Helmut Prosch

Helmut Prosch
Medical University of Vienna | MedUni Vienna · Department of Biomedical Imaging and Image-guided Therapy

Assoc. Prof. PD Dr.

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291
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Publications

Publications (291)
Article
Objectives Content-based image retrieval systems (CBIRS) are a new and potentially impactful tool for radiological reporting, but their clinical evaluation is largely missing. This study aimed at assessing the effect of CBIRS on the interpretation of chest CT scans from patients with suspected diffuse parenchymal lung disease (DPLD). Materials and...
Article
Rationale: Pulmonary hypertension (PH) is a common, yet severe comorbidity in interstitial lung diseases (ILD) such as pulmonary fibrosis (PF), with limited treatment options. Excessive vascular fibrosis and inflammation are often present in PH, but the underlying mechanisms are still not well understood. Objective: To identify a novel functiona...
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Zusammenfassung Klinisches Problem Raucherassoziierte interstitielle Lungenerkrankungen umfassen heterogene pulmonale Pathologien, deren korrekte Diagnostik prognostische und therapeutische Konsequenzen hat. In diesem Artikel werden die gängigsten raucherassoziierten interstitiellen Lungenerkrankungen beschrieben sowie eine strukturierte Herangehe...
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Purposes Programmed death-ligand 1 (PD-L1) testing is performed mainly on biopsy specimens in patients with advanced lung cancer. It is questionable whether the small amount of tissue analysed in biopsies may represent the true PD-L1 expression of a tumour. Methods In this retrospective study, PD-L1 expression on tumour cells derived from bronchos...
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Background Long-lasting symptoms following SARS-CoV2-infection have been described in several studies. However, there is only limited knowledge about the ongoing pathophysiology and the association with pathological findings in medical examinations. Methods In this post hoc analysis of a prospective trial, 135 patients following COVID-19 were enro...
Article
Zusammenfassung Die Lungenbeteiligung ist die häufigste Todesursache bei Patienten mit systemischer Sklerose (SSc). Da eine Lungenbeteiligung häufig asymptomatisch ist, wird derzeit empfohlen, bei allen Patienten mit einer neu diagnostizierten SSc eine Thorax-CT durchzuführen. Uneinigkeit herrscht derzeit darüber, wie SSc-Patienten, bei denen zum D...
Chapter
Sowohl Rippen- als auch Sternumfrakturen sind sonographisch gut darstellbar. Die sonographische Frakturdiagnostik ist nicht nur deutlich sensitiver als das konventionelle Röntgenbild, darüber hinaus lassen sich auch begleitende Weichteilläsionen, Hämatome und Pleuraergüsse sicher und rasch bildgebend erfassen. Die Darstellung von Lymphknoten und ei...
Conference Paper
Aim: F-18 FDG PET/CT imaging radiomics and cell free DNA (cfDNA) analysis also known as liquid biopsy are both gaining interest for characterization of tumors in personalized cancer therapy. Both are minimal invasive, widely availability and feasible. Aim of this study was to examine the correlation of the F-18 PET/CT radiomics with the lung cance...
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Hypersensitivity pneumonitis (HP) is a complex and heterogeneous interstitial lung disease (ILD) that occurs when susceptible individuals develop an exaggerated immune response to an inhaled antigen. In this review, we discuss the latest guidelines for the diagnostic evaluation of patients with suspected HP, the importance of identifying patients w...
Article
Background The long-term pulmonary sequelae of coronavirus disease 2019 (COVID-19) is not well known. Purpose To characterize patterns and rates of improvement of chest CT abnormalities one year after COVID-19 pneumonia. Materials and Methods This was a secondary analysis of a prospective, multicenter observational cohort study conducted fro...
Preprint
Purposes: Programmed death-ligand 1 (PD-L1) testing is performed mainly on biopsy specimens in patients with advanced lung cancer. It is questionable whether the small amount of tissue analysed in biopsies may represent the true PD-L1 expression of a tumour. Methods: In this retrospective study, PD-L1 expression on tumour cells derived from broncho...
Article
The use of ultrasound has revolutionized the evaluation of pulmonary complaints and pathology. Historically, most lung ultrasound uses described are limited to B-mode, M-mode and occasionally color Doppler. However, the use of contrast can significantly expand the diagnostic capabilities of lung ultrasound. Ultrasound contrast enables significant e...
