Publications by authors named "Kolja Thierfelder"

Article Synopsis
  • Automated perfusion imaging can identify stroke patients eligible for thrombolysis, but it's not widely available; a new method using CT hypoperfusion-hypodensity mismatch offers a potential alternative.
  • In a study involving 247 patients, 88.7% were deemed eligible for thrombolysis, with the hypoperfusion-hypodensity mismatch detecting 96.4% of eligible patients within the 4.5-hour time frame compared to only 44.7% by the automated method.
  • This new CT method demonstrated higher sensitivity for identifying eligible patients but lower specificity, suggesting that it could help more patients receive treatment.
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Background And Purpose: Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether a simple method of computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours.

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Article Synopsis
  • The study aimed to determine if CT hypoperfusion-hypodensity mismatch can effectively identify patients experiencing ischemic stroke within 4.5 hours of their symptoms starting.
  • Out of 666 patients analyzed, a significant majority (94.2%) with symptom onset within 4.5 hours showed hypoperfusion-hypodensity mismatch, indicating strong predictive value for identifying timely thrombolysis candidates.
  • The findings suggest that detecting this mismatch on CT scans can potentially guide treatment decisions for patients whose stroke onset time is unclear.
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Background:  Multiparametric magnetic resonance imaging (MRI) of the prostate plays a central role in the diagnosis of patients with suspected prostate cancer. The increasing distribution and application of the guideline for the standardization of image acquisition, evaluation, and reporting (Prostate Imaging - Reporting and Data System, PI-RADS), which was updated in 2019 to version 2.1, contributes to the success of the technique.

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Article Synopsis
  • The study aimed to investigate the prevalence and clinical importance of extravascular findings (EVFs) on magnetic resonance angiography (MRA) in patients with suspected or known peripheral artery disease (PAD).
  • The research involved re-evaluating MRAs of 194 patients, uncovering 501 EVFs in 172 patients, with 12% of those having major clinical relevance, mainly in soft tissues and linked to infections or neoplastic conditions.
  • The findings highlight the need for thorough evaluation of all organ systems in MRA reports, as significant non-vascular issues can frequently arise alongside vascular assessments.
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Background:  The rapid progress in oncology research requires numerous new scientific publications. This article aims to provide an overview of criteria-based imaging and response evaluation of lymphoma according to the current status of knowledge. In fact, common criteria for evaluating data, especially imaging response evaluation, are essential for comparability of studies.

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  • Stress fractures are common injuries classified as either fatigue fractures (in healthy bones) or insufficiency fractures (in already weakened bones).
  • Imaging techniques include X-rays as the first step, followed by MRI for better sensitivity; CT is used for detailed fracture line mapping, and bone scintigraphy detects increased bone metabolism.
  • Key imaging signs vary by method, including specific features identifiable on X-rays, MRIs showing edema and reactions, and CT displaying hypodense fracture lines; recognizing these signs is crucial for accurate diagnosis and determining further imaging needs when initial tests are inconclusive.
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Background And Purpose: Imaging-based selection of stroke patients for endovascular thrombectomy (EVT) remains an ongoing challenge. Our aim was to determine the value of a combined parameter of ischemic core volume (ICV) and the relative degree of cerebral blood flow in the penumbra for morphologic and clinical outcome prediction.

Methods: In this Institutional Review Board (IRB)-approved prospective observational study, 221 consecutive patients with large vessel occlusion anterior circulation stroke within 6 hours of symptom onset and subsequent EVT were included between June 2015 and August 2017.

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Benign bone tumors are frequently discovered as incidental findings, whereas malignant tumors and metastases often become clinically noticeable due to pain or swelling. The initial radiological diagnostics by conventional X‑ray imaging, magnetic resonance imaging (MRI) and computed tomography (CT) play an important role in the assessment of dignity and further treatment planning. The aftercare of bone tumors is necessary for the recognition of recurrences and distant metastases as well as the detection of complications, e.

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Background: Wavelet transformed reconstructions of dynamic susceptibility contrast (DSC) MR perfusion (wavelet-MRP) are a new and elegant way of visualizing vascularization. Wavelet-MRP maps yield a clear depiction of hypervascular tumor regions, as recently shown.

Objective: The aim of this study was to elucidate a possible connection of the wavelet-MRP power spectrum in glioblastoma (GBM) with local vascularity and cell proliferation.

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Background The diagnosis of ischemic cerebellar stroke is challenging because of nonspecific symptoms and very limited accuracy of commonly applied computed tomography (CT) imaging. Advances in CT perfusion imaging provide increasing value in the detection of posterior circulation stroke, but the prognostic value remains unclear. We aimed to identify imaging parameters that predict morphologic outcome in cerebellar stroke patients using advanced CT including whole-brain CT perfusion (WB-CTP).

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Imaging bone tumors often causes uncertainty, especially outside dedicated sarcoma treatment centers. Conventional radiography remains the backbone of bone tumor diagnostics, but MR imaging has a role. Radiographs are crucial for assessing the tumor matrix and aggressiveness.

