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1. Pre-examinations Improve Automated Metastases Detection on Cranial MRI

Author

Deike-Hofmann, Katerina, Dancs, Dorottya, Paech, Daniel, Schlemmer, Heinz-Peter, Maier-Hein, Klaus, Bäumer, Philipp, Radbruch, Alexander, and Götz, Michael

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition, Physics - Medical Physics, Quantitative Biology - Quantitative Methods
Abstract

Materials and methods: First, a dual-time approach was assessed, for which the CNN was provided sequences of the MRI that initially depicted new MM (diagnosis MRI) as well as of a prediagnosis MRI: inclusion of only contrast-enhanced T1-weighted images (CNNdual_ce) was compared with inclusion of also the native T1-weighted images, T2-weighted images, and FLAIR sequences of both time points (CNNdual_all).Second, results were compared with the corresponding single time approaches, in which the CNN was provided exclusively the respective sequences of the diagnosis MRI.Casewise diagnostic performance parameters were calculated from 5-fold cross-validation. Results: In total, 94 cases with 494 MMs were included. Overall, the highest diagnostic performance was achieved by inclusion of only the contrast-enhanced T1-weighted images of the diagnosis and of a prediagnosis MRI (CNNdual_ce, sensitivity = 73%, PPV = 25%, F1-score = 36%). Using exclusively contrast-enhanced T1-weighted images as input resulted in significantly less false-positives (FPs) compared with inclusion of further sequences beyond contrast-enhanced T1-weighted images (FPs = 5/7 for CNNdual_ce/CNNdual_all, P < 1e-5). Comparison of contrast-enhanced dual and mono time approaches revealed that exclusion of prediagnosis MRI significantly increased FPs (FPs = 5/10 for CNNdual_ce/CNNce, P < 1e-9).Approaches with only native sequences were clearly inferior to CNNs that were provided contrast-enhanced sequences. Conclusions: Automated MM detection on contrast-enhanced T1-weighted images performed with high sensitivity. Frequent FPs due to artifacts and vessels were significantly reduced by additional inclusion of prediagnosis MRI, but not by inclusion of further sequences beyond contrast-enhanced T1-weighted images. Future studies might investigate different change detection architectures for computer-aided detection.

Published
2024
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2. Gadolinium dose reduction for brain MRI using conditional deep learning

Author

Pinetz, Thomas, Kobler, Erich, Haase, Robert, Luetkens, Julian A., Meetschen, Mathias, Haubold, Johannes, Deuschl, Cornelius, Radbruch, Alexander, Deike, Katerina, and Effland, Alexander

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition, Computer Science - Machine Learning
Abstract

Recently, deep learning (DL)-based methods have been proposed for the computational reduction of gadolinium-based contrast agents (GBCAs) to mitigate adverse side effects while preserving diagnostic value. Currently, the two main challenges for these approaches are the accurate prediction of contrast enhancement and the synthesis of realistic images. In this work, we address both challenges by utilizing the contrast signal encoded in the subtraction images of pre-contrast and post-contrast image pairs. To avoid the synthesis of any noise or artifacts and solely focus on contrast signal extraction and enhancement from low-dose subtraction images, we train our DL model using noise-free standard-dose subtraction images as targets. As a result, our model predicts the contrast enhancement signal only; thereby enabling synthesization of images beyond the standard dose. Furthermore, we adapt the embedding idea of recent diffusion-based models to condition our model on physical parameters affecting the contrast enhancement behavior. We demonstrate the effectiveness of our approach on synthetic and real datasets using various scanners, field strengths, and contrast agents.

Published
2024

4. Rasmussen’s encephalitis: structural, functional, and clinical correlates of contralesional epileptiform activity

Author

Bauer, Tobias, von Wrede, Randi D., Pujar, Suresh, Rácz, Attila, Hoppe, Christian, Baumgartner, Tobias, Varadkar, Sophia, Held, Nina R., Reiter, Johannes T., Enders, Selma, David, Bastian, Prillwitz, Conrad C., Brugues, Mar, Keil, Vera C. W., Jeub, Monika, Borger, Valeri, Sander, Josemir W., Kunz, Wolfram S., Radbruch, Alexander, Weber, Bernd, Helmstaedter, Christoph, Vatter, Hartmut, Baldeweg, Torsten, Becker, Albert J., Cross, J. Helen, Surges, Rainer, and Rüber, Theodor

