J Kaminsky

Publications of J Kaminsky

• [Cranial nerve deficits caused by uncommon skull base lesions of the cavernous sinus]

  Authors: A Gharabaghi, S Heckl, J Kaminsky, W Torka, T Nägele, M Tatagiba, H Löwenheim

  HNO. 05/2007; 55(4):278-80.

• [Intracranial complications of sinusitis sphenoidalis]

  Authors: A Gharabaghi, S Heckl, J Kaminsky, S Paasch, T Nägele, M Tatagiba, H Löwenheim

  HNO. 04/2007; 55(3):202-5.

• Endoscope-assisted retrosigmoid intradural suprameatal approach to the middle fossa: anatomical and surgical considerations.

  Authors: F H Ebner, A Koerbel, A Kirschniak, F Roser, J Kaminsky, M Tatagiba

  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 03/2007; 33(1):109-13.

  INTRODUCTION: Lesions involving the posterior and middle fossa may be reached by several surgical approaches depending mostly on tumors' location and characteristics. The retrosigmoid intraduralINTRODUCTION: Lesions involving the posterior and middle fossa may be reached by several surgical approaches depending mostly on tumors' location and characteristics. The retrosigmoid intradural suprameatal approach has been used to remove tumors of the posterior fossa extending into Meckel's cave and the middle fossa. With large tumors, this approach may allow exposure of the oculomotor and optic nerves, the supraclinoid internal carotid and communicating posterior arteries. METHODS: Three formaldehyde-fixed specimens have been prepared on both sides using the conventional retrosigmoidal-suprameatal approach. The entire endoscopic preparations have been documented via a digital recording system, using a 5mm endoscope with a 25 degrees perspective. The authors describe the anatomical corridor and technique of the endoscope-assisted retrosigmoid intradural suprameatal approach to lesions that are located predominantly within the posterior fossa and supratentorial extension into Meckel's cave, sellar and parasellar region. CONCLUSIONS: The endoscope-assisted suprameatal approach provides exposure of the antero-medial middle fossa even in cases of skull base lesions that have not caused significant displacement of neurovascular structures.

• [Massive epistaxis with haemorrhagic shock in the late phase after skull-base fracture]

  Authors: H Löwenheim, A Koerbel, B Nohé, E Bültmann, B Hirt, J Kaminsky, M Tatagiba, U Ernemann

  HNO. 11/2006; 54(10):768-71.

• Evaluation of surface and volume rendering in 3D-CT of facial fractures.

  Authors: T Rodt, S O Bartling, J E Zajaczek, M A Vafa, T Kapapa, O Majdani, J K Krauss, M Zumkeller, H Matthies, H Becker, J Kaminsky

  Dento maxillo facial radiology. 08/2006; 35(4):227-31.

  OBJECTIVES: Three-dimensional computed tomography (3D-CT) of facial fractures has been reported as beneficial using surface (SR) and volume rendering (VR). There are controversial statementsOBJECTIVES: Three-dimensional computed tomography (3D-CT) of facial fractures has been reported as beneficial using surface (SR) and volume rendering (VR). There are controversial statements concerning the preferable algorithm. The purpose of this study was to evaluate and compare SR and VR for clinical 3D-CT in facial fractures on an experimental basis. METHODS: Multislice CT was obtained in 22 patients with facial fractures using two data acquisition protocols. Five SR and VR post-processing protocols were applied. Five assessors independently evaluated the quality of visualization of the fracture gap and dislocated fragments as well as the overall image quality using a five-point rating scale. The potential benefit of the 3D-images for radiological diagnosis and presentation was evaluated. The influence of the data acquisition protocol was analysed. RESULTS: SR in general achieved better evaluation scores than VR at corresponding thresholds. Variation of evaluation scores for all criteria was found for SR and VR depending on the segmentation threshold. Apart from the overall image quality no significant influence of the data acquisition technique was found for the evaluated criteria. CONCLUSIONS: SR provided sufficient and time efficient means for 3D-visualization of facial fractures in this study. No diagnostic benefit of VR over SR was found.

