Refine
Is part of the Bibliography
- yes (130)
Year of publication
Document Type
- Journal article (122)
- Doctoral Thesis (7)
- Preprint (1)
Language
- English (130) (remove)
Keywords
- magnetic resonance imaging (10)
- MRI (8)
- CT angiography (4)
- deep learning (4)
- Bildgebendes Verfahren (3)
- Medizin (3)
- cardiac magnetic resonance imaging (3)
- endovascular (3)
- lung (3)
- machine learning (3)
- multiple myeloma (3)
- radiomics (3)
- rotator cuff (3)
- stroke (3)
- 18F-FDG PET/CT (2)
- AMADEUS (2)
- Cystic fibrosis (2)
- Heart (2)
- Kernspintomografie (2)
- Myocardial infarction (2)
- PET/CT (2)
- X-ray computed (2)
- aorta (2)
- arthrography (2)
- blood flow (2)
- bone (2)
- case report (2)
- central nervous system (2)
- data acquisition (2)
- diagnosis (2)
- echocardiography (2)
- elbow joint (2)
- endovascular therapy (2)
- follow-up (2)
- giant cell arteritis (2)
- imaging (2)
- joint instability (2)
- knee (2)
- lesions (2)
- magnetic resonance (2)
- mouse (2)
- muscle degeneration (2)
- myocardial infarction (2)
- outcome (2)
- preclinical research (2)
- prostate cancer (2)
- pulmonary embolism (2)
- radiography (2)
- radiology (2)
- relapse (2)
- shoulder surgery (2)
- spectroscopy (2)
- tomography (2)
- translational research (2)
- 11C-Methionine PET/CT (1)
- 1H-Magnetic resonance spectroscopy (1H-MRS) (1)
- 2-dimensional speckle tracking (1)
- 2D-perfusion angiography (1)
- 3D printing (1)
- 3 T (1)
- 4D flow cardiovascular magnetic resonance (1)
- 4D-MRI (1)
- 68Ga-Pentixafor PET/CT (1)
- 7 T (1)
- 7T (1)
- ASE formula (1)
- Adaptive cell transfer (1)
- Alter (1)
- Anderson-Fabry Disease (1)
- Applied physics (1)
- Arterial Diameters (1)
- Arthrography (1)
- B (1)
- BM (1)
- Bestimmung des Relaxations-Parameters in der Magnetresonanztomografie (1)
- Bewegungsfixateur (1)
- Biomedical engineering (1)
- CCS (1)
- CD38 (1)
- CMR (1)
- CMV (1)
- CRC (1)
- CT (1)
- CT perfusion (1)
- CT-angiography (1)
- CTNNB1 (1)
- Cancellous bone (1)
- Carcinomatosis (1)
- Cardiac magnetic resonance imaging (1)
- Cardiac ventricles (1)
- Cisplatin (1)
- Clinical Genetics (1)
- Computed axial tomography (1)
- Computertomographie (1)
- Cone-beam computed tomography (1)
- Convolutional Neural Network (1)
- Crohn’s disease (1)
- Cushing’s disease (1)
- Cushing’s syndrome (1)
- D313Y genotype (1)
- DSA (1)
- Data acquisition (1)
- Deep learning (1)
- Desmoplakin (1)
- Diagnostic medicine (1)
- Diffusion tensor imaging (1)
- Diffusionsgewichtete Bildgebung (1)
- Donor lymphocytes (1)
- EULAR guidelines (1)
- EVT (1)
- Echtzeit (1)
- Eigenvectors (1)
- Elbow (1)
- Elbow joint (1)
- Ellenbogengelenk (1)
- Exercise capacity (1)
- Extracellular volume (1)
- Extracorporeal membrane oxygenation (1)
- Fabry cardiomyopathy (1)
- Fabry nephropathy (1)
- Fabry-associated pain (1)
- Fats (1)
- Flow (1)
- Fluss (1)
- Funktionelle NMR-Tomographie (1)
- GCA (1)
- GFAP (1)
- Gehirn (1)
- Gelenkinstabilität (1)
- Geschlecht (1)
- Gesicht (1)
- Giant cell arteritis (GCA (1)
- HMDP hydroxymethylene diphosphonate (1)
- Herz (1)
- Herzfunktion (1)
- Herzmuskel (1)
- ICRS (1)
- Imaging (1)
- Imaging techniques (1)
- Immunotherapy (1)
- Inflammatory diseases (1)
- Informationsverarbeitung (1)
- JCV (1)
- Juvenile biventricular cardiomyopathy (1)
- KOOS (1)
- Kernspintomographie (1)
- Korrelation (1)
- L-arginine (1)
- Large vessel vasculitides (LVV) (1)
- Lung (1)
- Lung disease, (1)
- Lunge (1)
- Lungenembolie (1)
- M2 (1)
- MOLLI (1)
- MOR202 (1)
- MR angiography (1)
- MRI spectroscopy (1)
- Magnetic Resonance Relaxometry (1)
- Magnetic Resonance Spectroscopy Imaging (1)
- Magnetic resonance imaging (1)
