Publications by authors named "Ahmed Othman"

223 Publications

Analysis of a Deep Learning-Based Superresolution Algorithm Tailored to Partial Fourier Gradient Echo Sequences of the Abdomen at 1.5 T: Reduction of Breath-Hold Time and Improvement of Image Quality.

Invest Radiol 2021 Sep 9. Epub 2021 Sep 9.

From the Departments of Diagnostic and Interventional Radiology Internal Medicine I, Eberhard Karls University Tuebingen, Tuebingen MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany Digital Technology and Innovation, Siemens Healthineers, Princeton, NJ Department of Neuroradiology, University Medical Center, Mainz, Germany.

Objectives: The aim of this study was to investigate the feasibility and impact of a novel deep learning superresolution algorithm tailored to partial Fourier allowing retrospectively theoretical acquisition time reduction in 1.5 T T1-weighted gradient echo imaging of the abdomen.

Materials And Methods: Fifty consecutive patients who underwent a 1.5 T contrast-enhanced magnetic resonance imaging examination of the abdomen between April and May 2021 were included in this retrospective study. After acquisition of a conventional T1-weighted volumetric interpolated breath-hold examination using Dixon for water-fat separation (VIBEStd), the acquired data were reprocessed including a superresolution algorithm that was optimized for partial Fourier acquisitions (VIBESR). To accelerate theoretically the acquisition process, a more aggressive partial Fourier setting was applied in VIBESR reconstructions practically corresponding to a shorter acquisition for the data included in the retrospective reconstruction. Precontrast, dynamic contrast-enhanced, and postcontrast data sets were processed. Image analysis was performed by 2 radiologists independently in a blinded random order without access to clinical data regarding the following criteria using a Likert scale ranging from 1 to 4 with 4 being the best: noise levels, sharpness and contrast of vessels, sharpness and contrast of organs and lymph nodes, overall image quality, diagnostic confidence, and lesion conspicuity.Wilcoxon signed rank test for paired data was applied to test for significance.

Results: Mean patient age was 61 ± 14 years. Mean acquisition time for the conventional VIBEStd sequence was 15 ± 1 seconds versus theoretical 13 ± 1 seconds of acquired data used for the VIBESR reconstruction. Noise levels were evaluated to be better in VIBESR with a median of 4 (4-4) versus a median of 3 (3-3) in VIBEStd by both readers (P < 0.001). Sharpness and contrast of vessels as well as organs and lymph nodes were also evaluated to be superior in VIBESR compared with VIBEStd with a median of 4 (4-4) versus a median of 3 (3-3) (P < 0.001). Diagnostic confidence was also rated superior in VIBESR with a median of 4 (4-4) versus a median of 3.5 (3-4) in VIBEStd by reader 1 and with a median of 4 (4-4) for VIBESR and a median of 4 (4-4) for VIBEStd by reader 2 (both P < 0.001).

Conclusions: Image enhancement using deep learning-based superresolution tailored to partial Fourier acquisitions of T1-weighted gradient echo imaging of the abdomen provides improved image quality and diagnostic confidence in combination with more aggressive partial Fourier settings leading to shorter scan time.
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http://dx.doi.org/10.1097/RLI.0000000000000825DOI Listing
September 2021

Evaluation of the potential drug interactions mediated through P-gp, OCT2, and MATE1/2K with filgotinib in healthy subjects.

Clin Transl Sci 2021 Sep 9. Epub 2021 Sep 9.

Gilead Sciences, Inc., Foster City, California, USA.

Filgotinib, a preferential Janus Kinase-1 inhibitor, is approved in Europe and Japan for treatment of rheumatoid arthritis and is being developed for treatment of other chronic inflammatory diseases. Three drug-drug interactions studies were conducted in healthy subjects to evaluate the effect of P-glycoprotein (P-gp) modulation (study 1: P-gp inhibition by itraconazole and study 2: P-gp induction by rifampin) on filgotinib pharmacokinetics and the potential of filgotinib to impact exposure of metformin, an organic cation transporter (OCT) 2 and multidrug and toxin extrusion (MATE) 1/2K substrate (study 3). Co-administration of filgotinib with itraconazole increased filgotinib exposure (maximum concentration [C ] by 64% and area under the curve to infinity [AUC ] by 45%) but had no effect on the exposure of GS-829845, filgotinib's primary metabolite. Rifampin moderately reduced exposures of filgotinib and GS-829845 (C by 26% and AUC by 27% for filgotinib; C by 19% and AUC by 38% for GS-829845). The data confirmed that filgotinib is a P-gp substrate. However, the magnitude of change in filgotinib/GS-829845 exposure by P-gp modulators is not deemed to be clinically relevant based on filgotinib exposure-response analyses in subjects with rheumatoid arthritis. Filgotinib did not alter metformin exposures, indicating that filgotinib and GS-829845 do not inhibit OCT2 and MATE1/2K at the clinical doses. Filgotinib was generally well-tolerated when administered alone or with the co-administered drugs in the studies. Results from these studies were the basis to enable the use of P-gp modulators and substrates of OCT2, MATE1, and MATE2K with filgotinib without the need for dose modifications in the current approved rheumatoid arthritis population.
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http://dx.doi.org/10.1111/cts.13152DOI Listing
September 2021

Assessment of the Effect of Filgotinib on the Pharmacokinetics of Atorvastatin, Pravastatin, and Rosuvastatin in Healthy Adult Participants.

Clin Pharmacol Drug Dev 2021 Sep 1. Epub 2021 Sep 1.

Gilead Sciences, Inc., Foster City, California, USA.

Filgotinib, an oral Janus kinase-1 preferential inhibitor, is approved in Europe and Japan for adults with rheumatoid arthritis. Patients with rheumatoid arthritis are at higher risk of cardiovascular morbidity/mortality; thus, it is important to understand potential drug-drug interactions of filgotinib with lipid-lowering agents. This open-label, randomized, 2-way crossover study evaluated the pharmacokinetics of atorvastatin, pravastatin, and rosuvastatin with and without filgotinib coadministration. Healthy participants (N = 27) received single doses of atorvastatin (40 mg) and of a pravastatin (40 mg)/rosuvastatin (10 mg) cocktail-alone or with filgotinib (200 mg once daily for 11 days)-on 2 different occasions with washout in between. Serial pharmacokinetic blood samples were collected, and safety was assessed. Pharmacokinetic parameters were evaluated using 90% confidence intervals (CI) of the geometric least-squares mean (GLSM) ratio of the test treatment (statin coadministration with filgotinib) vs statin alone, with prespecified lack-of-interaction bounds of 0.70 to 1.43. Coadministration of filgotinib did not affect atorvastatin area under the plasma concentration-time curve extrapolated to infinity (AUC ; [GLSM ratios (90% CI): 0.91 (0.84-0.99)]), but maximum concentration [C ] was slightly lower [0.82 (0.69-0.99)]. The exposure of 2-hydroxy-atorvastatin was unaffected (GLSM ratios [90% CI], 0.98 [0.81-1.19] for C ; 1.11 [1.02-1.22] for AUC ). Pravastatin AUC was also unaffected (GLSM ratios, 1.22 [1.05-1.41], but C was slightly higher 1.25 [1.01-1.54]). Rosuvastatin exposure was moderately higher with filgotinib coadministration-GLSM ratios (90% CI), 1.68 (1.43-1.97) for C ; 1.42 (1.30-1.57) for AUC -but this was not considered clinically relevant. These results indicate that filgotinib has no clinically meaningful effect on exposure of atorvastatin, pravastatin, or rosuvastatin.
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http://dx.doi.org/10.1002/cpdd.1015DOI Listing
September 2021

Feasibility and Implementation of a Deep Learning MR Reconstruction for TSE Sequences in Musculoskeletal Imaging.

