13 results on '"Metzger, Giulia"'
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2. Keeping Up With ChatGPT: Evaluating Its Recognition and Interpretation of Nuclear Medicine Images
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Rogasch, Julian M.M., Jochens, Hans V., Metzger, Giulia, Wetz, Christoph, Kaufmann, Jonas, Furth, Christian, Amthauer, Holger, and Schatka, Imke
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- 2024
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3. Plasma Markers for Therapy Response Monitoring in Patients with Neuroendocrine Tumors Undergoing Peptide Receptor Radionuclide Therapy
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Wetz, Christoph, primary, Ruhwedel, Tristan, additional, Schatka, Imke, additional, Grabowski, Jane, additional, Jann, Henning, additional, Metzger, Giulia, additional, Galler, Markus, additional, Amthauer, Holger, additional, and Rogasch, Julian M. M., additional
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- 2023
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4. 68Ga-labeled fibroblast activation protein inhibitor (FAPI) PET/CT for locally advanced or recurrent pancreatic cancer staging and restaging after chemoradiotherapy.
- Author
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Metzger, Giulia, Bayerl, Christian, Rogasch, Julian M. M., Furth, Christian, Wetz, Christoph, Beck, Marcus, Mehrhof, Felix, Amthauer, Holger, Ghadjar, Pirus, Neumann, Christopher, Pelzer, Uwe, Zips, Daniel, Hofheinz, Frank, Grabowski, Jane, Schatka, Imke, and Zschaeck, Sebastian
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- 2024
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5. ChatGPT: Can You Prepare My Patients for [18F]FDG PET/CT and Explain My Reports?
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Rogasch, Julian M.M., primary, Metzger, Giulia, additional, Preisler, Martina, additional, Galler, Markus, additional, Thiele, Felix, additional, Brenner, Winfried, additional, Feldhaus, Felix, additional, Wetz, Christoph, additional, Amthauer, Holger, additional, Furth, Christian, additional, and Schatka, Imke, additional
- Published
- 2023
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6. Reevaluating the relevance of 18F-FDG PET findings for diagnosis of neurosarcoidosis: a case series.
- Author
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Chen, Jessy, Metzger, Giulia, Furth, Christian, Bohner, Georg, and Siffrin, Volker
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POSITRON emission ,POSITRON emission tomography ,MAGNETIC resonance imaging ,CENTRAL nervous system - Abstract
Objective: The diagnosis of neurosarcoidosis (NS) remains challenging due to the difficulty to obtain central nervous system (CNS) biopsies. Various diagnostic parameters are considered for the definition of possible, probable and definite NS. Magnetic resonance imaging (MRI) is the imaging gold standard and considered in diagnostic criteria. Fluorodeoxyglucose positron emission (
18 F-FDG PET) is sometimes performed additionally to identify possible systemic biopsy targets. However, at present, its findings are not incorporated into the diagnostic criteria for neurosarcoidosis (NS). Methods: We conducted a single center retrospective search for the period 2020–2022, for patients with neurological symptoms in a diagnostic context of suspected NS who underwent MRI and additional18 F-FDG PET scans to identify potential hypermetabolism in the CNS and biopsy targets. Results: We identified three cases of NS, where Gadolinium-enhanced MRI scans did not show abnormalities while18 F-FDG PET revealed hypermetabolic lesions in areas of the CNS. Additional MRI scans were still inconclusive for structural changes. We diagnosed a "probable" NS in all cases with histopathological confirmation of systemic sarcoidosis which led to an intensified therapy regime. Discussion:18 F-FDG PET is an early indicator for metabolic changes. It appears to be a useful add-on to improve accuracy of diagnostic criteria in suspected NS without MRI findings. [ABSTRACT FROM AUTHOR]- Published
- 2024
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7. ChatGPT: Can You Prepare My Patients for [18F]FDG PET/CT and Explain My Reports?
