Tibiopedal and distal femoral retrograde vascular access for challenging chronic total occlusions: predictors for technical success, and complication rates in a large single-center cohort.

Objective: To evaluate the safety and effectiveness of tibiopedal and distal femoral access for retrograde crossing of chronic total occlusion (CTO) in Rutherford stage III to VI peripheral arterial occlusive disease, and to determine factors that correlate with technical success.

Material And Methods: One hundred seventy-one consecutive patients were included in this retrospective study. Rutherford stages were III, IV, and V/VI in 24%, 8%, and 67% of patients.

Predictive performance of the mHAP-II score in a real-life western cohort with hepatocellular carcinoma following trans-arterial chemoembolisation with drug-eluting beads (DEB-TACE).

Objectives: To evaluate the predictive performance of the modified hepatoma arterial embolisation prognostic II (mHAP-II) score in a real-life western hepatocellular carcinoma (HCC) cohort treated with drug-eluting bead-TACE and compare the mHAP-II with other scores in this cohort.

Methods: One hundred seventy-nine HCC patients (mean age 77 (± 9) years, 87% male) with one or more drug-eluting bead (DEB)-TACE sessions using 100-300 μm microspheres were retrospectively analysed. Performance analysis of the mHAP-II score was based on Mann-Whitney U tests, the Kaplan-Meier method, log-rank tests, receiver operating characteristics, Akaike's information criterion and Cox regression models.

Virtual reality in preoperative imaging in maxillofacial surgery: implementation of "the next level"?

Not only are current imaging techniques - cone-beam computed tomography (CT), CT, and magnetic resonance imaging (MRI) - becoming more precise in capturing data, but the illustration and interpretation of the acquired images is no longer limited to conventional display screens or projectors. The so-called "virtual reality" (VR) glasses have the potential to engage the viewer in a 3-dimensional space, and ultimately to enable evaluation of the reconstructed anatomical structures from a new perspective. For the first time in the field of oral and maxillofacial surgery (OMFS), a 3-dimensional imaging dataset (cone-beam CT, CT, and MRI) can be evaluated by using VR glasses.

Dose Optimization of Perfusion-derived Response Assessment in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization: Comparison of Volume Perfusion CT and Iodine Concentration.

Rationale And Objectives: We assessed the value of iodine concentration (IC) as a perfusion-derived response marker for hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) in comparison with volume perfusion computed tomography (VPCT) parameters.

Materials And Methods: Forty-one HCC lesions in 32 patients examined before and after TACE were analyzed retrospectively. VPCT-parameters were calculated and lesion iodine-maps were computed using subtraction of the baseline and the scan 7 seconds after aortic peak enhancement from the corresponding 80 kVp-VPCT data set.

Reliability and Accuracy of Peri-Interventional Stenosis Grading in Peripheral Artery Disease Using Color-Coded Quantitative Fluoroscopy: A Phantom Study Comparing a Clinical and Scientific Postprocessing Software.

Purpose: To assess quantitative stenosis grading by color-coded fluoroscopy using an in vitro pulsatile flow phantom.

Methods: Three different stenotic tubes (80%, 60%, and 40% diameter restriction) and a nonstenotic reference tube were compared regarding their different flow behavior by using contrast-enhanced fluoroscopy with a flat-detector system for visualisation purposes. Time-density curves (TDC), area under the curve (AUC), time-to-peak (TTP), and different ROI sizes were analyzed in three independent measurements using two different postprocessing software solutions.

Cone beam computed tomography improves the detection of injured vessels and involved vascular territories in patients with bleeding of uncertain origin.

Objective: The purpose of this preliminary retrospective study was to analyse if cone beam CT (CBCT) is able to identify more bleeding sites and corresponding feeding arteries in patients with haemorrhage of uncertain origin.

Methods: In 18 vascular territories (16 patients), pre-interventional CT angiography (CTA) and selective angiograms resulted in discordant information regarding the suspected bleeding site and hence received CBCT. Image data of CTA and selective angiograms in comparison to CBCT were independently reviewed by two interventional radiologists.

Coronary and carotid atherosclerosis in asymptomatic male marathon runners.