Diagnostics (Basel) 2021 Aug 16;11(8). Epub 2021 Aug 16.

Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany.

Magnetic Resonance Imaging (MRI) of the musculoskeletal system is one of the most common examinations in clinical routine. The application of Deep Learning (DL) reconstruction for MRI is increasingly gaining attention due to its potential to improve the image quality and reduce the acquisition time simultaneously. However, the technology has not yet been implemented in clinical routine for turbo spin echo (TSE) sequences in musculoskeletal imaging. The aim of this study was therefore to assess the technical feasibility and evaluate the image quality. Sixty examinations of knee, hip, ankle, shoulder, hand, and lumbar spine in healthy volunteers at 3 T were included in this prospective, internal-review-board-approved study. Conventional (TSE) and DL-based TSE sequences (TSE) were compared regarding image quality, anatomical structures, and diagnostic confidence. Overall image quality was rated to be excellent, with a significant improvement in edge sharpness and reduced noise compared to TSE ( < 0.001). No difference was found concerning the extent of artifacts, the delineation of anatomical structures, and the diagnostic confidence comparing TSE and TSE ( > 0.05). Therefore, DL image reconstruction for TSE sequences in MSK imaging is feasible, enabling a remarkable time saving (up to 75%), whilst maintaining excellent image quality and diagnostic confidence.
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http://dx.doi.org/10.3390/diagnostics11081484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394583PMC
August 2021

1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 2.

Invest Radiol 2021 Aug 19. Epub 2021 Aug 19.

From the Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Bonn, Bonn Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn Department of Neuroradiology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.

Abstract: The second part of this review deals with experiences in neuroradiological and pediatric examinations using modern magnetic resonance imaging systems with 1.5 T and 3 T, with special attention paid to experiences in pediatric cardiac imaging. In addition, whole-body examinations, which are widely used for diagnostic purposes in systemic diseases, are compared with respect to the image quality obtained in different body parts at both field strengths. A systematic overview of the technical differences at 1.5 T and 3 T has been presented in part 1 of this review, as well as several organ-based magnetic resonance imaging applications including musculoskeletal imaging, abdominal imaging, and prostate diagnostics.
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http://dx.doi.org/10.1097/RLI.0000000000000818DOI Listing
August 2021

Diagnostic Performance of a Contrast-Enhanced Ultra-Low-Dose High-Pitch CT Protocol with Reduced Scan Range for Detection of Pulmonary Embolisms.

Diagnostics (Basel) 2021 Jul 13;11(7). Epub 2021 Jul 13.

Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, 72076 Tuebingen, Germany.

(1) Background: To evaluate the diagnostic performance of a simulated ultra-low-dose (ULD), high-pitch computed tomography pulmonary angiography (CTPA) protocol with low tube current (mAs) and reduced scan range for detection of pulmonary embolisms (PE). (2) Methods: We retrospectively included 130 consecutive patients (64 ± 16 years, 69 female) who underwent clinically indicated high-pitch CTPA examination for suspected acute PE on a 3rd generation dual-source CT scanner (SOMATOM FORCE, Siemens Healthineers, Forchheim, Germany). ULD datasets with a realistic simulation of 25% mAs, reduced scan range (aortic arch-basal pericardium), and Advanced Modeled Iterative Reconstruction (ADMIRE®, Siemens Healthineers, Forchheim, Germany) strength 5 were created. The effective radiation dose (ED) of both datasets (standard and ULD) was estimated using a dedicated dosimetry software solution. Subjective image quality and diagnostic confidence were evaluated independently by three reviewers using a 5-point Likert scale. Objective image quality was compared using noise measurements. For assessment of diagnostic accuracy, patients and pulmonary vessels were reviewed binarily for affection by PE, using standard CTPA protocol datasets as the reference standard. Percentual affection of pulmonary vessels by PE was computed for disease severity (modified Qanadli score). (3) Results: Mean ED in ULD protocol was 0.7 ± 0.3 mSv (16% of standard protocol: 4.3 ± 1.7 mSv, < 0.001, > 0.5). Comparing ULD to standard protocol, subjective image quality and diagnostic confidence were comparably good ( = 0.486, > 0.5) and image noise was significantly lower in ULD ( < 0.001, > 0.5). A total of 42 patients (32.2%) were affected by PE. ULD protocol had a segment-based false-negative rate of only 0.1%. Sensitivity for detection of any PE was 98.9% (95% CI, 97.2-99.7%), specificity was 100% (95% CI, 99.8-100%), and overall accuracy was 99.9% (95% CI, 98.6-100%). Diagnoses correlated strongly between ULD and standard protocol (Chi-square (1) = 42, < 0.001) with a decrease in disease severity of only 0.48% (T = 1.667, = 0.103). (4) Conclusions: Compared to a standard CTPA protocol, the proposed ULD protocol proved reliable in detecting and ruling out acute PE with good levels of image quality and diagnostic confidence, as well as significantly lower image noise, at 0.7 ± 0.3 mSv (84% dose reduction).
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http://dx.doi.org/10.3390/diagnostics11071251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304674PMC
July 2021

Lumbar Spondylolysis Reconstruction-Stabilization Using a Motion-Preserving Technique.

World Neurosurg 2021 Aug 3. Epub 2021 Aug 3.

Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Minia University, El-Minia, Egypt; Minia University Spine Unit (MUSU), Faculty of Medicine, Minia University, El-Minia, Egypt.

Background: Conservative methods are the traditional options in the management of lumber spondylolysis whereas surgery is indicated for symptomatic patients not responding to medical treatment and cases with a multilevel pars defect. The aim of this prospective study was to evaluate the clinical, functional, and radiologic results of using bone graft and fixation with pedicular screw-rod-laminar hook construct in treatment of lumber spondylolysis.

Patients And Methods: Between October 2017 and January 2020, 20 patients with symptomatic lumbar spondylolysis not responding to conservative treatment for more than 6 months were treated by defect reconstruction fixation using bone block autografting and pedicular screw laminar hook construct. The mean follow-up time was 12.5 ± 03.5 months. All patients were examined pre- and postoperatively and followed up clinically (pain [visual analog scale]), functionally (Oswestry Disability Index, Modified Prolo Functional Economic Scales, and Macnab criteria), and radiologically (pars defect healing). Perioperative outcomes and complications were documented.