Article
Clinical issue: Diffuse parenchymal lung diseases include a heterogeneous group of diseases of the lung parenchyma, the alveolar spaces, the vessels and the airways, which can be triggered by various pathomechanisms, such as inflammation and fibrotic changes. Since the therapeutic approaches and prognoses differ significantly between the diseases,...
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Objectives Despite the high frequency of segmentation anomalies in the human sacrum, their evolutionary and clinical implications remain controversial. Specifically, inconsistencies involving the classification and counting methods obscure accurate assessment of lumbosacral transitional vertebrae. Therefore, we aim to establish more reliable morpho...
Preprint
Machine learning in medical imaging during clinical routine is impaired by changes in scanner protocols, hardware, or policies resulting in a heterogeneous set of acquisition settings. When training a deep learning model on an initial static training set, model performance and reliability suffer from changes of acquisition characteristics as data a...
Article
Clinical Practice Points •Small cell lung cancer (SCLC) is a highly aggressive disease closely linked to tobacco consumption and therefore very rare in patients who never smoked. •SCLC can occur de novo or from the histologic transformation of non-small cell lung cancer (NSCLC) due to acquired TKI (tyrosine kinase inhibitor) resistance. •In patien...
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This document from the European Society of Thoracic Imaging (ESTI) and the European Society of Radiology (ESR) discusses the role of imaging in the long-term follow-up of COVID-19 patients, to define which patients may benefit from imaging, and what imaging modalities and protocols should be used. Insights into imaging features encountered on compu...
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Hundreds of millions got infected, and millions have died worldwide and still the number of cases is rising. Chest radiographs and computed tomography (CT) are useful for imaging the lung but their use in infectious diseases is limited due to hygiene and availability. Lung ultrasound has been shown to be useful in the context of the pandemic, provi...
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Background Elevated D-dimer is known as predictor for severity of SARS-CoV2-infection. Increased D-dimer is associated with thromboembolic complications, but it is also a direct consequence of the acute lung injury seen in COVID-19 pneumonia. Objectives To evaluate the rate of persistent elevated D-dimer and its association with thromboembolic com...
Article
The evolution of ultrasound imaging into a key technology for diagnostic practice has resulted in its incorporation into the education of medical students worldwide. Although the introduction of ultrasound into medical schools’ curricula is relatively recent, training of sonographers and other ultrasound users is mature. Ultrasound is being used in...
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Medical imaging is a central part of clinical diagnosis and treatment guidance. Machine learning has increasingly gained relevance because it captures features of disease and treatment response that are relevant for therapeutic decision-making. In clinical practice, the continuous progress of image acquisition technology or diagnostic procedures, t...
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Zusammenfassung Hintergrund Nach einer Coronavirus-Krankheit-2019 (COVID-19) berichtet ein Teil der Patienten über länger andauernde oder sich verschlechternde Symptome und Beeinträchtigungen. Diese anhaltenden Symptome werden mit dem Begriff „Long-COVID“-Syndrom zusammengefasst. Sie können mit radiologischen Veränderungen in der Computertomograph...
Article
Objectives Interstitial lung disease (ILD) associated with the antimelanoma differentiation-associated protein 5 (anti-MDA5) antibody is a rapidly progressive disease that requires timely, aggressive treatment. However, prompt diagnosis is difficult due to the longer time required for antibody detection. This study described the computed tomography...
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Objectives: To explore the potential of Radiomics alone and in combination with a diffusion-weighted derived quantitative parameter, namely the apparent diffusion co-efficient (ADC), using supervised classification algorithms in the prediction of outcomes and prognosis. Materials and methods: Retrospective evaluation of the imaging was conducted...
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Medical imaging methods are assuming a greater role in the workup of patients with COVID-19, mainly in relation to the primary manifestation of pulmonary disease and the tissue distribution of the angiotensin-converting-enzyme 2 (ACE 2) receptor. However, the field is so new that no consensus view has emerged guiding clinical decisions to employ im...
Preprint
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Objectives: To explore the potential of Radiomics alone and in combination with diffusion-weighted derived quantitative parameter namely apparent diffusion co-efficient (ADC) using supervised classification algorithms in predicting outcomes and prognosis. Materials and Methods: Retrospective evaluation of the imaging was done for a study cohort of...