- Magnetic resonance imaging(MRI) (1)
- Magnetresonanz-Relaxometrie (1)
- Magnetresonanztomographie (1)
- Marfan syndrome (1)
- Maschinelles Lernen (1)
- Mastoid process (1)
- Merkel cell carcinoma (1)
- Metabolomic Imaging (1)
- Metabolomics (1)
- Model Based Reconstruction Algorithms in Magnetic Resonance Imaging (1)
- Modellbasierte-Rekonstruktionsalgorithmen in der Magnetresonanztomografie (1)
- Molecular imaging (1)
- Morphing (1)
- Multidetector computed tomography (1)
- Muscle function (1)
- Muscle power (1)
- Myeloma (1)
- NIHSS (1)
- NMR relaxation (1)
- NMR-Bildgebung (1)
- NR3C1 (1)
- Nervenfaser (1)
- NfL (1)
- Non-rigid image registration (1)
- Orthopädische Chirurgie (1)
- PCI (1)
- PET (1)
- PLAG1 rearrangement (1)
- PML (1)
- PMR (1)
- PROM (1)
- PSMA (1)
- PSMA-RADS (1)
- PTA (1)
- Palmoplantar keratoderma (1)
- Phosphorylation (1)
- Positron emission tomography (1)
- Primary hyperparathyroidism (pHPT) (1)
- Prodigy (1)
- Prostatakrebs (1)
- Prostate cancer diagnostics (1)
- Protonen-NMR-Spektroskopie (1)
- Radiation exposure (1)
- Radiologische Diagnostik (1)
- Radiotherapy treatment planning (1)
- Relaxation Parameter Mapping in Magnetic Resonance Imaging (1)
- Respiratory induced tumor motion (1)
- SASHA (1)
- SP-fixation (1)
- SPECT (1)
- ST-elevation myocardial infarction (1)
- STEMI (1)
- Scar (1)
- Segmentation (1)
- ShMOLLI (1)
- Soft tissues (1)
- Somatostatin receptor expression (1)
- Swine (1)
- T1 mapping (1)
- Teichholz formula (1)
- Tomography (1)
- Tractography (1)
- Triangular fibrocartilage (1)
- USP28 (1)
- USP8 (1)
- Vasculitis (1)
- Vaskuläre Rekonstruktion (1)
- Ventricular septal rupture (1)
- Wernicke's perpendicular fasciculus (1)
- Wernickes Assoziationsbündel (1)
- Wrist (1)
- X-ray radiography (1)
- [18F]FDG PET/CT (1)
- [18F]FDG-PET-CT (1)
- \(^{18}\)F-PSMA-1007 (1)
- abdominal lymph node metastases (1)
- adolescents (1)
- adrenocortical (1)
- algorithms (1)
- alkaline phosphatase (1)
- amyloidosis (1)
- aneurysmal subarachnoid hemorrhage (1)
- aneurysms (1)
- angiography (1)
- animal model (1)
- anorectal angl (1)
- aortic dissection (1)
- apolipoprotein-E (1)
- arteriitis temporal arteriitis (1)
- asfotase alfa (1)
- aspiration (1)
- association (1)
- atheriosclerosis (1)
- atypical (1)
- biomedical engineering (1)
- bisphosphonates (1)
- bladder cancer (1)
- blood coagulation factor XIII (1)
- bone biology (1)
- bone bruise (1)
- bone fractures (1)
- bone marrow edema (1)
- bone marrow lesion/edema (1)
- bone-marrow (1)
- brain metastases (1)
- breast cancer (1)
- breast cancer imaging (1)
- c-reactive protein (1)
- cable-clamp implants (1)
- cancellous bone (1)
- cancer (1)
- cancer imaging (1)
- carcinoma (1)
- carcinoma metastases to pancreas (1)
- cardiac (1)
- cardiac MRI (1)
- cardiac function (1)
- cardiac imaging (1)
- cardiac magnetic resonance (1)
- cardiac transplantation (1)
- cardiovascular MRI (1)
- cardiovascular magnetic resonance (1)
- cardiovascular magnetic resonance (CMR) (1)
- cartilage (1)
- cartilage defect (1)
- central venous catheter (1)
- cerebral arteries (1)
- cerebral metastases (1)
- cerebrospinal fluid (1)
- cervical vertebrae pneumatization (1)
- chemotherapy (1)
- children (1)
- chondral defect (1)
- chronic mesenteric ischemia (1)
- cine loop (1)
- classification (1)
- clinical manifestations (1)
- cold pressor test (1)
- color-coded (1)
- color-coding (1)
- colorectal cancer (1)
- complication aortic-aneurysm (1)
- computational neural networks (1)
- computed tomography (1)
- computed tomography angiography (CTA) (1)
- concomitant radiotherapy (1)
- cone-beamcomputed tomography (1)