The aim of the study was to evaluate the diagnostic accuracy of carotid ultrasound (CU) to predict coronary atherosclerosis in asymptomatic male marathon runners. A total of 49 male marathon runners older than 45 years (mean age 53.3 ± 7.

Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta.

Objectives: To compare a low-dose, tin-filtered, nonenhanced, high-pitch Sn100 kVp CT protocol (Sn100) with a standard protocol (STP) for the detection of calcifications in the ascending aorta in patients scheduled for cardiac surgery.

Methods: Institutional Review Board approval for this retrospective study was waived and the study was HIPAA-compliant. The study included 192 patients (128 men; age 68.

Effect of reduced z-axis scan coverage on diagnostic performance and radiation dose of neck computed tomography in patients with suspected cervical abscess.

Purpose: To evaluate the effect of reduced z-axis scan coverage on diagnostic performance and radiation dose of neck CT in patients with suspected cervical abscess.

Methods: Fifty-one patients with suspected cervical abscess were included and underwent contrast-enhanced neck CT on a 2nd or 3rd generation dual-source CT system. Image acquisition ranged from the aortic arch to the upper roof of the frontal sinuses (CTstd).

Evaluation of Texture Analysis Parameter for Response Prediction in Patients with Hepatocellular Carcinoma Undergoing Drug-eluting Bead Transarterial Chemoembolization (DEB-TACE) Using Biphasic Contrast-enhanced CT Image Data: Correlation with Liver Perfusion CT.

Rationale And Objectives: This study aimed to evaluate the potential role of computed tomography texture analysis (CTTA) of arterial and portal-venous enhancement phase image data for prediction and accurate assessment of response of hepatocellular carcinoma undergoing drug-eluting bead transarterial chemoembolization (TACE) by comparison to liver perfusion CT (PCT).

Materials And Methods: Twenty-eight patients (27 male; mean age 67.2 ± 10.

Results of a prospective clinical study on the diagnostic performance of standard magnetic resonance imaging in comparison to a combination of 3T MRI and additional CT imaging in Kienböck's disease.

Purpose: This prospective clinical study examined standard wrist magnetic resonance imaging (MRI) examinations and the incremental value of computed tomography (CT) in the diagnosis of Kienböck's disease (KD) with regard to reliability and precision in the different diagnostic steps during diagnostic work-up.

Materials And Methods: Sixty-four consecutive patients referred between January 2009 and January 2014 with positive initial suspicion of KD according to external standard wrist MRI were prospectively included (step one). Institutional review board approval was obtained.

Impact of transjugular intrahepatic portosystemic shunt implantation on liver perfusion measured by volume perfusion CT.

Background Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) induces changes of liver perfusion. Purpose To determine the changes in arterial, portal venous, and total perfusion of the liver parenchyma induced by TIPS using the technique of volume perfusion computed tomography (VPCT) and compare results with invasively measured hepatic intravascular pressure values. Material and Methods VPCT quantification of liver perfusion was performed in 23 patients (mean age, 62.

CT-perfusion measurements in pancreatic carcinoma with different kinetic models: Is there a chance for tumour grading based on functional parameters?

Background: To evaluate the interchangeability of perfusion parameters obtained with help of models used for post-processing of perfusion-CT images in pancreatic adenocarcinoma and to determine the mean values and ranges of perfusion in different tumour gradings.

Methods: Perfusion-CT imaging was performed prospectively in 48 consecutive patients with pancreatic adenocarcinoma. In 42 patients biopsy-proven tumor grading was available (4 × G1/24 × G2/14 × G3/6× unknown).

Implantability, Complications, and Follow-Up After Transjugular Intrahepatic Portosystemic Stent-Shunt Creation With the 6F Self-Expanding Sinus-SuperFlex-Visual Stent.

Background: The transjugular intrahepatic portosystemic stent-shunt (TIPSS) builds a shortcut between the portal vein and a liver vein, and represents a sophisticated alternative to open surgery in the management of portal hypertension or its complications.

Objectives: To describe clinical experiences with a low-profile nitinol stent system in TIPSS creation, and to assess primary and long-term success.