Results: Clinical, radiologic, and functional outcomes were significantly improved. Bony union was evident in all patients (100%). Blood loss, operative time, and hospital stay increased in cases with a multilevel pars defect and cases with associated injuries. Two cases reported complications in this study as misplaced pedicular screw and superficial wound infection.

Conclusions: Reconstruction fixation of pars defect using this construct is an effective, feasible procedure in the treatment of lumber spondylosis regarding the preservation of lumbar motion and avoidance of adjacent-segment problems after fusion.
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http://dx.doi.org/10.1016/j.wneu.2021.07.124DOI Listing
August 2021

Accelerated T2-Weighted TSE Imaging of the Prostate Using Deep Learning Image Reconstruction: A Prospective Comparison with Standard T2-Weighted TSE Imaging.

Cancers (Basel) 2021 Jul 17;13(14). Epub 2021 Jul 17.

Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany.

Multiparametric MRI (mpMRI) of the prostate has become the standard of care in prostate cancer evaluation. Recently, deep learning image reconstruction (DLR) methods have been introduced with promising results regarding scan acceleration. Therefore, the aim of this study was to investigate the impact of deep learning image reconstruction (DLR) in a shortened acquisition process of T2-weighted TSE imaging, regarding the image quality and diagnostic confidence, as well as PI-RADS and T2 scoring, as compared to standard T2 TSE imaging. Sixty patients undergoing 3T mpMRI for the evaluation of prostate cancer were prospectively enrolled in this institutional review board-approved study between October 2020 and March 2021. After the acquisition of standard T2 TSE imaging (T2), the novel T2 TSE sequence with DLR (T2) was applied in three planes. Overall, the acquisition time for T2 resulted in 10:21 min versus 3:50 min for T2. The image evaluation was performed by two radiologists independently using a Likert scale ranging from 1-4 (4 best) applying the following criteria: noise levels, artifacts, overall image quality, diagnostic confidence, and lesion conspicuity. Additionally, T2 and PI-RADS scoring were performed. The mean patient age was 69 ± 9 years (range, 49-85 years). The noise levels and the extent of the artifacts were evaluated to be significantly improved in T2 versus T2 by both readers ( < 0.05). Overall image quality was also evaluated to be superior in T2 versus T2 in all three acquisition planes ( = 0.005-<0.001). Both readers evaluated the item lesion conspicuity to be superior in T2 with a median of 4 versus a median of 3 in T2 ( = 0.001 and <0.001, respectively). T2-weighted TSE imaging of the prostate in three planes with an acquisition time reduction of more than 60% including DLR is feasible with a significant improvement of image quality.
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http://dx.doi.org/10.3390/cancers13143593DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303682PMC
July 2021

[Primary treatment of prostate cancer using 1.5 T MR-linear accelerator].

Radiologe 2021 Sep 23;61(9):839-845. Epub 2021 Jul 23.

Klinik für Radioonkologie und Strahlentherapie, Ludwigsburg, Deutschland.

Background: Hybrid devices of MR-scanners and linear accelerators (MR-Linacs) represent a new and promising extension of radiotherapeutic options for prostate cancer. The potential advantage of magnetic resonance imaging (MRI) over computed tomography (CT) for soft tissue contrast is well-known and leads to more consistent and smaller target volumes and improved normal tissue sparing.

Objectives: This article presents an overview of clinical experience, indications, advantages and challenges of utilizing a 1.5 T MR-Linac in the setting of radiotherapy of prostate cancer.

Results: All current indications for radiotherapy of prostate cancer can be treated with an MR-Linac. The advantages include daily MR-based imaging in treatment position and daily adaption of the treatment plan on current anatomy (adaptive radiotherapy). Additionally, functional MRI sequences might be exploited to enhance treatment individualization and response assessment. Ultimately treatment on an MR-Linac might further increase the therapeutic window. The limitations of using MR-Linac include treatment complexity and the duration of each session.

Conclusions: MR-Linacs expand the spectrum of radiotherapeutic options for prostate cancer. Increased precision can be reached with daily MRI-based target volume definition and plan adaption. Clinical studies are necessary to identify patient groups who would benefit most from radiotherapy on a MR-Linac.
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http://dx.doi.org/10.1007/s00117-021-00882-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410708PMC
September 2021

Pull-off resistance of a screwless implant-abutment connection and surface evaluation after cyclic loading.

J Adv Prosthodont 2021 Jun 25;13(3):152-159. Epub 2021 Jun 25.

Department of CAD/CAM and Digital Technologies in Dentistry, Danube Private University, Krems, Austria.

Purpose: The aim of this study was to investigate to what extent cyclic load affects the screwless implant-abutment connection for Morse taper dental implants.

Materials And Methods: 16 implants (SICvantage max) and 16 abutments (Swiss Cross) were used. The screwless implant-abutment connection was subjected to 10,000 cycles of axial loading with a maximum force of 120 N. For the pull-off testing, before and after the same cyclic loading, the required force for disconnecting the remaining 6 implant-abutment connections was measured. The surface of 10 abutments was examined using a scanning electron microscope 120× before and after loading.

Results: The pull-off test showed a significant decrease in the vertical force required to pull the abutment from the implant with mean 229.39 N ± 18.23 before loading, and 204.30 N ± 13.51 after loading (<.01). Apart from the appearance of polished surface areas and slight signs of wear, no visible damages were found on the abutments.

Conclusion: The deformation on the polished abutment surface might represent the result of micro movements within the implant-abutment connection during loading. Although there was a decrease of the pull-off force values after cyclic loading, this might not have a notable effect on the clinical performance.
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http://dx.doi.org/10.4047/jap.2021.13.3.152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250190PMC
June 2021

Fixed lingual orthodontic retainer with bilateral missing lateral incisors produced in PEEK material using CAD/CAM technology.

J Clin Exp Dent 2021 Jun 1;13(6):e549-e551. Epub 2021 Jun 1.

Ass. Prof. Dr, MSc. Orthodontic researcher in digital technologies in dentistry and CAD/CAM department-Danube Private University-Krems-Austria.

Background: The aim of this investigation is to evaluate the feasibility of digital workflow for lingual fixed retainer based on digital intraoral scan and appliance production from Polyetheretherketone (PEEK) material for clinical consideration.

Material And Methods: Fully virtual lingual retainer with bilateral missing lateral incisors was designed using inlab software (Dentsply Sirona, Pennsylvania, USA). The designed retainer was produced in PEEK material and clinically adhered to lingual surfaces of the lower front teeth.

Results: Lingual retainer was successfully fabricated by full digital workflow and produced from PEEK material for clinical usage.

Conclusions: Although full digital workflow can be clinically used for production of prefabricated lingual retainer, however further software adaptions are required for improvement of the orthodontic workflow. PEEK, CAD/CAM, digital orthodontics, lingual retainer.
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http://dx.doi.org/10.4317/jced.58035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223158PMC
June 2021

Early Tumor Size Reduction of at least 10% at the First Follow-Up Computed Tomography Can Predict Survival in the Setting of Advanced Melanoma and Immunotherapy.

Acad Radiol 2021 Jun 12. Epub 2021 Jun 12.

Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tuebingen University Hospital, Tuebingen, Germany; Department of Neuroradiology, University Medical Center Mainz, Mainz, Germany. Electronic address:

Rationale And Objectives: Early tumor size reduction (TSR) has been explored as a prognostic factor for survival in patients with advanced melanoma in clinical trials. The purpose of this analysis is to validate, in a routine clinical milieu, the predictive capacity of TSR by 10% for overall survival (OS) and progression-free survival (PFS) and to compare its predictive performance with the RECIST 1.1 criteria.

Materials And Methods: This retrospective study was approved by the local ethics committee. A total of 152 patients with both CT before immunotherapy initiation and at first response evaluation after immunotherapy initiation were included. Prior to statistical analysis, treatment response was trichotomized as follows: Complete response and/or partial response, stable disease and progressive disease. Furthermore, response was dichotomized regarding TSR (TSR ≥ 10% and TSR < 10%). Kaplan-Meier survival estimates, Cox regression and Harrel's concordance index (C-index) were computed for prediction of overall survival and progression-free survival.

Results: Tumor size reduction by at least 10% significantly differentiated between patients with increased survival from the ones with decreased survival (median OS: TSR ≥ 10%: 2137 days vs. TSR < 10%: 263 days) (p < 0.001) (median PFS: TSR ≥ 10%: 590 days vs.  TSR < 10%: 11 days) (p < 0.001).

Regarding An Executive Summary: Early tumor size reduction serves as a simple-to-use metric which can be implemented on the first follow-up CT. Tumor size reduction by at least 10% can be considered an additional biomarker predictive of survival in routine clinical care and not only in the context of clinical trials in patients with advanced melanoma undergoing immunotherapy.

Conclusion: Early tumor size reduction serves as a simple-to-use metric which can be implemented on the first follow-up CT. Tumor size reduction by at least 10% can be considered an additional biomarker predictive of overall survival and progression-free survival in routine clinical care and not only in the context of clinical trials in patients with advanced melanoma undergoing immunotherapy. Nevertheless, RECIST-based criteria should remain the main tool of treatment response assessment until results of prospective studies validating the TSR method are available.
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http://dx.doi.org/10.1016/j.acra.2021.04.015DOI Listing
June 2021

Effect of Upadacitinib on the Pharmacokinetics of Rosuvastatin or Atorvastatin in Healthy Subjects.

Clin Pharmacol Drug Dev 2021 Jun 9. Epub 2021 Jun 9.

AbbVie Inc., North Chicago, Illinois, USA.

This phase 1, 2-part, 2-period, open-label, drug-drug interaction study evaluated the potential for pharmacokinetic interactions between upadacitinib and rosuvastatin, an organic anion transporting polypeptide (OATP) 1B1 and breast cancer resistance protein substrate, or atorvastatin, a cytochrome P450 3A, OATP1B1, and OATP1B3 substrate, in 36 healthy volunteers. During period 1, a single dose of rosuvastatin (5 mg; part 1) or atorvastatin (10 mg; part 2) was administered on day 1, followed by a washout period of 5 days. During period 2, once-daily doses of upadacitinib extended-release (30 mg) were administered on days 1 to 10, and a single dose of rosuvastatin (5 mg; part 1) or atorvastatin (10 mg; part 2) was administered 1 hour after the upadacitinib dose on day 7. Serial blood samples were collected for assays of drug concentrations. In Part 1, rosuvastatin maximum observed plasma concentration (C ) and area under the plasma concentration-time curve from time 0 to infinity (AUC ) were 23% and 33% lower, respectively, when administered with upadacitinib relative to when administered alone. In part 2, atorvastatin C and AUC was 11% and 23% lower, respectively, when administered with upadacitinib relative to when administered alone. The C and AUC of the active metabolite ortho-hydroxyatorvastatin remained unchanged. Administration of a single 5-mg dose of rosuvastatin or a single 10-mg dose of atorvastatin had no relevant effect on upadacitinib C or area under the plasma concentration-time curve. These results demonstrated that upadacitinib has no clinically relevant effect on the pharmacokinetics of rosuvastatin and atorvastatin or on substrates transported by OATP1B or breast cancer resistance protein.
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http://dx.doi.org/10.1002/cpdd.957DOI Listing
June 2021

The Role of Double Modality Ultrasonographic and Fluoroscopic Guided Superior Hypogastric Plexus Neurolysis in Treating Intractable Pelvic Cancer Pain: A Comparative Study.

J Pain Res 2021 27;14:1465-1473. Epub 2021 May 27.

Department of Anesthesia, ICU And Pain Relief, National Cancer Institute, Cairo University, Cairo, Egypt.

Background: Superior hypogastric neurolytic block is performed to block visceral pelvic pain. This could be performed through the anterior approach guided by CT or ultrasound and through a posterior approach, guided by fluoroscopy or CT.

Methods: Sixty adult patients with severe visceral pelvic pain (VAS>70 mm) were randomly divided into two groups. Group S: SHP block was done ultrasound guided using the anterior approach and confirmed by fluoroscopy. Group F: SHP block was done fluoroscopic guided using the posterior oblique approach. The VAS (visual analog scale), duration of the technique, time of X-ray exposure, patient satisfaction score, patient global impression of change (PGIC), quality of life score, and daily morphine consumption (mg/day) were measured pre-procedure and at the 1st, 4th, 8th, and 12th week after the procedure. In addition, any side effects of the procedure were recorded.

Results: There was a significant difference in VAS between the two groups (<0.01) (better in group S). The quality of life score was improved from the pre-procedure in both groups (<0.05), and morphine consumption was significantly lower in group S than in group F (<0.05) at the 1st, 4th, and 8th week and not significant at the 12th week. The two groups show a statistically significant difference as regards the duration of the procedure and X-ray exposure (<0.01). There was a statistically significant difference in the satisfactory score between the two groups at the 1st, 4th, 8th, and 12th week (<0.01). As regards the PGIC score, there was no statistically significant difference between the two groups (>0.05). In group S, no back pain was reported, while 11 patients of group F complained from post-procedure back pain (<0.001).

Conclusion: The anterior ultrasound guided SHPB aided by fluoroscopy is suggested to be more superior to the standard fluoroscopic guided technique in relieving pelvic cancer pain and decreasing morphine consumption.
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http://dx.doi.org/10.2147/JPR.S308743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166312PMC
May 2021

Development and Evaluation of Deep Learning-Accelerated Single-Breath-Hold Abdominal HASTE at 3 T Using Variable Refocusing Flip Angles.

Invest Radiol 2021 Oct;56(10):645-652

From the Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, Tuebingen.

Objective: Deep learning (DL) reconstruction enables substantial acceleration of image acquisition while maintaining diagnostic image quality. The aims of this study were to overcome the drawback of specific absorption rate (SAR)-related limitations at 3 T and to develop a DL-accelerated single-breath-hold half-Fourier acquisition single-shot turbo spin echo (HASTE) sequence for 2-dimesional T2-weighted fat-suppressed magnetic resonance imaging of the abdomen at 3 T using a variable flip angle (FA) evolution for the refocusing radiofrequency pulses, as well as to evaluate its feasibility and image quality in comparison to state-of-the-art T2-weighted fat-suppressed imaging technique (BLADE).