- continuous extracorporeal femoral perfusion model (1)
- contrast-enhanced ultrasound (1)
- conventional imaging (1)
- convolution kernel (1)
- convolutional neural network (1)
- convolutional neural networks (1)
- coracohumeral distance (1)
- coracohumeral impingement (1)
- coronary arteries (1)
- corpus cavernosum (1)
- correlation (1)
- corticosteroid treatment (1)
- cross-sectional imaging (1)
- cystic fibrosis (1)
- daratumumab (1)
- deformation (1)
- density (1)
- diagnostics (1)
- diffusion tractography (1)
- diffusion weighted mri (1)
- diffusion-weighted MRI (1)
- digital subtraction angiography (1)
- digital subtraction angiography (DSA) (1)
- disease (1)
- distal occlusion (1)
- dorsal instrumentation (1)
- double-blind (1)
- drug-eluting beads (1)
- dual-energy (1)
- dual-energy CT (1)
- dual-energy computed tomography (1)
- dual-room trauma suite (1)
- dual-room whole-body CT (1)
- dual-source CT (1)
- echo planar imaging (1)
- ejection fraction (1)
- electrical and electronic engineering (1)
- embolism/thrombosis (1)
- encephalitis (1)
- endothelium (1)
- endovascular repair (1)
- endovascular treatment (1)
- epicondyles (1)
- erythrocyte sedimentation-rate (1)
- experimental models of disease (1)
- extramedullary hematopoiesis (1)
- extremities (1)
- extremity trauma (1)
- face morphing (1)
- facial age (1)
- facial gender (1)
- fatty degeneration (1)
- femoral arteries (1)
- fenestration (1)
- fibroblast activation protein (1)
- fibrosis (1)
- flow patterns (1)
- fluoroscopy (1)
- forearm (1)
- fracture (1)
- fracture-associated vascular damage (1)
- fractures, bone (1)
- fragility fracture (1)
- free‐breathing (1)
- functional MRI (1)
- functional imaging (1)
- functional magnetic resonance imaging (1)
- g-factor (1)
- gefitinib (1)
- gender (1)
- general anaesthesia (1)
- glial damage (1)
- glial fibrillary acidic protein (1)
- glucocorticoid excess (1)
- goutallier (1)
- gradient impulse response function (1)
- gradient system respose (1)
- gradient system trasfer function (1)
- grading system of chondral defects (1)
- head and neck cancer (1)
- healing and remodelling processes (1)
- heart (1)
- hemodialysis (1)
- hemodynamics (1)
- hepatocellular carcinoma (1)
- high risk (1)
- high tibial osteotomy (1)
- hinged external fixator (1)
- hypercortisolism (1)
- hypertrophic cardiomyopathy (1)
- hypophosphatasia (1)
- identification (1)
- idiopathic fecal incontinence (1)
- image analysis (1)
- image processing (1)
- image segmentation (1)
- imaging techniques (1)
- immune check inhibitor (1)
- impact (1)
- in vivo imaging (1)
- infarction size (1)
- inferior vena cava (1)
- infiltrate (1)
- inflammation (1)
- inherited metabolic disorders (1)
- interventional procedures (1)
- interventional radiology (1)
- intravascular ultrasound (IVUS) (1)
- ionizing radiation (1)
- ischemic stroke (1)
- juvenile idiopathic arthritis (1)
- ketogenic diet (1)
- ketone bodies (1)
- large animal models (1)
- large vessel occlusion (1)
- large-vessel vasculitis (1)
- late enhancement (1)
- late gadolinium-enhancement (1)
- late thrombectomy (1)
- left lateral wall (1)
- left ventricular hypertrophy (1)
- left ventricular mass index (1)
- level of evidence: IV (1)
- lipoblastoma (1)
- local point-spread function (1)
- lymphatic metastasis (1)
- matched filters (1)
- mechanical thrombectomy (1)
- medical research (1)
- mesenteric stenting (1)
- meta-analysis (1)
- metabolic profile (1)
- metabolism (1)
- mice (1)
- minimal invasive surgery (1)
- molecular diagnostics (1)
- molecular imaging (1)
- motor cortex (1)
- movable sliding gantry (1)
- multiparametric CT (1)