• [3D-Visualisation of the middle ear by computer-assisted post-processing of helical multi-slice CT data]

  Authors: T Rodt, H P Burmeister, S Bartling, J Kaminsky, B Schwab, R Kikinis, H Becker

  Laryngo- rhino- otologie. 08/2004; 83(7):438-44.

  Post-processing of CT-data allows non-invasive 3D-Visualisation of the middle ear for diagnosis and surgical planning. In this study different post-processing techniques and the clinical applicationPost-processing of CT-data allows non-invasive 3D-Visualisation of the middle ear for diagnosis and surgical planning. In this study different post-processing techniques and the clinical application of a 3D-postprocessing algorithm in a large number of patients are presented. 20 normal patients, 6 dissected temporal bones and 213 patients with suspected middle ear pathology were examined using a low-dosage Multi-Slice CT protocol. Virtual endoscopic views of the middle ear and 3D-images of the ossicles were generated using a standardised algorithm. Evaluation of the image quality was performed. The virtual views of the dissected temporal bones were compared to real views. In 32 patients high-quality 3D-models of the individual anatomical structures were generated and displayed using different visualisation techniques. The standardised and evaluated method enabled visualisation of the normal middle ear anatomy. Assessment of different pathologies, especially malformation, trauma, implants and postoperative alterations, was facilitated. The high-quality 3D-models allowed precise imaging of the anatomical structures. 3D-Visualisation of the middle ear using CT-data is beneficial for radiological diagnosis and surgical planning in cases of complex middle ear pathology as a complementary examination technique.

• [Multisegmental image fusion of the spine]

  Authors: J Kaminsky, T Rodt, J Zajaczek, F Donnerstag, M Zumkeller

  Biomedizinische Technik. Biomedical engineering. 04/2004; 49(3):49-55.

  Fusion of medical images is a technique that permits the correlation of homologous anatomical structures in different imaging modalities on the basis of a spatial transformation of the data sets. CTFusion of medical images is a technique that permits the correlation of homologous anatomical structures in different imaging modalities on the basis of a spatial transformation of the data sets. CT and MRI of the spine provide complementary information of possible relevance for diagnostic and therapeutic decisions. Methods enabling a multisegmental CT-MRI fusion of the spine were developed. These solve the problem of altered spatial relationships of the individual anatomical structures due to differing patient positioning in successive data acquisitions. Routine clinical CT and MRI data of a thoracic section of the spine were obtained and transferred to a PC-workstation. Following segmentation of the CT-data, landmarks for each individual vertebra were defined in the CT and MRI data. For each individual vertebra the algorithm we developed then carried out a rigid registration of the CT information to the MR data. The fused data sets were presented as colour-coded images or on the basis of dynamic variation of transparency. To assess registration precision, fiducial registration errors (FRE) and target registration errors (TRE) were calculated. The algorithm permitted multi-segmental image fusion of the spine. The average time required for defining the landmarks was 22 seconds per landmark for CT, and 34 seconds per landmark for MR. The average FRE was 1.53 mm. The TRE for the vertebrae was less than 2 mm. The colour-coded images were particularly suitable for assessing the contours of the anatomical structures, whereas dynamic variation of the transparency of overlapping CT images enabled a better overall assessment of the spatial relationship of the anatomical structures. The algorithm permits precise multi-segmental fusion of CT and MR of the spine, which was not possible using current fusion-algorithms due to variations in the spatial orientation of the anatomical structures caused by different positioning of the axial skeleton in successive examinations.

• [Three-dimensional-segmentation of the spine with specially adapted tools]

  Authors: J Kaminsky, Th Rodt, A Gharabaghi, W Lüdemann, J Zajaczek, M Samii

  Biomedizinische Technik. Biomedical engineering. 12/2003; 48(11):312-8.

