Publications by authors named "Tim-Rasmus Kiehl"

Integrating digital pathology (DP) and artificial intelligence (AI) algorithms can potentially improve diagnostic practice and precision medicine. Developing reliable, generalizable, and comparable AI algorithms depends on access to meticulously annotated data. However, achieving this requires robust collaboration among pathologists, computer scientists and other researchers to ensure data quality and consistency.

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  • - The PROSurvival project focuses on enhancing predictions for prostate cancer recurrence-free survival by using federated machine learning to analyze whole slide images along with specific clinical data while ensuring data privacy compliance.
  • - Anonymized datasets created from image and clinical data will adhere to the General Data Protection Regulation (GDPR) and follow principles for data accessibility and interoperability, utilizing the DICOM standard for images and a modified version of the oBDS standard for clinical data.
  • - The project faced challenges regarding clinical data anonymization and navigating various approval processes from data protection officers at different clinics, but the new German Health Data Utilization Act is anticipated to streamline future data sharing efforts.
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Over the past decade, artificial intelligence (AI) methods in pathology have advanced substantially. However, integration into routine clinical practice has been slow due to numerous challenges, including technical and regulatory hurdles in translating research results into clinical diagnostic products and the lack of standardized interfaces. The open and vendor-neutral EMPAIA initiative addresses these challenges.

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Aims: Pathology education is a core component of medical training, and its literature is critical for refining educational modalities. We performed a cross-sectional bibliometric analysis to explore publications on pathology education, focusing on new medical education technologies.

Methods: The analysis identified 64 pathology journals and 53 keywords.

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Pathology laboratories are increasingly using digital workflows. This has the potential of increasing laboratory efficiency, but the digitization process also involves major challenges. Several reports have been published describing the individual experiences of specific laboratories with the digitization process.

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The current move towards digital pathology enables pathologists to use artificial intelligence (AI)-based computer programmes for the advanced analysis of whole slide images. However, currently, the best-performing AI algorithms for image analysis are deemed black boxes since it remains - even to their developers - often unclear why the algorithm delivered a particular result. Especially in medicine, a better understanding of algorithmic decisions is essential to avoid mistakes and adverse effects on patients.

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The interest in implementing digital pathology (DP) workflows to obtain whole slide image (WSI) files for diagnostic purposes has increased in the last few years. The increasing performance of technical components and the Food and Drug Administration (FDA) approval of systems for primary diagnosis led to increased interest in applying DP workflows. However, despite this revolutionary transition, real world data suggest that a fully digital approach to the histological workflow has been implemented in only a minority of pathology laboratories.

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Objective: We aimed to delineate the distribution of periventricular nodular heterotopia (PNH) in patients with 22q11.2 microdeletion syndrome (22q11.2DS) and place this in the context of other genetic forms of PNH.

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Background: Sporadic arteriovenous malformations of the brain, which are morphologically abnormal connections between arteries and veins in the brain vasculature, are a leading cause of hemorrhagic stroke in young adults and children. The genetic cause of this rare focal disorder is unknown.

Methods: We analyzed tissue and blood samples from patients with arteriovenous malformations of the brain to detect somatic mutations.

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Background: Radiotherapy with procarbazine, lomustine, and vincristine improves overall survival (OS) in patients with 1p19q co-deleted anaplastic oligodendroglioma/anaplastic oligoastrocytoma.

Methods: This retrospective analysis investigated outcomes in patients with 1p19q co-deleted/partially deleted oligodendroglioma, oligoastrocytoma, anaplastic oligodendroglioma, or anaplastic oligoastrocytoma. OS and progression-free survival (PFS) were analyzed using the Kaplan-Meier method and prognostic factors using the Cox proportional hazard model.

