Hatem Alkadhi

University of Zurich, Zürich, Zurich, Switzerland

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Publications (402)1318.69 Total impact

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    ABSTRACT: To assess radiation dose and image quality in body CT-angiography (CTA) with automated attenuation-based tube voltage selection (ATVS) on a 192-slice dual-source CT (DSCT). Forty patients (69.5 ± 9.6 years) who had undergone body CTA with ATVS (ref.kVp 100, ref.mAs 90) using a 2x192-slice CT in single-source mode were retrospectively included. All patients had undergone prior CTA with a 2x128-slice CT and ATVS with identical imaging and contrast media protocols, serving for comparison. Images were reconstructed with iterative reconstruction at similar strength levels. Radiation dose was determined. Image quality was assessed semi-quantitatively (1:excellent, 5:non-diagnostic), aortic attenuation, noise and CNR were determined. As compared to 128-slice DSCT, 192-slice DSCT selected tube voltages were lower in 30 patients (75 %), higher in 3 (7.5 %), and similar in 7 patients (17.5 %). CTDIvol was lower with 192-slice DSCT (4.7 ± 1.9 mGy vs. 5.8 ± 2.1 mGy; p < 0.001). Subjective image quality, mean aortic attenuation (342 ± 67HU vs. 268 ± 67HU) and CNR (9.8 ± 2.5 vs. 8.2 ± 2.9) were higher with 192-slice DSCT (all p < 0.01), all datasets being diagnostic. Our study suggests that ATVS of 192-slice DSCT for body CTA is associated with an improved image quality and further radiation dose reduction of 19 % compared to 128-slice DSCT. • 192-slice DSCT allows imaging from 70 kVp to 150 kVp at 10 kVp increments. • 192-slice DSCT allows for radiation-dose reduction in body-CTA with ATVS. • Subjective and objective image quality increase compared to 128-slice DSCT.
    European radiology. 02/2015;
  • European heart journal. 02/2015;
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    ABSTRACT: Objectives: To determine the number of imaging examinations, radiation dose, and the time to complete trauma-related imaging in multiple trauma patients before and after introduction of whole-body CT (WBCT) into early trauma care. Methods: 120 consecutive patients before and 120 patients after introduction of WBCT into our hospitals' trauma algorithm were compared regarding number and type of CT, radiography, focused assessment with sonography for trauma (FAST), additional CT examinations (defined as CT of same body regions after radiography and/or FAST), and the time to complete trauma-related imaging. Results: In the WBCT cohort significantly more patients underwent CT of the head, neck, chest, and abdomen (P<.001) as compared to the non-WBCT cohort, whereas the number of radiography of the cervical spine, chest and pelvis and of FAST examinations were significantly lower (P<.001). There were no significant differences between cohorts regarding the number of radiography of upper (P=.56) and lower extremities (P=.30). We found significantly higher effective doses in the WBCT (29.5mSv) as compared to the non-WBCT cohort (15.9mSv, P<.001), but less additional CT for completing the work-up were needed in the WBCT cohort (P<.001). The time to complete trauma-related imaging was significantly shorter in the WBCT (12min) as compared to the non-WBCT cohort (75min, P<.001). Conclusion: Including WBCT in the initial work-up of trauma patients results in higher radiation dose, but less additional CT is needed, and the time for completing trauma-related imaging is shorter. Advances in knowledge: WBCT in trauma patients is associated with a high radiation dose of 29.5mSv.
    The British journal of radiology. 01/2015;
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    ABSTRACT: To investigate the dual-energy CT behavior of cocaine and heroin and of typical adulterants, and to evaluate the elemental composition of pure cocaine and heroin compared with cocaine and heroin in bodypacks. Pure heroin and pure synthetic cocaine samples, eight different adulterants, and in each case ten different bodypacks containing cocaine or heroin, were imaged at 80, 100, 120, and 140 kVp in a dual source CT system at two different degrees of compression. Two radiologists, blinded to the samples, measured the attenuation. The dual-energy index (DEI) was calculated. We performed atomic mass spectrometry for the elemental analysis of pure cocaine, pure heroin, and heroin and cocaine in bodypacks, and 140 kVp in a dual-source CT system. Inter- and intra-observer agreement for attenuation measurements was good (r = 0.61-0.72; p < 0.01). The cocaine bodypacks had a positive DEI of 0.029, while the pure drugs and the heroin bodypacks had a negative DEI (-0.051 to -0.027). Levamisole was the only substance which expressed a positive DEI of 0.011, while the remaining adulterants had negative DEIs ranging between -0.015 and -0.215. Atomic mass spectrometry revealed a concentration of tin in the cocaine bodypack that was 67 times higher than in the pure synthetic cocaine sample. The different DEIs of bodypacks containing cocaine and heroin allow them to be distinguished with dual-energy CT. Although the material properties of pure cocaine, pure heroin, or common drug extenders do not explain the differences in DEI, tin contamination during illicit natural cocaine production may be a possible explanation.
