T A Bley

University Medical Center Hamburg - Eppendorf, Hamburg, Hamburg, Germany

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Publications (160)425.18 Total impact

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    ABSTRACT: Purpose To assess the diagnostic accuracy of contrast material-enhanced magnetic resonance (MR) imaging of superficial cranial arteries in the initial diagnosis of giant cell arteritis (GCA). Materials and Methods Following institutional review board approval and informed consent, 185 patients suspected of having GCA were included in a prospective three-university medical center trial. GCA was diagnosed or excluded clinically in all patients (reference standard [final clinical diagnosis]). In 53.0% of patients (98 of 185), temporal artery biopsy (TAB) was performed (diagnostic standard [TAB]). Two observers independently evaluated contrast-enhanced T1-weighted MR images of superficial cranial arteries by using a four-point scale. Diagnostic accuracy, involvement pattern, and systemic corticosteroid (sCS) therapy effects were assessed in comparison with the reference standard (total study cohort) and separately in comparison with the diagnostic standard TAB (TAB subcohort). Statistical analysis included diagnostic accuracy parameters, interobserver agreement, and receiver operating characteristic analysis. Results Sensitivity of MR imaging was 78.4% and specificity was 90.4% for the total study cohort, and sensitivity was 88.7% and specificity was 75.0% for the TAB subcohort (first observer). Diagnostic accuracy was comparable for both observers, with good interobserver agreement (TAB subcohort, κ = 0.718; total study cohort, κ = 0.676). MR imaging scores were significantly higher in patients with GCA-positive results than in patients with GCA-negative results (TAB subcohort and total study cohort, P < .001). Diagnostic accuracy of MR imaging was high in patients without and with sCS therapy for 5 days or fewer (area under the curve, ≥0.9) and was decreased in patients receiving sCS therapy for 6-14 days. In 56.5% of patients with TAB-positive results (35 of 62), MR imaging displayed symmetrical and simultaneous inflammation of arterial segments. Conclusion MR imaging of superficial cranial arteries is accurate in the initial diagnosis of GCA. Sensitivity probably decreases after more than 5 days of sCS therapy; thus, imaging should not be delayed. Clinical trial registration no. DRKS00000594 © RSNA, 2014.
    Radiology 08/2014; · 6.34 Impact Factor
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    ABSTRACT: To assess deep temporal artery and temporalis muscle involvement in patients with giant cell arteritis (GCA).
    European radiology. 06/2014;
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    ABSTRACT: Purpose: Marfan syndrome (MFS) is a genetic disorder of the connective tissue. Aortic root dilation is a main criterion of the Ghent Nosology. Dural ectasia and the presence of mitral valve prolapse (MVP) contribute to its systemic score. The purpose of this study was to investigate the frequency of dural ectasia and its correlation with cardiovascular manifestations in a pediatric study population.Patients and methods: 119 pediatric patients with confirmed or suspected MFS were examined in the local Marfan Clinic. 31 children with MFS who underwent magnetic resonance imaging (MRI) were included. Each patient was evaluated according to the Ghent nosology. Echocardiography was used to measure the aortic root diameter and assess the presence of MVP and mitral regurgitation. Z-scores were calculated for the evaluation of the aortic root diameters. MRI was performed to determine the dural sac ratio (DSR).Results: The prevalence of dural ectasia was 90.3 %, of aortic root dilation 32.2 %, of MVP 64.5 % and of mitral regurgitation 51.6 %. DSR at L5 correlated with the intraindividual z-scores (slope, 3.62 ± 1.5 [0.56; 6.68]; r = 0.17; p = 0.02; F = 5.84). Z-scores ≥ 2 were accompanied by dural ectasia in 100 %, MVP in 95 % and mitral regurgitation in 100 % of cases. MVP was accompanied by mitral regurgitation in 70 % of cases.Conclusion: As the examined cardiac manifestations show a coincidence with dural ectasia in 95 - 100 % of cases, MRI for diagnostic dural sac imaging should be reserved for MFS suspicions with the absence of those manifestations in order to establish the diagnosis according to the Ghent criteria. Thus, the present study supports the recent downgrading of dural ectasia to a contributor to the systemic score.Citation Format:
    RöFo - Fortschritte auf dem Gebiet der R 09/2013; · 2.76 Impact Factor