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Prostate cancer (PCa) is a genetically heterogeneous cancer entity that causes challenges in pre-treatment clinical evaluation, such as the correct identification of the tumor stage. Conventional clinical tests based on digital rectal examination, Prostate-Specific Antigen (PSA) levels, and Gleason score still lack accuracy for stage prediction. We hypothesize that unraveling the molecular mechanisms underlying PCa staging via integrative analysis of multi-OMICs data could significantly improve the prediction accuracy for PCa pathological stages.

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Background and Purpose- Large vessel occlusion stroke leads to highly variable hyperacute infarction growth. Our aim was to identify clinical and imaging parameters associated with hyperacute infarction growth in patients with an large vessel occlusion stroke of the anterior circulation. Methods- Seven hundred twenty-two consecutive patients with acute stroke were prospectively included in our monocentric stroke registry between 2009 and 2017.

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Purpose: Leptomeningeal collaterals can slow down infarction growth; however, despite good collaterals in the DAWN and DEFUSE 3 trials, outcomes were devastating if reperfusion was not attempted. The aim of this study was to compare the influence of collaterals on morphological and functional outcome in patients with acute middle cerebral artery (MCA) stroke undergoing intravenous thrombolysis (IVT) vs. supportive care (non-IVT).

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Article Synopsis
  • The original paper had a mistake in the Acknowledgements section.
  • The Acknowledgements were accidentally removed during early editing.
  • This correction highlights the importance of careful manuscript review.
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Purpose: To evaluate technical success and long-term outcome of CT-guided radiofrequency ablation (RFA) of spinal osteoid osteomas (OO) and osteoblastomas (OB) in six different European centres.

Methods: Eighty-seven patients with spinal OO (77) or OB (10) were treated with CT-guided RFA, after three-dimensional CT-guided access planning. Patient's long-term outcome was assessed by clinical examination and questionnaire-based evaluation including 10-point visual analogue scales (VAS) regarding the effect of RFA on severity of pain and limitations of daily activities.

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Background Recent studies have proven the effectiveness of thrombectomy up to 24 hours after stroke onset for patients with specific criteria at advanced CT or MRI. Clinical implementation of treatment in this extended time window remains a challenge, as many stroke centers do not routinely use advanced imaging. Purpose To determine whether automated cerebral x-ray attenuation measurements at noncontrast CT provide information on the presence of CT perfusion-defined ischemic core as applied in late time windows for thrombectomy.

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Article Synopsis
  • Muscle injuries in the hip and thigh are common in competitive athletes, particularly soccer players, often leading to missed games.
  • MRI is the primary imaging technique used for diagnosing these injuries, and radiologists must be skilled at interpreting typical MRI findings like edema and tears.
  • Recent research suggests that recovery time can be influenced by additional factors beyond traditional grading, such as the length of a tear and the presence of ongoing edema.
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Purpose: Leptomeningeal collaterals play a pivotal role in acute ischemic stroke. While most collateral scores rely on subjective visual analysis, an objective quantification is possible using dynamic computed tomography (CT) angiography (dynCTA). The aim was to determine the value of collateral filling delay (CFD) as assessed by dynCTA for predicting subacute stroke complications.

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Objectives: Parameter maps based on wavelet-transform post-processing of dynamic perfusion data offer an innovative way of visualizing blood vessels in a fully automated, user-independent way. The aims of this study were (i) a proof of concept regarding wavelet-based analysis of dynamic susceptibility contrast (DSC) MRI data and (ii) to demonstrate advantages of wavelet-based measures compared to standard cerebral blood volume (CBV) maps in patients with the initial diagnosis of glioblastoma (GBM).

Methods: Consecutive 3-T DSC MRI datasets of 46 subjects with GBM (mean age 63.

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Background: Anton's syndrome is a rare neurological disorder characterized by a combination of visual anosognosia and confabulation of visual experience, most often seen after bilateral ischemic damage to the posterior occipital cortex.

Case Report: We report the first case of an acute synchronous P2 occlusion as confirmed by multiparametric computed tomography (CT) including perfusion. After the administration of Recombinant tissue plasminogen activator (rtPA), Anton's syndrome completely resolved.

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Total knee arthroplasty (TKA) has significant medical and economic implications. The correct placement of the femoral and tibial components is vital to ensure a functional knee and also low failure and revision surgery rates. This article provides the most relevant information regarding knee endoprosthesis from a radiologic point of view.

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Article Synopsis
  • Researchers wanted to see how well a special heart scan called CCTA works for patients who might have heart problems based on other tests.
  • They checked 100 patients with a concerning heart scan and did the CCTA before a procedure called ICA.
  • They found that almost half of the patients (48%) didn’t have serious blockages in their heart arteries, even though their previous tests looked bad.
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Purpose To determine the impact of patient age on the cost-effectiveness of endovascular therapy (EVT) in addition to standard care (SC) in large-vessel-occlusion stroke for patients aged 50 to 100 years in the United States. Materials and Methods A decision-analytic Markov model was used to estimate direct and indirect lifetime costs and quality-adjusted life years (QALYs). Age-dependent input parameters were obtained from the literature.

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