Published
2024
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5. Contrast media for hysterosalpingography: systematic search and review providing new guidelines by the Contrast Media Safety Committee of the European Society of Urogenital Radiology

Author

Geenen, Remy W. F., van der Molen, Aart J., Dekkers, Ilona A., Bellin, Marie-France, Bertolotto, Michele, Correas, Jean-Michel, Heinz-Peer, Gertraud, Mahnken, Andreas H., Quattrocchi, Carlo C., Radbruch, Alexander, Reimer, Peter, Roditi, Giles, Sebastià, Carmen, Stacul, Fulvio, Romanini, Laura, Clément, Olivier, and Brismar, Torkel B

Published
2024
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8. Analytical interference of intravascular contrast agents with clinical laboratory tests: a joint guideline by the ESUR Contrast Media Safety Committee and the Preanalytical Phase Working Group of the EFLM Science Committee

Author

van der Molen, Aart J., Krabbe, Johannes G., Dekkers, Ilona A., Geenen, Remy W. F., Bellin, Marie-France, Bertolotto, Michele, Brismar, Torkel B., Cadamuro, Janne, Correas, Jean-Michel, Heinz-Peer, Gertraud, Langlois, Michel R., Mahnken, Andreas H., Ozben, Tomris, Quattrocchi, Carlo C., Radbruch, Alexander, Reimer, Peter, Roditi, Giles, Romanini, Laura, Sebastià, Carmen, Simundic, Ana-Maria, Stacul, Fulvio, and Clement, Olivier

Published
2024
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10. Faithful Synthesis of Low-dose Contrast-enhanced Brain MRI Scans using Noise-preserving Conditional GANs

Author

Pinetz, Thomas, Kobler, Erich, Haase, Robert, Deike-Hofmann, Katerina, Radbruch, Alexander, and Effland, Alexander

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition
Abstract

Today Gadolinium-based contrast agents (GBCA) are indispensable in Magnetic Resonance Imaging (MRI) for diagnosing various diseases. However, GBCAs are expensive and may accumulate in patients with potential side effects, thus dose-reduction is recommended. Still, it is unclear to which extent the GBCA dose can be reduced while preserving the diagnostic value -- especially in pathological regions. To address this issue, we collected brain MRI scans at numerous non-standard GBCA dosages and developed a conditional GAN model for synthesizing corresponding images at fractional dose levels. Along with the adversarial loss, we advocate a novel content loss function based on the Wasserstein distance of locally paired patch statistics for the faithful preservation of noise. Our numerical experiments show that conditional GANs are suitable for generating images at different GBCA dose levels and can be used to augment datasets for virtual contrast models. Moreover, our model can be transferred to openly available datasets such as BraTS, where non-standard GBCA dosage images do not exist., Comment: Early accepted by MICCAI 2023

Published
2023

14. Waiting times between examinations with intravascularly administered contrast media: a review of contrast media pharmacokinetics and updated ESUR Contrast Media Safety Committee guidelines

Author

van der Molen, Aart J., Dekkers, Ilona A., Geenen, Remy W. F., Bellin, Marie-France, Bertolotto, Michele, Brismar, Torkel B., Correas, Jean-Michel, Heinz-Peer, Gertraud, Mahnken, Andreas H., Quattrocchi, Carlo C., Radbruch, Alexander, Reimer, Peter, Roditi, Giles, Romanini, Laura, Sebastià, Carmen, Stacul, Fulvio, and Clement, Olivier

Published
2024
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16. Synchronous versus metachronous spinal metastasis: a comparative study of survival outcomes following neurosurgical treatment

Author

Banat, Mohammed, Potthoff, Anna-Laura, Hamed, Motaz, Borger, Valeri, Scorzin, Jasmin E., Lampmann, Tim, Asoglu, Harun, Khalafov, Logman, Schmeel, Frederic C., Paech, Daniel, Radbruch, Alexander, Nitsch, Louisa, Weller, Johannes, Herrlinger, Ulrich, Toma, Marieta, Gielen, Gerrit H., Vatter, Hartmut, and Schneider, Matthias