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Rogasch, Julian M. M., Metzger, Giulia, Preisler, Martina, Galler, Markus, Thiele, Felix, Brenner, Winfried, Feldhaus, Felix, Wetz, Christoph, Amthauer, Holger, Furth, Christian, and Schatka, Imke
- Published
- 2023
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8. Der Transkriptionsfaktor CUX1 beeinflusst epigenetisch induzierte zelluläre Stressreaktionen im hepatozellulären Karzinom
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Metzger, Giulia
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HDACis ,ER-Stress ,Apoptose ,CUX1 ,Panobinostat ,Medizin ,Autophagie ,HCC ,Medical sciences Medicine - Abstract
Hepatocellular carcinoma is the second most worldwide cancer-related death. Due to the absence of symptoms in the early stage of the disease and the late diagnosis, a curative treatment seems to be mostly ineffetctive. The multi-kinase-inhibitors Sorafenib (Nexavar) and Lenvatinib (Lenvima) are the only evidence-based drugs with a first-line use approved by the European Medicines Ageny (EMA) for systemic treatment of advanced local or even metastatic stage of hepatocellular carcinoma within the Child-Pugh-Score A. Despite many attempts of the current investigations to identify molecular-targeting drugs beside sorafenib, the results have been unsatisfying so far. Hopefully, the induction of epigenetic modifications could represent a promising approach for the development of a new systemic therapy. The application of deacetylase inhibitors (DACis) results in an increase of endoplasmatic-reticulum stress and autophagic process, which trigger liver cancer cell death. The study here proposed focused on the role exerted by the highly evolutionary conserved transcription factor CUX1 in DACi-mediated endoplasmic reticulum stress/autophagic mechanisms in HCC cells. CUX1 is responsible for promoting cell motility, invasion and cell cycle progression as well as for causing cell death resistance. Clinical studies associate a high level of CUX1 transcript in several cancers. The aim of this study was to elucidate the oncogenic and/or tumor suppressive potential of CUX1 in HCC cells. CUX1 transient knockdown was performed in two human HCC-cell lines Hep3B (p53-deficient) and HepG2 (p53-wildtype). After a 6 hour treatment (RT-qPCR) and 24 hour treatment (RT-qPCR and Western Blot) with Thapsigargin and the DACis Trichostatin A (TSA), SAHA and Panobinostat the expression of autophagic markers was detected by RT-qPCR and Western Blot. Fluorescent microscopy was performed to visualize the autophagosome maturation after autophagy induction via Panobinostat-treatment in the absence of CUX1. The effect of transient CUX1-knockdown on cell proliferation was detected by real time cell viability assays. CUX1 transient knockdown reduced the efficacy of short-term (6h) administration of especially thapsigargin and panobinostat in promoting the expression of ER-stress-markers. These findings could reveal oncogenic potential of CUX1-regulation regarding ER-Stress-mediated drug resistance. The real time cell viability assay pointed out an altered cell proliferation with the most significant effect in the absence of CUX1 and the administration of panobinostat in Hep3B cells. Regarding a possible resistance to apoptosis, CUX1 exerts an oncogenic function. Decreased mRNA-expression of autophagic markers after CUX1-Knockdown suggests impaired autophagic mechanism, depending on the time of administration with the DACis and the p53-levels of the examined cell lines. The measurement of increased Beclin1 and MAP1LC3B protein levels in the Western Blot analysis contributed to a reduced efficacy of the compounds to perform autophagy after CUX1-silencing. Autophagy, as a catabolic process, leads to a massive protein degradation. An increase of the protein levels within a reduction of the