- musculoskeletal system (1)
- myocardial perfusion (1)
- myocardium (1)
- neoadjuvant therapies (1)
- neural networks (1)
- neurofilament light chain (1)
- neurology (1)
- neuronavigation (1)
- neuroradiology (1)
- neurosurgery (1)
- nnU-net (1)
- non-small-cell lung (1)
- novel human cadaveric perfusion model (1)
- obesity (1)
- ocular manifestations (1)
- ollimator (1)
- oncology (1)
- ophthalmic artery (1)
- optic nerve (1)
- orbit (1)
- organoid (1)
- orthopedic surgery (1)
- osteoarthritis (1)
- osteomalacia (1)
- osteoporosis (1)
- outcome prediction (1)
- palliative care (1)
- parathyroid carcinoma (1)
- pattern (1)
- pediatric (1)
- pediatrics (1)
- pedicle screws (1)
- pelvic trauma (1)
- pembrolizumab (1)
- penile thrombosis (1)
- perfusion map (1)
- phase-contrast MRI (1)
- photon-counting (1)
- photon-counting computed tomography (CT) (1)
- photon-counting-detector CT (1)
- pig (1)
- polymyalgia rheumatica (1)
- polymyalgia-rheomatica (1)
- positive nodal status (1)
- post-neoadjuvant therapies (1)
- post-reconstruction filtering (1)
- preoperative localization (1)
- prestyloid recess (1)
- priapism (1)
- prognosis (1)
- progression (1)
- pubic symphysis (1)
- pulmonary arteries (1)
- quality (1)
- quantification (1)
- radial (1)
- radiation dose (1)
- radiation dose reduction (1)
- radiation myelitis (1)
- radical cystectomy (1)
- radiogenomics (1)
- rare bone disease (1)
- real-time imaging (1)
- recurrence (1)
- refractory (1)
- regression analysis (1)
- relaxation (physics) (1)
- relaxation time (1)
- renal artery (1)
- renal system (1)
- repeat surgery (1)
- repeated surgery (1)
- reproducibility (1)
- reproducibility of results (1)
- research infrastructure (1)
- resolution (1)
- resuscitation time (1)
- retroperitoneal tumor (1)
- rickets (1)
- rotator cuff tear (1)
- sacral nerve stimulation (1)
- sacral neuromodulation (1)
- salvage radiotherapy (1)
- sauropod dinosaurs (1)
- scanner (1)
- seahorse (1)
- segmentation (1)
- self‐gated (1)
- semantic segmentation (1)
- sequence imaging protocol (1)
- shimming (1)
- signal filtering (1)
- signal to noise ratio (1)
- skeletal (1)
- skull (1)
- small animal SPECT (1)
- small bowel MRI (1)
- small pixel effect (1)
- small-animal imaging (1)
- small-cell lung (1)
- smoking (1)
- smoldering myeloma (1)
- spectral CT (1)
- spectral imaging (1)
- spine (1)
- spine trauma (1)
- spiral trajectory (1)
- spleen (1)
- squamous tumors (1)
- staging (1)
- standardized reporting system (1)
- statistical data (1)
- stem cell transplantation (1)
- stenosis (1)
- stent (1)
- stent retriever (1)
- subscapularis tear (1)
- surgical repair (1)
- surgical trauma room (1)
- surgical treatment (1)
- synovitis (1)
- systematic review (1)
- systemic vasculitides (1)
- temperature dependency (1)
- tetraparesis (1)
- therapy (1)
- thermal variation (1)
- thorax (1)
- three-dimensional imaging (1)
- totally implantable venous access port (1)
- transarterial chemoembolization (1)
- transfer learning (1)
- trauma centre (1)
- trauma management (1)
- triangular fibrocartilage (1)
- triangular fibrocartilage complex (1)
- triglycerides (1)
- tumor (1)
- tumor burden (1)
- ultrahigh field (1)
- ultrahigh resolution (1)
- ultrahigh-field (1)
- ultrahigh-field MRI (1)
- ultrasound (1)
- undersampling (1)
- variational network (1)
- vascular (1)
- vascular access (1)
- vascular reconstruction (1)
- vasculature (1)
- vasculitis (1)
- vertebral pedicles (1)
- vertebral pneumaticity (1)
- virtual non-contrast (1)
- virtual noncalcium imaging (1)
- volume determination (1)
- wall shear stress (1)
- wave‐CAIPI (1)
- workflow (1)
- wrist (1)