Published
2024
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17. Abstract: Deep Learning-based Detection of Vessel Occlusions on CT-Angiography in Patients with Suspected Acute Ischemic Stroke

Author

Brugnara, Gianluca, primary, Baumgartner, Michael, additional, Scholze, Edwin D., additional, Deike-Hofmann, Katerina, additional, Kades, Klaus, additional, Scherer, Jonas, additional, Denner, Stefan, additional, Meredig, Hagen, additional, Rastogi, Aditya, additional, Mahmutoglu, Mustafa A., additional, Ulfert, Christian, additional, Neuberger, Ulf, additional, Schönenberger, Silvia, additional, Schlamp, Kai, additional, Bendella, Zeynep, additional, Pinetz, Thomas, additional, Schmeel, Carsten, additional, Wick, Wolfgang, additional, Ringleb, Peter A., additional, Floca, Ralf, additional, Möhlenbruch, Markus, additional, Radbruch, Alexander, additional, Bendszus, Martin, additional, Maier-Hein, Klaus, additional, and Vollmuth, Philipp, additional

Published
2024
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18. Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses

Author

Zeyen, Thomas, Paech, Daniel, Weller, Johannes, Schäfer, Niklas, Tzaridis, Theophilos, Duffy, Cathrina, Nitsch, Louisa, Schneider, Matthias, Potthoff, Anna-Laura, Steinbach, Joachim Peter, Hau, Peter, Schlegel, Uwe, Seidel, Clemens, Krex, Dietmar, Grauer, Oliver, Goldbrunner, Roland, Zeiner, Pia Susan, Tabatabai, Ghazaleh, Galldiks, Norbert, Stummer, Walter, Hattingen, Elke, Glas, Martin, Radbruch, Alexander, Herrlinger, Ulrich, and Schaub, Christina

Published
2023
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20. Deep-learning based detection of vessel occlusions on CT-angiography in patients with suspected acute ischemic stroke

Author

Brugnara, Gianluca, Baumgartner, Michael, Scholze, Edwin David, Deike-Hofmann, Katerina, Kades, Klaus, Scherer, Jonas, Denner, Stefan, Meredig, Hagen, Rastogi, Aditya, Mahmutoglu, Mustafa Ahmed, Ulfert, Christian, Neuberger, Ulf, Schönenberger, Silvia, Schlamp, Kai, Bendella, Zeynep, Pinetz, Thomas, Schmeel, Carsten, Wick, Wolfgang, Ringleb, Peter A., Floca, Ralf, Möhlenbruch, Markus, Radbruch, Alexander, Bendszus, Martin, Maier-Hein, Klaus, and Vollmuth, Philipp

Published
2023
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21. An open presurgery MRI dataset of people with epilepsy and focal cortical dysplasia type II

Author

Schuch, Fabiane, Walger, Lennart, Schmitz, Matthias, David, Bastian, Bauer, Tobias, Harms, Antonia, Fischbach, Laura, Schulte, Freya, Schidlowski, Martin, Reiter, Johannes, Bitzer, Felix, von Wrede, Randi, Rácz, Atilla, Baumgartner, Tobias, Borger, Valeri, Schneider, Matthias, Flender, Achim, Becker, Albert, Vatter, Hartmut, Weber, Bernd, Specht-Riemenschneider, Louisa, Radbruch, Alexander, Surges, Rainer, and Rüber, Theodor

Published
2023
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27. Deep-learning-based reconstruction of undersampled MRI to reduce scan times: a multicentre, retrospective, cohort study

Author

Rastogi, Aditya, Brugnara, Gianluca, Foltyn-Dumitru, Martha, Mahmutoglu, Mustafa Ahmed, Preetha, Chandrakanth J, Kobler, Erich, Pflüger, Irada, Schell, Marianne, Deike-Hofmann, Katerina, Kessler, Tobias, van den Bent, Martin J, Idbaih, Ahmed, Platten, Michael, Brandes, Alba A, Nabors, Burt, Stupp, Roger, Bernhardt, Denise, Debus, Jürgen, Abdollahi, Amir, Gorlia, Thierry, Tonn, Jörg-Christian, Weller, Michael, Maier-Hein, Klaus H, Radbruch, Alexander, Wick, Wolfgang, Bendszus, Martin, Meredig, Hagen, Kurz, Felix T, and Vollmuth, Philipp