    Forensic Science Medicine and Pathology 01/2015; 11(1). · 1.96 Impact Factor
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    ABSTRACT: To compare low-contrast detectability, and qualitative and quantitative image parameters on standard and reduced radiation dose abdominal CT reconstructed with filtered back projection (FBP) and model-based iterative reconstruction (MBIR). A custom built liver phantom containing 43 lesions was imaged at 120 kVp and four radiation dose levels (100% = 188 mAs, 50%, 25%, and 10%). Image noise and contrast-to-noise ratios (CNR) were assessed. Lesion detection and qualitative image analysis (five-point Likert scale with 1 = worst, 5 = best for confidence) was performed by three independent radiologists. CNR on MBIR images was significantly higher (mean 246%, range 151-383%) and image noise was significantly lower (69%, 59-78%) than on FBP images at the same radiation dose (both p < 0.05). On MBIR 10% images, CNR (3.3 ± 0.3) was significantly higher and noise (15 ± 1HU) significantly lower than on FBP 100% images (2.5 ± 0.1; 21 ± 1 HU). On 100% images, lesion attenuation was significantly lower with MBIR than with FBP (mean difference -2 HU). Low-contrast detectability and qualitative results were similar with MBIR 50% and FBP 100%. Low-contrast detectability with MBIR 50% and FBP 100% were equal. Quantitative parameters on even lower dose MBIR images are superior to 100%-dose FBP images. Some attenuation values differ significantly with MBIR compared with FBP. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
    Clinical Radiology 12/2014; · 1.66 Impact Factor
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    ABSTRACT: Current technological advances in CT, specifically those with a major impact on clinical imaging, are discussed. The intent was to provide for both medical physicists and practicing radiologists a summary of the clinical impact of each advance, offering guidance in terms of utility and day-to-day clinical implementation, with specific attention to radiation dose reduction.
    Investigative Radiology 12/2014; · 4.45 Impact Factor
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    ABSTRACT: Objective Coronary angiography (CA) remains the standard for preoperative planning for surgical revascularization. However, besides anatomical imaging, current guidelines recommend additional functional imaging before a therapy decision is made. We assess the impact of functional imaging on the strategy of coronary artery bypass grafting (CABG) with particular regards on postoperative patency and myocardial perfusion. Methods After CA, 55 patients (47 males/8 females; age: 65.1 ± 9.5 years) underwent perfusion cardiovascular magnetic resonance (CMR) and dual-source computed tomography (DSCT) before isolated CABG (n = 31), CABG and concomitant valve surgery (valve + CABG; n = 10) and isolated valve surgery (n = 14; control). DSCT was used for analysis of significant stenosis, CMR for myocardial-perfusion to discriminate between: no ischemia (normal), ischemia, or scar. The results, unknown to the surgeons, were compared with CA and related to the location and number of distal anastomoses. Nineteen CABG patients underwent follow-up CMR and DSCT (FU: 13 ± 3 months) to compare the preop findings with the postop outcomes. Results Thirty-nine patients either received CABG alone (n = 31) or a combined procedure (n = 10) with a total of 116 distal anastomoses. DSCT was compared with CA regarding accuracy of coronary stenosis and showed 91% sensitivity, 88% specificity, and negative/positive predictive values of 89/90%. In total, 880 myocardial segments (n = 55, 16 segments/patient) were assessed by CMR. In 17% (149/880) of segments ischemia and in 8% (74/880) scar tissue was found. Interestingly, 14% (16/116) of bypass-anastomoses were placed on non-ischemic myocardium and 3% (4/116) on scar tissue. In a subgroup of 19 patients 304 segments were evaluated. Thirty-nine percent (88/304) of all segments showed ischemia preoperatively, while 94% (83/88) of these ischemic segments did not show any ischemia postoperatively. In regard to performed anastomoses, 79% of all grafts (49/62) were optimally placed, whereas 21% (13/62) were either placed into non-ischemic myocardium or scar tissue, including 10% occluded grafts (6/62). Conclusion In the whole cohort analysis, 17% of grafts were placed in regions with either no ischemia or scar tissue. The subgroup analysis revealed that 94% of all ischemic segments were successfully revascularized after CABG. Thus, functional imaging could be a promising tool in preoperative planning of revascularization strategy. Avoidance of extensive and unnecessary grafting could further optimize outcomes after CABG. Georg Thieme Verlag KG Stuttgart · New York.
