B Krug

University of Cologne, Köln, North Rhine-Westphalia, Germany

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Publications (149)234.72 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: BACKGROUND: Our rationale was to evaluate whether a 64-slice CT scanner allows accurate measurement of computed tomographic (CT) changes in coronary artery flow profiles and whether CT flow measurements are suitable for classifying the significance and hemodynamic relevance of a stenosis and thereby supplement as a functional parameter for morphological stenosis analysis. METHODS: A total of 50 patients prospectively underwent computed tomography coronary angiography (coronary CTA) in a multidetector CT scanner (Brilliance 64, Philips)±1 day before or after invasive coronary angiography (ICA). Immediately thereafter, 2 radiologists reviewed the imaging data to detect any vessel segments with morphology poorly evaluable by coronary CTA. A locally constant cyclical measurement was acquired in these coronary arteries in breath-hold technique during the passage of a 50ml bolus of contrast media. For analysis, time-density curves of the bolus passage were registered in the coronary artery and the aorta (internal reference), the up-slopes were determined and correlated with each other. The results were compared with the ICA findings. RESULTS: 47 of 50 CT flow measurements were evaluable. A good correlation was found between the degrees of stenosis and slope ratios in aorta and coronary artery (R(2)=0.92). The threshold corridor was 0.55-0.77 for distinguishing hemodynamically (≥70%) from non-hemodynamically relevant stenoses. CONCLUSIONS: CT-based coronary artery flow measurements (CTFM) correlate well with the angiographically determined degree of stenosis and can elevate by non-invasive means the diagnostic accuracy of coronary CTA. From both a clinically diagnostic and scientific standpoint, CTFM proves a suitable method for quantifying coronary blood flow.
    European journal of radiology 12/2012; · 2.65 Impact Factor
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    ABSTRACT: Structural disconnectivity has been hypothesized as being accountable for the pathophysiology of schizophrenia. Morphometric variables suitable for the empirical study of disconnectivity were studied aiming at the research question whether empirical indicators for disconnectivity are already informative in subjects at risk (SAR) and in young matched patients diagnosed with schizophrenia (SZ). In MRI data of subjects of the two diagnostic groups SZ and SAR, the size of the corpus callosum (CC) as indicator for interhemispherical long distance connections and the gyrification index (GI) as indicator for cortico-cortical connections were analyzed compared to a healthy controls (HC). Each subgroup consists of 21 subjects matched for sex and age. Measurements of the CC and GI were estimated in manually performed tracing procedures. GI data revealed significant differences between the diagnostic groups of both SAR and SZ as compared to HC in the frontal and parietal cortices. Measurements of total CC yielded no significant differences between diagnostic groups. The results are suggestive for impaired cortico-cortical connections as indicated by gyrification changes in SZ and also in SAR, whereas interhemispherical connectivity at the same time appears to be unaffected.
    European Archives of Psychiatry and Clinical Neuroscience 07/2012; · 2.75 Impact Factor
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    ABSTRACT: Der retroperitonealen Fibrose (RPF) liegt eine entzündliche Bindegewebsproliferation ungeklärter Ätiologie mit Bevorzugung des Retroperitoneums zugrunde. Die Beteiligung des ableitenden Harntraktes manifestiert sich durch uni- oder bilaterale Ureterobstruktion bis hin zur Anurie und Urämie. Aufgrund der ungeklärten Ätiologie wird das therapeutische Vorgehen – konservativ versus operativ – kontrovers diskutiert. Im folgenden berichten wir über unsere Ergebnisse in der Behandlung der RPF. Von 1986 bis 1997 wurde bei 39 Patienten die Diagnose einer RPF gestellt, 21 mal lag eine primäre, 18 mal eine sekundäre RRF vor. 21 Patienten wiesen eine uni-, 16 Patienten eine bilaterale und 2 Patienten keine Harnstauung auf. In allen Fällen einer primären RPF fand sich eine beschleunigte BSG, 5/21 wiesen eine beginnende Niereninsuffizienz auf, ein erhöhtes C-reaktives Protein lag bei 16/21 vor. Bei der sekundären RPF fand sich in 4 Fällen eine Erhöhung der Retentionswerte. Bei 19/21 Patienten erfolgte die primäre Entlastung der Niere mit anschließender Cortison- und/oder Azathioprintherapie über 6 Monate; eine Besserung sahen wir in allen Fällen, eine komplette Remission in 2 Fällen. Bei 19 Patienten war eine operative Intervention notwendig: 17 mal Ureterolyse mit Intraperitonealisierung (n = 10) bzw. Omentum-majus-Ummantelung (n = 7). Bei 1 Patienten war die bilaterale Boari-Plastik, bei 1 Patienten ein bilaterales Ileum-Ureterinterponat notwendig. Bei 16/18 Patienten mit sekundärer RPF erfolgte die primäre Entlastung der Niere gefolgt von Ureterolyse