C J Herold

Medical University of Vienna, Wien, Vienna, Austria

Are you C J Herold?

Claim your profile

Publications (173)432.56 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: During the past decade, with its breakthroughs in systems biology, precision medicine (PM) has emerged as a novel health-care paradigm. Challenging reductionism and broad-based approaches in medicine, PM is an approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. It involves integrating information from multiple sources in a holistic manner to achieve a definitive diagnosis, focused treatment, and adequate response assessment. Biomedical imaging and imaging-guided interventions, which provide multiparametric morphologic and functional information and enable focused, minimally invasive treatments, are key elements in the infrastructure needed for PM. The emerging discipline of radiogenomics, which links genotypic information to phenotypic disease manifestations at imaging, should also greatly contribute to patient-tailored care. Because of the growing volume and complexity of imaging data, decision-support algorithms will be required to help physicians apply the most essential patient data for optimal management. These innovations will challenge traditional concepts of health care and business models. Reimbursement policies and quality assurance measures will have to be reconsidered and adapted. In their 10th biannual symposium, which was held in August 2013, the members of the International Society for Strategic Studies in Radiology discussed the opportunities and challenges arising for the imaging community with the transition to PM. This article summarizes the discussions and central messages of the symposium. (©) RSNA, 2015.
    Radiology 10/2015; DOI:10.1148/radiol.2015150709 · 6.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To determine whether in patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue lymphoma (MALT), delayed-time-point 2-F-fluoro-2-deoxy-D-glucose-positron emission tomography (F-FDG-PET) performs better than standard-time-point F-FDG-PET. Materials and methods: Patients with untreated histologically verified MALT lymphoma, who were undergoing pretherapeutic F-FDG-PET/computed tomography (CT) and consecutive F-FDG-PET/magnetic resonance imaging (MRI), using a single F-FDG injection, in the course of a larger-scale prospective trial, were included. Region-based sensitivity and specificity, and patient-based sensitivity of the respective F-FDG-PET scans at time points 1 (45-60 minutes after tracer injection, TP1) and 2 (100-150 minutes after tracer injection, TP2), relative to the reference standard, were calculated. Lesion-to-liver and lesion-to-blood SUVmax (maximum standardized uptake values) ratios were also assessed. Results: F-FDG-PET at TP1 was true positive in 15 o f 23 involved regions, and F-FDG-PET at TP2 was true-positive in 20 of 23 involved regions; no false-positive regions were noted. Accordingly, region-based sensitivities and specificities were 65.2% (confidence interval [CI], 45.73%-84.67%) and 100% (CI, 100%-100%) for F-FDG-PET at TP1; and 87.0% (CI, 73.26%-100%) and 100% (CI, 100%-100%) for F-FDG-PET at TP2, respectively. FDG-PET at TP1 detected lymphoma in at least one nodal or extranodal region in 7 of 13 patients, and F-FDG-PET at TP2 in 10 of 13 patients; accordingly, patient-based sensitivity was 53.8% (CI, 26.7%-80.9%) for F-FDG-PET at TP1, and 76.9% (CI, 54.0%-99.8%) for F-FDG-PET at TP2. Lesion-to-liver and lesion-to-blood maximum standardized uptake value ratios were significantly lower at TP1 (ratios, 1.05 ± 0.40 and 1.52 ± 0.62) than at TP2 (ratios, 1.67 ± 0.74 and 2.56 ± 1.10; P = 0.003 and P = 0.001). Conclusions: Delayed-time-point imaging may improve F-FDG-PET in MALT lymphoma.This is an open-access article distributed under the terms of the Creative CommonsAttribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
    Clinical nuclear medicine 09/2015; DOI:10.1097/RLU.0000000000001005 · 3.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose To evaluate the diagnostic performance of imaging features of gadoxetic acid-enhanced magnetic resonance (MR) imaging to differentiate among hepatocellular adenoma (HCA) subtypes by using the histopathologic results of the new immunophenotype and genotype classification and to correlate the enhancement pattern on the hepatobiliary phase (HBP) with the degrees of expression of organic anion transporting polypeptide (OATP1B1/3), multidrug resistance-associated protein 2 (MRP) (MRP2), and MRP 3 (MRP3) transporters. Materials and Methods This retrospective study was approved by the institutional review board, and the requirement for informed consent waived. MR imaging findings of 29 patients with 43 HCAs were assessed by two radiologists independently then compared with the histopathologic analysis as the standard of reference. Receiver operating characteristic curves and Spearman rank correlation coefficient were used to test the diagnostic performance of gadoxetic acid-enhanced MR imaging features, which included the retention or washout at HBP and degree of transporter expression. Interreader agreement was assessed by using the κ statistic with 95% confidence interval. Results The area under the curve for the diagnosis of inflammatory HCA was 0.79 (95% confidence interval: 0.64, 0.90); for the steatotic type, it was 0.90 (95% confidence interval: 0.77, 0.97); and for the β-catenin type, it was 0.87 (95% confidence interval: 0.74, 0.95). There were no imaging features that showed a significant statistical correlation for the diagnosis of unclassified HCAs. On immunohistochemical staining, OATP1B1/3 expression was the main determinant for the retention, whereas MRP3 was the key determinant for washout of gadoxetic acid at HBP (P < .001). MRP2 appeared to have no role. Conclusion Gadoxetic acid-enhanced MR imaging features may suggest the subtype of HCA. The degree of OATP1B1/3 and MRP3 expression correlated statistically with gadoxetic acid retention and washout, respectively, in the HBP. (©) RSNA, 2015 Online supplemental material is available for this article.
    Radiology 05/2015; 277(1):142366. DOI:10.1148/radiol.2015142366 · 6.87 Impact Factor
  • Source
    A Ba-Ssalamah · C Herold ·