Published
2024
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29. Abstract: Deep Learning-based Detection of Vessel Occlusions on CT-Angiography in Patients with Suspected Acute Ischemic Stroke

Author

Brugnara, Gianluca, Baumgartner, Michael, Scholze, Edwin D., Deike-Hofmann, Katerina, Kades, Klaus, Scherer, Jonas, Denner, Stefan, Meredig, Hagen, Rastogi, Aditya, Mahmutoglu, Mustafa A., Ulfert, Christian, Neuberger, Ulf, Schönenberger, Silvia, Schlamp, Kai, Bendella, Zeynep, Pinetz, Thomas, Schmeel, Carsten, Wick, Wolfgang, Ringleb, Peter A., Floca, Ralf, Möhlenbruch, Markus, Radbruch, Alexander, Bendszus, Martin, Maier-Hein, Klaus, Vollmuth, Philipp, Gesellschaft für Informatik e.V. (GI), Maier, Andreas, editor, Deserno, Thomas M., editor, Handels, Heinz, editor, Maier-Hein, Klaus, editor, Palm, Christoph, editor, and Tolxdorff, Thomas, editor

Published
2024
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35. Correction to: Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses

Author

Zeyen, Thomas, Paech, Daniel, Weller, Johannes, Schäfer, Niklas, Tzaridis, Theophilos, Duffy, Cathrina, Nitsch, Louisa, Schneider, Matthias, Potthoff, Anna-Laura, Steinbach, Joachim Peter, Hau, Peter, Schlegel, Uwe, Seidel, Clemens, Krex, Dietmar, Grauer, Oliver, Goldbrunner, Roland, Zeiner, Pia Susan, Tabatabai, Ghazaleh, Galldiks, Norbert, Stummer, Walter, Hattingen, Elke, Glas, Martin, Radbruch, Alexander, Herrlinger, Ulrich, and Schaub, Christina

Published
2023
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36. Intravenous contrast medium extravasation: systematic review and updated ESUR Contrast Media Safety Committee Guidelines

Author

Roditi, Giles, Khan, Nadir, van der Molen, Aart J., Bellin, Marie-France, Bertolotto, Michele, Brismar, Torkel, Correas, Jean-Michel, Dekkers, Ilona A., Geenen, Remy W. F., Heinz-Peer, Gertraud, Mahnken, Andreas H., Quattrocchi, Carlo C., Radbruch, Alexander, Reimer, Peter, Romanini, Laura, Stacul, Fulvio, Thomsen, Henrik S., and Clément, Olivier

Published
2022
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37. Phase I/II trial of meclofenamate in progressive MGMT-methylated glioblastoma under temozolomide second-line therapy—the MecMeth/NOA-24 trial

Author

Zeyen, Thomas, Potthoff, Anna-Laura, Nemeth, Robert, Heiland, Dieter H., Burger, Michael C., Steinbach, Joachim P., Hau, Peter, Tabatabai, Ghazaleh, Glas, Martin, Schlegel, Uwe, Grauer, Oliver, Krex, Dietmar, Schnell, Oliver, Goldbrunner, Roland, Sabel, Michael, Thon, Niklas, Delev, Daniel, Clusmann, Hans, Seidel, Clemens, Güresir, Erdem, Schmid, Matthias, Schuss, Patrick, Giordano, Frank A., Radbruch, Alexander, Becker, Albert, Weller, Johannes, Schaub, Christina, Vatter, Hartmut, Schilling, Judith, Winkler, Frank, Herrlinger, Ulrich, and Schneider, Matthias

Published
2022
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40. Revealing Hidden Potentials of the q-Space Signal in Breast Cancer

Author

Jaeger, Paul, Bickelhaupt, Sebastian, Laun, Frederik Bernd, Lederer, Wolfgang, Heidi, Daniel, Kuder, Tristan Anselm, Paech, Daniel, Bonekamp, David, Radbruch, Alexander, Delorme, Stefan, Schlemmer, Heinz-Peter, Steudle, Franziska, and Maier-Hein, Klaus H.