Patients And Methods: Twenty-six patients (5 females, 21 males; mean age 54.

Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies - A Retrospective Study.

The aim of the study was to evaluate safety, effectiveness, recurrence rate and 10-year survival after bronchial artery embolization (BAE) in benign and malignant etiologies. The retrospective study includes 100 BAE procedures in 88 patients. Underlying disease was classified as benign (n = 67) and malignant (n = 21) etiologies.

C-arm computed tomography and volume perfusion computed tomography (VPCT)-based assessment of blood volume changes in hepatocellular carcinoma in prediction of midterm tumor response to transarterial chemoembolization: a single center retrospective trial.

Background: This study aims to evaluate immediate changes in perfusion parameters in hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE) in C-arm computed tomography (CT) and volume perfusion CT (VPCT) and prediction of midterm tumor response.

Methods: Twenty-five patients (median age 66, range 61 to 75 years) with 62 HCC lesions undergoing TACE received immediate pre- and post-interventional assessment by C-arm CT and VPCT. Cross-sectional imaging was analyzed at baseline and approximately 12 weeks after TACE according to modified RECIST criteria.

[A rare cause of pulmonary embolism].

History And Admission Findings: We report on a patient with acute dyspnea after several vertebral body interventions, among others a kyphoplasty, that was performed a few days earlier.

Investigations: In the computed tomography we prove a bilateral pulmonary embolism (cement and thrombus). There is no right heart failure.

Correlation of magnetic resonance signal characteristics and perfusion parameters assessed by volume perfusion computed tomography in hepatocellular carcinoma: Impact on lesion characterization.

Aim: To find out if magnetic resonance (MR)-signal characteristics of hepatocellular carcinomas (HCC) correlate with perfusion parameters assessed by volume perfusion computed tomography (VPCT).

Methods: From October 2009 to January 2014, 26 (mean age, 69.3 years) patients with 36 HCC lesions who underwent both VPCT and MR liver imaging were analysed.

Assessment of the parenchymal blood volume by C-arm computed tomography for radioembolization dosimetry.

Purpose: Aim of the study was to evaluate the impact of parenchymal blood volume (PBV) C-arm CT in transarterial radioembolization (TARE) planning procedure regarding the appropriateness of segmental blood supply from selective catheter positions defined by angiographic images compared to PBV mapsto determine the influence of changed target volumes on dose calculation.

Material And Methods: A total of 22 consecutive patients (median age, 62 years) underwent a TARE planning procedure were included in this retrospective study. Selective angiograms and selective PBV C-arm CT (right and left liver lobe) were evaluated in a blinded fashion, regarding segmental hepatic artery variants.

German Center Subanalysis of the LEVANT 2 Global Randomized Study of the Lutonix Drug-Coated Balloon in the Treatment of Femoropopliteal Occlusive Disease.

Purpose: To report a subanalysis of the German centers enrolling patients in the prospective, global, multicenter, randomized LEVANT 2 pivotal trial (ClinicalTrials.gov identifier NCT01412541) of the Lutonix drug-coated balloon (DCB) for the treatment of femoropopliteal occlusive disease.

Methods: Among the 476 patients in LEVANT 2, 126 patients (mean age 67.

Three-dimensional C-arm CT-guided transjugular intrahepatic portosystemic shunt placement: Feasibility, technical success and procedural time.

Objectives: Establishment of transjugular intrahepatic portosystemic shunts (TIPS) constitutes a standard procedure in patients suffering from portal hypertension. The most difficult step in TIPS placement is blind puncture of the portal vein. This study aimed to evaluate three-dimensional mapping of portal vein branches and targeted puncture of the portal vein.

Imaging of HCC-Current State of the Art.

Early diagnosis of hepatocellular carcinoma (HCC) is crucial for optimizing treatment outcome. Ongoing advances are being made in imaging of HCC regarding detection, grading, staging, and also treatment monitoring. This review gives an overview of the current international guidelines for diagnosing HCC and their discrepancies as well as critically summarizes the role of magnetic resonance imaging (MRI) and computed tomography (CT) techniques for imaging in HCC.