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    ABSTRACT: BACKGROUND: There is growing concern over the long-term radiation exposure from serial computed tomographic (CT) scan follow-up after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs). Screening for endoleaks with non-contrast-enhanced volumetric CT has been shown to significantly reduce radiation doses. We evaluated the use of NCT as the primary method of follow-up after EVAR of AAAs. METHODS: Our institutional post-EVAR CT protocol consisted of contrast-enhanced CT angiography (CTA) 1 month after repair, followed by NCT at 3 or 6 and 12 months, and annually thereafter. At each follow-up scan, immediate 3-dimensional volume analysis was performed. If the volume change was <2%, NCT follow-up was continued. If the volume increased by ≥2% on nonenhanced images, contrast-enhanced CT was performed immediately to identify potential endoleaks. All images were reviewed by an experienced cardiovascular radiologist. End points included identification of endoleak, reintervention, and rupture. RESULTS: Over a 7-year period, 126 patients were followed. Serial CTA was performed in 59 patients, while 67 patients were followed with the NCT protocol. The mean follow-up was 2.07 years. There were no differences in age, sex, or initial aneurysm volume or size. There were 35 total endoleaks identified. Twenty of these were early endoleaks (<30 days post-EVAR). The remaining 15 leaks were late in nature (10 in the contrast group and 5 in the noncontrast group; P = 0.17). NCT aneurysm sac volume changes prompted contrasted studies in all 5 late leaks. The mean volume change was 11.2 cm(3), an average change of 5.88%. These findings were not significantly different than the late leaks found by routine contrast studies (8.9 cm(3); 4.98% [P = 0.58]). There were no delayed ruptures or emergent reinterventions in the NCT group. CONCLUSIONS: Serial NCT appears to be safe and effective as the sole means of follow-up after EVAR for AAAs. AAA volume increases of ≥2% should prompt further contrast-enhanced CT imaging. Changes of <2% can be safely followed with serial NCT. This protocol requires dedicated cardiovascular radiologist involvement, and patients should be retained in the radiology suite until real-time image evaluation can be completed.
    Annals of Vascular Surgery 05/2013; · 0.99 Impact Factor
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    ABSTRACT: OBJECTIVE: To evaluate the association between aortic arch calcifications (AAC) on chest radiography and coronary artery calcium (CAC) score determined by CT. METHODS: A total of 128 patients (75 men; 69.3 ± 14.7 years) who underwent chest radiography and CAC scoring at CT were included in this retrospective analysis. The extent of AAC on chest radiography was evaluated independently by two blinded observers using a semi-quantitative four-point scale (0-3). Intra- and interobserver agreement was assessed by weighted ĸ statistics. Amount of AAC determined on radiography was correlated with CAC and ROC analyses performed to characterise the diagnostic performance of AAC grading. RESULTS: Excellent intraobserver (ĸ = 0.82) and good interobserver (ĸ = 0.75) agreement of AAC grading was noted. Moderate agreement (ĸ = 0.46, 95 % CI 0.36-0.56) with a linear trend (P < 0.0001) between AAC grades and CAC scores was found. Cut-off between AAC grades 0-2 and 3 had a sensitivity of 38.6 %, specificity of 96.4 %, PPV of 85.0 %, NPV of 75.0 % and accuracy of 76.6 % for the correct identification of CAC scores greater than 400. CONCLUSION: Semi-quantitative AAC grading on chest radiography is reliable and positively associated with CAC scoring. We propose to report the extent of AAC in comprehensive radiological reports as "not present", "moderate" or "severe", as severe AAC strongly suggests coronary artery calcification. KEY POINTS: • Semi-quantitative aortic arch calcification (AAC) grading on plain chest radiography appears reliable. • AAC grading is positively associated with CT coronary artery calcium scoring. • AAC grading has a high specificity for ruling out CAC scores greater than 400. • We propose the reporting of the extent of AAC grade in chest X-ray (CXR) reports.
    European Radiology 05/2013; · 4.34 Impact Factor
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    ABSTRACT: Giant cell arteritis (GCA) is the most common systemic vasculitis in persons aged 50 and above (incidence, 3.5 per 100 000 per year). It affects cranial arteries, the aorta, and arteries elsewhere in the body, e.g., in the limbs. We selectively review the pertinent literature, including guidelines and recommendations from Germany and abroad. The typical symptoms of new-onset GCA are bitemporal headaches, jaw claudiacation, scalp tenderness, visual disturbances, systemic symptoms such as fever and weight loss, and polymyalgia. The diagnostic assessment comprises laboratory testing (erythrocyte sedimentation rate, C-reactive protein), imaging studies (duplex sonography, high-resolution magnetic resonance imaging, positron-emission tomography), and temporal artery biopsy. The standard treatment is with corticosteroids (adverse effects: diabetes mellitus, osteoporosis, cataract, arterial hypertension). A meta-analysis of three randomized controlled trials led to a recommendation for treatment with methotrexate to lower the recurrence rate and spare steroids. Patients for whom methotrexate is contraindicated or who cannot tolerate the drug can be treated with azathioprine instead. Giant cell arteritis, if untreated, progresses to involve the aorta and its collateral branches, leading to various complications. Late diagnosis and treatment can have serious consequences, including irreversible loss of visual function.