  Segmented 3-D data of the spine form the basis for various modern clinical applications. Among these, multisegmental image fusion, image registration and finite element modeling for biomechanicalSegmented 3-D data of the spine form the basis for various modern clinical applications. Among these, multisegmental image fusion, image registration and finite element modeling for biomechanical analysis are promising innovative tools capable of facilitating treatment decisions and optimization of individual therapy in the future. However, the complex anatomy of the spine and the often extensive degenerative deformation presenting in clinical practice, generally limit the application of fully automated segmentation. A newly developed software system is presented that meets the complex requirements for image segmentation of the spine through the use of specially adapted interactive tools that take account of its axial skeletal structure. Furthermore, a standardized protocol is introduced that combines the newly developed interactive tools (rotation transformation, warped dissection plane) and standard segmentation tools to permit rapid and accurate segmentation. To date, the software environment presented herein has been applied with success to the segmentation of cervical, thoracic and lumbar spine.

• Navigation-guided opening of the internal auditory canal via the retrosigmoid route for acoustic neuroma surgery: cadaveric, radiological, and preliminary clinical study.

  Authors: A Samii, T Brinker, J Kaminsky, W R Lanksch, M Samii

  Neurosurgery. 09/2000; 47(2):382-7; discussion 388.

  OBJECTIVE: We investigated the usefulness of a microscope-based navigational system (Multi Koordinaten Manipulator; Zeiss, Oberkochen, Germany) for removal of the posterior wall of the internalOBJECTIVE: We investigated the usefulness of a microscope-based navigational system (Multi Koordinaten Manipulator; Zeiss, Oberkochen, Germany) for removal of the posterior wall of the internal auditory canal (IAC) via the retrosigmoid route. METHODS: A cadaveric study was performed to assess the navigational localization error for the retrosigmoid approach to the IAC. Computed tomographic findings for 47 acoustic neuroma cases were divided into three groups, on the basis of the relationship between the labyrinth and the sigmoid-fundus line (medial, on the line, or lateral). Furthermore, the shortest distances between the most medial labyrinthine extension and the resection line were measured. In 20 acoustic neuroma operations, the different features and the practicality of the microscope-based navigational system for opening of the IAC were evaluated. RESULTS: The mean anatomic localization errors were 0.67 +/- 0.2 mm (95th percentile, 1.32 mm) for navigation to the IAC and 0.71 +/- 0.37 mm (95th percentile, 1.68 mm) for navigation to the posterior semicircular canal. The average distances between the most medial labyrinthine extension and the resection line were 3.65, 3.36, and 2.0 mm for the lateral, on-the-line, and medial groups, respectively. Direct contouring of structures at risk does not take into account the localization error, nor does it provide reliable navigational information. A novel indirect contouring concept that takes into account the localization error (the safety corridor method) was therefore introduced. CONCLUSION: The value of navigational assistance for opening of the IAC is promising but still limited. Further development is required before the clinical effects of this navigational approach can be evaluated.

• Technical considerations regarding accuracy of the MKM navigation system. An experimental study on impact factors.

  Authors: J Kaminsky, T Brinker, A Samii, G Arango, P Vorkapic, M Samii

  Neurological research. 06/1999; 21(4):420-4.

  The purpose of this study was to investigate experimentally, factors determining the navigation accuracy of the MKM navigation system by Zeiss. The MKM consists of an operating microscope mounted toThe purpose of this study was to investigate experimentally, factors determining the navigation accuracy of the MKM navigation system by Zeiss. The MKM consists of an operating microscope mounted to a six-axis motor-driven robot arm and an alpha-workstation. The image-guided surgery device provides navigation information based on calculation of the cartesian coordinates of the robot arm, and coordinates of the focus point assessed by laser assisted measurement. Navigation information (current position, direction and distance to a previously selected target) is optically projected into the microscopic field. Following factors were examined in an experimental setting for their impact on accuracy of the MKM: optical system, mechanical precision of the robot arm, and registration procedure. The robot arm and the optical system of the microscope allow high precision measurements of any focus point (error < 2 mm if the following aspects are considered: the use of auto-focus function instead of manual focusing, positioning of the registration points as a square or a triangle focus point should be selected on a surface that is perpendicular to the optical axis.