Materials And Methods: First, a suitable FA evolution with low cardiac motion-related signal loss (CRSL) and low SAR was determined through a prospective volunteer study with 11 participants. Image quality and diagnostic confidence with 5 different FA evolutions of a HASTEDL were assessed to identify the most suitable FA evolution. Second, the identified FA evolution was implemented clinically and evaluated in 51 patients undergoing a clinically indicated liver magnetic resonance imaging at 3 T. Two radiologists assessed the HASTEDL and standard sequences regarding overall image quality, noise, contrast, sharpness, artifacts, CRSL, and diagnostic confidence using a Likert scale ranging from 1 to 4, with 4 being the best. Comparative analyses were conducted to assess the differences between HASTEDL (acquisition time, 21 seconds; single breath-hold) and the routinely used T2-weighted BLADE sequence (acquisition time, 4 minutes; respiratory triggering).

Results: From the volunteer study, the FA evolution characterized by the control points 130-90-110-130 degrees (HASTEDL) was identified as optimal among the 5 evolutions evaluated and was implemented in our clinical protocol. In all 51 patients, HASTEDL was successfully acquired at 3 T and showed excellent image quality (median, 4; interquartile range, 3-4). Although BLADE was rated significantly higher for overall image quality, noise, contrast, sharpness, artifacts, CRSL, and diagnostic confidence than HASTEDL, no differences were found concerning the number (n = 102) and measured diameter of the detected hepatic lesions between the 2 sequences BLADE and HASTEDL.

Conclusions: The proposed single-breath-hold abdominal HASTEDL with variable refocusing FAs is feasible at 3 T within SAR limits and yields high image quality and diagnostic confidence as compared with a standard T2-weighted acquisition technique, at a 10th of the acquisition time.
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http://dx.doi.org/10.1097/RLI.0000000000000785DOI Listing
October 2021

A novel acylated flavonol tetraglycoside and rare oleanane saponins with a unique acetal-linked dicarboxylic acid substituent from the xero-halophyte Bassia indica.

Fitoterapia 2021 Jul 20;152:104907. Epub 2021 Apr 20.

Department of Agro-environmental Sciences, Graduate School of Bioresources and Bioenvironmental Sciences, Kyushu University, Fukuoka 819-0395, Japan. Electronic address:

In recent years, the scientific interest and particularly the economic significance of halophytic plants has been highly demanding due to the medicinal and nutraceutical potential of its bioactive compounds. A xero-halophyte Bassia indica is deemed to be a very cheap source of natural entities without chemical or biological investigation. In this context, a new acylated flavonol tetraglycoside, kaempferol-3-O-β-d-glucopyranosyl-(1→6)-O-[β-D-galactopyranosyl-(1→3)-2-O-trans-feruloyl-α-L-rhamnopyranosyl-(1→2)]-β-D-glucopyranoside (14), together with rare occurring flavonol triglycoside, isorhamnetin-3-O-β-d-glucopyranosyl-(1→6)-O-[α-L-rhamnopyranosyl-(1→2)]-β-D-glucopyranoside (15), were isolated from the aqueous methanol extract of the aerial parts of B. indica. The study also reported an optimal separation and characterization of a new seco-glycosidic oleanane saponin with 2'R,3'S stereocenters, identified as (2'R,3'S)-3-O-[2'-hydroxy-3'-(2"-O-glycolyl)-oxo-propionic acid-β-D-glucuronopyranosyl]-28-O-β-D-glucopyranosyl-olean-12-en-3β-ol-28-oic acid (17), in addition to its derivative, 3-O-[2'-(2"-O-glycolyl)-glyoxylyl-β-D-glucuronopyranosyl]-28-O-β-d-glucopyranosyl-olean-12-en-3β-ol-28-oic acid (16). The structures of all isolated compounds were elucidated based on 1D, 2D NMR, and HR-MS analysis, as well as comparing with similar derivatives published in the literature. Furthermore, thirteen known compounds were isolated and identified as β-sitosterol (1), vanillic acid (2), o-hydroxybenzoic acid (3), р-hydroxybenzoic acid (4), 6,7-dihydroxycoumarin (5), methyl caffeate (6), caffeic acid (7), quercetin (8), uracil (9), thymidine (10), tachioside (11), isorhamnetin-3-O-β-D-glucopyranoside (12), kaempferol-3-O-rutinoside (13). The anticholinesterase activity of all isolated compounds was evaluated.
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http://dx.doi.org/10.1016/j.fitote.2021.104907DOI Listing
July 2021

A reporting and analysis framework for structured evaluation of COVID-19 clinical and imaging data.

NPJ Digit Med 2021 Apr 12;4(1):69. Epub 2021 Apr 12.

Computational Radiology, Dept. of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

The COVID-19 pandemic has worldwide individual and socioeconomic consequences. Chest computed tomography has been found to support diagnostics and disease monitoring. A standardized approach to generate, collect, analyze, and share clinical and imaging information in the highest quality possible is urgently needed. We developed systematic, computer-assisted and context-guided electronic data capture on the FDA-approved mint Lesion software platform to enable cloud-based data collection and real-time analysis. The acquisition and annotation include radiological findings and radiomics performed directly on primary imaging data together with information from the patient history and clinical data. As proof of concept, anonymized data of 283 patients with either suspected or confirmed SARS-CoV-2 infection from eight European medical centers were aggregated in data analysis dashboards. Aggregated data were compared to key findings of landmark research literature. This concept has been chosen for use in the national COVID-19 response of the radiological departments of all university hospitals in Germany.
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http://dx.doi.org/10.1038/s41746-021-00439-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041811PMC
April 2021

Prospective Image Quality and Lesion Assessment in the Setting of MR-Guided Radiation Therapy of Prostate Cancer on an MR-Linac at 1.5 T: A Comparison to a Standard 3 T MRI.

Cancers (Basel) 2021 Mar 26;13(7). Epub 2021 Mar 26.

Department of Radiation Oncology, Eberhard-Karls University, 72076 Tuebingen, Germany.

