95 results match your criteria: "Thoraxklinik at University Hospital Heidelberg[Affiliation]"

Editorial: Functional and quantitative imaging of the lung.

Front Med (Lausanne)

December 2024

Edinburgh Imaging, Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.

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Metastasis Detection Using True and Artificial T1-Weighted Postcontrast Images in Brain MRI.

Invest Radiol

November 2024

From the Department of Diagnostic and Interventional Neuroradiology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany (R.H., E.K., Z.B., D.P., R.C., A.R., K.D.); Institute of Applied Mathematics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany (T.P., A.E.); Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.P.); Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (D.P., H.-P.S.); Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany (M.F.-D., K.S., G.H., C.P.H.); Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany (M.F.-D.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (V.W., C.P.H.); Translational Lung Research Center Heidelberg, Member of the German Center of Lung Research (DZL), Heidelberg, Germany (C.P.H.); Praxisnetz, Radiology and Nuclear Medicine, Bonn, Germany (M.V.); Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany (J.A.L.); Chair of Civil Law, Data Protection Law, Law of Data Economy, Digitalization and AI Law, Faculty of Law, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany (L.S.-R.); and German Center for Neurodegenerative Diseases (DZNE), Helmholtz Association of German Research Centers, Venusberg-Campus 1, Bonn, Germany (A.R., K.D.).

Objectives: Small lesions are the limiting factor for reducing gadolinium-based contrast agents in brain magnetic resonance imaging (MRI). The purpose of this study was to compare the sensitivity and precision in metastasis detection on true contrast-enhanced T1-weighted (T1w) images and artificial images synthesized by a deep learning method using low-dose images.

Materials And Methods: In this prospective, multicenter study (5 centers, 12 scanners), 917 participants underwent brain MRI between October 2021 and March 2023 including T1w low-dose (0.

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Pulmonary MRI in Newborns and Children.

J Magn Reson Imaging

December 2024

POLARIS, Division of Clinical Medicine, School of Medicine & Population Health, Faculty of Health, The University of Sheffield, Sheffield, UK.

Lung MRI is an important tool in the assessment and monitoring of pediatric and neonatal lung disorders. MRI can provide both similar and complementary image contrast to computed tomography for imaging the lung macrostructure, and beyond this, a number of techniques have been developed for imaging the key functions of the lungs, namely ventilation, perfusion, and gas exchange, through the use of free-breathing proton and hyperpolarized gas MRI. Here, we review the state-of-the-art in MRI methods that have found utility in pediatric and neonatal lung imaging, the structural and physiological information that can be gleaned from such images, and strategies that have been developed to deal with respiratory (and cardiac) motion, and other technological challenges.

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Article Synopsis
  • Segmentation of lung structures in medical imaging is important for diagnosing and treating diseases like cystic fibrosis, with neural networks showing better results than traditional methods, but challenges remain with different imaging types and pathologies.
  • This study used deep learning to segment MRI scans from pediatric cystic fibrosis patients, employing the nnU-Net framework and analyzing data from 165 scans across various sequences (BLADE, VIBE, HASTE). The analysis focused on patient variability in disease severity and age.
  • Results indicated high segmentation accuracy (with Dice coefficients around 0.95-0.96) and consistent performance regardless of patient differences, although some issues with segmentation completeness were noted, particularly in the diaphragm area; the model also showed
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Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease, which is usually diagnosed late in advanced stages. Little is known about the subclinical development of IPF. We previously generated a mouse model with conditional deficiency () that develops IPF-like lung disease.

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Inert gas washout methods have been shown to detect pathological changes in the small airways that occur in the early stages of obstructive lung diseases such as asthma and COPD. Numerical lung models support the analysis of characteristic washout curves, but are limited in their ability to simulate the complexity of lung anatomy over an appropriate time period. Therefore, the interpretation of patient-specific washout data remains a challenge.

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Objective: Investigate the feasibility of detecting early treatment-induced tumor tissue changes in patients with advanced lung adenocarcinoma using diffusion-weighted MRI-derived radiomics features.

Methods: This prospective observational study included 144 patients receiving either tyrosine kinase inhibitors (TKI, n = 64) or platinum-based chemotherapy (PBC, n = 80) for the treatment of pulmonary adenocarcinoma. Patients underwent diffusion-weighted MRI the day prior to therapy (baseline, all patients), as well as either + 1 (PBC) or + 7 and + 14 (TKI) days after treatment initiation.

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Clinical trials show that lumacaftor/ivacaftor (LUM/IVA) treatment has the potential to modify early cystic fibrosis (CF) disease progression in children as young as 2 years of age. To assess the long-term impact of LUM/IVA treatment on CF disease progression in children aged 2-5 years. This phase 2 trial had two parts: part 1, a 48-week, randomized, double-blind, placebo-controlled study of LUM/IVA in children aged 2-5 years (previously reported) was followed by a 48-week open-label treatment period in which all children received LUM/IVA (part 2; reported here).

