf diesen Ergebnissen f{\"u}r gesunde Probanden wurde am Universit{\"a}tsklinikum W{\"u}rzburg eine prospektive klinische Studie an aGVHD-Patienten begonnen.}, subject = {T-Lymphozyt}, language = {de} } @article{HeroldHerzWinteretal.2017, author = {Herold, Volker and Herz, Stefan and Winter, Patrick and Gutjahr, Fabian Tobias and Andelovic, Kristina and Bauer, Wolfgang Rudolf and Jakob, Peter Michael}, title = {Assessment of local pulse wave velocity distribution in mice using k-t BLAST PC-CMR with semi-automatic area segmentation.}, series = {Journal of Cardiovascular Magnetic Resonance}, volume = {19}, journal = {Journal of Cardiovascular Magnetic Resonance}, number = {77}, doi = {10.1186/s12968-017-0382-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157696}, year = {2017}, abstract = {Background: Local aortic pulse wave velocity (PWV) is a measure for vascular stiffness and has a predictive value for cardiovascular events. Ultra high field CMR scanners allow the quantification of local PWV in mice, however these systems are yet unable to monitor the distribution of local elasticities. Methods: In the present study we provide a new accelerated method to quantify local aortic PWV in mice with phase-contrast cardiovascular magnetic resonance imaging (PC-CMR) at 17.6 T. Based on a k-t BLAST (Broad-use Linear Acquisition Speed-up Technique) undersampling scheme, total measurement time could be reduced by a factor of 6. The fast data acquisition enables to quantify the local PWV at several locations along the aortic blood vessel based on the evaluation of local temporal changes in blood flow and vessel cross sectional area. To speed up post processing and to eliminate operator bias, we introduce a new semi-automatic segmentation algorithm to quantify cross-sectional areas of the aortic vessel. The new methods were applied in 10 eight-month-old mice (4 C57BL/6J-mice and 6 ApoE\(^{(-/-)}\)-mice) at 12 adjacent locations along the abdominal aorta. Results: Accelerated data acquisition and semi-automatic post-processing delivered reliable measures for the local PWV, similiar to those obtained with full data sampling and manual segmentation. No statistically significant differences of the mean values could be detected for the different measurement approaches. Mean PWV values were elevated for the ApoE\(^{(-/-)}\)-group compared to the C57BL/6J-group (3.5 ± 0.7 m/s vs. 2.2 ± 0.4 m/s, p < 0.01). A more heterogeneous PWV-distribution in the ApoE \(^{(-/-)}\)-animals could be observed compared to the C57BL/6J-mice, representing the local character of lesion development in atherosclerosis. Conclusion: In the present work, we showed that k-t BLAST PC-MRI enables the measurement of the local PWV distribution in the mouse aorta. The semi-automatic segmentation method based on PC-CMR data allowed rapid determination of local PWV. The findings of this study demonstrate the ability of the proposed methods to non-invasively quantify the spatial variations in local PWV along the aorta of ApoE\(^{(-/-)}\)-mice as a relevant model of atherosclerosis.}, language = {en} } @article{VogelMarkertRueckertetal.2019, author = {Vogel, Patrick and Markert, Jonathan and R{\"u}ckert, Martin A. and Herz, Stefan and Keßler, Benedikt and Dremel, Kilian and Althoff, Daniel and Weber, Matthias and Buzug, Thorsten M. and Bley, Thorsten A. and Kullmann, Walter H. and Hanke, Randolf and Zabler, Simon and Behr, Volker C.}, title = {Magnetic Particle Imaging meets computed tomography: first simultaneous imaging}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-48960-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202501}, pages = {12627}, year = {2019}, abstract = {Magnetic Particle Imaging (MPI) is a promising new tomographic modality for fast as well as three-dimensional visualization of magnetic material. For anatomical or structural information an additional imaging modality such as computed tomography (CT) is required. In this paper, the first hybrid MPI-CT scanner for multimodal imaging providing simultaneous data acquisition is presented.