BMD accuracy errors specific to phantomless calibration of CT scans of the lumbar spine.

Opportunistic screening using existing CT images may be a new strategy to identify subjects at increased risk for osteoporotic fracture. Low bone mineral density (BMD) is a key parameter but routine clinical CT scans do not include a calibration phantom to calculate BMD from the measured CT values. An alternative is internal or phantomless calibration, which is based on the CT values of air and of internal tissues of the subject such as blood, muscle or adipose tissue.

Evaluation of a Novel Content-Based Image Retrieval System for the Differentiation of Interstitial Lung Diseases in CT Examinations.

To evaluate the reader's diagnostic performance against the ground truth with and without the help of a novel content-based image retrieval system (CBIR) that retrieves images with similar CT patterns from a database of 79 different interstitial lung diseases. We evaluated three novice readers' and three resident physicians' (with at least three years of experience) diagnostic performance evaluating 50 different CTs featuring 10 different patterns (e.g.

Evaluation of CT-Guided Ultra-Low-Dose Protocol for Injection Guidance in Preparation of MR-Arthrography of the Shoulder and Hip Joints in Comparison to Conventional and Low-Dose Protocols.

To evaluate patients' radiation exposure undergoing CT-guided joint injection in preparation of MR-arthrography. We developed a novel ultra-low-dose protocol utilizing tin-filtration, performed it in 60 patients and compared the radiation exposure (DLP) and success rate to conventional protocol (26 cases) and low-dose protocol (37 cases). We evaluated 123 patients' radiation exposure undergoing CT-guided joint injection from 16 January-21 March.

Cutting Staff Radiation Exposure and Improving Freedom of Motion during CT Interventions: Comparison of a Novel Workflow Utilizing a Radiation Protection Cabin versus Two Conventional Workflows.

This study aimed to evaluate the radiation exposure to the radiologist and the procedure time of prospectively matched CT interventions implementing three different workflows-the radiologist-(I) leaving the CT room during scanning; (II) wearing a lead apron and staying in the CT room; (III) staying in the CT room in a prototype radiation protection cabin without lead apron while utilizing a wireless remote control and a tablet. We prospectively evaluated the radiologist's radiation exposure utilizing an electronic personal dosimeter, the intervention time, and success in CT interventions matched to the three different workflows. We compared the interventional success, the patient's dose of the interventional scans in each workflow (total mAs and total DLP), the radiologist's personal dose (in µSV), and interventional time.

Scanned versus Fused-Reconstructed Oblique MR-Images for Assessment of the Tibiofibular Syndesmosis-Diagnostic PerFormance and Reader Agreement.

To evaluate the diagnostic performance and reader agreement of a novel MRI image fusion method enabling the reconstruction of oblique images for the assessment of the tibiofibular syndesmosis. We evaluated 40 magnetic resonance imaging examinations of patients with ankle sprains (16 with ruptures and 24 without) for the presence of anteroinferior tibiofibular ligament rupture. For all patients, we performed a fusion of standard two-dimensional transversal and coronal 3 mm PDw TSE images into an oblique-fusion reconstruction (OFR) and compared these against conventionally scanned oblique sequence for the evaluation of the tibiofibular syndesmosis.

Virtual Computed Tomography Colonography: Evaluation of 2D and Virtual 3D Image Quality of Sub-mSv Examinations Enabled by Third-generation Dual Source Scanner Featuring Tin Filtering.

Rationale And Objectives: To evaluate two- and three-dimensional (2D and 3D) image quality of sub-milliSievert (mSv) computed tomography (CT) colonography utilizing a third-generation dual source CT scanner featuring a tin filter.

Methods: We retrospectively evaluated 26 consecutive patients who underwent third-generation dual source CT colonography, nine with the standard-dose clinical-scan protocol (SDP) and 17 with a low-dose protocol (LDP) featuring a tin filter. Radiation dose was evaluated by volume computed tomography dose index (CTDI), dose length product (DLP), effective dose (E), and size-specific dose estimate.

Twelve-year survival and immune correlates in dendritic cell-vaccinated melanoma patients.

Background: Reports on long-term (≥10 years) effects of cancer vaccines are missing. Therefore, in 2002, we initiated a phase I/II trial in cutaneous melanoma patients to further explore the immunogenicity of our DC vaccine and to establish its long-term toxicity and clinical benefit after a planned 10-year followup.

Methods: Monocyte-derived DCs matured by TNFα, IL-1β, IL-6, and PGE2 and then loaded with 4 HLA class I and 6 class II-restricted tumor peptides were injected intradermally in high doses over 2 years.

Semi-automated De-identification of German Content Sensitive Reports for Big Data Analytics.