    Deutsches Ärzteblatt International 05/2013; 110(21):376-86. · 3.54 Impact Factor
  • P Bannas, G Adam, T A Bley
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    ABSTRACT: Many scientific manuscripts submitted for publication are flawed by conceptual mistakes. This leads to the rejection of potentially valuable scientific data in renowned journals. This article intends to guide young researchers with respect to writing a well-structured scientific radiological manuscript.
    RöFo - Fortschritte auf dem Gebiet der R 03/2013; · 2.76 Impact Factor
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    ABSTRACT: Purpose: In 2011 a nationwide outbreak of Shiga toxin-producing E. coli (STEC) O104:H4 infection occurred in Germany with severe hemorrhagic colitis and hemolytic-uremic syndrome (HUS). We defined abdominal radiologic findings in these patients and correlated them with clinical parameters. Materials and Methods: 23 patients (7 men; age: 48 ± 19 years) with O104:H4 colitis and/or HUS received abdominal CT (n = 12) or radiographs (n = 11). Colonic distension, air-fluid levels, and free intraabdominal air were assessed. Colonic wall thickening, contrast enhancement, pericolic stranding, and ascites were evaluated on CT. Laboratory parameters and clinical presentation were reviewed. Chi-square test, Student's t-test, McNemar's test and Spearman correlation were performed. Results: Colonic lumen distension was seen in 16/23 patients (69.6 %). The ascending colon (11/23 patients; 47.8 %) and transverse colon (12/23 patients; 52.2 %) were dilated significantly more often (p = 0.006 and p = 0.003, respectively) than the descending colon (1/23; 4.3 %). All 12 patients undergoing CT scanning had abnormally thickened colonic wall segments, 3 (25 %) had pancolic involvement and 9 (75 %) had segmental involvement. The descending colon was predominantly affected (11/12 patients; 91.7 %) and thickened significantly more often than other colonic segments (p < 0.001). Conclusion: The segmental type of STEC O104:H4 colitis mainly affects the descending colon with upstream distension of the transverse/ascending colon and differs from other types of colitis.
    RöFo - Fortschritte auf dem Gebiet der R 02/2013; · 2.76 Impact Factor
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    ABSTRACT: Otorhinolaryngologists require new diagnostic methods to give further insight into the physiology of nasal breathing. The functional aspects of radiological data in the field of ENT have rarely been examined. This study compares computed tomography (CT) scan area measurements of the paranasal sinuses with physiological data from rhinomanometry. In a retrospective study, paranasal CT scans from 36 patients were analysed for volume, width and hydraulic diameter of the five key regions of the nasal cavity (CT rhinometry) and compared to the active anterior rhinomanometric (RMM) results representing the gold standard in nasal flow description. The highest correlation between the rhinomanometric results and CT rhinometry was found at the internal ostium, followed by the diffuser region. The structures important for regulating nasal flow could thus be identified in the CT area data. CT rhinometry revealed structures important for nasal breathing, in addition to providing anatomical and topographical data. CT rhinometry measured volumes, width and hydraulic diameters of the nasal cavity correlated with measurements of transnasal flow.
    HNO 12/2012; 60(12):1067-74. · 0.42 Impact Factor
  • Zeitschrift für Rheumatologie 11/2012; 71(9):775-84. · 0.45 Impact Factor
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    ABSTRACT: Twelve infants (body weight, 3.59±1.36 kg) with congenital heart disease underwent a clinically indicated cardiovascular computed tomography angiography (CTA) study. Retrospectively, we investigated the feasibility and diagnostic capability of different non-electrocardiogram-triggered CTA protocols and assessed radiation doses. Scans were performed on a 256-multislice CT (MSCT) scanner with the vendor-preset helical protocol at 120 kV for babies, with axial single-shoot scans at 120 kV and 80 kV. The 80-kV protocol led to significantly reduced mean effective doses of 0.29±0.08 mSv (P=.017) and renders diagnostic image quality. All major cardiovascular defects were detected on MSCT, and all images were of diagnostic quality.