    Der Radiologe 01/2015; 55(1). DOI:10.1007/s00117-014-2702-y · 0.43 Impact Factor

  • Journal of Thoracic Imaging 01/2015; 30(1):5-13. · 1.74 Impact Factor
  • Source
    C R Krestan · C Herold ·

    Der Radiologe 08/2014; 54(9). DOI:10.1007/s00117-013-2633-z · 0.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lungenveränderungen im Rahmen der rheumatoiden Arthritis stellen einen klinisch bedeutsamen Aspekt dieser in Schüben verlaufenden chronischen Arthropathie dar. Die mit dem Bestehen einer rheumatoiden Arthritis verbundenen pulmonalen Veränderungen können alle anatomischen Teile des Lungenparenchyms, die Pleura sowie Teile des knöchernen Thorax betreffen. Die wichtigsten thorakalen Veränderungen im Rahmen der rheumatoiden Arthritis sind die nekrobiotischen Rheumaknoten, pleurale Veränderungen, das Caplan-Syndrom, die Lungenfibrose, die Bronchiolitis obliterans und medikamentös induzierte Lungenveränderungen. Der vorliegende Artikel beschreibt das Spektrum der Lungenveränderungen, die im Rahmen der rheumatoiden Arthritis vorkommen. Hierbei werden die klinischen und radiologischen Charakteristika dieser Veränderungen vorgestellt. Die Bedeutung der verschiedenen bildgebenden Methoden im diagnostischen Algorithmus wird diskutiert. Pulmonary complications caused by rheumatoid arthritis are a clinically relevant aspect of this chronic arthropathy. Those complications can involve all parts of the thorax, including the lung parenchyma, the pleura, and the thoracic cage. The most common complications are necrobiotic nodules, pleural abnormalities, Caplan's syndrome, parenchymal fibrosis, bronchiolitis obliterans, and iatrogenic damage of lung the parenchyma. This article reviews pulmonary abnormalities induced by rheumatoid arthritis and their clinical and radiological findings. In addition, the role of different imaging modalities in the diagnostic work-up of pulmonary complications caused by rheumatoid arthritis is discussed.
    Der Radiologe 08/2014; 36(8):637-645. DOI:10.1007/s001170050122 · 0.43 Impact Factor
  • C Herold · H Prosch · C Schaefer-Prokop ·

