TY - JOUR A1 - Grunz, Jan-Peter A1 - Kunz, Andreas Steven A1 - Baumann, Freerk T. A1 - Hasenclever, Dirk A1 - Sieren, Malte Maria A1 - Heldmann, Stefan A1 - Bley, Thorsten Alexander A1 - Einsele, Hermann A1 - Knop, Stefan A1 - Jundt, Franziska T1 - Assessing osteolytic lesion size on sequential CT scans is a reliable study endpoint for bone remineralization in newly diagnosed multiple myeloma JF - Cancers N2 - Multiple myeloma (MM) frequently induces persisting osteolytic manifestations despite hematologic treatment response. This study aimed to establish a biometrically valid study endpoint for bone remineralization through quantitative and qualitative analyses in sequential CT scans. Twenty patients (seven women, 58 ± 8 years) with newly diagnosed MM received standardized induction therapy comprising the anti-SLAMF7 antibody elotuzumab, carfilzomib, lenalidomide, and dexamethasone (E-KRd). All patients underwent whole-body low-dose CT scans before and after six cycles of E-KRd. Two radiologists independently recorded osteolytic lesion sizes, as well as the presence of cortical destruction, pathologic fractures, rim and trabecular sclerosis. Bland–Altman analyses and Krippendorff’s α were employed to assess inter-reader reliability, which was high for lesion size measurement (standard error 1.2 mm) and all qualitative criteria assessed (α ≥ 0.74). After six cycles of E-KRd induction, osteolytic lesion size decreased by 22% (p < 0.001). While lesion size response did not correlate with the initial lesion size at baseline imaging (Pearson’s r = 0.144), logistic regression analysis revealed that the majority of responding osteolyses exhibited trabecular sclerosis (p < 0.001). The sum of osteolytic lesion sizes on sequential CT scans defines a reliable study endpoint to characterize bone remineralization. Patient level response is strongly associated with the presence of trabecular sclerosis. KW - multiple myeloma KW - bone remineralization KW - computed tomography KW - whole-body imaging Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362526 SN - 2072-6694 VL - 15 IS - 15 ER - TY - JOUR A1 - Schnabel, Renate B. A1 - Camen, Stephan A1 - Knebel, Fabian A1 - Hagendorff, Andreas A1 - Bavendiek, Udo A1 - Böhm, Michael A1 - Doehner, Wolfram A1 - Endres, Matthias A1 - Gröschel, Klaus A1 - Goette, Andreas A1 - Huttner, Hagen B. A1 - Jensen, Christoph A1 - Kirchhof, Paulus A1 - Korosoglou, Grigorius A1 - Laufs, Ulrich A1 - Liman, Jan A1 - Morbach, Caroline A1 - Navabi, Darius Günther A1 - Neumann-Haefelin, Tobias A1 - Pfeilschifter, Waltraut A1 - Poli, Sven A1 - Rizos, Timolaos A1 - Rolf, Andreas A1 - Röther, Joachim A1 - Schäbitz, Wolf Rüdiger A1 - Steiner, Thorsten A1 - Thomalla, Götz A1 - Wachter, Rolf A1 - Haeusler, Karl Georg T1 - Expert opinion paper on cardiac imaging after ischemic stroke JF - Clinical Research in Cardiology N2 - This expert opinion paper on cardiac imaging after acute ischemic stroke or transient ischemic attack (TIA) includes a statement of the "Heart and Brain" consortium of the German Cardiac Society and the German Stroke Society. The Stroke Unit-Commission of the German Stroke Society and the German Atrial Fibrillation NETwork (AFNET) endorsed this paper. Cardiac imaging is a key component of etiological work-up after stroke. Enhanced echocardiographic tools, constantly improving cardiac computer tomography (CT) as well as cardiac magnetic resonance imaging (MRI) offer comprehensive non- or less-invasive cardiac evaluation at the expense of increased costs and/or radiation exposure. Certain imaging findings usually lead to a change in medical secondary stroke prevention or may influence medical treatment. However, there is no proof from a randomized controlled trial (RCT) that the choice of the imaging method influences the prognosis of stroke patients. Summarizing present knowledge, the German Heart and Brain consortium proposes an interdisciplinary, staged