    The Thoracic and Cardiovascular Surgeon 12/2014; · 1.08 Impact Factor
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    ABSTRACT: To determine qualitative and quantitative image-quality parameters in abdominal imaging using advanced modelled iterative reconstruction (ADMIRE) with third-generation dual-source 192 section CT.
    Clinical Radiology 09/2014; · 1.66 Impact Factor
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    ABSTRACT: Mortality from abdominal abscesses ranges from 30% in treated cases up to 80% to 100% in patients with undrained or nonoperated abscesses. Various computed tomographic (CT) imaging features have been suggested to indicate infection of postoperative abdominal fluid collections; however, features are nonspecific and substantial overlap between infected and noninfected collections exists. The purpose of this study was to develop and validate a scoring system on the basis of CT imaging findings as well as laboratory and clinical parameters for distinguishing infected from noninfected abdominal fluid collections after surgery.
    Investigative radiology. 09/2014;
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    ABSTRACT: Since the discovery of the obese (ob) gene product leptin, fat has been considered an endocrine organ. Especially epicardial fat has gained increasing attention in recent years. The epicardial fat plays a major role in fat metabolism; however, harmful properties have also been reported. Echocardiography, computed tomography and cardiac magnetic resonance imaging are the non-invasive tools used to measure epicardial fat volume. This review briefly introduces the basic physiological and pathophysiological considerations concerning epicardial fat. The main issue of this review is the presentation of non-invasive measurement techniques of epicardial fat using various imaging modalities and a literature overview of associations between epicardial fat and common cardiovascular diseases.
    Herz 09/2014; · 0.78 Impact Factor
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    ABSTRACT: Objectives: The aim of the study was to examine frequency, size and localization of peri-device leaks after percutaneous left atrial appendage(LAA)-closure with the AMPLATZER-Cardiac-Plug (ACP) by using a multimodal imaging approach, i.e. combined cardiac-CT and TEE follow-up.Background: Catheter-based LAA-occlusion using ACP aims to reduce the risk of stroke in patients with atrial fibrillation. Detection of peri-device leaks after ACP implantation by TEE is challenging, the few available data are inconsistent and the frequency of LAA leaks after ACP implantation remains therefore unclear.Methods: Cardiac-CT using a multi-phase protocol and a second-generation dual-source-CT-system was performed in twenty-four patients with non-valvular atrial fibrillation starting 3 months after LAA-closure by ACP. Color Doppler multiplane TEE was used to evaluate peri-device flow.Results: Cardiac-CT follow-up detected any persistent LAA contrast filling in 62% of patients (n=15), but leak-sizes were small (1.5±1.4mm). Peri-device leaks were almost exclusively localized at the posterior portion of the LAA-orifice (>90%). TEE follow-up revealed peri-device flow in 36% of patients (jet-sizes:≤4mm). ACP-lobe compression (>10 %) and perpendicular ACP-lobe orientation to the LAA-neck axis, that was also dependent on LAA anatomy, were substantially more frequent in patients with complete LAA closure.Conclusion: The present study evaluates for the first time peri-device flow after LAA closure by ACP using a combined cardiac-CT and TEE follow-up. Persistent LAA-perfusion was frequently detected, leak-sizes were small and were less frequent when lobe compression was >10% and lobe orientation was perpendicular to the LAA-neck axis, that was also related to the LAA anatomy. The clinical significance of these small leaks after LAA-closure using ACP needs to be further evaluated in future studies. © 2014 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 09/2014; · 2.51 Impact Factor
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    ABSTRACT: To investigate the use of computed tomography (CT) to measure the mitral valve annulus size before implantation of a percutaneous mitral valve annuloplasty device in an animal trial. Seven domestic pigs underwent CT before and after implantation of a Cardioband™ (a percutaneously implantable mitral valve annuloplasty device) with a second-generation 128-section dual-source CT machine. Implantation of the Cardioband™ was performed in a standard fashion according to a protocol. Animals were sacrificed afterwards and the hearts explanted. The Cardioband™ was found to be adequately implanted in all animals, with no anchor dehiscence and no damage of the circumflex artery (CX) or the coronary sinus (CS). The correct length of the band as chosen according to the length of the posterior mitral annulus measured in CT before implantation was confirmed in gross examination in all animals. The device did not result in a metal artifact-related degradation of image quality. The closest distance from the closest anchor to the CX was 2.1 ± 0.7 mm in diastole and 1.6 ± 0.5 mm systole. Mitral annulus distance to the CS was 6.4 ± 1.3 mm in diastole and 7.7 ± 1.1 mm in systole. CT visualization and measurement of the mitral valve annulus dimensions is feasible and can become the imaging method of choice for procedure planning of Cardioband™ implantations or other transcatheter mitral annuloplasty devices.