• An experimental approach to image guided skull base surgery employing a microscope-based neuronavigation system.

  Authors: T Brinker, G Arango, J Kaminsky, A Samii, U Thorns, P Vorkapic, M Samii

  Acta neurochirurgica. 02/1998; 140(9):883-9.

  INTRODUCTION: A cadaveric study was undertaken to investigate the usefulness and reliability of a microscope based navigation system (NS) for skull base surgery. MATERIAL AND METHODS: CT-scans (1 mmINTRODUCTION: A cadaveric study was undertaken to investigate the usefulness and reliability of a microscope based navigation system (NS) for skull base surgery. MATERIAL AND METHODS: CT-scans (1 mm slices) were performed in 10 fixed cadaver heads after implantation of fiducials. There upon, various skull base dissections were undertaken: transethmoidal-transsphenoidal approach to sella and clivus, retrosigmoidal approach to the internal auditory canal (IAC) and to the posterior semicircular canal (PSCC). The navigated dissections were performed with the MKM, a microscope based navigation system of Carl Zeiss (Oberkochen, Germany). RESULTS: The registration assessment by the NS yielded a mean deviation of 0.23 mm +/- 0.03 mm (mean +/- SD, n = 7, range 0.19 to 0.27 mm). The real anatomical deviation during dissection was 0.67 mm +/- 0.2 mm for navigation to the IAC and 0.71 mm +/- 0.37 mm to the PSCC. This accuracy was achieved with three fiducials (4 x 1 mm titanium screws) arranged as a triangle (side length 4-6 cm) nearby the surgical field. Navigation data on current position, direction and distance to a target structure were helpful in the transethmoidal-transsphenoidal approach to the clivus, as well as for accessing deep seated structures (C1-C2 junction, petrous bone tip). The contouring feature was beneficial for identifying structures embedded in the bone. However, due to inaccurate 3-D modelling this feature has a restricted reliability. DISCUSSION: Our cadaveric skull base study has shown that the MKM is a reliable tool with high anatomical accuracy and usefulness of most navigation features. However, in order to effectively and reliably use any NS the surgeon must be familiar with its potential features and limitations as is demonstrated in this study.

• The clinico-surgico-pathological spectrum of myxopapillary ependymomas--report of four unusal cases and review of the literature.

  Authors: J Schittenhelm, R Becker, D Capper, R Meyermann, J R Iglesias-Rozas, J Kaminsky, M Mittelbronn

  Clinical neuropathology. 27(1):21-8.

  According to the WHO grading system, myxopapillary ependymomas are assigned to WHO Grade I. However, the clinico-pathological spectrum might be very heterogenous. Herein, we report 4 cases exhibitingAccording to the WHO grading system, myxopapillary ependymomas are assigned to WHO Grade I. However, the clinico-pathological spectrum might be very heterogenous. Herein, we report 4 cases exhibiting lumbar tumor masses, 1 causing muscular atrophy over a 30-year period, 3 displaying clinical history of persisting lumbar pain for only several weeks. All tumors were crooked with dura and spinal roots resulting in incomplete resection in three cases. On histological examination, two tumors were almost acellular and showed polycyclic hyaline and fibrotic extracellular matrix leading to differential diagnoses of chordoma, meningioma, fibrolipoma and ependymoma. Finally, together with the immunohistochemical investigations, electron microscopy led to the diagnosis of myxopapillary ependymoma, WHO Grade I, with massive degenerative changes. The other 2 cases presented with the typical neuropathology of myxopapillary ependymomas but showed local recurrence within 1 and 13 years throughout the whole neuraxis, and in 1 case additional metastases of the 3rd ventricle. Although the morphological feature of these myxopapillary ependymomas was benign, the presented cases showed that the biological behavior of myxopapillary tumors might differ greatly and that these tumors present a serious operative and diagnostic challenge. Myxopapillary ependymomas occur most often in the lumbosacral region. Due to the anatomic complexity of the cauda equina, a complete resection can be technically challenging in this region. However, a gross total resection at the primary surgery is the most predictive factor for the outcome.

