Thomas C Lauenstein

University of Duisburg-Essen, Essen, North Rhine-Westphalia, Germany

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Publications (234)604.18 Total impact

  • S Kinner, M L Hahnemann, M Forsting, T C Lauenstein
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    ABSTRACT: Magnetic resonance imaging of the small bowel has been feasible for more than 15 years. This review is meant to give an overview of typical techniques, sequences and indications. Furthermore, newly evaluated promising techniques are presented, which have an impact on the advance of MR imaging of the small and large bowel. Key Points: • T2-weighted sequences both with and without fat saturation and T1-weighted fat saturated sequences prior to and following intravenous injection of a gadolinium-based contrast medium contitute the basics for bowel MR imaging.• Newer MR applications, such as diffusion-weighted imaging or contrast-enhaced dynamic sequences supply addtional information; they should thus be integrated in a regular sequence protocol für bowel MRI.• Additional new modalities like motility imaging and PET/MRI have to be evaluated in future studies. Citation Format: • Kinner S, Hahnemann ML, Forsting M et al. Magnetic Resonance Imaging of the Bowel: Today and Tomorrow. Fortschr Röntgenstr 2015; 187: 160 - 167. © Georg Thieme Verlag KG Stuttgart · New York.
    RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 03/2015; 187(3):160-167.
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    ABSTRACT: PurposeTo investigate whether additional diffusion-weighted imaging (DWI) improves therapy response evaluation by Gd-EOB magnetic resonance imaging (MRI) in hepatocellular carcinoma (HCC) after radioembolization.Materials and Methods Fifty patients with radioembolization for HCC underwent gadobutrol and Gd-EOB MRI with DWI prior to and 30, 90, and 180 days after radioembolization. A combination of gadobutrol MRI, alpha-fetoprotein, and imaging follow-up served as the reference standard. Two radiologists reviewed Gd-EOB alone (Gd-EOB), DWI alone (DWI), and the combination of both (Gd-EOB+DWI) separately and in consensus using a 4-point-scale: 1 = definitely no tumor progression (TP), 2 = probably no TP, 3 = probably TP, 4 = definitely TP. Receiver operating characteristic (ROC) and kappa analysis were performed.ResultsKappa values for Gd-EOB, DWI, and Gd-EOB+DWI ranged between 0.712 and 0.892 (P < 0.001). 30 days after radioembolization three out of 38 patients showed TP, which was missed by DWI in one case. No significant area under the curve (AUC) difference between Gd-EOB (1.0, P = 0.004), DWI (0.881, P = 0.030), and Gd-EOB+DWI (1.0, P = 0.004) was found (P = 0.320). 90 days after radioembolization six out of 28 patients showed TP, which was detected in one patient only by DWI and Gd-EOB+DWI. The AUC did not differ significantly (P = 0.319) between Gd-EOB (0.890, P = 0.004), DWI (1.0, P < 0.001), and Gd-EOB+DWI (1.0, P < 0.001). 180 days after radioembolization five patients showed TP, which in one case was missed by DWI. The AUC did not differ significantly (P1 = 0.322, P2 = 0.369, P3 = 0.350) between Gd-EOB (1.0, P = 0.003), DWI (0.913, P = 0.016), and Gd-EOB+DWI (0.963, P = 0.007).Conclusion Additional DWI does not substantially improve therapy response evaluation by Gd-EOB MRI in HCC after radioembolization but proved helpful in single cases. J. Magn. Reson. Imaging 2014.