    The International Journal of Cardiovascular Imaging 08/2014; · 2.32 Impact Factor
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    ABSTRACT: Objectives To assess the diagnostic accuracy of standard axial 64-Slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves. Materials & Methods The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly analysed for (i) the appearance of the valve cusps, (ii) the largest aortic sinus area, (iii) the longest aortic cusp length, (iv) the thickest aortic valve cusp and (v) valve calcification. A second blinded reader independently analysed the appearance of the valve cusps. Forty-two age- and sex-matched patients with known tricuspid aortic valves were used as controls. Retrospectively ECG-gated cardiac CT multiphase reconstructions of the aortic valve were used as the gold-standard. Results Fourteen (21%) scans were scored as unevaluable (7 bicuspid, 7 tricuspid). Of the remainder, there were 13 evaluable bicuspid valves, ten of which showed an aortic valve line sign, while the remaining three showed a normal Mercedes-benz appearance owing to fused valve cusps. The 35 evaluable tricuspid aortic valves all showed a normal Mercedes-benz appearance (P = 0.001). Kappa analysis = 0.62 indicating good interobserver agreement for the aortic valve cusp appearance. Aortic sinus areas, aortic cusp lengths and aortic cusp thicknesses of ≥ 3.8 cm2, 3.2 cm and 1.6 mm respectively on standard axial chest CT best distinguished bicuspid from tricuspid aortic valves (P < 0.0001 for all). Of evaluable scans, the sensitivity, specificity, positive and negative predictive values of standard axial chest CT in diagnosing bicuspid aortic valves was 77% (CI 0.54-1.0%), 100%, 100% and 70% respectively. Conclusion The aortic valve is evaluable in approximately 80% of standard chest 64-slice CT scans. Bicuspid aortic valves may be diagnosed on evaluable scans with good diagnostic accuracy. An aortic valve line sign, enlarged aortic sinuses and elongated, thickened valve cusps are specific CT features.
    European Journal of Radiology 08/2014; · 2.16 Impact Factor
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    ABSTRACT: To investigate the accuracy of post-mortem diffusion tensor imaging (DTI) for the detection of myocardial infarction (MI) and to demonstrate the feasibility of helix angle (HA) calculation to study remodelling of myofibre architecture.
    European Radiology 07/2014; · 4.34 Impact Factor
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    ABSTRACT: Computed tomography has become an important component in the initial assessment of severely injured patients over the last years. The liberal use coupled with advances in imaging technology often result in incidental findings. In our present investigation, the prevalence incidence of incidental findings of the spine and skull amounted to 58% of all patients with trauma. Degenerative changes were most commonly found, followed by congenital defects and neoplasms. Within the latter, further investigation was necessary in six cases, of which two findings proved to be malignant neoplasms. The high incidence of incidental findings calls for a uniform documentation, handling and clarification of responsibility in treatment and insurance-related competence.
    Praxis 07/2014; 103(14):819-24.
