Automated volumetry of core and peel intrapulmonary vasculature on computed tomography angiography for non-invasive estimation of hemodynamics in patients with pulmonary hypertension (2022 updated hemodynamic definition).

Background: Computed tomography pulmonary angiography (CTPA) is frequently performed in patients with pulmonary hypertension (PH) and may aid non-invasive estimation of pulmonary hemodynamics. We, therefore, investigated automated volumetry of intrapulmonary vasculature on CTPA, separated into core and peel fractions of the lung volume and its potential to differentially reflect pulmonary hemodynamics in patients with pre- and postcapillary PH.

Methods: A retrospective case-control study of 72 consecutive patients with PH according to the 2022 joint guidelines of the European Society of Cardiology and the European Respiratory Society who underwent right heart catheterization (RHC) and CTPA within 7 days between August 2013 and February 2016 at Thoraxklinik at Heidelberg University Hospital (Heidelberg, Germany) was conducted.

Nationwide Survey - What is important for a sustainable radiology?

Radiology departments with the large diagnostic devices CT and MRI contribute significantly to the overall energy consumption of health facilities. However, there is a lack of systematic knowledge about the opinions of radiological staff on the most relevant aspects of sustainability. For this reason, we conducted a comprehensive survey for radiology employees on sentiment and experiences regarding sustainability in radiology.

Impact of Structured Reporting of Lower Extremity CT Angiography on Report Quality and Workflow Efficiency.

We assessed the effects of structured reporting (SR) of lower extremity CT angiography (CTA) on report quality and workflow efficiency compared with conventional reports (CR). Surveys were conducted at an academic radiology department before and after the introduction of an SR template. Participants ( = 39, 21) rated report quality and report creation effort (1: very dissatisfied/low to 10: very satisfied/high) and whether SR represents an improvement over CR (1: completely disagree to 5: completely agree).

Rho-dependent transcriptional switches regulate the bacterial response to cold shock.

Binding of the bacterial Rho helicase to nascent transcripts triggers Rho-dependent transcription termination (RDTT) in response to cellular signals that modulate mRNA structure and accessibility of Rho utilization (Rut) sites. Despite the impact of temperature on RNA structure, RDTT was never linked to the bacterial response to temperature shifts. We show that Rho is a central player in the cold-shock response (CSR), challenging the current view that CSR is primarily a posttranscriptional program.

Calcium-Based Imaging of the Spine at Dual-Layer CT and Evaluation of Vertebral Fractures in Multiple Myeloma.

Purpose: To evaluate the prediction of vertebral fractures in plasma cell dyscrasias using dual-layer CT (DLCT) with quantitative assessment of conventional CT image data (CI), calcium suppressed image data (CaSupp), and calculation of virtual calcium-only (VCa) image data.

Material And Methods: Patients ( = 81) with the diagnosis of a plasma cell dyscrasia and whole-body DLCT at the time of diagnosis and follow-up were retrospectively enrolled. CI, CaSupp25, and CaSupp100 were quantitatively analyzed using regions of interest in the lumbar vertebral bodies and fractured vertebral bodies on baseline or follow-up imaging.

Feasibility of Reduced Iodine Loads for Vascular Assessment Prior to Transcatheter Aortic Valve Implantation (TAVI) Using Spectral Detector CT.

Reduced iodine loads for computed tomography (CT)-based vascular assessment prior to transcatheter aortic valve implantation (TAVI) may be feasible in conjunction with a spectral detector CT scanner. This prospective single-center study considered 100 consecutive patients clinically referred for pre-TAVI CT. They were examined on a dual-layer detector CT scanner to obtain an ECG-gated cardiac scan and a non-ECG-gated aortoiliofemoral scan.

BMI-Adapted Double Low-Dose Dual-Source Aortic CT for Endoleak Detection after Endovascular Repair: A Prospective Intra-Individual Diagnostic Accuracy Study.

Purpose: To assess the diagnostic accuracy of BMI-adapted, low-radiation and low-iodine dose, dual-source aortic CT for endoleak detection in non-obese and obese patients following endovascular aortic repair.

Methods: In this prospective single-center study, patients referred for follow-up CT after endovascular repair with a history of at least one standard triphasic (native, arterial and delayed phase) routine CT protocol were enrolled. Patients were divided into two groups and allocated to a BMI-adapted (group A, BMI < 30 kg/m; group B, BMI ≥ 30 kg/m) double low-dose CT (DLCT) protocol comprising single-energy arterial and dual-energy delayed phase series with virtual non-contrast (VNC) reconstructions.

Metal Artifact Reduction in Photon-Counting Detector CT: Quantitative Evaluation of Artifact Reduction Techniques.