    Journal of Magnetic Resonance Imaging 12/2014; · 2.57 Impact Factor
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    ABSTRACT: Background To evaluate the feasibility of 3 Tesla (T) high-resolution and gadolinium enhanced MRI of cartilage (dGEMRIC) in the thin and rounded hip cartilage of patients after acetabular matrix-based autologous chondrocyte transplantation (MACT).Methods Under general ethics approval, 24 patients were prospectively examined 6–31 months after acetabular MACT at 3T using high-resolution proton-density weighted (PDw) images (bilateral PD SPACE, 0.8 mm isotropic; unilateral PD-TSE coronal/sagittal, 0.8 × 0.8 resp. 0.5 × 0.5 × 2.5 mm) as well as T1 mapping (3D-FLASH, 0.78 mm isotropic) in dGEMRIC technique, and clinically scored. The cartilage transplant was evaluated using an adapted MOCART score (maximum 85 points). T1 relaxation times were measured independently by two radiologists. Here, regions of interest were placed manually in automatically calculated relaxation-maps, both in the transplant and adjacent healthy cartilage regions. Interobserver reliability was estimated by means of intraclass-correlation (ICC).ResultsThe transplant was morphologically definable in the PDw images of 23 patients with a mean MOCART score of 69 points (60–80 points, SD 6.5). T1 maps showed a clear differentiation between acetabular and femoral cartilage, but correlation with PDw images was necessary to identify the transplant. Mean T1 relaxation times of the transplant were 616.3 ms (observer 1) resp. 610.1 ms (observer 2), and of adjacent healthy acetabular cartilage 574.5 ms (observer 1) resp. 604.9 ms (observer 2). Interobserver reliability of the relaxation times in the transplant was excellent (ICC-coefficient 0.88) and in adjacent healthy regions good (0.77).Conclusion High-resolution PDw imaging with adapted MOCART scoring and dGEMRIC is feasible after MACT in the thin and rounded hip cartilage. J. Magn. Reson. Imaging 2014.
    Journal of Magnetic Resonance Imaging 12/2014; · 2.57 Impact Factor
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    ABSTRACT: The aim of this study was to assess the diagnostic benefit of diffusion-weighted imaging (DWI) in an (18)F-FDG PET/MR imaging protocol for whole-body staging of women with primary or recurrent malignancies of the pelvis. Forty-eight patients with a primary pelvic malignancy or suspected recurrence of a pelvic malignancy were included in our study. All patients underwent a whole-body (18)F-FDG PET/MR imaging examination that included DWI. Two radiologists separately evaluated the PET/MR imaging datasets without DWI followed by a second interpretation with DWI. First, both readers identified all primary tumors, as well as lymph node and distant metastases. In a second session, PET and DWI data were assessed qualitatively. Image interpretation comprised lesion conspicuity defined as visual lesion-to-background contrast (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale) for all tumors. The results from histopathologic examination and cross-sectional imaging follow-up (≥6 mo) were used as the reference standard. Statistical analysis was performed to assess the significance of differences between obtained values. Among the 122 suspected lesions seen, 98 (80.3%) were considered malignant. PET/MR imaging without DWI had a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 92.9%, 87.5%, 96.8%, 75.0%, and 91.8%, respectively, for the detection of malignant lesions. PET/MR imaging with DWI had slightly higher values (94.9%, 83.3%, 95.9%, 80.0%, and 92.6%, respectively), but the difference was not significant (P > 0.05). In the qualitative assessment of lesion-to-background contrast, PET had significantly (P < 0.05) higher values (3.79 ± 0.58) than DWI (3.63 ± 0.77). Furthermore, significantly (P < 0.05) higher scores were found for diagnostic confidence using PET (2.68 ± 0.64) for the determination of malignant lesions, when compared with DWI (2.53 ± 0.69). DWI in PET/MR imaging has no diagnostic benefit for whole-body staging of women with pelvic malignancies. The omission of DWI for staging or restaging gynecologic cancer may significantly reduce examination times, thus increasing patient comfort without a relevant decrease in diagnostic competence. © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
    Journal of Nuclear Medicine 12/2014; 55(12):1930-5. · 5.56 Impact Factor
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    ABSTRACT: Depiction of the exact arterial liver anatomy as well as identifying potential extrahepatic non-target vessels is crucial for a successful preparation of radioembolization (RE).
    Acta Radiologica 11/2014; · 1.35 Impact Factor
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    ABSTRACT: The objective of this study was to evaluate whether the use of automatically generated maps of bowel motility (motility mapping) in magnetic resonance imaging (MRI) leads to an increased detection rate of inflammatory bowel disease.
    Investigative Radiology 09/2014; · 4.45 Impact Factor
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    ABSTRACT: To evaluate the diagnostic potential of PET/MRI with [(18)F]FDG in recurrent ovarian and cervical cancer in comparison to PET/CT.
    European journal of nuclear medicine and molecular imaging 09/2014; · 5.22 Impact Factor
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    ABSTRACT: Magnetic resonance colonography (MRC) is a well-accepted, noninvasive imaging modality for the depiction of inflammatory bowel disease. Diffusion-weighted imaging (DWI) is very helpful to display inflammatory lesions. The aim of this retrospective study was to assess whether intravenous contrast is needed to depict inflammatory lesions in bowel magnetic resonance imaging if DWI is available.