• Universal interface for exchange of medical images via magneto-optical discs.

  Authors: J Kaminsky, B Kischnik, G Graubner, A Newe, J Lotz, S Hussein, H Becker, M Samii

  Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society. 24(2):99-104.

  Digital images are the ever-growing basis of modern medical imaging and treatment. Despite the advent of the DICOM 3.0 standard for medical image communication it still requires cumbersome efforts toDigital images are the ever-growing basis of modern medical imaging and treatment. Despite the advent of the DICOM 3.0 standard for medical image communication it still requires cumbersome efforts to export images from imaging modalities to other computer systems. This is true especially for smaller institutions, which often have limited resources for standardized image transfer. To gain access even to these data we developed an exchange interface on the basis of magneto-optical discs (MO-discs), as they are usually available in most of the imaging modalities in use today. Unfortunately images on MO-discs are usually stored in formats specific for each manufacturer. Therefore special routines to access the data on MO-discs had to be developed for each company or even each scanner. Over 10,000 CT and MRI images including their header information from different General Electric and Siemens scanners were extracted successfully from MO-discs. The interface proved to be reliable and easy to handle by technicians. Support of additional manufacturers and of the DICOM 3.0 standard are work in progress.

• Rosai-Dorfman disease involving the cranial base, paranasal sinuses and spinal cord.

  Authors: J Kaminsky, A Koerbel, M Mittelbronn, R Beschorner, U Ernemann, M Tatagiba

  Clinical neuropathology. 24(4):194-200.

  Rosai-Dorfman disease is a lymphoproliferative disease that rarely involves the central nervous system. A 32-year-old patient with an extensive process involving the petroclival region, cavernousRosai-Dorfman disease is a lymphoproliferative disease that rarely involves the central nervous system. A 32-year-old patient with an extensive process involving the petroclival region, cavernous sinuses, suprasellar region, anterior cranial fossa, paranasal sinuses, nasal cavity and spinal cord is reported. Sinus histiocytosis with massive lymphadenopathy lesions may be dural-based and located in the skull base. As these lesions may clinically and radiologically mimic meningiomas as well as other disorders, Rosai-Dorfman disease should be included in the differential diagnosis of extensive lesions involving the intracranial and spinal compartments along with meningiomatosis and inflammatory diseases. The individual management of Rosai-Dorfman disease may be challenging due to diffuse involvement of neurovascular structures at the skull base.

• [Development of a universal interface for the exchange of medical image data using magneto-optical media]

  Authors: J Kaminsky, Th Rodt, A Newe, F Donnerstag, M Zumkeller

  Biomedizinische Technik. Biomedical engineering. 49(1-2):6-10.

  Digital images generated by medical imaging form the basis for radiological diagnosis and surgical planning. Despite the advent of the DICOM 3.0 standard for medical image communication, widespreadDigital images generated by medical imaging form the basis for radiological diagnosis and surgical planning. Despite the advent of the DICOM 3.0 standard for medical image communication, widespread application of the existing information is often limited by incompatibility of the data formatting used by different equipment generations, and the manufacturer-specific standards employed. An exchange interface based on magneto optical discs has been developed to retrieve and present medical image data regardless of the technological hardware and the specific formats used. Specially adapted routines to retrieve the data first had to be developed. A modular program structure was used to allow flexibility in the implementation of further routines and other exchange media. Over 20,000 CT and MRI images including header information obtained from different General Electric and Siemens scanners were extracted successfully from MO discs. The image data were used for follow up and surgical planning and were transferred to a PAC-server. The interface proved reliable and easy to use. Support for further proprietary formats is currently being developed. The present exchange interface permits reliable retrieval of digital images for diagnostic and surgical planning purposes, regardless of the hardware generation and manufacturer-specific formats.