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

Mammography screening for early detection of breast lesions currently suffers from high amounts of false positive findings, which result in unnecessary invasive biopsies. Diffusion-weighted MR images (DWI) can help to reduce many of these false-positive findings prior to biopsy. Current approaches estimate tissue properties by means of quantitative parameters taken from generative, biophysical models fit to the q-space encoded signal under certain assumptions regarding noise and spatial homogeneity. This process is prone to fitting instability and partial information loss due to model simplicity. We reveal unexplored potentials of the signal by integrating all data processing components into a convolutional neural network (CNN) architecture that is designed to propagate clinical target information down to the raw input images. This approach enables simultaneous and target-specific optimization of image normalization, signal exploitation, global representation learning and classification. Using a multicentric data set of 222 patients, we demonstrate that our approach significantly improves clinical decision making with respect to the current state of the art., Comment: Accepted conference paper at MICCAI 2017

Published
2017
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41. Olfactory Dysfunction and Limbic Hypoactivation in Temporal Lobe Epilepsy.

Author

Schmidt, Markus, Bauer, Tobias, Kehl, Marcel, Minarik, Anna, Walger, Lennart, Schultz, Johannes, Otte, Martin S., Trautner, Peter, Hoppe, Christian, Baumgartner, Tobias, Specht‐Riemenschneider, Louisa, Mormann, Florian, Radbruch, Alexander, Surges, Rainer, and Rüber, Theodor

Abstract

The epileptogenic network in temporal lobe epilepsy (TLE) contains structures of the primary and secondary olfactory cortex such as the piriform and entorhinal cortex, the amygdala, and the hippocampus. Olfactory auras and olfactory dysfunction are relevant symptoms of TLE. This study aims to characterize olfactory function in TLE using olfactory testing and olfactory functional magnetic resonance imaging (fMRI). We prospectively enrolled 20 individuals with unilateral TLE (age 45 ± 20 years [mean ± SD], 65% female, 90% right‐handed) and 20 healthy individuals (age 33 ± 15 years [mean ± SD], 35% female, 90% right‐handed). In the TLE group, the presumed seizure onset zone was left‐sided in 75%; in 45% of the individuals with TLE limbic encephalitis was the presumed etiology; and 15% of the individuals with TLE reported olfactory auras. Olfactory function was assessed with a Screening Sniffin' Sticks Test (Burkhart, Wedel, Germany) during a pre‐assessment. During a pre‐testing, all individuals were asked to rate the intensity, valence, familiarity, and associated memory of five different odors (eugenol, vanillin, phenethyl alcohol, decanoic acid, valeric acid) and a control solution. During the fMRI experiment, all individuals repeatedly smelled eugenol (positively valenced odor), valeric acid (negatively valenced odor), and the control solution and were asked to rate odor intensity on a five‐point Likert scale. We acquired functional EPI sequences and structural images (T1, T2, FLAIR). Compared to healthy individuals, individuals with TLE rated the presented odors as more neutral (two‐sided Mann–Whitney U tests, FDR‐p < 0.05) and less familiar (two‐sided Mann–Whitney U tests, FDR‐p < 0.05). fMRI data analysis revealed a reduced response contrast in secondary olfactory areas (e.g., hippocampus) connected to the limbic system when comparing eugenol and valeric acid in individuals with TLE when compared with healthy individuals. However, no lateralization effect was obtained when calculating a lateralization index by the number of activated voxels in the olfactory system (two‐sided Mann–Whitney U test; U = 176.0; p = 0.525). TLE is characterized by olfactory dysfunction and associated with hypoactivation of secondary olfactory structures connected to the limbic system. These findings contribute to our understanding of the pathophysiology of TLE. This study was preregistered on OSF Registries (www.osf.io). [ABSTRACT FROM AUTHOR]

Published
2024
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42. Interictal blood–brain barrier dysfunction in piriform cortex of people with epilepsy.