}, language = {en} } @article{GrunzWenigKunzetal.2020, author = {Grunz, Jan-Peter and Wenig, Andreas Max and Kunz, Andreas Steven and Veyhl-Wichmann, Maike and Schmitt, Rainer and Gietzen, Carsten Herbert and Pennig, Lenhard and Herz, Stefan and Erg{\"u}n, S{\"u}leyman and Bley, Thorsten Alexander and Gassenmaier, Tobias}, title = {3D cone-beam CT with a twin robotic x-ray system in elbow imaging: comparison of image quality to high-resolution multidetector CT}, series = {European Radiology Experimental}, volume = {4}, journal = {European Radiology Experimental}, doi = {10.1186/s41747-020-00177-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229877}, year = {2020}, abstract = {Background Elbow imaging is challenging with conventional multidetector computed tomography (MDCT), while cone-beam CT (CBCT) provides superior options. We compared intra-individually CBCT versus MDCT image quality in cadaveric elbows. Methods A twin robotic x-ray system with new CBCT mode and a high-resolution clinical MDCT were compared in 16 cadaveric elbows. Both systems were operated with a dedicated low-dose (LD) protocol (equivalent volume CT dose index [CTDI\(_{vol(16 cm)}\)] = 3.3 mGy) and a regular clinical scan dose (RD) protocol (CTDI\(_{vol(16 cm)}\) = 13.8 mGy). Image quality was evaluated by two radiologists (R1 and R2) on a seven-point Likert scale, and estimation of signal intensity in cancellous bone was conducted. Wilcoxon signed-rank tests and intraclass correlation coefficient (ICC) statistics were used. Results The CBCT prototype provided superior subjective image quality compared to MDCT scans (for RD, p ≤ 0.004; for LD, p ≤ 0.001). Image quality was rated very good or excellent in 100\% of the cases by both readers for RD CBCT, 100\% (R1) and 93.8\% (R2) for LD CBCT, 62.6\% and 43.8\% for RD MDCT, and 0.0\% and 0.0\% for LD MDCT. Single-measure ICC was 0.95 (95\% confidence interval 0.91-0.97; p < 0.001). Software-based assessment supported subjective findings with less "undecided" pixels in CBCT than dose-equivalent MDCT (p < 0.001). No significant difference was found between LD CBCT and RD MDCT. Conclusions In cadaveric elbow studies, the tested cone-beam CT prototype delivered superior image quality compared to high-end multidetector CT and showed a potential for considerable dose reduction.}, language = {en} } @article{ReichelHerzelTabbakhetal.2021, author = {Reichel, Thomas and Herz, Stefan and el Tabbakh, Mohammed and Bley, Thorsten Alexander and Plumhoff, Piet and Rueckl, Kilian}, title = {Less than 9.5-mm coracohumeral distance on axial magnetic resonance imaging scans predicts for subscapularis tear}, series = {JSES International}, volume = {5}, journal = {JSES International}, number = {3}, doi = {10.1016/j.jseint.2021.01.014}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259118}, pages = {424-429}, year = {2021}, abstract = {Background Diagnosis of subscapularis (SSC) tendon lesions on magnetic resonance imaging (MRI) can be challenging. A small coracohumeral distance (CHD) has been associated with SSC tears. This study was designed to define a specific threshold value for CHD to predict SSC tears on axial MRI scans. Methods This retrospective study included 172 shoulders of 168 patients who underwent arthroscopic surgery for rotator cuff tear or glenohumeral instability. Diagnostic arthroscopy confirmed an SSC tear in 62 cases (36.0\%, test group a), rotator cuff tear tears other than SSC in 71 cases (41.3\%, control group b) and glenohumeral instability without any rotator cuff tear in 39 cases (22.7\%, zero-sample group c). All patients had a preoperative MRI of the shoulder (1.5T or 3T). Minimum CHD was measured on axial fat-suppressed proton density-, T2-, or T1-weigthed sequences. Receiver operating characteristics analysis was used to determine the threshold value for CHD, and sensitivity and specificity were calculated. Results CHD measurement had a good interobserver reliability (Intraclass correlation coefficient 0.799). Mean CHD was highly significantly (P < .001) less for test group a (mean 7.3 mm, standard deviation ± 2.2) compared with control group b (mean 11.1 mm, standard deviation ± 2.3) or zero-sample group c (mean 13.6 mm, standard deviation ± 2.9). A threshold value of CHD <9.5 mm had a sensitivity of 83.6\% and a specificity of 83.9\% to predict SSC tears. Conclusion A CHD <9.5 mm on MRI is predictive of SSC lesions and a valuable tool to diagnose SSC tears.}, language = {en} } @article{HockTerekhovStefanescuetal.2021, author = {Hock, Michael and Terekhov, Maxim and Stefanescu, Maria Roxana and Lohr, David and Herz, Stefan and Reiter, Theresa and Ankenbrand, Markus and Kosmala, Aleksander and Gassenmaier, Tobias and Juchem, Christoph and Schreiber, Laura Maria}, title = {B\(_{0}\) shimming of the human heart at 7T}, series = {Magnetic Resonance in Medicine}, volume = {85}, journal = {Magnetic Resonance in Medicine}, number = {1}, doi = {10.1002/mrm.28423}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218096}, pages = {182 -- 196}, year = {2021}, abstract = {Purpose Inhomogeneities of the static magnetic B\(_{0}\) field are a major limiting factor in cardiac MRI at ultrahigh field (≥ 7T), as they result in signal loss and image distortions. Different magnetic susceptibilities of the myocardium and surrounding tissue in combination with cardiac motion lead to strong spatio-temporal B\(_{0}\)-field inhomogeneities, and