- x-ray computed (1)
- zoledronic acid (1)
- β-Hydroxybutyrate (1)
Institute
- Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik) (130) (remove)
Sonstige beteiligte Institutionen
- Cheng Lab, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA (1)
- Datenintegrationszentrum Würzburg (DIZ) (1)
- Interdisziplinäre Biomaterial- und Datenbank Würzburg (ibdw) (1)
- Würzburg Fabry Center for Interdisciplinary Therapy (FAZIT), University of Würzburg, Würzburg, Germany (1)
Purpose
Artificial neural networks show promising performance in automatic segmentation of cardiac MRI. However, training requires large amounts of annotated data and generalization to different vendors, field strengths, sequence parameters, and pathologies is limited. Transfer learning addresses this challenge, but specific recommendations regarding type and amount of data required is lacking. In this study, we assess data requirements for transfer learning to experimental cardiac MRI at 7T where the segmentation task can be challenging. In addition, we provide guidelines, tools, and annotated data to enable transfer learning approaches by other researchers and clinicians.
Methods
A publicly available segmentation model was used to annotate a publicly available data set. This labeled data set was subsequently used to train a neural network for segmentation of left ventricle and myocardium in cardiac cine MRI. The network is used as starting point for transfer learning to 7T cine data of healthy volunteers (n = 22; 7873 images) by updating the pre-trained weights. Structured and random data subsets of different sizes were used to systematically assess data requirements for successful transfer learning.
Results
Inconsistencies in the publically available data set were corrected, labels created, and a neural network trained. On 7T cardiac cine images the model pre-trained on public imaging data, acquired at 1.5T and 3T, achieved DICE\(_{LV}\) = 0.835 and DICE\(_{MY}\) = 0.670. Transfer learning using 7T cine data and ImageNet weight initialization improved model performance to DICE\(_{LV}\) = 0.900 and DICE\(_{MY}\) = 0.791. Using only end-systolic and end-diastolic images reduced training data by 90%, with no negative impact on segmentation performance (DICE\(_{LV}\) = 0.908, DICE\(_{MY}\) = 0.805).
Conclusions
This work demonstrates and quantifies the benefits of transfer learning for cardiac cine image segmentation. We provide practical guidelines for researchers planning transfer learning projects in cardiac MRI and make data, models, and code publicly available.
Background
Children with different underlying malignant diseases require long-term central venous access. As for port systems in a pectoral position, peripherally implanted port systems in the forearm revealed high levels of technical and clinical success in adult cohorts.
Objective
To investigate the technical and clinical outcomes of percutaneous central venous port implantation in the forearm in adolescents.
Materials and methods
Between April 2010 and August 2020, 32 children ages 9 to 17 years with underlying malignancy received 35 totally implantable venous access ports (TIVAPs) in the forearm. All venous port systems were peripherally inserted under ultrasound guidance. Correct catheter placement was controlled by fluoroscopy. As primary endpoints, the technical success, rate of complications and catheter maintenance were analyzed. Secondary endpoints were the side of implantation, vein of catheter access, laboratory results on the day of the procedure, procedural radiation exposure, amount of contrast agent and reasons for port device removal.