und Omentum-majus-Ummantelung (n = 11), Harnleiter- Ileuminterponat (n = 3), Nephrektomie (n = 1) und endoluminale Ballondilatation (n = 3). Das Follow-up variiert zwischen 6 und 120 Monaten: 3 Patienten mit primärer RPF und 1 Patient mit sekundärer RPF entwickelten ein Rezidiv; die Abflußverhältnisse der übrigen Patienten sind unauffällig. Aufgrund der Therapieergebnisse unserer Serie halten wir die kombinierte operative/immunsupprimierende Behandlung bei der primären RPF für erfolgversprechend; dabei geben wir der präoperativen Cortisontherapie mit nachfolgender Ureterolyse und Omentum-majus-Ummantelung den Vorzug. Bei sekundärer RPF bietet sich die primäre operative Versorgung mittels Ureterolyse und Omentum-Ummantelung an; lediglich bei kurzstreckiger extrinsischer Kompression sollte der Ballondilatation der Vorzug gegeben werden. Retroperitoneal fibrosis (RPF) is an uncommon inflammatory disease of the retroperitoneum leading to extensive fibrosis with consecutive obstruction of adjacent organs, namely the ureters. Since no consensus on the standard therapy exists, aim of the current study was to evaluate the outcome of 39 patients with RPF. Between 1986 and 1997 39 cases of RPF were diagnosed: 21 cases had primary RPF and 18 patients had secondary RPF after aortofemoral graft (n = 13), radiation (n = 2), or prior retroperitoneal surgery (n = 2). 21 patients demonstrated unilateral and 16 cases had bilateral hydronephrosis, in 2 patients no dilatation was observed. In 28 cases (n = 12 primary RPF, n = 16 secondary RPF) intial management consisted of DJ-stent placement, whereas in 11 cases (n = 9 primary RPF, n = 2 secondary RPF) percutaneous nephrostomy had to be placed. All patients received oral immunosuppressive agents (prednisolone 1 mg/kg, azathioprine 1 mg/kg/day) for 3 months before reevaluation was performed. In case of complete remission, immunosuppressive medication was continued for another 3 months, in case of stable disease or progression surgery was performed. In 26 cases (n = 15 primary RPF, n = 11 secondary RPF) ureterolysis with intraperitoneal displacement and omental wrapping was performed. 3 patients demonstrated complete remission after oral prednisolone/azathioprine; in 2 cases RPF presented as pelvic mass and was resected followed by immunsuppressive therapy, in another 2 cases bilateral ileal replacement of the ureters had to be performed and 4 cases remained on DJ-stents and nephrostomy, resp. Postoperatively, all patients with primary RPF were continued on immunsuppressive medication for another 3 months. After a follow-up of 6 to 120 months only 3 patients developed a retroperitoneal recurrence and were treated by unilateral nephrectomy or DJ stent placement (n = 2). Our data suggest that the combination of both immunosuppressive medication and surgical management results in an excellent longterm outcome in idiopathic retroperitoneal fibrosis with a recurrence rate of only 8 %. Combination therapy should be considered as therapeutic option early in the course of the disease. Primary reconstructive surgery appears to be the most promising approach in secondary retroperitoneal fibrosis with a recurrence rate of only 5 %; short external compression of the ureter might be managed by endoluminal balloon dilatation.
    Der Urologe 04/2012; 39(2):141-148. · 0.46 Impact Factor
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    ABSTRACT: Cortical thickness (CT) changes possibly contribute to the complex symptomatology of autism. The aberrant developmental trajectories underlying such differences in certain brain regions and their continuation in adulthood are a matter of intense debate. We studied 28 adults with high-functioning autism (HFA) and 28 control subjects matched for age, gender, IQ and handedness. A surface-based whole brain analysis utilizing FreeSurfer was employed to detect CT differences between the two diagnostic groups and to investigate the time course of age-related changes. Direct comparison with control subjects revealed thinner cortex in HFA in the posterior superior temporal sulcus (pSTS) of the left hemisphere. Considering the time course of CT development we found clusters around the pSTS and cuneus in the left and the paracentral lobule in the right hemisphere to be thinner in HFA with comparable age-related slopes in patients and controls. Conversely, we found clusters around the supramarginal gyrus and inferior parietal lobule (IPL) in the left and the precentral and postcentral gyrus in the right hemisphere to be thinner in HFA, but with different age-related slopes in patients and controls. In the latter regions CT showed a steady decrease in controls but no analogous thinning in HFA. CT analyses contribute in characterizing neuroanatomical correlates of HFA. Reduced CT is present in brain regions involved in social cognition. Furthermore, our results demonstrate that aberrant brain development leading to such differences is proceeding throughout adulthood. Discrepancies in prior morphometric studies may be induced by the complex time course of cortical changes.