their homogenization (B0 shimming) is a prerequisite. Limitations of state-of-the-art shimming are described, regional B\(_{0}\) variations are measured, and a methodology for spherical harmonics shimming of the B\(_{0}\) field within the human myocardium is proposed. Methods The spatial B\(_{0}\)-field distribution in the heart was analyzed as well as temporal B\(_{0}\)-field variations in the myocardium over the cardiac cycle. Different shim region-of-interest selections were compared, and hardware limitations of spherical harmonics B\(_{0}\) shimming were evaluated by calibration-based B0-field modeling. The role of third-order spherical harmonics terms was analyzed as well as potential benefits from cardiac phase-specific shimming. Results The strongest B\(_{0}\)-field inhomogeneities were observed in localized spots within the left-ventricular and right-ventricular myocardium and varied between systolic and diastolic cardiac phases. An anatomy-driven shim region-of-interest selection allowed for improved B\(_{0}\)-field homogeneity compared with a standard shim region-of-interest cuboid. Third-order spherical harmonics terms were demonstrated to be beneficial for shimming of these myocardial B\(_{0}\)-field inhomogeneities. Initial results from the in vivo implementation of a potential shim strategy were obtained. Simulated cardiac phase-specific shimming was performed, and a shim term-by-term analysis revealed periodic variations of required currents. Conclusion Challenges in state-of-the-art B\(_{0}\) shimming of the human heart at 7 T were described. Cardiac phase-specific shimming strategies were found to be superior to vendor-supplied shimming.}, language = {en} } @article{HerzStefanescuLohretal.2022, author = {Herz, Stefan and Stefanescu, Maria R. and Lohr, David and Vogel, Patrick and Kosmala, Aleksander and Terekhov, Maxim and Weng, Andreas M. and Grunz, Jan-Peter and Bley, Thorsten A. and Schreiber, Laura M.}, title = {Effects of image homogeneity on stenosis visualization at 7 T in a coronary artery phantom study: With and without B1-shimming and parallel transmission}, series = {PloS One}, volume = {17}, journal = {PloS One}, number = {6}, doi = {10.1371/journal.pone.0270689}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300129}, year = {2022}, abstract = {Background To investigate the effects of B\(_1\)-shimming and radiofrequency (RF) parallel transmission (pTX) on the visualization and quantification of the degree of stenosis in a coronary artery phantom using 7 Tesla (7 T) magnetic resonance imaging (MRI). Methods Stenosis phantoms with different grades of stenosis (0\%, 20\%, 40\%, 60\%, 80\%, and 100\%; 5 mm inner vessel diameter) were produced using 3D printing (clear resin). Phantoms were imaged with four different concentrations of diluted Gd-DOTA representing established arterial concentrations after intravenous injection in humans. Samples were centrally positioned in a thorax phantom of 30 cm diameter filled with a custom-made liquid featuring dielectric properties of muscle tissue. MRI was performed on a 7 T whole-body system. 2D-gradient-echo sequences were acquired with an 8-channel transmit 16-channel receive (8 Tx / 16 Rx) cardiac array prototype coil with and without pTX mode. Measurements were compared to those obtained with identical scan parameters using a commercially available 1 Tx / 16 Rx single transmit coil (sTX). To assess reproducibility, measurements (n = 15) were repeated at different horizontal angles with respect to the B0-field. Results B\(_1\)-shimming and pTX markedly improved flip angle homogeneity across the thorax phantom yielding a distinctly increased signal-to-noise ratio (SNR) averaged over a whole slice relative to non-manipulated RF fields. Images without B\(_1\)-shimming showed shading artifacts due to local B\(_1\)\(^+\)-field inhomogeneities, which hampered stenosis quantification in severe cases. In contrast, B\(_1\)-shimming and pTX provided superior image homogeneity. Compared with a conventional sTX coil higher grade stenoses (60\% and 80\%) were graded significantly (p<0.01) more precise. Mild to moderate grade stenoses did not show significant differences. Overall, SNR was distinctly higher with B\(_1\)-shimming and pTX than with the conventional sTX coil (inside the stenosis phantoms 14\%, outside the phantoms 32\%). Both full and half concentration (10.2 mM and 5.1 mM) of a conventional Gd-DOTA dose for humans were equally suitable for stenosis evaluation in this phantom study. Conclusions B\(_1\)-shimming and pTX at 7 T can distinctly improve image homogeneity and therefore provide considerably more accurate MR image analysis, which is beneficial for imaging of small vessel structures.}, language = {en} }