Author

Schulte, Freya, Reiter, Johannes T., Bauer, Tobias, Taube, Julia, Bitzer, Felix, Witt, Juri‐Alexander, Piper, Rory, Thanabalasingam, Anoja, von Wrede, Randi, Racz, Attila, Baumgartner, Tobias, Borger, Valeri, Specht‐Riemenschneider, Louisa, Vatter, Hartmut, Hattingen, Elke, Deichmann, Ralf, Helmstaedter, Christoph, Radbruch, Alexander, Friedman, Alon, and Surges, Rainer

Subjects
TEMPORAL lobe epilepsy, PEOPLE with epilepsy, EPILEPSY surgery, VERBAL memory, CONTRAST media, TEMPORAL lobectomy
Abstract

Objective: The piriform cortex is considered to be highly epileptogenic. Its resection during epilepsy surgery is a predictor for postoperative seizure freedom in temporal lobe epilepsy. Epilepsy is associated with a dysfunction of the blood–brain barrier. We investigated blood–brain barrier dysfunction in the piriform cortex of people with temporal lobe epilepsy using quantitative T1‐relaxometry. Methods: Gadolinium‐based contrast agent was administered ictally and interictally in 37 individuals before undergoing quantitative T1‐relaxometry. Postictal and interictal images were co‐registered, and subtraction maps were created as biomarkers for peri‐ictal (∆qT1interictal‐postictal) and interictal (∆qT1noncontrast‐interictal) blood–brain barrier dysfunction. Values were extracted for the piriform cortex, hippocampus, amygdala, and the whole cortex. Results: In temporal lobe epilepsy (n = 14), ∆qT1noncontrast‐interictal was significantly higher in the piriform cortex than in the whole cortex (p = 0.02). In extratemporal lobe epilepsy (n = 23), ∆qT1noncontrast‐interictal was higher in the hippocampus than in the whole cortex (p = 0.05). Across all individuals (n = 37), duration of epilepsy was correlated with ∆qT1noncontrast‐interictal (ß = 0.001, p < 0.001) in all regions, while the association was strongest in the piriform cortex. Impaired verbal memory was associated with ∆qT1noncontrast‐interictal only in the piriform cortex (p = 0.04). ∆qT1interictal‐postictal did not show differences in any region. Interpretation: Interictal blood–brain barrier dysfunction occurs in the piriform cortex in temporal lobe epilepsy. This dysfunction is linked to longer disease duration and worse cognitive deficits, emphasizing the central role of the piriform cortex in the epileptogenic network of temporal lobe epilepsy. [ABSTRACT FROM AUTHOR]

Published
2024
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43. Clinical significance and prevalence of subarachnoid hyperdensities on flat detector CT after mechanical thrombectomy: does it really matter?

Author

Zidan, Mousa, Shiwa Ghaei, Bode, Felix J., Weller, Johannes M., Krueger, Nadine, Lehnen, Nils Christian, Petzold, Gabor C., Radbruch, Alexander, Dorn, Franziska, and Paech, Daniel

Subjects
NIH Stroke Scale, T-test (Statistics), LOGISTIC regression analysis, KRUSKAL-Wallis Test, BRAIN diseases, TREATMENT effectiveness, DESCRIPTIVE statistics, CHI-squared test, MULTIVARIATE analysis, MANN Whitney U Test, RETROSPECTIVE studies, ODDS ratio, STROKE, THROMBECTOMY, DATA analysis software, CONFIDENCE intervals, DISEASE risk factors, DISEASE complications
Abstract

Background Subarachnoid hyperdensities after mechanical thrombectomy (MT) are a common finding. However, it is often regarded as clinically insignificant. Objective With this single-center investigation, to identify the prevalence of subarachnoid hyperdensities following MT, associated predictors, and the impact on the clinical outcome of the patients. Methods 383 patients from the stroke registry were analyzed for the presence of subarachnoid hyperdensities on flat detector CT (FDCT) directly after the completion of MT, and on follow-up dual-energy CT, then classified according to a visual grading scale. 178 patients were included with anterior circulation occlusions. Regression analysis was performed to identify significant predictors, and Kruskal-Wallis analysis and X² test were performed to test the variables among the different groups. The primary outcome was the modified Rankin Scale (mRS) score at 90 days and was analyzed with the Wilcoxon-Mann-Whitney rank-sum test. Results The prevalence of subarachnoid hyperdensities on FDCT was (66/178, 37.1%) with patients experiencing a significant unfavorable outcome (P=0.035). Significantly fewer patients with subarachnoid hyperdensities achieved a mRS score of ≤3 at 90 days 25/66 (37.9%) vs 60/1 12 (53.6%), P=0.043). In addition, mortality was significantly higher in the subarachnoid hyperdensities group (34.8% vs 19.6%, P=0.024). Distal occlusions and a higher number of device passes were significantly associated with subarachnoid hyperdensities (P=0.026) and (P=0.001), respectively. Patients who received intravenous tissue plasminogen activator had significantly fewer subarachnoid hyperdensities (P=0.029). Conclusions Postinterventional subarachnoid hyperdensities are a frequent finding after MT and are associated with neurological decline and worse functional outcome. They are more common with distal occlusions and multiple device passes. [ABSTRACT FROM AUTHOR]

Published
2024
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44. Human brain clearance imaging: Pathways taken by magnetic resonance imaging contrast agents after administration in cerebrospinal fluid and blood.