    Clinical imaging 11/2012; 36(6):746-53. · 0.73 Impact Factor
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    RöFo - Fortschritte auf dem Gebiet der R 10/2012; · 2.76 Impact Factor
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    ABSTRACT: OBJECTIVES: Anemia is associated with increased mortality in patients with acute symptomatic pulmonary embolism (PE). The purpose of this study was to evaluate the feasibility of Hounsfield unit (HU) measurements on the single unenhanced trigger slice of pulmonary CT angiography scans for diagnosis of anemia. MATERIAL AND METHODS: 150 consecutive patients (median age 64±16 years) with suspected PE underwent pulmonary CT angiography. Two radiologists, blinded to laboratory results, performed HU measurements in the single unenhanced trigger scan independently by region-based analysis (ROI). HU values from ascending and descending aorta and the calculated mean of both were correlated with serum hemoglobin levels. Inter- and intraobserver variability was determined for HU measurements, and ROC analysis was performed for diagnosis of anemia. Calculated linear models were used to assess formulas for estimation of hemoglobin levels from HU measurements. RESULTS: HU measurements revealed high intra- and interrater reliability (ICC>0.981 and ICC>0.965, respectively). Calculated mean HU values showed a strong correlation with serum hemoglobin levels (r=0.734), which allowed generation of different formulas for calculation of hemoglobin levels from HU measurements. ROC analyses confirmed a high sensitivity (80.4 for men; 91.3 for women) and specificity (84.0 for men; 84.9 for women) for diagnosing anemia. CONCLUSION: Diagnosis of anemia and quantification of hemoglobin levels upon a single unenhanced trigger scan of pulmonary CT angiography is feasible. We suggest disclosing the anemic state in the radiological report, independent of the presence of PE, since anemia carries increased risks of morbidity and mortality.
    European journal of radiology 08/2012; · 2.65 Impact Factor
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    ABSTRACT: Objective. To compare the impact of initial corticosteroid treatment on high-resolution MRI and colour-coded duplex sonography (CCDS) findings in patients with GCA (temporal). Methods. Sensitivity and specificity of CCDS and high-resolution contrast-enhanced MRI studies of 59 patients with suspected GCA were retrospectively analysed. Patients were grouped according to the duration of steroid treatment before imaging: 0-1 day, 2-4 days and >4 days. In 41 patients, imaging results were compared with findings of temporal artery biopsy (TAB). Results. Sixty-one per cent (36/59) of patients were diagnosed with GCA. TAB findings were positive in 59% (24/41). The compared results of TAB sensitivity of CCDS and MRI under steroid treatment of 0-1 day were 92% and 90%, 2-4 days 80% and 78% and >4 days 50% and 80%, respectively. The compared results of the final clinical diagnosis sensitivity of CCDS and MRI under steroid treatment of 0-1 day was 88% and 85%, 2-4 days 50% and 64% and >4 days 50% and 56%, respectively. Conclusion. Sensitivity of a first-time CCDS or an MRI for detection of GCA rapidly decreases under corticosteroid treatment. Therefore imaging of patients with suspected GCA should be performed as soon as possible, preferably within the first days of treatment.
    Rheumatology (Oxford, England) 07/2012; 51(11):1999-2003. · 4.24 Impact Factor
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    ABSTRACT: The potentials and pitfalls of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in the diagnosis of large vessel vasculitis are summarized in this review article. With the ability to visualize the lumen and vessel walls of large and medium sized arteries, MRI and MRA have great potential to play a unique role in the diagnosis of large vessel vasculitis. This is underlined by the fact that mural inflammatory changes typically involve uptake of contrast agent that can be visualized with MRI. The cranial, intracranial and extracranial involvement pattern can be studied in a combined approach including an MRI examination of the superficial cranial arteries and an MRA examination of the thoracic aorta with its major supra-aortic branches. Typical MRI sequence parameters are given including monophasic MRA and time-resolved MRA protocols at 3 T. The MRI and MRA techniques have the potential to determine the most suitable (inflamed) segment for temporal artery biopsy and to monitor treatment. Initial results of multicenter studies for the diagnostic accuracy of these relatively new methods are expected soon. The MRA technique is recognized as an interesting alternative to invasive catheter angiography for the evaluation of central nervous system (CNS) vasculitis.