    Der Radiologe 05/2014; 54(5):425-6. DOI:10.1007/s00117-013-2598-y · 0.43 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To determine whether gadoxetic acid-enhanced magnetic resonance (MR) imaging can be used to distinguish between simple steatosis and nonalcoholic steatohepatitis (NASH) in patients with nonalcoholic fatty liver disease (NAFLD), defined according to the steatosis activity and fibrosis (SAF) scoring system, which is based on the semiquantitative scoring of steatosis activity and liver fibrosis. Materials and methods: The local institutional review committee approved this study and waived written informed consent. This was a retrospective study of gadoxetic acid-enhanced 3-T MR imaging performed in 81 patients with NAFLD (45 men [56%]; mean age, 56 years; range, 25-78 years). The MR images were analyzed by using the relative enhancement (the ratio of signal intensities of the liver parenchyma before and 20 minutes after intravenous administration of gadoxetic acid). Univariate and multiple regression analyses were applied to identify variables associated with relative enhancement measurements. The ability of relative enhancement to allow differentiation between simple steatosis and NASH was assessed by using area under the receiver operating characteristic (ROC) curve analysis. Results: Relative enhancement negatively correlated with the degree of lobular inflammation (r = -0.59, P < .0001), ballooning (r = -0.44, P < .0001), and fibrosis (r = -0.59, P ≤ .0001), but not with steatosis (r = -0.16, P = .15). Patients with NASH had a significantly lower relative liver enhancement (0.82 ± 0.22) than those with simple steatosis (1.39 ± 0.52) (P < .001). Relative enhancement measurements performed well in the differentiation between simple steatosis and NASH, with an area under the ROC curve of 0.85 (95% confidence interval: 0.75, 0.91) (cutoff = 1.24, sensitivity = 97%, specificity = 63%). Conclusion: Gadoxetic acid relative enhancement was significantly lower in patients with NASH than in patients with simple steatosis, but further prospective studies are warranted.
    Radiology 02/2014; 271(3):131890. DOI:10.1148/radiol.14131890 · 6.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A recent paradigm shift in radiology has focused on the globalization of so-called P4 radiology. P4 radiology represents delivery of imaging results that are predictive, personalized, pre-emptive and participatory. The combination of the P4 approach and biomarkers is particularly pertinent to MRI, especially with technological advances such as diffusion-weighted imaging. The development of new liver-specific MRI contrast media, particularly gadoxetic acid, demonstrate specific pharmacokinetic properties, which provide combined morphologic and functional information in the same setting. The evaluation of hepatobiliary pathology beyond morphology gives rise to the possibilty of using gadoxetic acid-enhanced MRI as an imaging biomarker of hepatobiliary diseases. The integration of functional imaging with an understanding of complex disease mechanisms forms the basis for P4 radiology, which may ultimately lead to individualized, cost-effective, targeted therapy for patients. This will enable radiologists to determine the prognosis of the disease and estimate early response to treatment, with the participation of all the required medical disciplines.
    Expert review of gastroenterology & hepatology 02/2014; 8(2):147-60. DOI:10.1586/17474124.2014.876359 · 2.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To retrospectively assess the use of a combination of cancellous bone reconstructions (CBR) and multiplanar reconstructions (MPRs) for the detection of bone metastases at thoracoabdominal computed tomography (CT) compared with the use of MPRs alone. Materials and methods: The study was approved by the local institutional review board. Included were 156 consecutive patients with confirmed cancer who underwent a whole-body positron emission tomography (PET)/CT examination for clinical purposes (93 male and 63 female patients; mean age ± standard deviation, 59.8 years ± 14.9; range, 11-85 years). Only the CT images were processed with the CBR algorithm, which segments the bones and removes the cortical layer from the images. The PET images served as part of the reference standard. Images from 15 patients were used as a training set. Four radiologists independently evaluated images of half of the remaining 141 patients by using CBRs and MPRs together, and the other half by using MPRs only. Radiologists were blinded to patient names, and patient order was randomized. Results for detection rates and reporting time were recorded and compared with a standard of reference for each patient that was created by one senior radiologist and one nuclear medicine specialist by using all available CT and PET data, CBRs, and follow-up examinations. General estimation equations were used for statistical analysis. Results: There were 349 lesions found in 103 patients, with 203 classified as malignant. Each patient was assessed by two readers per method, leading to a total of 698 lesions. The detection rate for all bone lesions was 35% (247 of 698) for MPRs and 74% (520 of 698) when CBRs and MPRs were used together, which was significantly higher (P < .001). The average reading time decreased from 85 to 43 seconds (P < .001) when both reconstructions were used. Conclusion: Advanced visualization of cancellous bone significantly increased the detection of bone metastases and reduced the time for interpretation.
    Radiology 12/2013; 270(3):130789. DOI:10.1148/radiol.13130789 · 6.87 Impact Factor
  • Source
    M E Mayerhoefer · C J Herold ·