The objective of this study is to conduct a qualitative and a quantitative image quality and lesion evaluation in patients undergoing MR-guided radiation therapy (MRgRT) for prostate cancer on a hybrid magnetic resonance imaging and linear accelerator system (MR-Linac or MRL) at 1.5 Tesla. This prospective study was approved by the institutional review board. A total of 13 consecutive patients with biopsy-confirmed prostate cancer and an indication for MRgRT were included. Prior to radiation therapy, each patient underwent an MR-examination on an MRL and on a standard MRI scanner at 3 Tesla (MRI). Three readers (two radiologists and a radiation oncologist) conducted an independent qualitative and quantitative analysis of T2-weighted (T2w) and diffusion-weighted images (DWI). Qualitative outcome measures were as follows: zonal anatomy, capsule demarcation, resolution, visibility of the seminal vesicles, geometric distortion, artifacts, overall image quality, lesion conspicuity, and diagnostic confidence. All ratings were performed on an ordinal 4-point Likert scale. Lesion conspicuity and diagnostic confidence were firstly analyzed only on MRL. Afterwards, these outcome parameters were analyzed in consensus with the MRI. Quantitative outcome measures were as follows: anteroposterior and right left diameter of the prostate, lesion size, PI-RADS score (Prostate Imaging-Reporting and Data System) and apparent diffusion coefficient (ADC) of the lesions. Intergroup comparisons were computed using the Wilcoxon-sign rank test and tests. A post-hoc regression analysis was computed for lesion evaluation. Finally, inter-/intra-reader agreement was analyzed using the Fleiss kappa and intraclass correlation coefficient. For T2w images, the MRL showed good results across all quality criteria (median 3 and 4). Furthermore, there were no significant differences between MRL and MRI regarding capsule demarcation or geometric distortion. For the DWI, the MRL performed significantly less than MRI across most image quality criteria with a median ranging between 2 and 3. However, there were no significant differences between MRL and MRI regarding geometric distortion. In terms of lesion conspicuity and diagnostic confidence, inter-reader agreement was fair for MRL alone (Kappa = 0.42) and good for MRL in consensus with MRI (Kappa = 0.708). Thus, lesion conspicuity and diagnostic confidence could be significantly improved when reading MRL images in consensus with MRI (Odds ratio: 9- to 11-fold for the T2w images and 5- to 8-fold for the DWI) ( < 0.001). For measures of lesion size, anterior-posterior and right-left prostate diameter, inter-reader and intersequence agreement were excellent (ICC > 0.90) and there were no significant differences between MRL and MRI among all three readers. In terms of Prostate Imaging Reporting and Data System (PIRADS) scoring, no significant differences were observed between MRL and MRI. Finally, there was a significant positive linear relationship between lesion ADC measurements (r = 0.76, < 0.01) between the ADC values measured on both systems. In conclusion, image quality for T2w was comparable and diagnostic even without administration of spasmolytic- or contrast agents, while DWI images did not reach diagnostic level and need to be optimized for further exploitation in the setting of MRgRT. Diagnostic confidence and lesion conspicuity were significantly improved by reading MRL in consensus with MRI which would be advisable for a safe planning and treatment workflow. Finally, ADC measurements of lesions on both systems were comparable indicating that, lesion ADC as measured on the MRL could be used as a biomarker for evaluation of treatment response, similar to examinations using MRI.
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http://dx.doi.org/10.3390/cancers13071533DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036991PMC
March 2021

Preliminary feasibility torque mechanical evaluation for 3D printed orthodontic springs with different parameters: in vitro study.

BMC Oral Health 2021 03 7;21(1):104. Epub 2021 Mar 7.

Digital Technologies in Dentistry and CAD/CAM Department, Danube Private University, Steiner Landstraße 124, 3500, Krems an der Donau, Austria.

Background: The purpose of the presented investigation is to evaluate the resulting torque on loaded 3D printed springs using different coil thickness and length.

Methods: Specimens were designed and printed using the 3D printer MAX (Asiga, Sydney, Australia) with 3D printable, experimental, flexible material (Code:BM2008, GC, Tokyo, Japan). The specimens were divided into three groups according to spring coil design. Control group (n = 18), length group (n = 19) and thickness group (n = 22). Groups were tested using a Sauter Machine for torque calculation (DB, Grindelwald, Switzerland) in conjunction with a universal testing machine (Zwick Z010, Ulm, Germany) for clock-wise and anti-clockwise testing. Statistical analysis was performed using the Steel-Dwass test to compare median values of the three groups in both testing directions (p < 0.001).

Results: The highest torque value was determined in the thickness group for both clockwise and anti-clockwise testing directions, achieving 44.00 N/mm and 39.62 N/mm respectively. The length group ranged from 21.65 to 11.04 N/mm in clockwise direction and from 18.04 to 11.38 N/mm in counter-clockwise testing. The control group ranged from 22.72 to 17.18 N/mm in the clock-wise direction while in the anti-clock wise testing it ranged from 21.34 to 16.02 N/mm.

Conclusions: The amount of torque produced from the computer aided designing/computer aided manufacturing (CAD/CAM) springs is being affected by diameter more than the length design parameter in comparison to the control group. The values of the thickness group are significantly higher than those of the length group (P < 0.001).
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http://dx.doi.org/10.1186/s12903-021-01473-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938560PMC
March 2021

Comparative mechanical testing for the digitally produced provisional fixed partial denture prostheses to the conventional method: in-vitro study.

Int J Prosthodont 2021 Feb 26. Epub 2021 Feb 26.

Purpose: To examine and compare the fracture strength of digitally produced interim materials to the conventional chairside method for implant-cemented fixed partial denture prostheses.

Materials And Methods: Three groups of seven specimens each were produced: group A, 3D-printed with VarseoSmile Temp material (Bego); group B, milled using Telio CAD material (Ivoclar Vivadent), and group C, conventional chairside manufacturing method using Luxatemp material (DMG). All groups were cemented using FujiCEM 2 (GC) to Standard Abutments (SIC) placed in artificial Sawbones blocks. The fracture strength was performed using universal testing machine Z010 (ZwickRoell). Statistical analysis of the resultant maximum forces was performed using SPSS (version 25.0, IBM) software (Mann- Whitney U test, P < .05).

Results: The mean fracture strength of the printed provisional fixed partial dentures was 260.14 ± 28.88 N, of the milled interim fixed partial dentures was 663.57 ± 140.55 N, and for the control group reached 266.65 ± 63.66 N. Data showed a significant deviation of the normal distribution Kolmogorov-Smirnov test > .05 for all groups.

Conclusion: Milled provisional fixed partial dentures showed a higher fracture resistance compared to 3D-printed and control chairside groups. However, for 3D-printed and control groups, no such difference could be detected.
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http://dx.doi.org/10.11607/ijp.6440DOI Listing
February 2021

Image Quality Improvement of Dynamic Contrast-Enhanced Gradient Echo Magnetic Resonance Imaging by Iterative Denoising and Edge Enhancement.

Invest Radiol 2021 Jul;56(7):465-470

From the Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen.

Objectives: The aim of this study was to investigate the impact of a novel edge enhancement and iterative denoising algorithm in 1.5-T T1-weighted dynamic contrast-enhanced (DCE) gradient echo (GRE) magnetic resonance imaging of the abdomen on image quality, noise levels, diagnostic confidence, and lesion detectability.

Materials And Methods: Fifty patients who underwent a clinically indicated magnetic resonance imaging with DCE imaging of the abdomen between June and August 2020 were included in this retrospective, monocentric, institutional review board-approved study. For DCE imaging, a series of 3 volume interpolated breath-hold examinations (VIBEs) was performed. The raw data of all DCE imaging studies were processed twice, once using standard reconstruction (DCES) and again using an edge enhancement and iterative denoising approach (DCEDE). All imaging studies were randomly reviewed by 2 radiologists independently regarding noise levels, arterial contrast, sharpness of vessels, overall image quality, and diagnostic confidence using a Likert scale ranging from 1 to 4, with 4 being the best. Furthermore, lesion detectability was evaluated using the same ranking system.