Results
Percutaneous TIVAP placement under sonographic guidance was technically successful in 34 of 35 procedures (97.1%). Procedure-related complications did not occur. During the follow-up, 13,684 catheter days were analyzed, revealing 11 complications (0.8 per 1,000 catheter-duration days), Of these 11 complications, 7 were major and 10 occurred late. In seven cases, the port device had to be removed; removal-related complications did not occur.
Conclusion
Peripheral TIVAP placement in the forearms of children is a feasible, effective and safe technique with good midterm outcome. As results are comparable with standard access routes, this technique may be offered as an alternative when intermittent venous access is required.
Purpose
To evaluate the technical and clinical outcome of Sinus-XL stent placement in patients with malignant obstruction syndrome of the inferior vena cava.
Methods
Between October 2010 and January 2021, 21 patients with different malignant primary disease causing inferior vena cava obstruction were treated with Sinus-XL stent implantation. Procedural data, technical and clinical outcome parameters were retrospectively analyzed.
Results
Technical success was 100%. Analysis of available manometry data revealed a significant reduction of the mean translesional pressure gradient following the procedure (p = 0.008). Reintervention rate was 4.8% (1/21). The available follow-up imaging studies showed primary and primary-assisted stent patency rates of 93% (13/14) and 100% (14/14), respectively. Major complications did not occur. The clinical success regarding lower extremity edema was 82.4% (14/17) for the first and 85.7% (18/21) for the last follow-up. Longer lengths of IVC obstruction were associated with reduced clinical improvement after the procedure (p = 0.025). Improvement of intraprocedural manometry results and lower extremity edema revealed only minor correlation. Ascites and anasarca were not significantly positively affected by the procedure.
Conclusion
Sinus-XL stent placement in patients with malignant inferior vena cava obstruction showed high technical success and low complication rates. Regarding the clinical outcome, significant symptom improvement could be achieved in lower extremity edema, whereas ascites and anasarca lacked satisfying symptom relief. Based on our results, this procedure should be considered as a suitable therapy in a palliative care setting for patients with advanced malignant disease.
Background: Endovascular therapy is the gold standard in patients with hemodynamic relevant renal artery stenosis (RAS) resistant to medical therapy. The severity grading of the stenosis as well as the result assessment after endovascular approach is predominantly based on visible estimations of the anatomic appearance. We aim to investigate the application of color-coded DSA parameters to gain hemodynamic information during endovascular renal artery interventions and for the assessment of the procedures technical success.
Methods: We retrospectively evaluated 32 patients who underwent endovascular renal artery revascularization and applied color-coded summation imaging on selected monochromatic DSA images. The differences in time to peak (dTTP) of contrast enhancement in predefined anatomical measuring points were analyzed. Furthermore, differences in systolic blood pressure values (SBP) and serum creatinine were obtained. The value of underlying diabetes mellitus as a predictor for clinical outcome was assessed. Correlation analysis between the patients gender as well as the presence of diabetes mellitus and dTTP was performed.
Results: Endovascular revascularization resulted in statistically significant improvement in 4/7 regions of interest. Highly significant improvement of perfusion in terms of shortened TTP values could be found at the segmental artery level and in the intrastenotical segment (p<0.001), significant improvement prestenotical and in the apical renal parenchyma (p<0.05). In the other anatomic regions, differences revealed not to be significant. Differences between SBP and serum creatinine levels before and after the procedure were significant (p=0.004 and 0.0004). Patients ' gender as well as the presence of diabetes mellitus did not reveal to be predictors for the clinical success of the procedure. Furthermore, diabetes and gender did not show relevant correlation with dTTP in the parenchymal measuring points.
Conclusions: The supplementary use of color-coding DSA and the data gained from parametric images may provide helpful information in the evaluation of the procedures ' technical success. The segmental artery might be a particularly suitable vascular territory for analyzing differences in blood flow characteristics. Further studies with larger cohorts are needed to further confirm the diagnostic value of this technique.
Background
To analyze the benefit of color-coded summation images in the assessment of target lumen perfusion in patients with aortic dissection and malperfusion syndrome before and after fluoroscopy-guided aortic fenestration.