    NeuroImage 09/2011; 58(2):391-400. · 6.25 Impact Factor
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    ABSTRACT: To describe cortical reorganization after classic hypoglossal-facial nerve anastomosis (HFA) (four patients), hypoglossal-facial nerve jump anastomosis (HFJA) (three patients), and facial nerve interpositional graft (FNIG) (three patients). Prospective case series. Functional magnetic resonance imaging (fMRI) was performed during lip and tongue movement using a block or an event-related design. Despite the presence of some intersubject variability, the following general brain activation patterns were revealed: As expected, lip movements after FNIG led to selective brain activation in the original facial motor cortex, and lip movements after HFA were associated with activation in the hypoglossal motor cortex. Following HFJA, lip movements resulted in overlapping activation encompassing both the original facial and the hypoglossal motor cortex, but tongue movements led solely to strong activation within the original hypoglossal motor cortex. In contrast, tongue movements after HFA were associated with strong activation in the original hypoglossal motor cortex and weaker activation in the facial motor cortex. Direct facial nerve repair (FNIG) leads to restoration of the original cortical activation. A cross nerve suture (HFA or HFJA) changes cortical activation and leads to different patterns of cortical activation during lip and tongue movements.
    The Laryngoscope 01/2011; 121(4):699-706. · 1.98 Impact Factor
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    ABSTRACT: Cell therapy (CTx) is a strategy to support cardiac regeneration after myocardial infarction (MI). Thus far, clinical studies provided mixed results. Here, we investigated whether transmurality of the infarct may play a relevant role. 18 patients (63 ± 3 years, 15 male) undergoing elective coronary artery bypass graft (CABG) surgery 2.2 ± 0.7 months post MI participated. 10 had transmural and 8 non-transmural infarct scars assessed by Tc-99m-MIBI Single-Photon Emission Computed Tomography (SPECT) and F18-FDG-Positron-Emission-Tomography (PET). During surgery, 10 ml of sternal bone marrow were obtained, mononuclear cells (MNC) were isolated. At the end of surgery MNC were injected into the infarctions' center and border zones (10 injections, 2 ml total, 6.6 ± 1.3 × 10(7) MNC). No major complications attributable to cell therapy were observed. The sizes of non-transmural scars were reduced at 3 and 24 months after treatment (7.7 ± 1.1% and 5.5 ± 1.8 vs. 17.5 ± 4.9%, P=0.05 and P=0.04), while transmural scars remained unchanged (23.5 ± 2.6% and 23.8±3.2 vs. 23.5 ± 2.6%, P>0.99 and P=0.95). A trend towards improved LVEF was seen in patients with non-transmural scars (MRI: 48.8 ± 5.1% vs. 30.6 ± 8.7%, P=0.3; SPECT: 54.1 ± 3.1 vs. 41.0 ± 4.0, P=0.086), but not in patients with transmural scars (MRI: 36.7 ± 3.9 vs. 34.3 ± 5.0, P=0.63, SPECT: 37.8 ± 3.1 vs. 37.9 ± 2.3%, P=0.96). A single hybrid intervention of MNC recovery, purification and injection with CABG-surgery (MNC/CABG) may be an attractive modality for cell therapy. However, no regeneration of avital transmural scar tissue seems to occur, while the contribution of MNC to improved perfusion in non-transmural myocardial infarct scars remains to be determined.