Results: All 50 imaging studies were successfully reconstructed with both methods. Interreader agreement (Cohen κ) was substantial to perfect for both readers. Arterial contrast and sharpness of vessels were rated superior by both readers with a median of 4 in DCEDE versus a median of 3 in DCES (P < 0.001). Furthermore, noise levels as well as overall image quality were rated higher with a median of 4 in DCEDE compared with a median of 3 in DCES (P < 0.001). Lesion detectability was evaluated to be superior in DCEDE with a median of 4 versus DCES with a median of 3 (P < 0.001). Consequently, diagnostic confidence was also rated to be superior in DCEDE with a median of 4 versus DCES with a median of 3 (P < 0.001).

Conclusions: Iterative denoising and edge enhancement are feasible in DCE imaging of the abdomen providing superior arterial contrast, noise levels, and overall image quality. Furthermore, lesion detectability and diagnostic confidence were significantly improved using this novel reconstruction method. Further reduction of acquisition time might be possible via reduction of increased noise levels using this presented method.
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http://dx.doi.org/10.1097/RLI.0000000000000761DOI Listing
July 2021

Deep Learning-Based Superresolution Reconstruction for Upper Abdominal Magnetic Resonance Imaging: An Analysis of Image Quality, Diagnostic Confidence, and Lesion Conspicuity.

Invest Radiol 2021 Aug;56(8):509-516

From the Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tuebingen University Hospital, Tuebingen.

Objectives: The aim of this study was to investigate the impact of a deep learning-based superresolution reconstruction technique for T1-weighted volume-interpolated breath-hold examination (VIBESR) on image quality in comparison with standard VIBE images (VIBESD).

Methods: Between May and August 2020, a total of 46 patients with various abdominal pathologies underwent contrast-enhanced upper abdominal VIBE magnetic resonance imaging (MRI) at 1.5 T. After data acquisition, the precontrast and postcontrast T1-weighted VIBE raw data were processed by a deep learning-based prototype algorithm for deblurring and denoising the images as well as for enhancing their sharpness (VIBESR). In a randomized and blinded manner, 2 radiologists independently analyzed the image data sets using the unprocessed images VIBESD as a standard reference. Outcome measures were as follows: overall image quality, anatomic clarity of organ borders, sharpness of vessels, artifacts, noise, and diagnostic confidence. All ratings were performed on an ordinal 4-point Likert scale. If the MRI examination encompassed a hepatic lesion, the maximum diameter of the largest hepatic lesion was quantified, and lesion sharpness and conspicuity were evaluated on an ordinal 4-point Likert scale. In addition, a post hoc regression analysis for lesion evaluation was computed. Finally, interrater/intrarater agreement was analyzed.

Results: The overall image quality, anatomic clarity of organ borders, and sharpness of vessels in both precontrast and postcontrast images were rated significantly higher in VIBESR than in VIBESD (P < 0.001). Similarly, diagnostic confidence was higher in VIBESR than in VIBESD (P < 0.001). Furthermore, VIBESR images were rated to have significantly less noise and fewer artifacts in comparison with VIBESD (P < 0.001). The interreader agreement was substantial with a Cohen κ of 0.72 for the precontrast analysis and a κ of 0.74 for the postcontrast analysis. A total of 28 hepatic lesions were analyzed. For both readers, lesion sharpness and conspicuity were rated significantly better in VIBESR than in VIBESD in both the precontrast and postcontrast data sets (P < 0.01), which was consistent with the post hoc regression analysis (for every 1-point increase in sharpness/conspicuity, the odds ratio revealed a positive relation with VIBESR of 13-fold to 17-fold in comparison with VIBESD; P < 0.001). In terms of lesion size, there was no significant difference between the precontrast VIBESD and VIBESR or between the postcontrast VIBESD and VIBESR for both readers. Similarly, there was an excellent interreader agreement regarding lesion size (intraclass correlation coefficient, >0.9).

Conclusions: The data-driven superresolution reconstruction (VIBESR) is clinically feasible for precontrast and postcontrast upper abdominal VIBE MRI, providing improved image quality, diagnostic confidence, and lesion conspicuity compared with standard VIBESD images.
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http://dx.doi.org/10.1097/RLI.0000000000000769DOI Listing
August 2021

Deep learning-accelerated T2-weighted imaging of the prostate: Reduction of acquisition time and improvement of image quality.

Eur J Radiol 2021 Apr 15;137:109600. Epub 2021 Feb 15.

Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen, Germany; Department of Neuroradiology, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany. Electronic address:

Purpose: To introduce a novel deep learning (DL) T2-weighted TSE imaging (T2) sequence in prostate MRI and investigate its impact on examination time, image quality, diagnostic confidence, and PI-RADS classification compared to standard T2-weighted TSE imaging (T2).

Method: Thirty patients who underwent multiparametric MRI (mpMRI) of the prostate due to suspicion of prostatic cancer were included in this retrospective study. Standard sequences were acquired consisting of T1- and T2-weighted imaging and diffusion-weighted imaging as well as the novel T2. Axial acquisition time of T2 was 4:37 min compared to 1:38 min of T2. Two radiologists independently evaluated all imaging datasets in a blinded reading regarding image quality, lesion detectability, and diagnostic confidence using a Likert-scale ranging from 1 to 4 with 4 being the best. T2 score as well as PI-RADS score were obtained for the most malignant lesion.

Results: Mean patient age was 65 ± 11 years. Noise levels and overall image quality were rated significantly superior by both readers with a median of 4 in T2 compared to a median of 3 in T2 (all p < 0.001). Lesion detectability was also rated higher in T2 by both readers with a median of 4 versus a median of 3 in T2 (p = 0.005 and <0.001, respectively). There was no difference regarding PI-RADS scoring between T2 and T2 affecting patient management.

Conclusions: Deep learning axial T2w TSE imaging of the prostate is feasible with reduction of examination time of 65 % compared to standard imaging and improvement of image quality and lesion detectability.
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http://dx.doi.org/10.1016/j.ejrad.2021.109600DOI Listing
April 2021

Dynamic visceral ischemia in type A dissection.

J Card Surg 2021 Mar 24;36(3):1136-1137. Epub 2021 Jan 24.

Liverpool Cardiovascular Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.

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http://dx.doi.org/10.1111/jocs.15374DOI Listing
March 2021

Bassiamide A, a new alkaloid from xero-halophyte Wight.

Nat Prod Res 2021 Jan 18:1-9. Epub 2021 Jan 18.

Department of Agro-environmental Sciences, Graduate School of Bioresources and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan.

-[(3-(3-methyl-1-oxo-butyl)amino)propyl]-3-(3,4-dihydroxyphenyl)prop-2-enamide (), named 'Bassiamide A', a new alkaloid, together with six known compounds including one lignan () and five lignanamides (), were isolated from the aerial parts of Wight. The study also reported an optimal separation of a rare occurring -isomer lignanamide derivative () from a natural origin, in addition to its known corresponding -isomer (). Structures of isolated compounds were elucidated based on NMR spectroscopic data, HR-MS, and comparison with known related ones, and they were identified as syringaresinol (), --feruloyl-3-methoxytyramine (), --feruloyltyramine (), -(-)---feruloyl normetanephrine (), -(-)---feruloyl octopamine (), -(+)---feruloyl octopamine (). The isolated compounds were evaluated for their anti-acetylcholinesterase activity, and they showed weak inhibitory activity.
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http://dx.doi.org/10.1080/14786419.2021.1872572DOI Listing
January 2021

The life in their years versus the years in their life.