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    ABSTRACT: Objective To determine the best predictor for the response to and survival with transarterial radioembolisation (RE) with 90yttrium microspheres in patients with liver metastases. Methods Forty consecutive patients with liver metastases undergoing RE were evaluated with multiphase CT, perfusion CT and 99mTc-MAA SPECT. Arterial perfusion (AP) from perfusion CT, HU values from the arterial (aHU) and portal venous phase (pvHU) CT, and 99mTc-MAA uptake ratio of metastases were determined. Morphologic response was evaluated after 4 months and available in 30 patients. One-year survival was calculated with Kaplan-Meier curves. Results We found significant differences between responders and non-responders for AP (P < 0.001) and aHU (P = 0.001) of metastases, while no differences were found for pvHU (P = 0.07) and the 99mTc-MAA uptake ratio (P = 0.40). AP had a significantly higher specificity than aHU (P = 0.003) for determining responders to RE. Patients with an AP >20 ml/100 ml/min had a significantly (P = 0.01) higher 1-year survival, whereas an aHU value >55 HU did not discriminate survival (P = 0.12). The Cox proportional hazard model revealed AP as the only significant (P = 0.02) independent predictor of survival. Conclusion Compared to arterial and portal venous enhancement and the 99mTc-MAA uptake ratio of liver metastases, the AP from perfusion CT is the best predictor of morphologic response to and 1-year survival with RE. Key Points • Perfusion CT allows for calculation of the liver arterial perfusion. • Arterial perfusion of liver metastases differs between responders and non-responders to RE. • Arterial perfusion can be used to select patients responding to RE.
    European Radiology 07/2014; 24(7). · 4.34 Impact Factor
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    ABSTRACT: To evaluate image quality, maximal heart rate allowing for diagnostic imaging, and radiation dose of turbo high-pitch dual-source coronary computed tomographic angiography (CCTA).
    European Radiology 05/2014; · 4.34 Impact Factor
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    ABSTRACT: To determine the average heart rate (HR) and heart rate variability (HRV) required for diagnostic imaging of the coronary arteries in patients undergoing high-pitch CT-angiography (CTA) with third-generation dual-source CT. Fifty consecutive patients underwent CTA of the thoracic (n = 8) and thoracoabdominal (n = 42) aorta with third-generation dual-source 192-slice CT with prospective electrocardiography (ECG)-gating at a pitch of 3.2. No β-blockers were administered. Motion artifacts of coronary arteries were graded on a 4-point scale. Average HR and HRV were noted. The average HR was 66 ± 11 beats per minute (bpm) (range 45-96 bpm); the HRV was 7.3 ± 4.4 bpm (range 3-20 bpm). Interobserver agreement on grade of image quality for the 642 coronary segments evaluated by both observers was good (κ = 0.71). Diagnostic image quality was found for 608 of the 642 segments (95 %) in 43 of 50 patients (86 %). In 14 % of the patients, image quality was nondiagnostic for at least one segment. HR (p = 0.001) was significantly higher in patients with at least one non-diagnostic segment compared to those without. There was no significant difference (p > 0.05) in HRV between patients with nondiagnostic segments and those with diagnostic images of all segments. All patients with a HR < 70 bpm had diagnostic image quality in all coronary segments. The effective radiation dose and scan time for the heart were 0.4 ± 0.1 mSv and 0.17 ± 0.02 s, respectively. Third-generation dual-source 192-slice CT allows for coronary angiography in the prospectively ECG-gated high-pitch mode with diagnostic image quality at HR up to 70 bpm. HRV is not significantly related to image quality of coronary CTA.
    The international journal of cardiovascular imaging 05/2014; · 2.15 Impact Factor
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    ABSTRACT: The purpose of this study was to determine the value of magnetic resonance imaging (MRI) for characterization of indeterminate spleen lesions in primary computed tomography (CT) of patients with blunt abdominal trauma. Twenty-five consecutive patients (8 female, 17 male, mean age 51.6 ± 22.4 years) with an indeterminate spleen lesion diagnosed at CT after blunt abdominal trauma underwent MRI with T2- and T1-weighted images pre- and post-contrast material administration. MRI studies were reviewed by two radiologists. Age, gender, injury mechanism, injury severity score (ISS), management of patients, time interval between CT and MRI, and length of hospital stay were included into the analysis. Patient history, clinical history, imaging, and 2-month clinical outcome including review of medical records and telephone interviews served as reference standard. From the 25 indeterminate spleen lesions in CT, 11 (44 %) were traumatic; nine (36 %) were non-traumatic (pseudocysts, n = 5; hemangioma, n = 4) and five proven to represent artifacts in CT. The ISS (P < 0.001) and the length of hospital stay (P = 0.03) were significantly higher in patients with spleen lesions as compared with those without. All other parameters were similar among groups (all, P > 0.05). The MRI features ill-defined lesion borders, variable signal intensity on T1- and T2-weighted images depending on the age of the hematoma, focal contrast enhancement indicating traumatic pseudoaneurysm, perilesional contrast enhancement, and edema were most indicative for traumatic spleen lesions. As compared with CT (2/25), MRI (5/25) better depicted thin subcapsular hematomas as indicator of traumatic spleen injury. In conclusion, MRI shows value for characterizing indeterminate spleen lesions in primary CT after blunt abdominal trauma.