Article
Background Fetal MRI-based differential diagnosis of congenital lung malformations is difficult because of the paucity of well-described imaging markers. Purpose To characterize the hyperintense bronchus sign (HBS) in in vivo fetal MRI of congenital lung malformation cases. Materials and Methods In this retrospective two-center study, fetal MRI sca...
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A Correction to this paper has been published: https://doi.org/https://doi.org/10.1007/s00330-021-07995-7
Article
Introduction Both, Langerhans cell histiocytosis (LCH) and Erdheim-Chester Disease (ECD) belong to the heterogeneous group of histiocytoses. Their association is exceptional and thought to be linked to the BRAF mutation. Both diseases express with different radiographic and histopathologic phenotypes. Radiological features of pulmonary LCH include...
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Background: To assess inter reader variability of lung parenchymal observations in treated lung cancer patients with initially negative RTPCR result for COVID 19, among radiologists with various experience levels. Methods: Three radiologists with different levels of clinical experience in interpretation of chest CT study (range, 4–25 years), rated...
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Interstitielle Lungenerkrankungen (ILD) sind eine heterogene Gruppe von Pathologien, die zunehmend als relevanter Faktor pulmonaler Morbidität und Mortalität erkannt werden. Verschiedene ILD wie die idiopathische Lungenfibrose (IPF), aber auch durch Autoimmunprozesse oder durch exogene Noxen bedingte ILD können zu progredienter, meist irreversibler...
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Objectives Acute respiratory distress syndrome (ARDS) constitutes a major factor determining the clinical outcome in polytraumatized patients. Early prediction of ARDS is crucial for timely supportive therapy to reduce morbidity and mortality. The objective of this study was to develop and test a machine learning–based method for the early predicti...
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Machine learning methods offer great promise for fast and accurate detection and prognostication of coronavirus disease 2019 (COVID-19) from standard-of-care chest radiographs (CXR) and chest computed tomography (CT) images. Many articles have been published in 2020 describing new machine learning-based models for both of these tasks, but it is unc...
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Unlike most other primary epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC), exon 20 insertions, comprising approximately 4% to 10% of all EGFR mutations, are generally considered to be resistant to EGFR tyrosine kinase inhibitors (TKIs). However, EGFR exon 20 insertions are structurally and pharmacologically h...
Conference Paper
Knowledge, Attitudes and Perception of Lung cancer screening among smoking software professionals in India
Article
The analysis of vertical reverberation artefacts is an essential component of the differential diagnosis in pulmonary ultra-sound. Traditionally, they are often, but not exclusively, called B-line artefacts (BLA) and/or comet tail artefacts (CTA), but this view is misleading. In this position paper we clarify the terminology and relation of the two...
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Background: After the 2002/2003 SARS outbreak, 30% of survivors exhibited persisting structural pulmonary abnormalities. The long-term pulmonary sequelae of coronavirus disease 2019 (COVID-19) are yet unknown, and comprehensive clinical follow-up data are lacking. Methods: In this prospective, multicentre, observational study, we systematically...
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Background: Automatically detecting and quantifying pneumothorax on chest computed tomography (CT) may impact clinical decision-making. Machine learning methods published so far struggle with the heterogeneity of technical parameters and the presence of additional pathologies, highlighting the importance of stable algorithms. Methods: A deep res...
Article
Introduction We aimed to interpret MR mammography (MRM) using the Kaiser scores for equivocal or inconclusive lesions on mammography (MG). Methods Retrospective IRB-approved evaluation of 3,623 MG for which MRM was deployed as a problem-solving tool, after inclusion-exclusion criteria were met. Three readers with different levels of experience assi...
Conference Paper
Background The study was done to appraise whether tumor response to CPI in RCC varies among organs and describe the response patterns in a population of surgically treated metastatic RCC patients treated with Nivolumab. Methods A retrospective analysis was conducted in patients receiving Nivolumab for metastatic RCC after first-line therapy, betwee...
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In clinical practice, patients with anaplastic lymphoma kinase (ALK)-rearrangement-positive non-small-cell lung cancer commonly receive sequential treatment with ALK tyrosine kinase inhibitors. The third-generation agent lorlatinib has been shown to inhibit a wide range of ALK resistance mutations and thus offers potential benefit in later lines, a...