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CT-guided needle biopsy is not associated with increased ipsilateral pleural metastasis.

Lung Cancer

August 2024

Department of Thoracic Surgery, Thoraxklinik at the University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany.

Article Synopsis
  • - Histological confirmation through either CT-guided needle biopsy (CTGNB) or bronchoscopy is crucial for planning lung cancer treatment, with concerns raised about CTGNB potentially increasing pleural recurrence risk, especially considering tumor proximity to the pleura.
  • - A study of 844 lung cancer patients revealed a low pleural recurrence rate (3.2%), and while CTGNB resulted in tumors being closer to the pleura, the biopsy method itself did not significantly impact the recurrence risk.
  • - The analysis concluded that CTGNB is safe and does not increase the risk of pleural recurrence, but this finding needs to be corroborated with data from larger, multicenter studies.
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Objective: Thoracic neurogenic tumors usually present as benign nerve sheath tumors that can be resected via transthoracic or posterior approaches, depending on the anatomical location. Robot-assisted thoracic surgery (RATS) is increasingly being used for the transthoracic approach, but evidence is very limited. The authors initiated the current study to evaluate the efficacy and safety of RATS for thoracic neurogenic tumors.

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Diagnostic leukapheresis reveals distinct phenotypes of NSCLC circulating tumor cells.

Mol Cancer

May 2024

Department of Personalized Oncology, DKFZ-Hector Cancer Institute, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

Article Synopsis
  • Circulating tumor cells (CTCs) are critical for understanding tumor diversity and treatment resistance, but traditional methods often capture low numbers, especially in non-small cell lung cancer (NSCLC).
  • This study utilized diagnostic leukapheresis (DLA) on six advanced NSCLC patients to access larger blood volumes and employed a new two-step method to enrich CTCs for analysis.
  • The results unveiled 3,363 unique CTC transcriptomes, revealing significant heterogeneity and potential distinct phenotypes, which suggests CTCs can serve as valuable indicators for tumor monitoring and targeted therapies in the future.
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Lung Cancer in Ever- and Never-Smokers: Findings from Multi-Population GWAS Studies.

Cancer Epidemiol Biomarkers Prev

March 2024

Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas.

Background: Clinical, molecular, and genetic epidemiology studies displayed remarkable differences between ever- and never-smoking lung cancer.

Methods: We conducted a stratified multi-population (European, East Asian, and African descent) association study on 44,823 ever-smokers and 20,074 never-smokers to identify novel variants that were missed in the non-stratified analysis. Functional analysis including expression quantitative trait loci (eQTL) colocalization and DNA damage assays, and annotation studies were conducted to evaluate the functional roles of the variants.

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Objectives: Molecular diagnosis for targeted therapies has been improved significantly in non-small-cell lung cancer (NSCLC) patients in recent years. Here we report on the prevalence of rare fusions in NSCLC and dissect their genomic architecture and potential clinical implications.

Materials And Methods: Overall, n = 5554 NSCLC patients underwent next-generation sequencing (NGS) for combined detection of oncogenic mutations and fusions either at primary diagnosis (n = 5246) or after therapy resistance (n = 308).

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As a byproduct of the increased use of high-resolution radiological imaging, the prevalence of incidental findings (IFs) has been increasing for years. The discovery of an incidental finding can allow early treatment of a potentially health-threatening disease and thus decisively change the course of the disease. However, many incidental findings are of low risk with little or no health impact, and yet their discovery often leads to a cascade of additional investigations.

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"Lung perfusion" in the context of imaging conventionally refers to the delivery of blood to the pulmonary capillary bed through the pulmonary arteries originating from the right ventricle required for oxygenation. The most important physiological mechanism in the context of imaging is the so-called hypoxic pulmonary vasoconstriction (HPV, also known as "Euler-Liljestrand-Reflex"), which couples lung perfusion to lung ventilation. In obstructive airway diseases such as asthma, chronic-obstructive pulmonary disease (COPD), cystic fibrosis (CF), and asthma, HPV downregulates pulmonary perfusion in order to redistribute blood flow to functional lung areas in order to conserve optimal oxygenation.

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Airway Stents from Now to the Future: A Narrative Review.

Respiration

June 2023

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.

Airway stent insertion is important for patients with airway stenosis. Currently, the most widely used airway stents in clinical procedures are silicone and metallic stents, which offer patients effective treatment. However, these stents composed of permanent materials need to be removed, subjecting patients to invasive manipulation once more.