    Der Radiologe 08/2013; 53(8):667-8. DOI:10.1007/s00117-013-2501-x · 0.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The purpose of this study was to use second-generation dual-source CT to assess the influence of size, degree of stenosis, luminal contrast attenuation, and plaque geometry on stenosis quantification in a coronary artery phantom. Materials and methods: Six vessel phantoms with three outer diameters (2, 3, and 4 mm), each containing three radiolucent plaques (72.2 HU) that simulated eccentric and concentric 43.8%, 75%, and 93.8% stenoses were made with a 3D printer system. These phantoms were filled with an iodine-saline solution mixture at luminal attenuations of 150, 200, 250, 300, and 350 HU and were attached to a cardiac motion simulator. Dual-source CT was performed with a standardized ECG-gated protocol (120 kV, 360 mAs per rotation) at a simulated heart rate of 70 beats/min. Two independent readers quantified the degree of stenosis using area-based measurements. Results: All measurements were highly reproducible (intraclass correlation, ≥ 0.791; p < 0.001). The mean measured degree of stenosis for a phantom with a 3-mm outer diameter at 250-HU luminal attenuation was 49.0% ± 10.0% for 43.8% stenosis, 71.7% ± 9.6% for 75.0% stenosis, and 85.4% ± 5.9% for 93.8% stenosis. With decreasing phantom size, measurement error increased for all degrees of stenosis. The absolute error increased for measurements at a low luminal attenuation of 150 HU (p < 0.001) and for low-grade stenoses compared with medium-and high-grade stenoses (p < 0.001). Conclusion: The results are an overview of factors that influence stenosis quantification in simulated coronary arteries. Dual-source CT is highly reproducible and accurate for quantification of low-density stenosis in vessels with a diameter of 3 mm and attenuation of at least 200 HU for different degrees of stenosis and plaque geometry.
    American Journal of Roentgenology 08/2013; 201(2):W227-34. DOI:10.2214/AJR.12.9453 · 2.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The National Lung Screening Trial (NLST) could demonstrate, for the first time, in a prospective randomized trial, that low-dose CT screening (LD-CT) may decrease lung cancer mortality. At the moment, it is unclear how these results will be applicable to Austria. Specifically, the definition of the population at an increased risk for lung cancer and management of the high rate of false-positive results are problematic. As a consequence, lung cancer screening in Austria is recommended following the guidelines of the Austrian Society of Radiology and the Austrian Society of Pneumology. The recommendations suggest that only individuals with a significantly increased risk for lung cancer should be screened (age > 55 years, 30 pack-years, active or former smokers since < 15 years). The screened individuals must be informed about the high probability of false-positive screening results and the necessity for additional follow-up examinations or invasive examinations. The screened individuals must be informed that a CT screening may not prevent them from developing an inoperable lung cancer. In addition, CT screening examinations should be performed with a low-dose CT technique for at least three years at yearly intervals. In view of the high probability of false-positive findings, the evaluation of detected pulmonary nodules should be performed according to an already established standardized protocol.