    International journal of cardiology 12/2010; 156(3):303-8. · 7.08 Impact Factor
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    ABSTRACT: To examine in vitro whether an assessment of flow in normal and obstructed vessels is essentially possible using modern multislice CT-scanners. An experimental model allowed known stenoses to be perfused at defined flow rates. Aorta and coronary arteries were simulated by silicone tubes. A pulsatile pump was used to perfuse water through the system with intermittent injection of a bolus of radio-opaque contrast agent. CT-measurements were carried out with slice orientation perpendicular to the tubes. 50-90% concentric stenoses were examined 5 times at 4 different stenosis slice distances. A mathematical algorithm calculated the temporal density changes within a ROI in the tube cross-sections. Quantitative assessment of the data simultaneously acquired with the 16-slice system for the "coronary" and "aortal" time-density curves showed that the model allowed for exclusion of a ≥ 80% stenosis grade with a 99% probability when the slopes of the density increase quotient was > 0.79; a stenosis grade of ≥ 90% could be excluded when the slopes of the density increase quotient was > 0.52. A Quotient > 0.94 for "peak density" was associated with a 99% probability of a stenosis grade ≥ 70%. The 64-slice system allowed stenosis grades of ≥ 80% to be discriminated from lower grades. The general feasibility of the in vitro approach was verified in an in vivo model. The spatial, contrast and temporal resolution of CT scanners with at least 16 detector rows enables qualitative and semiquantitative assessment of stenotic changes in flow.
    The international journal of cardiovascular imaging 10/2010; 27(6):795-804. · 2.15 Impact Factor
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    ABSTRACT: The goal of the study was to investigate the size of the corpus callosum (CC) and its subsegments in relation to total brain volume (TBV) as an empirical indicator of impaired connectivity in autism with special respect to gender. In MRI data sets of 29 adults with high-functioning autism (HFA) and 29 age-, gender- and IQ-matched control subjects, the TBV was measured and the CC was analyzed as a whole and in subsegments employing two different manual segmentation procedures. With respect to diagnosis, there were no significant differences in the dependent variables (CC, CC subsegments, and TBV). With respect to gender, only TBV was significantly increased in males compared with females, resulting in a significantly decreased CC/TBV ratio in males. This finding, however, was independent from gender and can be fully attributed to brain size. Our findings do not support the following hypotheses: (1) a hypothesis of impaired CC in HFA adults as a subgroup of patients with autism spectrum disorders, and (2) the sexual dimorphism hypothesis of the CC.
    Psychiatry Research 07/2010; 183(1):38-43. · 2.46 Impact Factor
  • Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren - ROFO-FORTSCHR RONTGENSTRAHL. 01/2010; 182.
  • Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren - ROFO-FORTSCHR RONTGENSTRAHL. 01/2010; 182.
  • Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren - ROFO-FORTSCHR RONTGENSTRAHL. 01/2010; 182.
  • H.T. Eich, B. Krug
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    ABSTRACT: Grundlage der stadienadaptierten Therapie maligner Lymphome ist die Detektion befallener Lymphknoten bzw. Lymphknotenregionen anhand der Ann-Arbor-Klassifikation. Das initiale Staging, Verlaufskontrollen unter Therapie sowie die Nachsorge erfolgen primär durch die Computertomographie (CT). Die MR-Tomographie (MRT) liefert im Staging gleichwertige Ergebnisse wie die CT, wird aber in der Routinediagnostik überwiegend zum Nachweis eines Befalls des ZNS oder des Knochenmarks eingesetzt. Die CT stellt die Basis für die Bestrahlungsplanung dar. Die 3D-CT-gestützte rechneroptimierte Bestrahlungsplanung ist Grundlage für die beim Hodgkin-Lymphom heute routinemäßig praktizierte „Involved-Field“-Radiotherapie. Dieses gilt auch für die mögliche weitere Reduktion der Bestrahlungsvolumina im Sinne einer „Involved-Node“-Radiotherapie. Die elektronische Ergänzung der CT-basierten Bestrahlungsplanung durch die Informationen der FDG-PET (Fluor-18-Desoxy-glucose-PET) erscheint attraktiv. Ihr Nutzen muss in weiteren Studien überprüft werden. The basis for stage-adapted treatment of malignant lymphomas is the detection of involved lymph nodes as well as lymph node regions according to the Ann Arbor classification system. Computed tomography (CT) is the method of choice for the initial staging, treatment response, and relapse analysis. Although the results of magnetic resonance imaging (MRI) for staging are comparable to those of CT, MRI is mainly used as an adjunct to assess the involvement of the central nervous system or bone marrow. CT is the basis for modern radiation treatment planning. Nowadays, three-dimensional CT treatment planning is routinely used for“involved field” radiotherapy of Hodgkin’s lymphoma, as well as for the new target volume concept known as involved-node radiotherapy. The additional use of electronic fluorodeoxyglucose positron emission tomography information in CT-based radiation treatment planning is attractive, but its value must be analysed in further studies.