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  • The study investigates the effectiveness of renal denervation (RDN) in reducing ventricular arrhythmias (VAs) in pigs that had suffered a heart attack, specifically focusing on its impact on the sympathetic nervous system's role in the heart.
  • Pigs with implantable cardioverter defibrillators underwent myocardial infarction and were later treated with either real or sham RDN; results showed that real RDN dramatically cut down the rate of spontaneous VAs (100% reduction) and decreased sympathetic nerve activity in the heart.
  • These findings suggest that RDN could have therapeutic potential for managing arrhythmias following heart attacks by lowering sympathetic cardiovascular influences.
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Background And Purpose: Cerebral microbleeds (petechial hemorrhages) are a well-known consequence of cerebral amyloid angiopathy and chronic hypertension among other causes. We report 12 patients with a clinically and radiologically distinct microbleed phenomenon in the cerebral white matter.

Methods: These patients were assessed at the University Health Network (Toronto, Canada) between 2004 and 2014.

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Delayed intracranial hemorrhage is a rare complication of treatment for central nervous system tumors. This may be secondary to malignant transformation of the tumor or vasculopathy related to radiation therapy (RT). While most reports on radiation-induced vasculopathy in children with optic pathway gliomas are associated with ischemic complications, there are only two reports of hemorrhagic complications in these patients.

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Objective: To determine whether large (≥3 mm thick) but nonstenotic (<50%) carotid artery atherosclerotic plaque predominantly occurs ipsilateral rather than contralateral to cryptogenic stroke.

Methods: This was a cross-sectional observational study. Using a stroke registry, we identified consecutive patients with anterior circulation embolic stroke of undetermined source (ESUS).

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Immunotherapy with monoclonal antibodies targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4) or programmed cell death 1 (PD-1) has improved the survival of patients with metastatic melanoma. These agents carry a certain risk of adverse immune-related events. We present a patient with widely metastatic melanoma who was initially treated with ipilimumab and subsequently with nivolumab.

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  • - The study compares two surgical approaches—endoscopic endonasal (EEA) and bifrontal craniotomy (BFC)—for treating olfactory groove meningiomas, focusing on outcomes and MRI changes post-surgery.
  • - A total of 70 patients were examined, and after matching 10 pairs based on tumor volumes and timing of scans, key outcomes like cerebrospinal fluid leaks and resection rates were analyzed, showing similar overall results.
  • - Notably, EEA showed significantly less postoperative FLAIR signal change in the frontal lobe compared to BFC, suggesting EEA may result in better postoperative MRI outcomes.
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Evidence suggests hyperglycemia is associated with worse outcomes in glioblastoma (GB). This study aims to confirm the association between glycemia during radiotherapy (RT) and temozolomide (TMZ) treatment and overall survival (OS) in patients with newly diagnosed GB. This retrospective study included GB patients treated with RT and TMZ from 2004 to 2011, randomly divided into independent derivation and validation datasets.

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Medulloblastoma is the most common malignant pediatric brain tumor. Standard treatment consists of surgical resection, followed by radiation and high-dose chemotherapy. Despite these efforts, recurrence is common, leading to reduced patient survival.

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Focal myositis secondary to an intramuscular vascular malformation has rarely been reported in the literature. We describe a 21-year-old woman presenting with left thigh pain. Imaging of the thigh muscles showed a vascular malformation and muscle biopsy demonstrated focal changes diagnosed initially as myositis.

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Spindle cell oncocytoma of the adenohypophysis is a rare tumor classified by the World Health Organization as benign with no malignant features. Recent publications have questioned its identity as a benign tumor, as six postsurgical recurrences of spindle cell oncocytoma (SCO) have been reported. This case is the first to illustrate the natural history of the disease due to delayed intervention, as the tumor showed virtually no growth.

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In this work, we explored the potential of measuring shear wave propagation using optical coherence elastography (OCE) in an inhomogeneous phantom and carotid artery samples based on a swept-source optical coherence tomography (OCT) system. Shear waves were generated using a piezoelectric transducer transmitting sine-wave bursts of 400 μs duration, applying acoustic radiation force (ARF) to inhomogeneous phantoms and carotid artery samples, synchronized with a swept-source OCT (SS-OCT) imaging system. The phantoms were composed of gelatin and titanium dioxide whereas the carotid artery samples were embedded in gel.

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