Author

van Osch, Matthias J. P., Wåhlin, Anders, Scheyhing, Paul, Mossige, Ingrid, Hirschler, Lydiane, Eklund, Anders, Mogensen, Klara, Gomolka, Ryszard, Radbruch, Alexander, Qvarlander, Sara, Decker, Andreas, Nedergaard, Maiken, Mori, Yuki, Eide, Per Kristian, Deike, Katerina, and Ringstad, Geir

Subjects
MAGNETIC resonance imaging, INTRAVENOUS injections, INTRATHECAL injections, CONTRAST media, CEREBROSPINAL fluid
Abstract

Over the last decade, it has become evident that cerebrospinal fluid (CSF) plays a pivotal role in brain solute clearance through perivascular pathways and interactions between the brain and meningeal lymphatic vessels. Whereas most of this fundamental knowledge was gained from rodent models, human brain clearance imaging has provided important insights into the human system and highlighted the existence of important interspecies differences. Current gold standard techniques for human brain clearance imaging involve the injection of gadolinium‐based contrast agents and monitoring their distribution and clearance over a period from a few hours up to 2 days. With both intrathecal and intravenous injections being used, which each have their own specific routes of distribution and thus clearance of contrast agent, a clear understanding of the kinetics associated with both approaches, and especially the differences between them, is needed to properly interpret the results. Because it is known that intrathecally injected contrast agent reaches the blood, albeit in small concentrations, and that similarly some of the intravenously injected agent can be detected in CSF, both pathways are connected and will, in theory, reach the same compartments. However, because of clear differences in relative enhancement patterns, both injection approaches will result in varying sensitivities for assessment of different subparts of the brain clearance system. In this opinion review article, the "EU Joint Programme – Neurodegenerative Disease Research (JPND)" consortium on human brain clearance imaging provides an overview of contrast agent pharmacokinetics in vivo following intrathecal and intravenous injections and what typical concentrations and concentration–time curves should be expected. This can be the basis for optimizing and interpreting contrast‐enhanced MRI for brain clearance imaging. Furthermore, this can shed light on how molecules may exchange between blood, brain, and CSF. [ABSTRACT FROM AUTHOR]

Published
2024
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45. Tumor-associated epilepsy in patients with brain metastases: necrosis-to-tumor ratio forecasts postoperative seizure freedom

Author

Bahna, Majd, Heimann, Muriel, Bode, Christian, Borger, Valeri, Eichhorn, Lars, Güresir, Erdem, Hamed, Motaz, Herrlinger, Ulrich, Ko, Yon-Dschun, Lehmann, Felix, Potthoff, Anna-Laura, Radbruch, Alexander, Schaub, Christina, Surges, Rainer, Weller, Johannes, Vatter, Hartmut, Schäfer, Niklas, Schneider, Matthias, and Schuss, Patrick

Published
2022
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47. Radiologic progression of glioblastoma under therapy—an exploratory analysis of AVAglio

Author

Nowosielski, Martha, Ellingson, Benjamin M, Chinot, Olivier L, Garcia, Josep, Revil, Cedric, Radbruch, Alexander, Nishikawa, Ryo, Mason, Warren P, Henriksson, Roger, Saran, Frank, Kickingereder, Philipp, Platten, Michael, Sandmann, Thomas, Abrey, Lauren E, Cloughesy, Timothy F, Bendszus, Martin, and Wick, Wolfgang

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Rare Diseases, Brain Disorders, Cancer, Clinical Research, Neurosciences, Brain Cancer, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Bevacizumab, Biomarkers, Tumor, Brain Neoplasms, Chemoradiotherapy, DNA Methylation, Disease Progression, Double-Blind Method, Female, Follow-Up Studies, Glioblastoma, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Promoter Regions, Genetic, Retrospective Studies, Survival Rate, Temozolomide, bevacizumab, MRI, radiologic phenotypes, treatment resistance, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