    Zeitschrift für Rheumatologie 07/2012; 71(5):430-5. · 0.45 Impact Factor
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    ABSTRACT: To prove the feasibility of using Hounsfield attenuation values at MDCT to detect bone bruises related to sacral insufficiency fractures. Twenty-two patients with acute sacrum trauma and no fracture findings at MDCT were included in our prospective study. Two observers independently reviewed CTs regarding visual signs of bone bruises in 132 defined regions of the sacral alae. Interobserver agreement was tested by κ statistics. Subsequently, HU values were obtained in the same regions, and attenuation differences between the two sides were calculated. Validity and reliability were assessed by intraclass correlation coefficient and Bland-Altman analysis. HU differences were subjected to ROC curve analysis to determine sensitivity, specificity, PPV and NPV. MRI served as standard reference. MRI revealed 19 regions with bone bruises and associated sacral insufficiency fractures. HU measurements demonstrated good validity and reliability (r = 0.989). ROC curve analysis exhibited an ideal cutoff value of 35.7 HU density difference between affected and non-affected regions. Visual evaluation revealed moderate agreement (κ = 0.48); diagnostic accuracy was inferior to objective evaluation. Assessment of differences in bone marrow density by HU measurements is an objective and reliable tool for detection of bone bruises associated with occult sacral insufficiency fractures. KEY POINTS : • Bone bruising is associated with occult sacral insufficiency fractures. • Assessment of differences in bone marrow CT attenuation appears valid and reliable. • Comparative HU measurements of bone marrow allow detection of bone bruises. • Comparative HU measurements have high specificity and negative predictive values. • Comparative HU measurements may make further diagnostic workup with MRI unnecessary.
    European Radiology 05/2012; 22(10):2229-36. · 4.34 Impact Factor
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    ABSTRACT: To compare the diagnostic performance of whole-body MRI (WBMRI) with haematological parameters for detecting persistent or relapsing disease in patients with multiple myeloma after stem cell transplantation. Sixty-six WBMRI acquisitions were performed in 33 patients with multiple myeloma at two time points after stem cell transplantation. Extent of disease and inter-test dynamics of intra- and extramedullary myeloma manifestations were compared (kappa statistics) with Uniform Response Criteria, comprising haematological parameters. Using data from 66 sequential WBMRI acquisitions in 33 patients, 10 patients (30.3 %) were classified as having progressive disease and 23 (69.7 %) as being in remission. Eight (80 %) of the ten patients with progressive disease revealed intramedullary lesions, and two patients (20 %) had intra- and extramedullary lesions. WBMRI and laboratory tests were concordant in 26/33 (78.8 %) patients. We found an agreement of 51.2 %, 95 % confidence interval 19.8 %-82.6 %, between results from WBMRI and haematological parameters. WBMRI had a sensitivity of 63.6 %, specificity of 86.4 %, PPV of 70.0 %, NPV of 82.6 % and accuracy of 78.8 % for detection of remission. WBMRI allows the detection and exact localisation of intra- and extramedullary myeloma manifestations after stem cell transplantation, but shows only moderate agreement with routinely performed laboratory tests for determination of remission.
    European Radiology 04/2012; 22(9):2007-12. · 4.34 Impact Factor
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    ABSTRACT: Computed tomography pulmonary angiography (CTPA) has evolved as the gold standard for diagnosing pulmonary embolism. However, subsegmental arteries are often not assessed to do insufficient attenuation. To evaluate the influence of simultaneous bilateral versus unilateral injection of a fixed amount of contrast media on pulmonary artery opacification and image quality in CTPA. In this institutional review board-approved prospective study, 180 patients (91 women, mean age 61.9 ± 16.5 years) referred for CTPA (100 kV) due to suspected pulmonary embolism were randomized in groups of 45 patients each, with either unilateral (A:4 mL/s; B:6 mL/s) or bilateral (C: 6 mL/s; D: 8 mL/s) (Y-shaped line) injection of 50 mL contrast media. Attenuation was assessed including the subsegmental arteries (4th order). Image quality was evaluated by two readers in consensus using a three-point grading scale (3 = excellent image quality, no artifacts, 1 = non-diagnostic). Mean pulmonary artery attenuation was significantly higher with bilateral injection (1st to 3rd order: A: 303.6 ± 8.8HU; B: 371.1 ± 11.0HU vs. C: 443.2 ± 24.1HU; D: 562.3 ± 15.3HU, P < 0.001). Evaluation of subsegmental arteries was feasible for all patients in groups B-D, but only in 36/45 (80%) patients in group A. Subsegmental attenuation was significantly higher with bilateral injection (A: 284.7 ± 12.1HU; B: 367.4 ± 12.1HU vs. C: 494.2 ± 21.5HU; D: 562.3 ± 26.7HU, P < 0.001). Image quality was diagnostic for all patients but best for group C (A: 2.15 ± 0.4; B: 2.14 ± 0.5; C: 2.92 ± 0.3, and D: 2.51 ± 0.5). Using the same amount of contrast media, bilateral injection yields higher pulmonary artery attenuation and better image quality than unilateral injection. This technique may improve subsegmental pulmonary artery assessment.