 Projects involving collaborations between different institutions require data security via selective de-identification of words or phrases. A semi-automated de-identification tool was developed and evaluated on different types of medical reports natively and after adapting the algorithm to the text structure.  A semi-automated de-identification tool was developed and evaluated for its sensitivity and specificity in detecting sensitive content in written reports.

Evaluation of a Marker Clip System in Sonographically Guided Core Needle Biopsy for Breast Cancer Localization Before and After Neoadjuvant Chemotherapy.

The placement of intramammary marker clips has proven to be helpful for tumor localization in patients undergoing neoadjuvant chemotherapy and breast-conserving surgery. The purpose of our study was to investigate the feasibility of using a clip marker system for breast cancer localization and its influence on the imaging assessment of treatment responses after neoadjuvant chemotherapy. Between March and June 2015, a total of 25 patients (n = 25), with a suspicion of invasive breast cancer with diameters of at least 2 cm (cT2), underwent preoperative sonographically guided core needle biopsy using a single-use breast biopsy system (HistoCore™) and intramammary clip marking using a directly adapted clip system based on the established O-Twist Marker™, before their scheduled preoperative neoadjuvant chemotherapy.

FLAIRfusion Processing with Contrast Inversion : Improving Detection and Reading Time of New Cerebral MS Lesions.

Purpose: To evaluate the performance of an innovative image processing approach for detection of T2-weighted hyperintense multiple sclerosis (MS) lesions.

Methods: In this study 20 consecutive patients with inflammatory demyelinating lesions were retrospectively evaluated of whom 10 patients featured progressive disease and 10 a stable lesion load. 3 mm transversal FLAIRfusion imaging was processed and archived.

Evaluation of Rib Fractures on a Single-in-plane Image Reformation of the Rib Cage in CT Examinations.

Rationale And Objectives: This study aimed to evaluate the diagnostic performance of using a reformatted single-in-plane image reformation of the rib cage for the detection of rib fractures in computed tomography (CT) examinations, employing different levels of radiological experience.

Materials And Methods: We retrospectively evaluated 10 consecutive patients with and 10 patients without rib fractures, whose CT scans were reformatted to a single-in-plane image reformation of the rib cage. Eight readers (two radiologists, two residents in radiology, and four interns) independently evaluated the images for the presence of rib fractures using a reformatted single-in-plane image and a multi-planar image reformation.

Computer-aided evaluation of low-dose and low-contrast agent third-generation dual-source CT angiography prior to transcatheter aortic valve implantation (TAVI).

Purpose: To evaluate the performance of computer-aided evaluation software for a comprehensive workup of patients prior to transcatheter aortic valve implantation (TAVI) using low-contrast agent and low radiation dose third-generation dual-source CT angiography.

Methods: We evaluated 30 consecutive patients scheduled for TAVI. All patients underwent ECG-triggered high-pitch dual-source CT angiography of the aortic root and aorta with a standardized contrast agent volume (30 ml Imeron350, flow rate 4 ml/s) and low-dose (100 kv/350 mAs) protocol.

Osteoblastic lesion screening with an advanced post-processing package enabling in-plane rib reading in CT-images.

Background: To evaluate screening and diagnostic accuracy for the detection of osteoblastic rib lesions using an advanced post-processing package enabling in-plane rib reading in CT-images.

Methods: We retrospectively assessed the CT-data of 60 consecutive prostate cancer patients by applying dedicated software enabling in-plane rib reading. Reading the conventional multiplanar reconstructions was considered to be the reference standard.

Vertebral body fractures of unknown origin in cancer patients receiving MDCT: reporting by radiologists and awareness by clinicians.

Background: To evaluate prevalence, radiological reporting and clinical management of pathologic vertebral body fractures (VBFs) of unknown origin in cancer patients receiving computed tomography (CT) examinations.

Methods: We investigated all CT examinations (over 1 year) of male and female patients with an underlying malignancy and an increased risk of osteoporosis (age 55-79 years) for the presence of VBFs. We evaluated midline sagittal CT-reformations of the spine for prevalence, fracture type, severity and location, the accuracy and style of radiological reporting, subsequent clinical management and documentation in hospital discharge letters.

Fine needle aspiration cytology of lymph nodes in breast cancer follow-up is a feasible alternative to watchful waiting and to histology.

Background: Early detection of loco-regional breast cancer recurrence improves patients' overall survival, as treatment can be initiated or active treatment can be changed. If a suspicious lymph node is diagnosed during a follow-up exam, surgical excision is often performed. The aim of this study was to evaluate the diagnostic performance of the minor invasive ultrasound-guided fine-needle aspiration cytology (FNAC) in sonomorphologically suspicious lymph nodes in breast cancer follow-up.