Objectives: With the introduction of clinical photon-counting detector computed tomography (PCD-CT) and its novel reconstruction techniques, a quantitative investigation of different acquisition and reconstruction settings is necessary to optimize clinical acquisition protocols for metal artifact reduction.

Materials And Methods: A multienergy phantom was scanned on a clinical dual-source PCD-CT (NAEOTOM Alpha; Siemens Healthcare GmbH) with 4 different central inserts: water-equivalent plastic, aluminum, steel, and titanium. Acquisitions were performed at 120 kVp and 140 kVp (CTDI vol 10 mGy) and reconstructed as virtual monoenergetic images (VMIs; 110-150 keV), as T3D, and with the standard reconstruction "none" (70 keV VMI) using different reconstruction kernels (Br36, Br56) and with as well as without iterative metal artifact reduction (iMAR).

Standardizing lymphangiography and lymphatic interventions: a preclinical in vivo approach with detailed procedural steps.

Purpose: To present a preclinical in vivo approach for standardization and training of lymphangiography and lymphatic interventions using a pictorial review.

Materials And Methods: Different lipiodol- and gadolinium-based lymphangiography and lymphatic interventions were performed in twelve (12) landrace pigs with a mean bodyweight of 34 ± 2 kg using various imaging and guiding modalities, similar to the procedures used in humans. The techniques used were explicitly introduced and illustrated.

Effect of intra-arterial nimodipine on iatrogenic vasospasms during endovascular stroke treatment - angiographic resolution and infarct growth in follow-up imaging.

Purpose: The treatment of vasospasms during endovascular stroke treatment (EST) with intra-arterial nimodipine (NM) is routinely performed. However, the efficacy of resolving iatrogenic vasospasms during the angiographic intervention and the infarct development in follow-up imaging after EST has not been studied yet.

Methods: Retrospective single-center analysis of patients receiving EST for anterior circulation vessel occlusion between 01/2015 and 12/2021.

COVID-19 pneumonia: Prediction of patient outcome by CT-based quantitative lung parenchyma analysis combined with laboratory parameters.

Objectives: To evaluate the prognostic value of fully automatic lung quantification based on spectral computed tomography (CT) and laboratory parameters for combined outcome prediction in COVID-19 pneumonia.

Methods: CT images of 53 hospitalized COVID-19 patients including virtual monochromatic reconstructions at 40-140keV were analyzed using a fully automated software system. Quantitative CT (QCT) parameters including mean and percentiles of lung density, fibrosis index (FIBI-700, defined as the percentage of segmented lung voxels ≥-700 HU), quantification of ground-glass opacities and well-aerated lung areas were analyzed.

Experimental investigation of transvenous embolization of arteriovenous malformations using different in vivo models.

Background: Transvenous embolization (TVE) is an emerging technique for the endovascular treatment of cerebral arteriovenous malformations (AVMs). The aim of this study was to investigate two in vivo AVM models and to assess TVE techniques using these models.

Methods: Blood flow in the porcine rete mirabile (RM) was modified by either creating a carotid-jugular fistula or by placing a balloon guide catheter in the carotid artery.

Diagnostic accuracy of automated 3D volumetry of cardiac chambers by CT pulmonary angiography for identification of pulmonary hypertension due to left heart disease.

Objectives: To assess diagnostic accuracy of automated 3D volumetry of cardiac chambers based on computed tomography pulmonary angiography (CTPA) for the differentiation of pulmonary hypertension due to left heart disease (group 2 PH) from non-group 2 PH compared to manual diameter measurements.

Methods: Patients with confirmed PH undergoing right heart catheterisation and CTPA within 100 days for diagnostic workup of PH between August 2013 and February 2016 were included in this retrospective, single-centre study. Automated 3D segmentation of left atrium, left ventricle, right atrium and right ventricle (LA/LV/RA/RV) was performed by two independent and blinded radiologists using commercial software.

Dual-Layer Spectral Detector CT in Comparison with FDG-PET/CT for the Assessment of Lymphoma Activity.

Purpose: In patients with malignant lymphoma, disease activity is recommended to be assessed by FDG-PET/CT and the Deauville five-point scale (5-PS). The purpose of this study was to explore the potential of iodine concentration measured in contrast-enhanced dual-layer spectral detector CT (SDCT) as an alternative surrogate parameter for lymphoma disease activity by investigating its correlation with maximum standardized uptake values (SUV) and 5-PS.

Materials And Methods: 25 patients were retrospectively analyzed.

Treatment of Postoperative Lymphatic Leakage Applying Transpedal Lymphangiography - Experience in 355 Consecutive Patients.

Purpose: Report of experience from a single institution in treating postoperative lymphatic leakage (PLL) applying conventional transpedal lymphangiography (TL).