    Emergency Radiology 05/2014;
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    ABSTRACT: Purpose To evaluate computed tomography (CT) perfusion for assessment of early treatment response after transarterial radioembolization of patients with liver malignancy. Materials and Methods Dynamic contrast-enhanced CT liver perfusion was performed before and 4 weeks after transarterial radioembolization in 40 patients (25 men and 15 women; mean age, 64 y ± 11; range, 35–80 y) with liver metastases (n = 27) or hepatocellular carcinoma (HCC) (n = 13). Arterial perfusion (AP) of tumors derived from CT perfusion and tumor diameters were measured on CT perfusion before and after transarterial radioembolization. Success of transarterial radioembolization was evaluated on morphologic follow-up imaging (median follow-up time, 4 mo) based on Response Evaluation Criteria in Solid Tumors (Version 1.1). CT perfusion parameters before and after transarterial radioembolization for different response groups were compared. Kaplan-Meier curves were plotted to illustrate overall 1-year survival rates. Results Liver metastases showed significant differences in AP before and after transarterial radioembolization in responders (P < .05) but not in nonresponders (P = .164). In HCC, AP values before and after transarterial radioembolization were not significantly different in responders and nonresponders (P = .180 and P = .052). Tumor diameters were not significantly different on CT perfusion before and after transarterial radioembolization in responders and nonresponders with liver metastases and HCC (P = .654, P = .968, P = .148, P = .164). In patients with significant decrease of AP in liver metastases after transarterial radioembolization, 1-year overall survival was significantly higher than in patients showing no reduction of AP. Conclusions CT perfusion showed early reduction of AP in liver metastases responding to transarterial radioembolization; tumor diameter remained unchanged early after treatment. No significant early treatment response to transarterial radioembolization was found in patients with HCC. In patients with liver metastases, a decrease of AP after transarterial radioembolization was associated with a higher 1-year overall survival rate.
    Journal of vascular and interventional radiology: JVIR 05/2014; · 1.81 Impact Factor

Publication Stats

8k Citations
1,318.69 Total Impact Points

Institutions

  • 2001–2014
    • University of Zurich
      • • Center for Integrative Human Physiology
      • • Division of Neuropsychology
      Zürich, Zurich, Switzerland
  • 2013
    • Duke University Medical Center
      • Department of Radiology
      Durham, North Carolina, United States
  • 2010–2013
    • Massachusetts General Hospital
      • Department of Radiology
      Boston, MA, United States
    • Medical University of Vienna
      • Universitätsklinik für Radiodiagnostik
      Vienna, Vienna, Austria
  • 2012
    • University Hospital Zürich
      Zürich, Zurich, Switzerland
    • Memorial Sloan-Kettering Cancer Center
      • Department of Radiology
      New York City, NY, United States
    • University of Pittsburgh
      Pittsburgh, Pennsylvania, United States
  • 2008–2012
    • Kantonsspital St. Gallen
      San Gallo, Saint Gallen, Switzerland
  • 2001–2012
    • ETH Zurich
      • • Department of Mechanical and Process Engineering
      • • Computer Vision Laboratory
      Zürich, ZH, Switzerland
  • 2011
    • Partners HealthCare
      Boston, Massachusetts, United States
    • Boston Children's Hospital
      Boston, Massachusetts, United States
  • 2010–2011
    • Harvard Medical School
      Boston, Massachusetts, United States
  • 2009–2011
    • Medizinische Universität Innsbruck
      • Univ.-Klinik für Radiologie
      Innsbruck, Tyrol, Austria
    • Zürcher Höhenklinik Wald
      Zürich, Zurich, Switzerland
  • 2005
    • Solothurner Spitäler AG
      Soleure, Solothurn, Switzerland
  • 2004
    • Cantonal Hospital of Schwyz
      Schwyz, Schwyz, Switzerland
  • 2002
    • San Raffaele Scientific Institute
      Milano, Lombardy, Italy