mRNA expression of autophagic markers therefore supports an impairment of autophagy in the absence of CUX1. A reduced maturation of the autophagosome vesicles (Hep3B-cells) as well as impaired autophagosome-lysosome-fusion (HepG2-cells) was observed under fluorescence microscopy in the absence of CUX1 after the administration of panobinostat. These findings suggest a tumor suppressive potential of CUX1 on HCC cells performing autophagic cell death after DACi treatment. Regarding to current studies implicating the contribution of CUX1 to resistance towards apoptosis highlights a possible interaction between autophagic-related cell death and apoptosis. CUX1 could either inhibit, promote or necessitate apoptosis and autophagy. While showing its pro-tumorigenic potential in HCC, CUX1 simultaneously promotes autophagy-related cell death and therefore exerts anti tumorigenic role too. Clinical studies analysing the effect of a combined treatment of sorafenib and panobinostat in metastatic stage of HCC and might provide a base for further clinical investigations regarding the influence of CUX1., Das hepatozelluläre Karzinom rangiert hinsichtlich der malignomassoziierten Mortalität auf Platz zwei weltweit und zeigt im Rahmen ernüchternder systemischer Therapieoptionen bei fortgeschrittenem Krebsleiden die Grenzen bislang erforschter Therapieansätze auf. Ein zunächst eher symptomarmer Krankheitsverlauf und eine somit mehrheitliche Diagnosestellung in fortgeschrittenen Krankheitsstadien erschweren eine kurative Behandlung. In lokoregionär fortgeschrittenen oder fernmetastasierten Krankheitsstadien des HCCs der Child-Pugh-Klassifikation A gelten die Multikinaseinhibitoren Sorafenib (Nexavar) und Lenvatinib (Lenvima ) als bislang einzige von der European Medicines Agency (EMA) zugelassene, medikamentöse Therapieoptionen der Erstlinientherapie. Eine Überlegenheit anderer molekularer, therapeutischer Ansätze gegenüber diesen Multikinaseinhibitoren konnte bisher nicht gezeigt werden. Die Induktion epigenetischer Modifikation in Krebszellen stellt währenddessen einen neuen Ansatz bezüglich der Systemtherapie des metastasierten HCCs dar. Die Applikation von Histondeacetylaseinhibitoren (DACis) führt zu vermehrten Stressreaktionen des Endoplasmatischen Retikulums und einer konsekutiven Induktion autophagischer Prozesse, welche die HCC-Zellen in einen protrahierten Zelltod senden. Basierend auf dieser Grundlage wurde in dieser experimentellen Arbeit der evolutionär hoch konservierte und bislang unzureichend erforschte Transkriptionsfaktor CUX1 auf sein etwaiges regulatorisches Potential hinsichtlich der ER-Stress- und Autophagie-Induktion nach DACi-Behandlung von HCC-Zellen untersucht. Bisher werden CUX1 in maligne transformierten Zellen regulatorische Fähigkeiten bezüglich der Zellzyklusprogression, Zellmotilität und Zellinvasion sowie Induktion einer Apoptoseresistenz attestiert. Es galt als Ziel dieser Arbeit, das onkogene aber auch das tumorsuppressive Potential von CUX1 in HCC-Zellen unter Substanzbehandlung zu analysieren. Anhand zweier humaner HCC-Zelllinien mit p53-wildtyp Status (HepG2) und p53-defizientem Status (Hep3B) wurde über die Transfektion mit einer siRNA für CUX1 ein Knockdown erzielt. Nach 6- und nach 24-stündiger Applikation der DACis TSA, SAHA und Panobinostat sowie des Kalziumkanal-Inhibitors Thapsigargin wurde in Gegenüberstellung der CUX1-Knockdown-Gruppe und einer Kontrollgruppe die Expression der ER-Stress-Indikatoren BIP, CHOP, ATF4 und AT6 sowie die Expression der Autophagie-Marker BECN1, MAP1LC3B, TFEB und UVRAG durch qRT-PCR-Versuche und Western Blot-Analysen untersucht. Die fluoreszenzmikroskopische Darstellung des Effekts eines CUX1-Knockdowns auf die Autophagosomen-Reifung sowie die Echtzeit-Analyse der Zellproliferation unter CUX1-Defizienz nach ER-Stress- und Autophagie-Induktion sollten die Experimente