J Thorac Cardiovasc Surg 2021 May 12;161(5):e361-e362. Epub 2021 Jan 12.

Department of Cardiac Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.

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http://dx.doi.org/10.1016/j.jtcvs.2020.11.113DOI Listing
May 2021

Simulated Radiation Dose Reduction in Whole-Body CT on a 3rd Generation Dual-Source Scanner: An Intraindividual Comparison.

Diagnostics (Basel) 2021 Jan 13;11(1). Epub 2021 Jan 13.

Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany.

To evaluate the effect of radiation dose reduction on image quality and diagnostic confidence in contrast-enhanced whole-body computed tomography (WBCT) staging. We randomly selected March 2016 for retrospective inclusion of 18 consecutive patients (14 female, 60 ± 15 years) with clinically indicated WBCT staging on the same 3rd generation dual-source CT. Using low-dose simulations, we created data sets with 100, 80, 60, 40, and 20% of the original radiation dose. Each set was reconstructed using filtered back projection (FBP) and Advanced Modeled Iterative Reconstruction (ADMIRE, Siemens Healthineers, Forchheim, Germany) strength 1-5, resulting in 540 datasets total. ADMIRE 2 was the reference standard for intraindividual comparison. The effective radiation dose was calculated using commercially available software. For comparison of objective image quality, noise assessments of subcutaneous adipose tissue regions were performed automatically using the software. Three radiologists blinded to the study evaluated image quality and diagnostic confidence independently on an equidistant 5-point Likert scale (1 = poor to 5 = excellent). At 100%, the effective radiation dose in our population was 13.3 ± 9.1 mSv. At 20% radiation dose, it was possible to obtain comparably low noise levels when using ADMIRE 5 ( = 1.000, = 0.29). We identified ADMIRE 3 at 40% radiation dose (5.3 ± 3.6 mSv) as the lowest achievable radiation dose with image quality and diagnostic confidence equal to our reference standard ( = 1.000, > 0.4). The inter-rater agreement for this result was almost perfect (ICC ≥ 0.958, 95% CI 0.909-0.983). On a 3rd generation scanner, it is feasible to maintain good subjective image quality, diagnostic confidence, and image noise in single-energy WBCT staging at dose levels as low as 40% of the original dose (5.3 ± 3.6 mSv), when using ADMIRE 3.
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http://dx.doi.org/10.3390/diagnostics11010118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828410PMC
January 2021

Comparative Study between the Overall Production Time of Digitally Versus Conventionally Produced Indirect Orthodontic Bonding Trays.

Turk J Orthod 2020 1;33(4):232-238. Epub 2020 Dec 1.

Department of Digital technologies in dentistry and CAD/CAM, Danube Private University, Krems an der Donau, Austria.

Objective: The purpose of this study was to compare the production time for indirect digitally and laboratory-produced orthodontic bonding trays.

Methods: Orthodontic study casts were used in this study (n=40). The specimens were equally and randomly divided. In the digitally produced indirect bonding tray (DIBT) group (n=20), the brackets were set virtually using the Orthoanalyzer program (3Shape, Copenhagen, Denmark) to produce an indirect bonding tray that was virtually designed and 3D printed using VarseoWax Splint material with a Varseo S 3D printer (Bego, Bremen, Germany). In the laboratory-produced indirect bonding tray (LIBT) group, the brackets were adhesively bonded to the study casts in the dental laboratory (Danube Private University, Krems, Austria), and a transfer bonding silicone tray was manufactured.

Results: The t-test results showed a significant difference between the passive time during the production of DIBTs (153.8±32.8 min) and LIBTs (7 min). However, the active production time was 13.6±0.8 min for DIBTs and 17.7±1.9 min for LIBTs. Every individual process step in both groups was measured in minutes, and statistical analysis was performed.

Conclusion: The total production time, including active working and passive non-working time, was higher for DIBTs than for LIBTs. However, the actual active production time for DIBTs was shorter than that for LIBTs. Within the study limitations, the digital planning and production of indirect orthodontic trays can be considered a time-efficient production method.
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http://dx.doi.org/10.5152/TurkJOrthod.2020.18079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771293PMC
December 2020

[Digital teaching with, during and after COVID-19].

Radiologe 2021 01 8;61(1):64-66. Epub 2021 Jan 8.

Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.

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http://dx.doi.org/10.1007/s00117-020-00794-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791335PMC
January 2021

Diagnostic Performance of Different Simulated Low-Dose Levels in Patients with Suspected Cervical Abscess Using a Third-Generation Dual-Source CT Scanner.

Diagnostics (Basel) 2020 Dec 10;10(12). Epub 2020 Dec 10.

Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany.

The aim of this study was to investigate the effects of dose reduction on diagnostic accuracy and image quality of cervical computed tomography (CT) in patients with suspected cervical abscess. Forty-eight patients (mean age 45.5 years) received a CT for suspected cervical abscess. Low-dose CT (LDCT) datasets with 25%, 50%, and 75% of the original dose were generated with a realistic simulation. The image data were reconstructed with filtered back projection (FBP) and with advanced modeled iterative reconstruction (ADMIRE) (strengths 3 and 5). A five-point Likert scale was used to assess subjective image quality and diagnostic confidence. The signal-to-noise ratio (SNR) of the sternocleidomastoid muscle and submandibular gland and the contrast-to-noise ratio (CNR) of the sternocleidomastoid muscle and submandibular glandular fat were calculated to assess the objective image quality. Diagnostic accuracy was calculated for LDCT using the original dose as the reference standard. The prevalence of cervical abscesses was high (72.9%) in the cohort; the mean effective dose for all 48 scans was 1.8 ± 0.8 mSv. Sternocleidomastoid and submandibular SNR and sternocleidomastoid muscle fat and submandibular gland fat CNR increased with higher doses and were significantly higher for ADMIRE compared to FBP, with the best results in ADMIRE 5 (all < 0.001). Subjective image quality was highest for ADMIRE 5 at 75% and lowest for FBP at 25% of the original dose ( < 0.001). Diagnostic confidence was highest for ADMIRE 5 at 75% and lowest for FBP at 25% ( < 0.001). Patient-based diagnostic accuracy was high for all LDCT datasets, down to 25% for ADMIRE 3 and 5 (sensitivity: 100%; specificity: 100%) and lower for FBP at 25% dose reduction (sensitivity: 88.6-94.3%; specificity: 92.3-100%). The use of a modern dual-source CT of the third generation and iterative reconstruction allows a reduction in the radiation dose to 25% (0.5 mSv) of the original dose with the same diagnostic accuracy for the assessment of neck abscesses.
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http://dx.doi.org/10.3390/diagnostics10121072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764070PMC
December 2020
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