Whitepaper: Training in Diagnostic and Interventional Breast Radiology.

Purpose: Breast imaging represents an integral part of radiology and is subject to strict quality controls. Regarding this, precise diagnostics including multimodal assessment by mammography, sonography, and MRI, including image-guided biopsy and localization procedures, is often decisive and must be performed by experts with profound knowledge and skills in all of these procedures.However, due to numerous restructurings, breast imaging has been shifted more and more towards large, specialized centers, resulting in less patient exposition and training opportunities for radiologists in smaller sites.

Nationwide Provision of Radiologically-guided Interventional Measures for the Supportive Treatment of Tumor Diseases in Germany - An Analysis of the DeGIR Registry Data.

Purpose: In addition to direct oncologic therapy, interventional radiology plays an important supportive role in oncologic therapy primarily guided by other disciplines. These supporting measures include diagnostic punctures, drainages, biliary interventions, central venous access including port implantations, osteoplasties, pain therapies etc.).

Availability of Interventional Oncology in Germany in the Years 2018 and 2019 - Results from a Nationwide Database (DeGIR Registry Data).

Objective: Over the past few decades, radiology has established itself in tumor therapy through interventional oncology including innovative and efficient procedures for minimalinvasive treatment of various tumor entities besides the "classic" therapeutic options such as surgery, chemotherapy and radiotherapy.Aim of this study was to evaluate the extent to which interventional oncology can provide nationwide care using the data from the register of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR registry), which records radiological interventions as part of quality assurance.

Methods: The numbers of interventions of participating clinics, which were recorded as part of module D (oncological procedures including TACE or other tumor-specific embolization, ablation, percutaneous tumor therapy) and identified by the DeGIR registry between 2018 and 2019, were analyzed retrospectively.

Availability of interventional-radiological revascularization procedures in Germany - an analysis of the DeGIR Registry Data 2018/19.

Purpose: Peripheral artery disease (PAD) is a common condition with high socio-economic relevance. Therefore, qualified nationwide provision of interventional treatments of PAD is important for maintaining a high quality medical service in Germany.

Materials And Methods: All data on revascularization procedures from the quality management system of the German interventional radiological society (DeGIR) for the years 2018 and 2019 were retrospectively analysed.

Availability of Transcatheter Vessel Occlusion Performed by Interventional Radiologists to Treat Bleeding in Germany in the Years 2016 and 2017 - An Analysis of the DeGIR Registry Data.

Purpose:  Acute bleeding is a life-threatening condition that can be effectively treated minimally invasively by interventional radiologists using transcatheter vessel occlusion (TCVO). The purpose of this study was to evaluate the availability of TCVO performed by interventional radiologists in Germany based on the DeGIR registry.

Materials And Methods:  TCVO interventions from the years 2016 and 2017 were included (DeGIR module B).

Surgical management of rectal foreign bodies: a 10-year single-center experience.

Background: Patients with a rectal foreign body (RFB) are still a rare entity in general surgery departments but with an increasing incidence over the last years. This case is sometimes difficult to treat, and due to a lack of standardized treatment options, the aim of the study was to present our clinical experiences with the diagnostic and therapeutic approach to RFBs and a review of the currently available literature.

Materials And Methods: Data were collected retrospectively from the patient's records of 20 patients who were treated due to an RFB between 2006 and 2016.

Neuronal Na+/K+ ATPase is an autoantibody target in paraneoplastic neurologic syndrome.

Objectives: To identify an autoreactivity in a 66-year-old woman who presented with combined brainstem and cerebellar syndrome including vertical gaze palsy, severe progressive ataxia, and spastic tetraparesis, an acute deterioration of vision, dysarthria, and dysphagia with concurrent diagnosis of a colon adenocarcinoma.

Methods: Patient's serum and CSF underwent comprehensive autoantibody screening by indirect immunofluorescence assay and immunoblot. For autoantigen purification, a histo-immunoprecipitation technique was developed followed by mass spectrometrical analysis.

Stent-assisted coil embolization of a traumatic wide-necked renal segmental artery pseudoaneurysm.

We present the case of an Afghan woman with a renal segmental artery false aneurysm of the right kidney due to a shell splinter injury. Stent-assisted coil embolization of the aneurysm is described in detail.

Impact of donor serum sodium levels on outcome after heart transplantation.

We investigated the impact of elevated donor serum sodium levels on outcome after heart transplantation in 336 consecutive heart transplantations. Mean donor serum sodium was 148.2+/-10.

Tacrolimus or cyclosporine: which is the better partner for mycophenolate mofetil in heart transplant recipients?

Background: The aim of this single-center study was to investigate whether trough level adjusted mycophenolate mofetil (MMF) is more efficacious in combination with tacrolimus (TAC) or cyclosporine (CsA) and to evaluate the impact of either drug on MMF dosage.