    Investigative Radiology 09/2014; · 4.45 Impact Factor
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    ABSTRACT: Diffusion-weighted imaging (DWI) is routinely used in magnetic resonance imaging (MRI) of prostate cancer. However, the routine use of b values higher than 1000 s/mm(2) is not clear up to present. Moreover, the complex diffusion behavior of malignant and benign prostate tissues hampers precise predictions of contrast in DWI images and apparent diffusion coefficient (ADC) maps.
    Acta Radiologica 08/2014; · 1.35 Impact Factor
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    ABSTRACT: PurposeTo characterize intermediate and high-risk prostate carcinomas with measurements of standardized uptake values (SUVs) and apparent diffusion coefficient (ADC) values by means of simultaneous [18F] choline PET/MRI.Materials and Methods35 patients with primary prostate cancer underwent simultaneous [18F] choline PET/MRI. From these, 21 patients with an intermediate and high risk constellation who were not under ongoing hormonal therapy were included. Altogether 32 tumor lesions with a focal uptake of [18F] choline could be identified. Average ADC values (ADCaver) minimum ADC values (ADCmin) as well as maximum and mean SUVs (SUVmax, SUVmean) of tumor lesions were assessed with volume-of-interest (VOI) and Region-of-interest (ROI) measurements. As a reference, also ADCaver, ADCmin and SUVmax and SUVmean of non-tumorous prostate tissue were measured. Statistical analysis comprised calculation of descriptive parameters and calculation of Pearson’s product moment correlations between ADC values and SUVs of tumor lesions.ResultsMean ADCaver and ADCmin of tumor lesions were 0.94±0.22×10−3 mm2/s and 0.65±0.21×10−3 mm2/s, respectively. Mean SUVmax and SUVmean of tumor lesions were 6.3±2.3 and 2.6±0.8, respectively. These values were in each case significantly different from the reference values (p<0.001). There was no significant correlation between the measured SUVs and ADC values (SUVmax vs. ADCaver: R = −0.24, p = 0.179; SUVmax vs. ADCmin: R = −0.03, p = 0.877; SUVmean vs. ADCaver: R = −0.27, p = 0.136; SUVmean vs. ADCmin: R = −0.08, p = 0.679).ConclusionBoth SUVs and ADC values differ significantly between tumor lesions and healthy tissue. However, there is no significant correlation between these two parameters. This might be explained by the fact that SUVs and ADC values characterize different parts of tumor biology.
    PLoS ONE 07/2014; 9(7):e101571. · 3.53 Impact Factor
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    ABSTRACT: The objective of this study was to assess the diagnostic value of integrated positron emission tomography/magnetic resonance imaging (PET/MRI) for whole-body staging of patients with recurrent gynecological pelvic malignancies, in comparison to whole-body MRI alone.
    Investigative Radiology 07/2014; · 4.45 Impact Factor
  • Der Nuklearmediziner 07/2014; 37(02):83-89.
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    ABSTRACT: Background Transarterial chemoembolization (TACE) is one of the standard treatments recommended for intermediate stage hepatocellular carcinoma (HCC). At the same time, only little is known about the use of radioembolization with Yttrium-90 microspheres (TARE Y-90) for this subset of patients.AimsTo perform comparative analysis between both locoregional therapies in intermediate HCCs. Primary endpoint was overall survival (OS), while safety, response rate, and time-to-progression (TTP) were considered as secondary endpoints.Methods We collected data of 86 HCC patients in two university hospitals at which conventional TACE with doxorubicin or TARE Y-90 using glass microspheres were performed. The median observation period was 10 months. Patients were followed for signs of toxicity and response. They underwent imaging analysis at baseline and follow-up at regular time intervals.ResultsEighty six HCC patients with intermediate stage B (BCLC) were treated with either TACE (n=42) or TARE Y-90 (n=44). Despite a higher tumor burden in the TARE Y-90 group, the median overall survival (TACE: 18 months vs. TARE Y-90: 16.4 months) and the median TTP (TACE: 6.8 months vs. TARE Y-90: 13.3 months) were not statistically different. The number of treatment sessions, the average rate of treatment sessions per patient, total hospitalization time and rate of adverse events were significantly higher in the TACE cohort.Conclusion In intermediate HCC stage patients, both treatments resulted in similar survival probabilities despite more advanced disease in the TARE Y-90 group. Still, TARE Y-90 was better tolerated and associated with less hospitalization and treatment sessions.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 07/2014; · 4.41 Impact Factor
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    ABSTRACT: To compare [(18) F]FDG PET/MRI with PET/CT for the assessment of bone lesions in oncologic patients.