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Mosaic Chromosomal Alterations Are Associated With Increased Lung Cancer Risk: Insight From the INTEGRAL-ILCCO Cohort Analysis.

J Thorac Oncol

August 2023

Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas; Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas. Electronic address:

Introduction: Mosaic chromosomal alterations (mCAs) detected in white blood cells represent a type of clonal hematopoiesis (CH) that is understudied compared with CH-related somatic mutations. A few recent studies indicated their potential link with nonhematological cancers, especially lung cancer.

Methods: In this study, we investigated the association between mCAs and lung cancer using the high-density genotyping data from the OncoArray study of INTEGRAL-ILCCO, the largest single genetic study of lung cancer with 18,221 lung cancer cases and 14,825 cancer-free controls.

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Spatial profiling of the microenvironment reveals low intratumoral heterogeneity and STK11-associated immune evasion in therapy-naïve lung adenocarcinomas.

Lung Cancer

June 2023

Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany; Translational Lung Research Center (TLRC) Heidelberg, German Center for Lung Research (DZL), Germany. Electronic address:

Objective: Intratumoral heterogeneity was found to be a significant factor causing resistance to lung cancer therapies, including immune checkpoint blockade. Lesser is known about spatial heterogeneity of the tumor microenvironment (TME) and its association with genetic properties of the tumor, which is of particular interest in the therapy-naïve setting.

Materials And Methods: We performed multi-region sampling (2-4 samples per tumor; total of 55 samples) from a cohort of 19 untreated stage IA-IIIB lung adenocarcinomas (n = 11 KRAS mutant, n = 1 ERBB2 mutant, n = 7 KRAS wildtype).

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Background: Detection of circulating tumour DNA (ctDNA) in biological fluids is a minimally invasive alternative to tissue biopsy for therapy monitoring. Cytokines are released in the tumour microenvironment to influence inflammation and tumorigenic mechanisms. Here, we investigated the potential biomarker utility of circulating cytokines vis-à-vis ctDNA in ALK-rearranged+ lung adenocarcinoma (ALK + NSCLC) and explored the optimal combination of molecular parameters that could indicate disease progression.

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Characterization of three new variants PiQ0, PiQ0 and PiQ0 in patients with severe alpha-1 antitrypsin deficiency.

Respir Med Case Rep

March 2023

Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Translational Lung Research Center (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany.

Background: The clinical and molecular characteristics of three patients with previously unreported mutations associated with severe alpha-1 antitrypsin deficiency (AATD) are described. The pathophysiology of the chronic obstructive pulmonary disease (COPD) present in these patients was characterized through clinical, biochemical, and genetic examinations.

Case Presentations: Case 1: A 73-year-old male with bilateral centri-to panlobular emphysema and multiple increasing ventrobasal bullae and incomplete fissures, COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade III B), progressive dyspnea on exertion (DOE), AAT level of 0.

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Purpose: Real-word evidence on the effectiveness of switching from dual therapies or triple therapies (multiple inhalers) to extrafine single-inhaler triple therapy (efSITT), which consists of the inhaled corticosteroid (ICS) beclomethasone, the long-acting β-agonist (LABA) formoterol and the long-acting muscarinic antagonist (LAMA) glycopyrronium, in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) is limited. The impact of switching to efSITT on health-related quality of life (HRQoL), COPD specific symptoms, lung function and treatment adherence were assessed in routine clinical care.

Patients And Methods: Patients were recruited at 148 sites in Germany between 2017 and 2020 in this multicenter, non-interventional observational study.

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Background: DNA methylation (5-mC) signals in cell-free DNA (cfDNA) of cancer patients represent promising biomarkers for minimally invasive tumor detection. The high abundance of cancer-associated 5-mC alterations permits parallel and highly sensitive assessment of multiple 5-mC biomarkers. Here, we performed genome-wide 5-mC profiling in the plasma of metastatic ALK-rearranged non-small cell lung cancer (NSCLC) patients receiving tyrosine kinase inhibitor therapy.

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Association of coronary artery calcification with clinical and physiological characteristics in patients with COPD: Results from COSYCONET.

Respir Med

November 2022

Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany; Germany University of Latvia, Faculty of Medicine, Raina bulvaris 19, Riga, 1586 Latvia; Christian-Albrechts-Universität zu Kiel, Faculty of Medicine, 24098, Kiel, Germany.

Chronic obstructive pulmonary disease (COPD) is frequently associated with coronary artery disease (CAD). When considering computed tomography (CT) for COPD phenotyping, coronary vessel wall calcification would be a potential marker of cardiac disease. However, non-ECG gated scans as used in COPD monitoring do not comply with established quantitative approaches using ECG-triggered CT and the Agatston score.

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