Methods
Between December 2011 and April 2020 25 patients with Stanford type A (n = 13) or type B dissection (n = 12) and malperfusion syndromes were treated with fluoroscopy-guided fenestration of the dissection flap using a re-entry catheter. The procedure was technically successful in 100% of the cases and included additional iliofemoral stent implantation in four patients. Intraprocedural systolic blood pressure measurements for gradient evaluation were performed in 19 cases. Post-processed color-coded DSA images were obtained from all DSA series before and following fenestration. Differences in time to peak (dTTP) values in the compromised aortic lumen and transluminal systolic blood pressure gradients were analyzed retrospectively. Correlation analysis between dTTP and changes in blood pressure gradients was performed.
Results
Mean TTP prior to dissection flap fenestration was 6.85 ± 1.35 s. After fenestration, mean TTP decreased significantly to 4.96 ± 0.94 s (p < 0.001). Available systolic blood pressure gradients between the true and the false lumen were reduced by a median of 4.0 mmHg following fenestration (p = 0.031), with significant reductions in Stanford type B dissections (p = 0.013) and minor reductions in type A dissections (p = 0.530). A moderate correlation with no statistical significance was found between dTTP and the difference in systolic blood pressure (r = 0.226; p = 0.351).
Conclusions
Hemodynamic parameters obtained from color-coded DSA confirmed a significant reduction of TTP values in the aortic target lumen in terms of an improved perfusion in the compromised aortic region. Color-coded DSA might thus be a suitable complementary tool in the assessment of complex vascular patterns prevailing in aortic dissections, especially when blood pressure measurements are not conclusive or feasible.
Background:
Ketogenic diets (KDs) or short-term fasting are popular trends amongst supportive approaches for cancer patients. Beta-hydroxybutyrate (3-OHB) is the main physiological ketone body, whose concentration can reach plasma levels of 2–6 mM during KDs or fasting. The impact of 3-OHB on the biology of tumor cells described so far is contradictory. Therefore, we investigated the effect of a physiological concentration of 3 mM 3-OHB on metabolism, proliferation, and viability of breast cancer (BC) cells in vitro.
Methods:
Seven different human BC cell lines (BT20, BT474, HBL100, MCF-7, MDA-MB 231, MDA-MB 468, and T47D) were cultured in medium with 5 mM glucose in the presence of 3 mM 3-OHB at mild hypoxia (5% oxygen) or normoxia (21% oxygen). Metabolic profiling was performed by quantification of the turnover of glucose, lactate, and 3-OHB and by Seahorse metabolic flux analysis. Expression of key enzymes of ketolysis as well as the main monocarboxylic acid transporter MCT2 and the glucose-transporter GLUT1 was analyzed by RT-qPCR and Western blotting. The effect of 3-OHB on short- and long-term cell proliferation as well as chemo- and radiosensitivity were also analyzed.
Results:
3-OHB significantly changed the oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) in BT20 cells resulting in a more oxidative energetic phenotype. MCF-7 and MDA-MB 468 cells had increased ECAR only in response to 3-OHB, while the other three cell types remained uninfluenced. All cells expressed MCT2 and GLUT1, thus being able to uptake the metabolites. The consumption of 3-OHB was not strongly linked to mRNA overexpression of key enzymes of ketolysis and did not correlate with lactate production and glucose consumption. Neither 3-OHB nor acetoacetate did interfere with proliferation. Further, 3-OHB incubation did not modify the response of the tested BC cell lines to chemotherapy or radiation.
Conclusions:
We found that a physiological level of 3-OHB can change the energetic profile of some BC cell lines. However, 3-OHB failed to influence different biologic processes in these cells, e.g., cell proliferation and the response to common breast cancer chemotherapy and radiotherapy. Thus, we have no evidence that 3-OHB generally influences the biology of breast cancer cells in vitro.
Purpose: In hepatocellular carcinoma patients with large or multinodal tumors, where curative treatment options are not feasible, transarterial therapies play a major role. Transarterial chemoembolization (TACE) with drug-eluting beads (DEB-TACE) is a promising new approach due to higher intratumoral and lower systemic concentration of the chemotherapeutic agent compared to conventional TACE (cTACE).
Patients and methods: In a retrospective analysis, 32 patients with hepatocellular carcinoma who received either DEB or a cTACE were compared regarding survival time, disease recurrence, and side effects such as pain and fever.