    European Radiology 06/2014; · 4.34 Impact Factor
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    ABSTRACT: ObjectivesAim of the study was to assess the feasibility and to compare three non-enhanced T1-weighted (w) sequences for liver vessel imaging at 7 Tesla (T).Material and Methods12 healthy volunteers were examined on a 7 T whole-body MR-system. The following non-enhanced sequences were acquired: T1w 2D FLASH, T1w 3D FLASH and Time of flight (TOF)-MRA. Qualitative image analysis was performed by two radiologists including over all image quality as well as vessel delineation of the liver arteries, liver veins and portal vein and the presence of artifacts using a five-point scale (5 = excellent vessel delineation to 1 = non-diagnostic). Contrast ratios (CR), SNR und CNR of the above named vessels in correlation to adjacent liver tissue were calculated for quantitative assessment. For statistical analysis, a Wilcoxon Rank Test was applied.ResultsAll three sequences provided a homogenous hyperintense delineation of the assessed liver vessels. Qualitative image analysis demonstrated the superiority of TOF-MRA, providing best overall image quality (TOF 4.17, 2D FLASH 3.42, 3D FLASH 3.46; p<0.01) as well as highest image quality values for all analyzed liver vessel segments. TOF-MRA was least impaired by B1 inhomogeneity (4.13) and susceptibility artifacts (4.63) out of all three sequences (p<0.01). Quantitative image analysis confirmed the superiority of TOF MRA showing significant higher CR values for all liver vessels (e.g. right hepatic artery TOF 0.47, 2D FLASH 0.09, 3D FLASH 0.11 with p = 0.02 and 0.01, respectively). Providing the lowest standard deviation in noise, TOF showed highest values for SNR and CNR.ConclusionsNon-enhanced T1w imaging in general and TOF MRA in particular, appear to be promising techniques for high quality non-enhanced liver vessel assessment at 7 T.
    PLoS ONE 06/2014; 9(6):e97465. · 3.53 Impact Factor
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    ABSTRACT: To evaluate a potential correlation of the maximum standard uptake value (SUVmax) and the minimum apparent diffusion coefficient (ADCmin) in primary and recurrent cervical cancer based on integrated PET/MRI examinations. 19 consecutive patients (mean age 51.6 years; range 30-72 years) with histopathologically confirmed primary cervical cancer (n = 9) or suspected tumor recurrence (n = 10) were prospectively enrolled for an integrated PET/MRI examination. Two radiologists performed a consensus reading in random order, using a dedicated post-processing software. Polygonal regions of interest (ROI) covering the entire tumor lesions were drawn into PET/MR images to assess SUVmax and into ADC parameter maps to determine ADCmin values. Pearson's correlation coefficients were calculated to assess a potential correlation between the mean values of ADCmin and SUVmax. In 15 out of 19 patients cervical cancer lesions (n = 12) or lymph node metastases (n = 42) were detected. Mean SUVmax (12.5±6.5) and ADCmin (644.5±179.7×10-5 mm2/s) values for all assessed tumor lesions showed a significant but weak inverse correlation (R = -0.342, p<0.05). When subdivided in primary and recurrent tumors, primary tumors and associated primary lymph node metastases revealed a significant and strong inverse correlation between SUVmax and ADCmin (R = -0.692, p<0.001), whereas recurrent cancer lesions did not show a significant correlation. These initial results of this emerging hybrid imaging technique demonstrate the high diagnostic potential of simultaneous PET/MR imaging for the assessment of functional biomarkers, revealing a significant and strong correlation of tumor metabolism and higher cellularity in cervical cancer lesions.