BackgroundIn this exploratory analysis of AVAglio, a randomized phase III clinical study that investigated the addition of bevacizumab (Bev) to radiotherapy/temozolomide in newly diagnosed glioblastoma, we aim to radiologically characterize glioblastoma on therapy until progression and investigate whether the type of radiologic progression differs between treatment arms and is related to survival and molecular data.MethodsFive progression types (PTs) were categorized using an adapted algorithm according to MRI contrast enhancement behavior in T1- and T2-weighted images in 621 patients (Bev, n = 299; placebo, n = 322). Frequencies of PTs (designated as classic T1, cT1 relapse, T2 diffuse, T2 circumscribed, and primary nonresponder), time to progression (PFS), and overall survival (OS) were assessed within each treatment arm and compared with molecular subtypes and O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status.ResultsPT frequencies differed between the Bev and placebo arms, except for "T2 diffuse" (12.4% and 7.1%, respectively). PTs showed differences in PFS and OS; with "T2 diffuse" being associated with longest survival. Complete disappearance of contrast enhancement during treatment ("cT1 relapse") showed longer survival than only partial contrast enhancement decrease ("classic T1"). "T2 diffuse" was more commonly MGMT hypermethylated. Only weak correlations to molecular subtypes from primary tissue were detected.ConclusionsProgression of glioblastoma under therapy can be characterized radiologically. These radiologic phenotypes are influenced by treatment and develop differently over time with differential outcomes. Complete resolution of contrast enhancement during treatment is a favorable factor for outcome.

Published
2018

48. Machine Learning–Based Perivascular Space Volumetry in Alzheimer Disease

Author

Deike, Katerina, primary, Decker, Andreas, additional, Scheyhing, Paul, additional, Harten, Julia, additional, Zimmermann, Nadine, additional, Paech, Daniel, additional, Peters, Oliver, additional, Freiesleben, Silka D., additional, Schneider, Luisa-Sophie, additional, Preis, Lukas, additional, Priller, Josef, additional, Spruth, Eike, additional, Altenstein, Slawek, additional, Lohse, Andrea, additional, Fliessbach, Klaus, additional, Kimmich, Okka, additional, Wiltfang, Jens, additional, Bartels, Claudia, additional, Hansen, Niels, additional, Jessen, Frank, additional, Rostamzadeh, Ayda, additional, Düzel, Emrah, additional, Glanz, Wenzel, additional, Incesoy, Enise I., additional, Butryn, Michaela, additional, Buerger, Katharina, additional, Janowitz, Daniel, additional, Ewers, Michael, additional, Perneczky, Robert, additional, Rauchmann, Boris-Stephan, additional, Teipel, Stefan, additional, Kilimann, Ingo, additional, Goerss, Doreen, additional, Laske, Christoph, additional, Munk, Matthias H., additional, Spottke, Annika, additional, Roy, Nina, additional, Wagner, Michael, additional, Roeske, Sandra, additional, Heneka, Michael T., additional, Brosseron, Frederic, additional, Ramirez, Alfredo, additional, Dobisch, Laura, additional, Wolfsgruber, Steffen, additional, Kleineidam, Luca, additional, Yakupov, Renat, additional, Stark, Melina, additional, Schmid, Matthias C., additional, Berger, Moritz, additional, Hetzer, Stefan, additional, Dechent, Peter, additional, Scheffler, Klaus, additional, Petzold, Gabor C., additional, Schneider, Anja, additional, Effland, Alexander, additional, and Radbruch, Alexander, additional

Published
2024
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49. Intact functional brain networks in the isolated hemisphere of people after hemispherotomy

Author

Bauer, Tobias, primary, Gauvry, Charlotte, additional, Markett, Sebastian, additional, Kreter-Schönleber, Thomas, additional, Hoppe, Christian, additional, Borger, Valeri, additional, Vatter, Hartmut, additional, Sander, Josemir, additional, Gabriel, Markus, additional, Mormann, Florian, additional, Radbruch, Alexander, additional, Surges, Rainer, additional, and Rüber, Theodor, additional

Published
2024
Full Text
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