standard diagnostic scheme for the detection of risk factors of cardio-embolic stroke. This expert opinion paper aims to give practical advice to physicians who are involved in stroke care. In line with the nature of an expert opinion paper, labeling of classes of recommendations is not provided, since many statements are based on expert opinion, reported case series, and clinical experience. KW - cardiac imaging KW - echocardiography KW - ischemic stroke KW - transient ischemic attack KW - expert opinion KW - magnetic resonance imaging KW - computed tomography Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-266662 SN - 1861-0692 VL - 110 IS - 7 ER - TY - JOUR A1 - Brandenburg, Vincent M. A1 - Kramann, Rafael A1 - Koos, Ralf A1 - Krueger, Thilo A1 - Schurgers, Leon A1 - Mühlenbruch, Georg A1 - Hübner, Sinah A1 - Gladziwa, Ulrich A1 - Drechler, Christiane A1 - Ketteler, Markus T1 - Relationship between sclerostin and cardiovascular calcification in hemodialysis patients: a cross-sectional study JF - BMC Nephrology N2 - Background: Sclerostin is a Wnt pathway antagonist regulating osteoblast activity and bone turnover. Here, we assessed the potential association of sclerostin with the development of coronary artery (CAC) and aortic valve calcifications (AVC) in haemodialysis (HD) patients. Methods: We conducted a cross-sectional multi-slice computed tomography (MS-CT) scanning study in 67 chronic HD patients (59.4 +/- 14.8 yrs) for measurement of CAC and AVC. We tested established biomarkers as well as serum sclerostin (ELISA) regarding their association to the presence of calcification. Fifty-four adults without relevant renal disease served as controls for serum sclerostin levels. Additionally, sclerostin expression in explanted aortic valves from 15 dialysis patients was analysed ex vivo by immunohistochemistry and mRNA quantification (Qt-RT-PCR). Results: CAC (Agatston score > 100) and any AVC were present in 65% and in 40% of the MS-CT patient group, respectively. Serum sclerostin levels (1.53 +/- 0.81 vs 0.76 +/- 0.31 ng/mL, p < 0.001) were significantly elevated in HD compared to controls and more so in HD patients with AVC versus those without AVC (1.78 +/- 0.84 vs 1.35 +/- 0.73 ng/mL, p = 0.02). Multivariable regression analysis for AVC revealed significant associations with higher serum sclerostin. Ex vivo analysis of uraemic calcified aortic valves (n = 10) revealed a strong sclerostin expression very close to calcified regions (no sclerostin staining in non-calcified valves). Correspondingly, we observed a highly significant upregulation of sclerostin mRNA in calcified valves compared to non-calcified control valves. Conclusion: We found a strong association of sclerostin with calcifying aortic heart valve disease in haemodialysis patients. Sclerostin is locally produced in aortic valve tissue adjacent to areas of calcification. KW - coronary calcification KW - cardiovascular disease KW - aortic valve disease KW - calcium KW - mortality KW - sclerostin KW - aortic valve KW - bone formation KW - computed tomography KW - fetuin A KW - risk factors KW - GLA protein UCMGP KW - kidney-disease CKD KW - coronary-artery calcification KW - hemodialysis KW - mineral metabolism KW - vascular calcification KW - renal osteodystrophy Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122070 SN - 1471-2369 VL - 14 IS - 219 ER - TY - JOUR A1 - Ullherr, Maximilian A1 - Diez, Matthias A1 - Zabler, Simon T1 - Robust image reconstruction strategy for multiscalar holotomography JF - Journal of Imaging N2 - Holotomography is an extension of computed tomography where samples with low X-ray absorption can be investigated with higher contrast. In order to achieve this, the imaging system must yield an optical resolution of a few micrometers or less, which reduces the measurement area (field of view = FOV) to a few mm at most. If the sample size, however, exceeds the field of view (called