    Der Onkologe 01/2009; 15(5):502-511. · 0.13 Impact Factor
  • Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren - ROFO-FORTSCHR RONTGENSTRAHL. 01/2009; 181.
  • Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren - ROFO-FORTSCHR RONTGENSTRAHL. 01/2009; 181.
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    ABSTRACT: Neue onkologische Therapiekonzepte beinhalten zunehmend „targeted drugs“. Diese neue Medikamentengruppe wirkt im Gegensatz zur konventionellen Chemo- und Strahlentherapie nicht zytotoxisch, sondern hemmt die Neubildung von Tumorgefäßen (antiangiogen), zerstört bereits gebildete Tumorgefäße (antivaskulär) oder induziert die Apoptose. Eine Größenreduktion des Tumors wird oft erst nach längerer Zeit beobachtet. Daher spiegelt ein rein morphologisch begründetes Therapiemonitoring anhand der üblicherweise verwendeten RECIST-Kriterien die Medikamentenwirkung nicht ausreichend wider. Dies findet in den aktualisierten RECIST-1.1-Kriterien ansatzweise Berücksichtigung. Neben der hohen Detailauflösung sind die radiologischen Schichtbildverfahren Computertomographie (CT) und Magnetresonanztomographie (MRT) in der Lage, die Tumorangioneogenese zu beurteilen (Perfusions- und Permeabilitätsbestimmungen) und unter Nutzung neuer spezifischer Kontrastmittel (KM), diffusionsgewichteter MR-Sequenzen und der MR-Spektroskopie proliferative und regressive Prozesse im Tumorgewebe auf der molekularen Ebene darzustellen. New antitumor therapy concepts often include “targeted drugs.” In contrast to chemotherapy or radiation therapy, targeted drugs have antiangiogenic rather than cytotoxic effects. Because tumor shrinkage often takes time, therapy monitoring with conventional morphology-based response evaluation criteria in solid tumors (RECIST) is insufficient, leading to the latest version, RECIST1.1. Computed tomography (CT) and magnetic resonance imaging (MRI) offer excellent spatial resolution. Recent advances in hardware and software enable monitoring of tumor angiogenesis with CT and MRI. Molecular MR contrast agents, diffusion-weighted MRI, and MR spectroscopy can visualize molecular tumor processes. In this article, the basic principles of these imaging techniques are discussed.
    Der Onkologe 01/2009; 15(5):457-464. · 0.13 Impact Factor
  • H. T. Eich, B. Krug
    Onkologe. 01/2009; 15(5):502-511.
  • B. Krug, K. Lackner
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    ABSTRACT: Ein vorwiegend von der Großgeräteindustrie und berufspolitischen Interessenverbänden verfolgter Weg zur Steigerung der Spezifität der PET (Positronenemissionstomographie) ist die elektronische Überlagerung von PET- und CT-Bildern, die an Hybridanlagen gewonnen wurden (integriertes PET-CT). Hierbei wird jedoch kein qualitativ neuer diagnostischer Parameter erzeugt. Alle Informationen sind bereits in den Einzeldatensätzen enthalten. Nach den Kriterien der evidenzbasierten Medizin und aus der Sicht des Strahlenschutzes bestehen nur wenige medizinisch gesicherte Indikationen für die Durchführung einer PET-CT-Untersuchung. Die alternative Fusion separat akquirierter Bilddatensätze hat den Vorteil der freien Modalitätenwahl. Voraussetzung ist lediglich, dass die gleiche Körperregion mit ähnlichen geometrischen Messparametern untersucht wurde. Weitere Vorteile liegen in den geringeren Kosten bei dieser Vorgehensweise und der Unabhängigkeit von der Beschaffung und Instandhaltung dedizierter Hybridgroßgeräte. Electronic fusion of PET and CT image data sets obtained with hybrid PET-CT systems (integrated PET-CT) in order to improve the specificity of PET examinations is mainly supported by industrial and professional policy pressure groups. However, no qualitatively new diagnostic parameter is created by hybrid technologies. All diagnostic information is already provided by the original PET and CT images. There are only few medical indications for performing an integrated PET-CT based on the criteria of evidence-based medicine and radiation protection. Alternative electronic fusion of image data sets acquired independently from each other has the advantage of a free choice of modality (CT, MRI, PET) provided that the same body region was assessed using comparable geometric acquisition parameters. Comparatively lower costs and the independence of purchasing and maintenance of hybrid systems are further advantages.