Isolated testicular pain mimicking ruptured abdominal aortic aneurysm in a nonagenarian.

Ruptured abdominal aortic aneurysm commonly presents as acute abdominal or lower back pain and hemodynamic instability. We discuss the case of a 90-year-old patient who presented to the emergency unit with a 3-day history of left testicular pain. Ultrasound scan demonstrated and a computed tomography scan confirmed a 6 cm in diameter ruptured abdominal aortic aneurysm with enlargement and hematoma of the left psoas muscle causing the symptoms.

Comparison of Sonography versus Digital Breast Tomosynthesis to Locate Intramammary Marker Clips.

This study aimed to compare the accuracy of sonography versus digital breast tomosynthesis to locate intramammary marker clips placed under ultrasound guidance. Fifty patients with suspicion of breast cancer (lesion diameter less than 2 cm [cT1]) had ultrasound-guided core needle biopsy with placement of a marker clip in the center of the tumor. Intramammary marker clips were subsequently located with both sonography and digital breast tomosynthesis.

Clinical evaluation of semi-automatic landmark-based lesion tracking software for CT-scans.

Background: To evaluate a semi-automatic landmark-based lesion tracking software enabling navigation between RECIST lesions in baseline and follow-up CT-scans.

Methods: The software automatically detects 44 stable anatomical landmarks in each thoraco/abdominal/pelvic CT-scan, sets up a patient specific coordinate-system and cross-links the coordinate-systems of consecutive CT-scans. Accuracy of the software was evaluated on 96 RECIST lesions (target- and non-target lesions) in baseline and follow-up CT-scans of 32 oncologic patients (64 CT-scans).

Pediatric cardiac MRI: automated left-ventricular volumes and function analysis and effects of manual adjustments.

Background: Cardiac MRI is an accurate and reproducible technique for the assessment of left ventricular volumes and function. The accuracy of automated segmentation and the effects of manual adjustments have not been determined in children.

Objective: To evaluate automated segmentation and the effects of manual adjustments for left ventricular parameter quantification in pediatric cardiac MR images.

Improving diagnostic accuracy in assessing pulmonary edema on bedside chest radiographs using a standardized scoring approach.

Background: To assess the value of a score-based system which allows standardized evaluation of pulmonary edema on bedside chest radiographs (CXRs) under routine clinical conditions.

Methods: Seven experienced readers assessed bedside CXRs of ten patients with an extravascular lung water (EVLW)-value of ≤ 8 mL/kg (range: 4-8 mL/kg; indicates no pulmonary edema) and a series of ten patients with an EVLW-value of ≥ 15 mL/kg (range: 15-21 mL/kg; = indicates a pulmonary edema) with and without customized software which would permit a standardized assessment of the various indications of pulmonary edema. The software provides a score that identifies patients with and without pulmonary edema.

Effects on posture by different neuromuscular afferent stimulations and proprioceptive insoles: Rasterstereographic evaluation.

Background: Proprioceptive neuromuscular stimulating insoles are increasingly applied in treating functional complaints, chronic pain, foot disorders and so on.

Objectives: To evaluate rasterstereography as a tool in objectifying postural changes resulting from neuromuscular afferent stimulation and proprioceptive neuromuscular stimulating insoles and to compare the respective effects on posture.

Study Design: This is a prospective experimental study.

Full Field Digital Mammography (FFDM) versus CMOS Technology, Specimen Radiography System (SRS) and Tomosynthesis (DBT) - Which System Can Optimise Surgical Therapy?

This prospective clinical study aimed to evaluate whether it would be possible to reduce the rate of re-excisions using CMOS technology, a specimen radiography system (SRS) or digital breast tomosynthesis (DBT) compared to a conventional full field digital mammography (FFDM) system. Between 12/2012 and 2/2013 50 patients were diagnosed with invasive breast cancer (BI-RADS™ 5). After histological verification, all patients underwent breast-conserving therapy with intraoperative imaging using 4 different systems and differing magnifications: 1.

Evaluation of Newly Adapted Clip Marker System in Ultrasound-Guided Core Needle Biopsy for Suspicion of Breast Cancer.

A newly adapted clip system for intramammary marking during ultrasound-guided core needle biopsy for suspicion of breast cancer is described and evaluated here. Fifty patients with suspicion of breast cancer (cT2) had ultrasound-guided core needle biopsy using a newly adapted clip marker system (HistoCore™ and O-Twist Marker™). Subsequently, ultrasound follow-up and tomosynthesis scans were done to determine the location of the marker clips.