    PLoS ONE 05/2014; 9(5):e96751. · 3.53 Impact Factor
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    ABSTRACT: The aim of this study was to achieve initial experience with non-contrast-enhanced (ne) magnetic resonance angiography (MRA) of the lower leg arteries in patients with peripheral arterial occlusive disease (PAOD) at 7 T. Seven patients with PAOD were examined on a 7-T whole-body magnetic resonance system. A custom-built 16-channel transmit/receive coil and a manually positionable AngioSURF table were used for multistation imaging. For ne-MRA, an axial T1-weighted Turbo-fast low angle shot sequence (repetition time, 700 milliseconds; echo time, 3.84 milliseconds; bandwidth, 930 Hz/pixel; voxel volume, 1 × 1 × 2 mm; matrix, 384 × 288) with phonocardiogram gating was acquired at 7 T. Acquisition time of an entire angiogram covering the vasculature from pelvis to feet amounted to approximately 30 minutes, depending on the patient's heart frequency. All patients underwent a contrast-enhanced MRA (ce-MRA) at 1.5 T as standard of reference. The presence of stenosis and occlusions was evaluated segment based and compared for both MRA techniques. The degree of stenosis was defined as low grade (<50%), high grade (50%-99%), and occlusion (100%). High-grade stenosis and occlusion were considered to be hemodynamically significant stenosis. The 7-T ne-MRA enabled a homogenous, hyperintense artery signal and nearly total venous suppression with accurate delineation of arterial anatomy both proximal and distal to stenotic disease. A total of 154 artery segments were depicted with ce-MRA at 1.5 T. At 7 T, only 124 segments (80.5%) were displayed and involved for analysis, as the iliacal region was displayed incompletely in 4 patients because of the fact that the fixed coil diameter was too small to contain the lower abdomen and pelvis of these patients. In comparison with ce-MRA at 1.5 T as the reference standard, there was total agreement regarding the characterization of an artery segment as being normal or having any kind of stenosis. Of the 124 included segments, 28 segments (23%) had hemodynamically significant stenosis evaluated with 7-T ne-MRA and 26 segments (21%) assessed with 1.5-T ce-MRA. The sensitivity and specificity values of 7-T ne-MRA for detecting segments with hemodynamically significant stenosis were 93% and 98%, respectively. Non-contrast-enhanced MRA by means of T1-weighted Turbo-fast low angle shot imaging at 7 T in patients with PAOD is feasible and allowed for good visualization of stenosis and occlusions in all analyzed artery segments in this small patient group. However, this study also shows the challenges of ultrahigh-field body imaging, and more experience is required to determine the impact of 7-T ne-MRA in clinical practice.
    Investigative radiology 03/2014; · 4.85 Impact Factor
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    ABSTRACT: To quantitatively analyze bone metastases from prostate cancer and correlate the apparent diffusion coefficients (ADCs) and standardized uptake values (SUVs). Fifty-five patients with biopsy-proven prostate cancer or suspected recurrent prostate cancer were examined with simultaneous [(18)F] choline Positron emission tomography (PET)/MRI at 3 T. In 11 patients, thirty-two PET-positive bone lesions could be identified that were located in the field-of-view of the Diffusion weighted imaging-sequence. Region-of-interest and volume-of-interest analyses were performed to measure the mean and minimal ADCs and to assess maximum and mean SUVs of every bone lesion. Correlations between maximum and mean SUVs and mean and minimal ADCs were calculated. The SUVmax of all lesions was 5.5 ± 3.1 (mean ± SD). The SUVmean was 1.8 ± 0.9. The mean ADC (ADCmean) of all lesions was 0.67 ± 0.13 × 10(-3) mm(2)/s. The minimal ADC (ADCmin) of all lesions was 0.56 ± 0.14 × 10(-3) mm(2)/s. There was a moderate but significant inverse correlation of SUVmax vs. ADCmean with a correlation coefficient of -0.4 (p = 0.02). There was also a significant inverse correlation of SUVmax vs. ADCmin with r = -0.41 (p = 0.02). Our initial results demonstrate a moderate but significant inverse correlation between increased choline metabolism and ADC values of bone metastases from prostate cancer. Further research on a multimodality approach using simultaneous PET/MRI in bone metastasis of prostate cancer seems to be justified.
    Annals of Nuclear Medicine 03/2014; · 1.41 Impact Factor
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    ABSTRACT: To assess the effect of gastroduodenal artery (GDA) occlusion prior to selective internal radiation therapy (SIRT) with regards to arterial hepato-intestinal collateralization (HIC). Six hundred and six patients were scheduled for SIRT between 2006 and 2012 at University Hospital Essen, Germany. Digital subtraction angiography (DSA) followed by administration of 99m-technetium labelled human serum albumin microspheres ((99m)Tc-HSAM) and single-photon emission computed tomography combined with computed tomography (SPECT/CT) was initially performed. Depending on vascular anatomy and hepatic tumour load, GDA coil embolization was considered. In subsequent (99m)Tc-HSAM rescans or therapeutic DSA, HIC and its consequences for SIRT were analysed. The GDA was occluded in 86 of 606 patients (14%). Twenty-two of these 86 patients did not undergo SIRT due to the patients' clinical status or SIRT contraindications. In 28 of the remaining 64 patients, newly apparent or reopened HIC were seen either at the site of the proximal GDA (n = 21) or in the periphery of the hepatic arteries (n = 7). In 25 of these 28 patients, the HIC could be occluded or the catheter position could be changed achieving a safe (90)Y application. However, due to the newly visible HIC in three of 28 patients, SIRT was regarded as unsafe and was abandoned. Coil embolization of the GDA may induce arterial hepato-intestinal collaterals. Although most of these collaterals do not impede (90)Y administration, SIRT may become unfeasible in specific occasions. Hence, segmental or lobar SIRT instead of a whole-liver approach with coiling of the GDA is recommended.