vervollständigen. Die Ergebnisse der genannten Versuche lassen regulatorisches Potential von CUX1 bezüglich Thapsigarin- und DACi-getriggerter ER-Stress und Autophagie-Mechanismen vermuten. Onkogene Eigenschaften des Transkriptionsfaktors werden einerseits durch eine defizitäre Expression der ER-Stress-Marker BIP, ATF4 und ATF6 unter CUX1-Knockdown und kurzzeitiger Substanzbehandlung deutlich. CUX1 könnte die Bildung von Chemo-oder Strahlenresistenzen durch die Stimulation des ER-Stresses als Initiator zelleigener Reparaturmechanismen begünstigen. Andererseits wird onkogenes Potential von CUX1 in den Zellproliferationsmessungen deutlich. Die Hep3B-Zelllinie wies hierbei unter CUX1-Knockdown und Panobinostat-Behandlung eine signifikante Abnahme der Zellproliferation auf. Die Förderung von Apoptose-Resistenzen durch CUX1 könnte diesen Proliferations-Stopp in den xCELLigence®-Analysen begründen. Tumorsuppressive Eigenschaften von CUX1 wurden durch den Nachweis defizitärer Autophagie-Mechanismen und einer möglichen Verzögerung des autophagic cell death als antikanzerogener Mechanismus deutlich. In Abhängigkeit des p53-Status der untersuchten Zelllinie sowie der Inkubationsdauer mit den DACis konnte dabei eine herunterregulierte Transkript-Expression der Autophagie-Marker nachgewiesen werden. Die Akkumulation der autophagischen Proteine MAP1LC3B und Beclin1 in den Western Blot Analysen sowie Defizite der Autophagosomen-Formation und der Autolysosomen-Bildung in der Fluoreszenzmikroskopie stützten die These defizitärer Autophagie-Mechanismen unter CUX1-Knockdown. Bezüglich jüngster Erkenntnisse zur CUX1-vermittelten Resistenzentwicklung gegen die Apoptose erscheint die Zusammenschau des programmierten Zelltodes und des Autophagie-bedingten Zelltodes sinnvoll. Durch ein komplexes Netzwerk an Signalkaskaden können sich Apoptose und Autophagie gegenseitig verstärken, hemmen oder wechselseitig bedingen, sodass CUX1 als multifunktionaler Transkriptionsfaktor und regulatorischer Mediator agieren könnte. Dabei soll die mehrheitliche Auffassung von CUX1 als Onkogen keineswegs negiert werden, sondern vielmehr das Potential einer simultanen tumorsuppressiven Wirkung im Autophagie-bezogenen Therapieregime im HCC betont werden. Bereits initiierte klinische Studien zur Kombinationstherapie aus Sorafenib und Panobinostat im metastasierten Krankheitsstadium des HCCs bilden eine Grundlage für klinische Forschungsansätze unter Einbezug von CUX1.
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- 2022
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9. Score-based improvement of the indication for surgical treatment of thyroid lesions
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Eilsberger, Friederike, additional, Hartenstein, Max Lennart, additional, Librizzi, Damiano, additional, Metzger, Giulia, additional, Luster, Markus, additional, Verburg, Frederik A., additional, and Pfestroff, Andreas, additional
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- 2020
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10. Wie werden Schilddrüsenknoten diagnostiziert?
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Eilsberger, Friederike, additional, Librizzi, Damiano, additional, Metzger, Giulia, additional, Luster, Markus, additional, and Pfestroff, Andreas, additional
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- 2019
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11. CUX1 controls endoplasmic reticulum stress and autophagy related cell death
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Metzger, Giulia, primary
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- 2017
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12. 68 Ga-labeled fibroblast activation protein inhibitor (FAPI) PET/CT for locally advanced or recurrent pancreatic cancer staging and restaging after chemoradiotherapy.