    Wiener klinische Wochenschrift 06/2013; 125(11-12):339-345. DOI:10.1007/s00508-013-0356-9 · 0.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die chronisch thrombembolische pulmonale Hypertension (CTEPH) ist ein seltenes Krankheitsbild, das vermutlich eine Folgeerscheinung nach rezidivierenden Pulmonalembolien darstellt. Die chirurgische Pulmonalisthrombendarteriektomie ist heute die Therapieoption der Wahl. Zur Planung dieser Operation ist eine exakte Darstellung der thrombotischen Gefäßwandveränderungen Voraussetzung. Als diagnostischer Goldstandard gilt bis heute die Pulmonalisangiographie. Die Einführung der Spiral-CT ermöglichte nun erstmals nichtinvasiv eine gute Kontrastierung der gesamten Pulmonalarterien und damit eine direkte und suffiziente Darstellung der Thromben in zentralen Pulmonalarterien. Sie ist in der Darstellung der Thromben in den zentralen Pulmonalarterien der Pulmonalisangiographie leicht überlegen, während dessen die Angiographie eine bessere Darstellung der Veränderungen in den Segmentarterien gibt. Die Diagnose der CTEPH ist alleine durch die Spiral-CT im Literaturvergleich in etwa 90 % zu stellen. Sowohl die Literatur als auch unsere eigenen Ergebnisse zeigen, daß bei ca. 80 % der Patienten die Entscheidung über die Operabilität des Patienten allein aufgrund der Spiral-CT Untersuchung möglich ist. Die Spiral-CT ist als nichtinvasive Untersuchung sowohl zum Screening als auch zur postoperativen Verlaufskontrolle geeignet und ermöglicht in Kombination mit der Pulmonalisangiographie eine optimale Operationsplanung. Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare result of recurrent pulmonary embolism and is treated by pulmonary thromboendarterectomy. Knowledge of the exact location of the thrombi is necessary in planning this operation. To date, pulmonary, angiography is the diagnostic imaging gold standard. Since the introduction of spiral CT excellent vascular opacification of the pulmonary arteries has become feasible, and thrombi in the pulmonary arteries can be visualized directly. Spiral CT is superior to angiography in demonstrating thrombi in the central pulmonary arteries, whereas angiography proves superior to CT in the evaluation of abnormalities within segmental arteries. The sensitivity of spiral CT in confirming the diagnosis of CTEPH is reported to be more than 90 %. According to the literature and based on our own results, the decision concerning operability is possible on the basis of spiral CT images in more than 80 % of patients with CTEPH. Spiral CT as a non-invasive tool may be used for CTEPH screening, for postoperative follow-up after pulmonary thrombendarterectomy and, combined with pulmonary angiography, to optimize operation planning.
    Der Radiologe 06/2013; 36(6):496-502. DOI:10.1007/s001170050103 · 0.43 Impact Factor
  • ME Mayerhoefer · H Prosch · C Herold · M Weber · G Karanikas ·