    Clinical Radiology 02/2014; · 1.66 Impact Factor
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    ABSTRACT: To compare ultra-high field, high-resolution bilateral magnetic resonance imaging (MRI) of the hips at 7 Tesla (T) with 3 T MRI in patients with avascular necrosis (AVN) of the femoral head by subjective image evaluations, contrast measurements, and evaluation of the appearance of imaging abnormalities. Thirteen subjects with avascular necrosis treated using advanced core decompression underwent MRI at both 7 T and 3 T. Sequence parameters as well as resolution were kept identical for both field strengths. All MR images (MEDIC, DESS, PD/T2w TSE, T1w TSE, and STIR) were evaluated by two radiologists with regard to subjective image quality, soft tissue contrasts, B1 homogeneity (four-point scale, higher values indicating better image quality) and depiction of imaging abnormalities of the femoral heads (three-point scale, higher values indicating the superiority of 7 T). Contrast ratios of soft tissues were calculated and compared with subjective data. 7-T imaging of the femoral joints, as well as 3-T imaging, achieved "good" to "very good" quality in all sequences. 7 T showed significantly higher soft tissue contrasts for T2w and MEDIC compared with 3 T (cartilage/fluid: 2.9 vs 2.2 and 3.6 vs 2.6), better detailed resolution for cartilage defects (PDw, T2w, T1w, MEDIC, DESS > 2.5) and better visibility of joint effusions (MEDIC 2.6; PDw/T2w 2.4; DESS 2.2). Image homogeneity compared with 3 T (3.9-4.0 for all sequences) was degraded, especially in TSE sequences at 7 T through signal variations (7 T: 2.1-2.9); to a lesser extent also GRE sequences (7 T: 2.9-3.5). Imaging findings related to untreated or treated AVN were better delineated at 3 T (≤1.8), while joint effusions (2.2-2.6) and cartilage defects (2.5-3.0) were better visualized at 7 T. STIR performed much more poorly at 7 T, generating large contrast variations (1.5). 7-T hip MRI showed comparable results in hip joint imaging compared with 3 T with slight advantages in contrast detail (cartilage defects) and fluid detection at 7 T when accepting image degradation medially.
    Skeletal Radiology 02/2014; · 1.74 Impact Factor

Publication Stats

3k Citations
604.18 Total Impact Points

Institutions

  • 2003–2014
    • University of Duisburg-Essen
      • • Faculty of Medicine
      • • Erwin L. Hahn Institute for Magnetic Resonance Imaging
      Essen, North Rhine-Westphalia, Germany
  • 2001–2014
    • University Hospital Essen
      • Institute of Diagnostic and Interventional Radiology and Neuroradiology
      Essen, North Rhine-Westphalia, Germany
  • 2013
    • Erwin L. Hahn Institute for Magnetic Resonance Imaging
      Essen, North Rhine-Westphalia, Germany
    • Huazhong University of Science and Technology
      • Department of Infectious Diseases
      Wu-han-shih, Hubei, China
  • 2012
    • Heinrich-Heine-Universität Düsseldorf
      • Institut für Diagnostische und Interventionelle Radiologie
      Düsseldorf, North Rhine-Westphalia, Germany
  • 2007–2009
    • Emory University
      • Department of Radiology
      Atlanta, GA, United States
  • 2008
    • Uppsala University Hospital
      Uppsala, Uppsala, Sweden
  • 2005–2006
    • University of Hamburg
      • • Medical Prevention Center Hamburg (MPCH)
      • • Department of Diagnostic and Interventional Neuroradiology
      Hamburg, Hamburg, Germany
    • Scott & White
      Temple, Texas, United States