- Author
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Metzger G, Bayerl C, Rogasch JM, Furth C, Wetz C, Beck M, Mehrhof F, Amthauer H, Ghadjar P, Neumann C, Pelzer U, Zips D, Hofheinz F, Grabowski J, Schatka I, and Zschaeck S
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- Humans, Female, Male, Middle Aged, Aged, Adult, Radiopharmaceuticals, Adenocarcinoma therapy, Adenocarcinoma diagnostic imaging, Adenocarcinoma pathology, Adenocarcinoma drug therapy, Aged, 80 and over, Quinolines, Positron Emission Tomography Computed Tomography methods, Pancreatic Neoplasms therapy, Pancreatic Neoplasms diagnostic imaging, Pancreatic Neoplasms pathology, Pancreatic Neoplasms drug therapy, Neoplasm Staging, Chemoradiotherapy methods, Neoplasm Recurrence, Local, Gallium Radioisotopes
- Abstract
Purpose:
68 Ga-labeled fibroblast activation protein inhibitor (FAPI) is a novel PET tracer with great potential for staging pancreatic cancer. Data on locally advanced or recurrent disease is sparse, especially on tracer uptake before and after high dose chemoradiotherapy (CRT). The aim of this study was to evaluate [68 Ga]Ga-FAPI-46 PET/CT staging in this setting. Methods: Twenty-seven patients with locally recurrent or locally advanced pancreatic adenocarcinoma (LRPAC n = 15, LAPAC n = 12) in stable disease or partial remission after chemotherapy underwent FAPI PET/CT and received consolidation CRT in stage M0 with follow-up FAPI PET/CT every three months until systemic progression. Quantitative PET parameters SUVmax , SUVmean , FAPI-derived tumor volume and total lesion FAPI-uptake were measured in baseline and follow-up PET/CT scans. Contrast-enhanced CT (ceCT) and PET/CT data were evaluated blinded and staged according to TNM classification. Results: FAPI PET/CT modified staging compared to ceCT alone in 23 of 27 patients in baseline, resulting in major treatment alterations in 52% of all patients (30%: target volume adjustment due to N downstaging, 15%: switch to palliative systemic chemotherapy only due to diffuse metastases, 7%: abortion of radiotherapy due to other reasons). Regarding follow-up scans, major treatment alterations after performing FAPI PET/CT were noted in eleven of 24 follow-up scans (46%) with switch to systemic chemotherapy or best supportive care due to M upstaging and ablative radiotherapy of distant lymph node and oligometastasis. Unexpectedly, in more than 90 % of the follow-up scans, radiotherapy did not induce local fibrosis related FAPI uptake. During the first follow-up, all quantitative PET metrics decreased, and irradiated lesions showed significantly lower FAPI uptake in locally controlled disease (SUVmax p = 0.047, SUVmean p = 0.0092) compared to local failure. Conclusion: Compared to ceCT, FAPI PET/CT led to major therapeutic alterations in patients with LRPAC and LAPAC prior to and after radiotherapy, which might help identify patients benefiting from adjustments in every treatment stage. FAPI PET/CT should be considered a useful diagnostic tool in LRPAC or LAPAC before and after CRT., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)- Published
- 2024
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13. ChatGPT: Can You Prepare My Patients for [ 18 F]FDG PET/CT and Explain My Reports?
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Rogasch JMM, Metzger G, Preisler M, Galler M, Thiele F, Brenner W, Feldhaus F, Wetz C, Amthauer H, Furth C, and Schatka I
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- Humans, Radiopharmaceuticals, Artificial Intelligence, Reproducibility of Results, Positron Emission Tomography Computed Tomography, Fluorodeoxyglucose F18
- Abstract
We evaluated whether the artificial intelligence chatbot ChatGPT can adequately answer patient questions related to [
18 F]FDG PET/CT in common clinical indications before and after scanning. Methods: Thirteen questions regarding [18 F]FDG PET/CT were submitted to ChatGPT. ChatGPT was also asked to explain 6 PET/CT reports (lung cancer, Hodgkin lymphoma) and answer 6 follow-up questions (e.g., on tumor stage or recommended treatment). To be rated "useful" or "appropriate," a response had to be adequate by the standards of the nuclear medicine staff. Inconsistency was assessed by regenerating responses. Results: Responses were rated "appropriate" for 92% of 25 tasks and "useful" for 96%. Considerable inconsistencies were found between regenerated responses for 16% of tasks. Responses to 83% of sensitive questions (e.g., staging/treatment options) were rated "empathetic." Conclusion: ChatGPT might adequately substitute for advice given to patients by nuclear medicine staff in the investigated settings. Improving the consistency of ChatGPT would further increase reliability., (© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2023
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