Methods: Sixty patients (TAC, n = 30; CsA, n = 30) undergoing heart transplantation were randomized into a prospective, open-label, controlled trial. Immunosuppression consisted of TAC or CsA in combination with MMF and corticosteroids.

Sirolimus impairs gonadal function in heart transplant recipients.

The impact of sirolimus on hormone levels involved in the hypothalamus-pituitary-gonad axis in male heart transplant recipients was investigated. A pair-matched analysis with 132 male heart transplant recipients on either sirolimus based- or calcineurin inhibitor-based immunosuppression was performed. Matching criteria were age, years after transplantation and creatinine levels.

Mycophenolate mofetil and sirolimus as calcineurin inhibitor-free immunosuppression for late cardiac-transplant recipients with chronic renal failure.

Background: Calcineurin-inhibitor (CNI)-related renal failure is a common problem after cardiac transplantation (HTx). The aim of this study was to introduce a CNI-free immunosuppressive regimen to HTx recipients with late posttransplant renal impairment and to evaluate the impact of conversion to this new immunosuppression (mycophenolate mofetil [MMF] and sirolimus [Sir]) treatment on renal function.

Methods And Results: Thirty-one HTx patients (25 men, 6 women; 0.

Transbrachial thrombolysis, PTA and stenting in the lower extremities.

We present an analysis of 37 interventions in the arteries of the lower limbs via a transbrachial arterial approach. Twenty-six patients (42-79 years) underwent 37 interventional procedures in the lower extremities (iliac n = 6, iliac + femoro-popliteal n = 1, femoro-popliteal n = 30) with a vascular approach via the brachial artery (33 left sided, 4 right sided, introducer sheath 4-7 F). The transbrachial approach was chosen to avoid puncture of femoral bypass graft material.

Renal recovery after conversion to a calcineurin inhibitor-free immunosuppression in late cardiac transplant recipients.

Objective: Calcineurin inhibitor (CNI)-related renal failure is a common problem after cardiac transplantation (HTx). The aim of this prospective study was to evaluate the safety and efficacy of a completely CNI-free immunosuppressive regimen [mycophenolate mofetil (MMF) and sirolimus (Sir)] in HTx-recipients with late post-transplant renal impairment.

Methods: Since 2001, 30 HTx-patients (25 men, 6 women; 0.

Impairment of the blood-brain barrier can result in tacrolimus-induced reversible leucoencephalopathy following heart transplantation.

Fatal leucoencephalopathy is a rare calcineurin inhibitor-related complication, especially in kidney and liver transplant recipients. The only means of clinical management reported so far is the discontinuation or reduction in the calcineurin inhibitor. We herein report a case of a 37-yr-old male who developed leucoencephalopathy 12 wk after heart transplantation and recovered after stabilization of metabolism and arterial blood pressure.

Sirolimus-eluting stents for the treatment of obstructive superficial femoral artery disease: six-month results.

Background: Stent implantation for obstructive femoropopliteal artery disease has been associated with poor long-term outcomes. This study evaluated the effectiveness of shape memory alloy recoverable technology (SMART) nitinol self-expanding stents coated with a polymer impregnated with sirolimus (rapamycin) versus uncoated SMART Stents in superficial femoral artery obstructions.

Methods And Results: Thirty-six patients were recruited for this double-blind, randomized, prospective trial.

Stereotactic linear accelerater-based radiosurgery for the treatment of patients with glomus jugulare tumors.

Background: The optimal treatment for patients with glomus jugulare tumor (GJT) of the skull base remains controversial. Surgical excision is associated with a high incidence of cranial nerve injury, decreased quality of life, and high mortality. Fractionated radiotherapy is used to control the majority of these tumors, but disadvantages are a prolonged therapy interval and exposition of adjacent brain tissue to irradiation.

Aneurysmal re-rupture during selective cerebral angiography.

Two cases of aneurysmal re-rupture during intracranial angiography are presented. This event is accompanied by disastrous consequences with regard to the clinical condition of the patient, as is evident from the cases presented as well as from the literature. Acute alterations of intraluminal pressure as well as a time interval of less than 6 h seems to increase the risk of re-bleeding during angiography.

Sirolimus-eluting stents for the treatment of obstructive superficial femoral artery disease: six-month results.

Background: Stent implantation for obstructive femoropopliteal artery disease has been associated with poor long-term outcomes. This study evaluated the effectiveness of shape memory alloy recoverable technology (SMART) nitinol self-expanding stents coated with a polymer impregnated with sirolimus (rapamycin) versus uncoated SMART stents in superficial femoral artery obstructions.

Methods And Results: Thirty-six patients were recruited for this double-blind, randomized, prospective trial.