    RöFo - Fortschritte auf dem Gebiet der R 04/2013; 185(S 01). DOI:10.1055/s-0033-1346647 · 1.40 Impact Factor
  • C Herold · M F Reiser · A Graser ·

    Der Radiologe 04/2013; · 0.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die onkologische Bildgebung umfasst die morphologische Darstellung der Primärtumorregion zur genauen Einteilung des Tumorstadiums und die der Lymphknotensitutation. Je nach Untersuchungsausdehnung kann auch die Beurteilung einer eventuellen Metastasierung erfolgen, sodass ein Staging nach der TNM(„tumor, node, metastasis“)-Stadieneinteilung möglich ist. Im klinischen Alltag werden diese Fragestellungen durch konventionelle morphologische Bildgebungstechniken, wie Ultraschall (US), Computer- (CT) und Magnetresonanztomographie (MRT), beantwortet. Zusätzlich umfasst die onkologische Bildgebung auch die Verlaufskontrolle von Therapien bei malignen Erkrankungen, um ein Ansprechen zu visualisieren und darüber hinaus nach RECIST(Response Evaluation Criteria In Solid Tumors)- oder WHO-Kriterien zu quantifizieren. Die enorme Dynamik im Bereich der Onkologie und die technischen Innovationen in der Bildgebung stellen eine besondere Herausforderung für die Radiologie dar.
    Der Radiologe 04/2013; 53(4). DOI:10.1007/s00117-012-2431-z · 0.43 Impact Factor
  • P Brader · Y Menu · S Kreuzer · S Polanec · M Mayerhoefer · C J Herold ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Oncologic imaging includes the morphological description of the primary tumor region for an accurate classification of the tumor and lymph node stage and whether distant metastases have occurred according to the TNM staging system. Knowing the stage of the disease helps to plan the treatment and to estimate the prognosis. In clinical routine this is accomplished by conventional imaging techniques, such as ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). Additionally, oncologic imaging is essential in treatment monitoring to visualize and quantify the effect of cancer therapy according to response evaluation criteria in solid tumors (RECIST) and World Health Organization (WHO) criteria. The tremendous development in oncology and technical innovations in imaging represent a particular challenge for radiology.
    Der Radiologe 03/2013; · 0.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: To evaluate the fetal magnetic resonance imaging findings of lymphangiomas. Methods: The magnetic resonance scans of eight fetuses with lymphangiomas were evaluated. Magnetic resonance evaluation included: number; size; signal intensities of the lesions; thickness of the septae; configuration of the margins; presence of blood breakdown products; change in size or signal intensity (in four patients with multiple examinations); exact expansion of the lesions to the adjacent anatomical structures; and concomitant pathological findings. Results were compared with postpartum clinical assessment and imaging in seven patients and with autopsy in one patient. Results: Two retroperitoneal, three thoracic, and three cervical lymphangiomas (diameters between 3.3 and 15.6 cm) were included. All lesions consisted of macrocysts, and additional microcystic parts were found in three lymphangiomas. Blood breakdown products were found in one lesion. Agreement with postpartum imaging was excellent. One patient received intrauterine drainage for chylothorax, and one pregnancy was terminated. Conclusions: Fetal lymphangiomas display the same magnetic resonance imaging features as postnatal lymphangiomas. Intrauterine magnetic resonance characterization of lymphangiomas provides the exact delineation, detection of associated and/or concomitant pathologies, and differential diagnosis among other cystic pathologies. Patient management may be altered with respect to the type and/or time of treatment, and with regard to the continuation or termination of pregnancy.
    Journal of Perinatal Medicine 01/2013; 41(4):1-7. DOI:10.1515/jpm-2012-0226 · 1.36 Impact Factor

Publication Stats

3k Citations
432.56 Total Impact Points

Top Journals


  • 2001-2015
    • Medical University of Vienna
      • Department of Radiology
      Wien, Vienna, Austria
  • 1996-2013
    • Ludwig Boltzmann Institute Of Electrical Stimulation
      Wien, Vienna, Austria
  • 2001-2012
    • Vienna General Hospital
      Wien, Vienna, Austria
  • 2011
    • Ludwig-Maximilians-University of Munich
      • Department of Clinical Radiology
      München, Bavaria, Germany
  • 2007
    • University of Amsterdam
      Amsterdamo, North Holland, Netherlands
  • 2005
    • University Medical Center Utrecht
      Utrecht, Utrecht, Netherlands
  • 1987-2005
    • University of Vienna
      • • Universitätsklinik für Radiodiagnostik
      • • Department of Anaesthesiology and General Intensive Care
      • • Department of Neurobiology
      Wien, Vienna, Austria
  • 2002
    • Ludwig Boltzmann Institute for Experimental and Clinical Traumatology
      Wien, Vienna, Austria
    • Ludwig Boltzmann Institut für Experimentelle und Klinische Traumatologie
      Wien, Vienna, Austria