local tomography or region of interest = ROI CT), filter problems arise during the CT reconstruction and phase retrieval in holotomography. In this paper, we will first investigate the practical impact of these filter problems and discuss approximate solutions. Secondly, we will investigate the effectiveness of a technique we call “multiscalar holotomography”, where, in addition to the ROI CT, a lower resolution non-ROI CT measurement is recorded. This is used to avoid the filter problems while simultaneously reconstructing a larger part of the sample, albeit with a lower resolution in the additional area. KW - reconstruction KW - region of interest KW - ROI KW - multiscalar holotomography KW - holotomography KW - computed tomography KW - CT KW - X-ray Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-262112 SN - 2313-433X VL - 8 IS - 2 ER - TY - JOUR A1 - Laqua, Fabian Christopher A1 - Woznicki, Piotr A1 - Bley, Thorsten A. A1 - Schöneck, Mirjam A1 - Rinneburger, Miriam A1 - Weisthoff, Mathilda A1 - Schmidt, Matthias A1 - Persigehl, Thorsten A1 - Iuga, Andra-Iza A1 - Baeßler, Bettina T1 - Transfer-learning deep radiomics and hand-crafted radiomics for classifying lymph nodes from contrast-enhanced computed tomography in lung cancer JF - Cancers N2 - Objectives: Positron emission tomography (PET) is currently considered the non-invasive reference standard for lymph node (N-)staging in lung cancer. However, not all patients can undergo this diagnostic procedure due to high costs, limited availability, and additional radiation exposure. The purpose of this study was to predict the PET result from traditional contrast-enhanced computed tomography (CT) and to test different feature extraction strategies. Methods: In this study, 100 lung cancer patients underwent a contrast-enhanced \(^{18}\)F-fluorodeoxyglucose (FDG) PET/CT scan between August 2012 and December 2019. We trained machine learning models to predict FDG uptake in the subsequent PET scan. Model inputs were composed of (i) traditional “hand-crafted” radiomics features from the segmented lymph nodes, (ii) deep features derived from a pretrained EfficientNet-CNN, and (iii) a hybrid approach combining (i) and (ii). Results: In total, 2734 lymph nodes [555 (20.3%) PET-positive] from 100 patients [49% female; mean age 65, SD: 14] with lung cancer (60% adenocarcinoma, 21% plate epithelial carcinoma, 8% small-cell lung cancer) were included in this study. The area under the receiver operating characteristic curve (AUC) ranged from 0.79 to 0.87, and the scaled Brier score (SBS) ranged from 16 to 36%. The random forest model (iii) yielded the best results [AUC 0.871 (0.865–0.878), SBS 35.8 (34.2–37.2)] and had significantly higher model performance than both approaches alone (AUC: p < 0.001, z = 8.8 and z = 22.4; SBS: p < 0.001, z = 11.4 and z = 26.6, against (i) and (ii), respectively). Conclusion: Both traditional radiomics features and transfer-learning deep radiomics features provide relevant and complementary information for non-invasive N-staging in lung cancer. KW - computed tomography KW - computational neural networks KW - lymphatic metastasis KW - carcinoma KW - non-small-cell lung KW - small-cell lung Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-319231 SN - 2072-6694 VL - 15 IS - 10 ER - TY - JOUR A1 - Noyalet, Laurent A1 - Ilgen, Lukas A1 - Bürklein, Miriam A1 - Shehata-Dieler, Wafaa A1 - Taeger, Johannes A1 - Hagen, Rudolf A1 - Neun, Tilmann A1 - Zabler, Simon A1 - Althoff, Daniel A1 - Rak, Kristen T1 - Vestibular aqueduct morphology and Meniere’s disease - development of the vestibular aqueduct score by 3D analysis JF - Frontiers in Surgery N2 - 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. KW - vestibular aqueduct (VA) KW - 3D analysis KW - temporal bone KW - saccotomy KW - computed tomography KW - Meniere’s disease Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-312893 SN - 2296-875X VL - 9 ER -