Results: No significant differences could be detected between the cTACE and DEB-TACE groups with regard to mean hospital stay, appearance of postinterventional fever, or 30-day mortality. However, the application of intravenous analgesics as postinterventional pain medication was needed more often in patients treated with DEB-TACE (57.1% vs 12.5%, P=0.0281). The overall median survival after the initial procedure was 10.8 months in the cTACE group and 9.2 months in the DEB-TACE group, showing no significant difference.
Conclusion: No survival benefit for patients treated with either DEB-TACE or cTACE was observed. Surprisingly, a higher rate of postinterventional pain could be detected after DEB-TACE.
Background
Solitary metastases to the pancreas are rare. Therefore the value of resection in curative intention remains unclear. In the literature there are several promising reports about resection of solitary metastasis to the pancreas mainly of renal origin.
Case presentation
Here we report for the first time on the surgical therapy of a 1.5 cm solitary pancreatic metastasis of an adrenocortical carcinoma. The metastasis occurred almost 6 years after resection of the primary tumor. A partial pancreatoduodenectomy was performed and postoperatively adjuvant mitotane treatment was initiated. During the follow-up of 3 years after surgery no evidence of tumor recurrence occurred.
Conclusion
Resection of pancreatic tumors should be considered, even if the mass is suspicious for metastatic disease including recurrence of adrenocortical cancer.
Background
Among the modalities for lung imaging, proton magnetic resonance imaging (MRI) has been the latest to be introduced into clinical practice. Its value to replace X-ray and computed tomography (CT) when radiation exposure or iodinated contrast material is contra-indicated is well acknowledged: i.e. for paediatric patients and pregnant women or for scientific use. One of the reasons why MRI of the lung is still rarely used, except in a few centres, is the lack of consistent protocols customised to clinical needs.
Methods
This article makes non-vendor-specific protocol suggestions for general use with state-of-the-art MRI scanners, based on the available literature and a consensus discussion within a panel of experts experienced in lung MRI.
Results
Various sequences have been successfully tested within scientific or clinical environments. MRI of the lung with appropriate combinations of these sequences comprises morphological and functional imaging aspects in a single examination. It serves in difficult clinical problems encountered in daily routine, such as assessment of the mediastinum and chest wall, and even might challenge molecular imaging techniques in the near future.
Conclusion
This article helps new users to implement appropriate protocols on their own MRI platforms.
Main Messages
• MRI of the lung can be readily performed on state-of-the-art 1.5-T MRI scanners.
• Protocol suggestions based on the available literature facilitate its use for routine
• MRI offers solutions for complicated thoracic masses with atelectasis and chest wall invasion.
• MRI is an option for paediatrics and science when CT is contra-indicated
Background
MRI of the lung is recommended in a number of clinical indications. Having a non-radiation alternative is particularly attractive in children and young subjects, or pregnant women.
Methods
Provided there is sufficient expertise, magnetic resonance imaging (MRI) may be considered as the preferential modality in specific clinical conditions such as cystic fibrosis and acute pulmonary embolism, since additional functional information on respiratory mechanics and regional lung perfusion is provided. In other cases, such as tumours and pneumonia in children, lung MRI may be considered an alternative or adjunct to other modalities with at least similar diagnostic value.
Results
In interstitial lung disease, the clinical utility of MRI remains to be proven, but it could provide additional information that will be beneficial in research, or at some stage in clinical practice. Customised protocols for chest imaging combine fast breath-hold acquisitions from a “buffet” of sequences. Having introduced details of imaging protocols in previous articles, the aim of this manuscript is to discuss the advantages and limitations of lung MRI in current clinical practice.
Conclusion
New developments and future perspectives such as motion-compensated imaging with self-navigated sequences or fast Fourier decomposition MRI for non-contrast enhanced ventilation- and perfusion-weighted imaging of the lung are discussed.
Main Messages
• MRI evolves as a third lung imaging modality, combining morphological and functional information.
• It may be considered first choice in cystic fibrosis and pulmonary embolism of young and pregnant patients.
• In other cases (tumours, pneumonia in children), it is an alternative or adjunct to X-ray and CT.
• In interstitial lung disease, it serves for research, but the clinical value remains to be proven.
• New users are advised to make themselves familiar with the particular advantages and limitations.