Article
Objective To evaluate the clinical and imaging characteristics of orbital lesions of pediatric Langerhans cell histiocytosis (LCH). Study design A retrospective analysis of clinical data and central review of magnetic resonance imaging scans in patients with LCH, enrolled into one of the consecutive international trials LCH I-III, or submitted for...
Article
Purpose/Objective(s): Radiation with concurrent chemotherapy forms the cornerstone of management for International Federation of Gynecology and Obstetrics (FIGO) stage IB2 to IVA uterine cervix carcinoma disease. Radiomics has emerged as a promising tool for imaging biomarker discovery in era of precision medicine. We explored potential of Radiomic...
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Acute or chronic non-neoplastic diffuse mediastinal diseases have multiple causes, degrees of severity, and a wide range of management. Some situations require emergency care while others do not need specific treatment. Although the diagnosis may be suspected on chest X-ray, it is mainly based on CT. A delayed recognition is not uncommonly observed...
Article
Background Improved imaging techniques have increased the incidence of subsegmental pulmonary embolism (ssPE). Indirect evidence is suggesting that ssPE may represent a more benign presentation of venous thromboembolism not necessarily requiring anticoagulant treatment. However, correctly diagnosing ssPE is challenging with reported low interobserv...
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Clinical issue: Since its emergence in late 2019, the disease caused by the novel coronavirus, termed COVID-19, has been declared a pandemic by the World Health Organization. Reference standard for the diagnosis of COVID-19 is a positive reverse transcription polymerase chain reaction (RT-PCR) test. While the RT-PCR shows a high specificity, its s...
Article
Objectives: To investigate the intra- and inter-scanner repeatability and reproducibility of CT radiomics features (RF) of fibrosing interstitial lung disease (fILD). Methods: For this prospective, IRB-approved test-retest study, CT data of sixty fILD patients were acquired. Group A (n=30) underwent one repeated CT scan on a single scanner. Grou...
Article
European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC) are written by experts representing all disciplines involved in cancer care in Europe. They give patients, health professionals, managers and policymakers a guide to essential care throughout the patient journey. Lung cancer is the leading cause of cancer mortality...
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Anaplastic lymphoma kinase (ALK)-translocations are present in up to 5% of non-small cell lung cancer (NSCLC), most of them being adenocarcinomas. Even though the availability of five potent ALK-inhibitors for the treatment of ALK-positive NSCLC patients, there is no consensus about the ideal therapy sequence. Alectinib has been so far successfully...
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Tumors in the prevascular compartment of the mediastinum are rare and imaging plays a major role in their detection, (differential) diagnosis, staging, and follow-up. The prevascular compartment is bordered anteriorly by the posterior aspect of the sternum, posteriorly by the ventral aspect of the pericardium, cranially by the thoracic outlet, and...
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Background: Automated segmentation of anatomical structures is a crucial step in image analysis. For lung segmentation in computed tomography, a variety of approaches exists, involving sophisticated pipelines trained and validated on different datasets. However, the clinical applicability of these approaches across diseases remains limited. Metho...
Article
Chest CT scans are one of the most common medical imaging procedures. The automatic extraction and quantification of imaging features may help in diagnosis, prognosis of, or treatment decision in cardiovascular, pulmonary, and metabolic diseases. However, an adequate sample size as a statistical necessity for radiomics studies is often difficult to...
Article
Background: Cholangiocarcinoma is the second most belligerent primary tumor of the liver after hepatocellular carcinoma (HCC). The promising field of radiomics has offered substantial potential in prognosis evaluation and prediction of treatment response. Methods: A predictive model was developed from a training cohort comprising 36 intrahepatic c...
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Lung cancer is the third most common cancer in the UK and is a leading cause of death. Radiology plays a central role in the diagnostic workup of patients with suspected and known lung cancer. Tumour assessment includes both local staging, as well as distant staging. Local staging objectives include the assessment of technical resectability with re...
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Background Despite the increasing role of ultrasound, structured ultrasound teaching is only slowly being integrated into the curricula of medical schools and universities all over Europe. Aim To survey the current situation at European universities regarding the integration of ultrasound in student medical education and to report on models of stud...