    Der Onkologe 01/2009; 15(5):465-473. · 0.13 Impact Factor
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    ABSTRACT: Absorbable sutures are not well accepted for reconstruction in high-pressure arterial segments because the suture line might break and aneurysmal changes could develop. This hypothesis was checked in the clinical setting of carotid surgery. The morphology of the carotid artery was evaluated by color-coded ultrasound in four groups of patients: group A, 25 patients who underwent standard carotid endarterectomy and patchplasty, including a transverse plication for which absorbable sutures had been used; group B, 10 patients who underwent eversion endarterectomy and reinsertion using absorbable sutures; group C, 15 patients who underwent standard carotid endarterectomy and patchplasty without a transverse placation; group D, 20 patients who suffered from atherosclerotic disease but did not have previous carotid surgery or other carotid pathology. All operations had been performed at least 3 years earlier than the actual examination. Along the internal carotid artery, where an aneurysmal change would have been expected to occur, no differences in absolute size or calculated elliptical cross-sectional vessel area were found. Patients after eversion endarterectomy did not show signs of aneurysmal changes in the area of reinsertion at the carotid bifurcation. Even in the long-term, for this group of patients, no significant aneurysmal changes of arterial reconstructions in carotid surgery performed with absorbable sutures were observed.
    World Journal of Surgery 12/2008; 33(1):145-9. · 2.23 Impact Factor
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    ABSTRACT: We assess whether negative findings on computed tomography (CT), magnetic resonance imaging (MRI), and/or 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) may contribute to the decision-making process of elective neck dissection (eND) in patients with squamous cell carcinoma of the oral cavity or the oropharynx (oSCC) staged cT1-T2 cN0 cM0. We interpreted CT, MRI, and 18FDG-PET images separately, after combining the data of CT with those of 18FDG-PET and the data of MRI with those of 18FDG-PET. Each set of results was then compared with the histopathologic results of ipsilateral or bilateral eND in a prospective, blinded study. The histopathologic examination of 594 lymph nodes revealed 4 metastases less than 4 mm in diameter and 3 micrometastases (less than 2 mm) in 6 of 17 patients. On CT, MRI, and 18FDG-PET, respectively, 5, 5, and 0 cases were true-malignant (true positives) and 4, 10, and 1 cases were false-malignant (false positives). The accuracy was not enhanced by fusing CT with 18FDG-PET or MRI with 18FDG-PET. The detectability threshold of occult metastases appears to be below the spatial and contrast resolution of CT, MRI, and 18FDG-PET. The decision for eND in patients with cT1-T2 cN0 cM0 oSCC cannot be based upon cross-sectional imaging at the resolutions currently available.
    The Annals of otology, rhinology, and laryngology 12/2008; 117(11):854-63. · 1.21 Impact Factor
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    ABSTRACT: Background Verbal learning and memory deficits are frequent among patients with schizophrenia and correlate with reduced magnetic resonance imaging (MRI) volumes of the hippocampus in these patients. A crucial question is the extent to which interrelated structural-functional deficits of the hippocampus reflect a vulnerability to schizophrenia, as opposed to the disorder per se.Method We combined brain structural measures and the Rey Auditory Verbal Learning Test (RAVLT) to assess hippocampal structure and function in 36 never-medicated individuals suspected to be in early (EPS) or late prodromal states (LPS) of schizophrenia relative to 30 healthy controls.Results Group comparisons revealed bilaterally reduced MRI hippocampal volumes in both EPS and LPS subjects. In LPS subjects but not in EPS subjects, these reductions were correlated with poorer performance in RAVLT delayed recall.Conclusions Our findings suggest progressive and interrelated structural-functional pathology of the hippocampus, as prodromal symptoms and behaviours accumulate, and the level of risk for psychosis increases. Given the inverse correlation of learning and memory deficits with social and vocational functioning in established schizophrenia, our findings substantiate the rationale for developing preventive treatment strategies that maintain cognitive capacities in the at-risk mental state.
    Psychological Medicine 05/2008; 38(06):843 - 851. · 5.59 Impact Factor

Publication Stats

660 Citations
234.72 Total Impact Points

Institutions

  • 1987–2012
    • University of Cologne
      • • Institute of Radiological Diagnostics
      • • Department of Internal Medicine
      • • Department of Vascular Surgery
      • • Zoological Institute
      Köln, North Rhine-Westphalia, Germany
  • 2004
    • University of Pennsylvania
      • Department of Radiology
      Philadelphia, PA, United States