    Acta Radiologica 12/2011; 53(1):69-75. · 1.33 Impact Factor
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    ABSTRACT: PURPOSE: Current CT-protocols for staging oral and oropharyngeal cancer include primary transversal slices and secondary tilted slices to avoid artifact-producing regions of dental metalwork. Some of the latest MDCT scanners do not allow gantry tilt. Hence, we assessed the relevance of secondary tilted slices in tumor staging. MATERIALS AND METHODS: Scans of a tiltable 64-row MDCT-scanner of 82 patients with oral or oropharyngeal cancer were retrospectively and independently evaluated twice by three readers: once using the primary transversal scans only, and once taking the transversal and secondary tilted scans into account. Tumor diameters and TN-stage were determined with both methods. Artifacts on transversal scans were analyzed using a 3-point-ranking-scale. RESULTS: Image quality was impaired by severe artifacts in 24% of transversal slices of the oral cavity and in 12% of the oropharynx. The three readers detected an average of 57.7±2.1 of 82 tumors (70%) on transversal CT slices. An average of 6.3±0.6 more tumors (8%) were detected when transversal studies were evaluated in conjunction with secondary tilted slices, leading to a significantly (p=0.0156-0.0313) increased average detection rate of 64.0±2.0 tumors (78%). Moreover, secondary tilted slices led to a correction of underestimated tumor stages in up to six patients (7.3%). CONCLUSION: Tilted slices that avoid artifact-producing regions of dental metalwork significantly improve the reader's sensitivity and are of incremental value for staging of oral and oropharyngeal cancers.
    European journal of radiology 09/2011; · 2.65 Impact Factor
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    ABSTRACT: To investigate the correlation of serum levels of high mobility group box 1 (HMGB1) with the extent of granulomatous inflammation in granulomatosis with polyangiitis (GPA). From 169 patients with GPA, 17 patients with granulomatous inflammation, without evidence of vasculitis were identified and 36 patients without measurable 'granuloma' formation. HMGB1 serum levels were determined and compared between the two groups, using a Mann-Whitney U test. Serum levels of 26 healthy individuals served as controls. In a further 21 patients with GPA with a pulmonary granulomatous manifestation from the study population, CT volumetry of 'granuloma' was performed. Volumes were compared with serum levels of HMGB1 (Spearman rank order test). Serum levels of HMGB1 were significantly higher in patients with predominant granulomatous disease than in patients without measurable 'granuloma' manifestations (6.44 ± 4.53 ng/ml vs 3.85 ± 2.88 ng/ml; p=0.0107). In both groups, levels of HMGB1 were significantly higher than in controls (2.34 ± 2.01 ng/ml; p<0.01). A positive correlation of HMGB1 serum levels with volumes of pulmonary 'granuloma' (r=0.761, p<0.0017) was seen. HMGB1 serum levels are significantly higher in GPA with predominant granulomatous manifestations and correlate with volumes of pulmonary 'granuloma'. HMGB1 may be used as a marker of the burden of granulomatous inflammation in GPA.
    Annals of the rheumatic diseases 08/2011; 70(11):1926-9. · 8.11 Impact Factor

Publication Stats

2k Citations
425.18 Total Impact Points


  • 2010–2012
    • University Medical Center Hamburg - Eppendorf
      • Department of Diagnostic and Interventional Radiology
      Hamburg, Hamburg, Germany
  • 2009–2011
    • University of Wisconsin, Madison
      • Department of Radiology
      Madison, MS, United States
  • 2002–2010
    • University of Freiburg
      • Department of Rheumatology and Clinical Immunology
      Freiburg, Baden-Württemberg, Germany
  • 2006–2009
    • Universitätsklinikum Freiburg
      • Department of Radiology and Radiotherapy
      Freiburg, Lower Saxony, Germany
  • 2008
    • Max Planck Institute of Biochemistry
      München, Bavaria, Germany