Materials And Methods: 453 patients with the initial diagnosis of PLL receiving TL between 03/1993 and 09/2018 were identified in the database. Only patients with confirmed PLL were included in the study.

Utility of Automated Cardiac Chamber Volumetry by Nongated CT Pulmonary Angiography for Detection of Pulmonary Hypertension Using the 2018 Updated Hemodynamic Definition.

Noninvasive tests for pulmonary hypertension (PH) are needed to help select patients for diagnostic right heart catheterization (RHC). CT pulmonary angiography (CTPA) is commonly performed for suspected PH. The purpose of this study was to assess the utility of CTPA-based cardiac chamber volumetric measurements for the diagnosis of PH in comparison with echocardiographic and conventional CTPA parameters, with the 2018 updated hemodynamic definition used as reference.

Acquisition of a Dose Management System with Consideration of Medico-Legal and Economic Aspects.

Background: New radiation protection regulation encompassing additional obligations for monitoring, reporting and recording of radiation exposure, was enacted on December 31, 2018. As a consequence, dose management systems (DMS) are necessary to fulfill the requirements. The process of selection, acquisition and implementation of a suitable IT solution for this purpose is a challenge that all X-ray-applying facilities, including hospitals and private practices, are currently facing.

Therapeutic lymphography for persistent chyle leak after pancreatic surgery.

Background: Chyle leak is a common complication following pancreatic surgery. After failure of conservative treatment, lymphography is one of the last therapeutic options. The objective of this study was to evaluate whether lymphography represents an effective treatment for severe chyle leak (International study Group on Pancreatic Surgery, grade C) after pancreatic surgery.

Insights into Clostridium tetani: From genome to bioreactors.

Tetanus vaccination is of major importance for public health in most countries in the world. The World Health Organization indicated that 15,000 tetanus cases were reported in 2018 (Organization, World Health, 2019). Currently, vaccine manufacturers use tetanus toxin produced by Clostridium tetani fermentation in complex media.

Percutaneous Irreversible Electroporation for Treatment of Small Hepatocellular Carcinoma Invisible on Unenhanced CT: A Novel Combined Strategy with Prior Transarterial Tumor Marking.

Introduction: To explore the feasibility, safety, and efficiency of ethiodized oil tumor marking combined with irreversible electroporation (IRE) for small hepatocellular carcinomas (HCCs) that were invisible on unenhanced computed tomography (CT).

Methods: A retrospective analysis of the institutional database was performed from January 2018 to September 2018. Patients undergoing ethiodized oil tumor marking to improve target-HCC visualization in subsequent CT-guided IRE were retrieved.

Single-energy versus dual-energy imaging during CT-guided biopsy using dedicated metal artifact reduction algorithm in an in vivo pig model.

Purpose: To evaluate dual-energy CT (DE) and dedicated metal artifact reduction algorithms (iMAR) during CT-guided biopsy in comparison to single-energy CT (SE).

Methods: A trocar was placed in the liver of six pigs. CT acquisitions were performed with SE and dose equivalent DE at four dose levels(1.

Long-Term Follow-Up and Clinical Relevance of Incidental Findings of Fibrin Sheath and Thrombosis on Computed Tomography Scans of Cancer Patients with Port Catheters.

Purpose: This retrospective study examined the incidence, progression, and clinical relevance of catheter-related thrombosis (CRT) and/or fibrin sheaths presenting as incidental findings on routine staging computed tomography (CT) scans performed in cancer patients.

Patients And Methods: Patients who underwent central venous port catheter (CVC) placement in a tertiary care hospital between September 2010 and August 2013 were followed up for up to five years. Two radiologists assessed the presence of fibrin sheath and thrombosis in consensus in staging CT scan.

Image quality evaluation of dual-layer spectral CT in comparison to single-layer CT in a reduced-dose setting.

Objectives: To quantitatively and qualitatively evaluate image quality in dual-layer CT (DLCT) compared to single-layer CT (SLCT) in the thorax, abdomen, and pelvis in a reduced-dose setting.

Methods: Intraindividual, retrospective comparisons were performed in 25 patients who received at least one acquisition of all three acquisition protocols SLCT (100 kVp), DLCT (120 kVp), and DLCT (120 kVp), all covering the venous-phase thorax, abdomen, and pelvis with matched CTDI between SLCT and DLCT. Reconstruction parameters were identical between all scans.

A Microwave-Assisted Direct Heteroarylation of Ketones Using Transition Metal Catalysis.

Heteroarylation introduces heteroaryl fragments to organic molecules. Despite the numerous available reactions reported for arylation via transition metal catalysis, the literature on direct heteroarylation is scarce. The presence of heteroatoms such as nitrogen, sulfur and oxygen often make heteroarylation a challenging research field due to catalyst poisoning, product decomposition and the rest.