Philipp Marius Paprottka

Technical University of Munich · Interventional Radiology

Purpose To investigate the effect of the ongoing COVID-19 pandemic on interventional radiology (IR) in Germany in 2020 and 2021. Materials und Methods This retrospective study is based on the nationwide interventional radiology procedures documented in the quality register of the German Society for Interventional Radiology and Minimally Invasive Th...

Purpose To test the feasibility of an online, simulator-based comprehensive interventional radiology (IR) training curriculum in times of COVID-19-induced travel restrictions. Materials and Methods A network of six VIST simulators (Mentice, Gothenburg, Sweden) was installed in six geographically different radiology departments. Two courses with six...

Background: Besides other factors, complication rate of transarterial interventions depends on the size of the vascular access. Therefore, the vascular access is mostly chosen as small as possible while still allowing all planned parts of the intervention. This retrospective analysis is to evaluate the safety and feasibility of sheathless arterial...

Introduction With the increasing need for minimally invasive procedures based on lower complication rates, higher patient acceptance, and technical developments, there is a growing focus on the sound interventional training of young radiologists. This survey aimed to analyze the current situation in interventional radiology (IR) training in Germany...

Purpose In addition to direct oncologic therapy, interventional radiology plays an important supportive role in oncologic therapy primarily guided by other disciplines. These supporting measures include diagnostic punctures, drainages, biliary interventions, central venous access including port implantations, osteoplasties, pain therapies etc.). Th...

Objective Over the past few decades, radiology has established itself in tumor therapy through interventional oncology including innovative and efficient procedures for minimalinvasive treatment of various tumor entities besides the “classic” therapeutic options such as surgery, chemotherapy and radiotherapy. Aim of this study was to evaluate the e...

Background: The first-line therapy for liver malignancies is a radical extended liver resection. This high-risk operation has a high incidence of post-hepatectomy liver failure (PHLF) due to a small future liver remnant (FLR). One of the procedures to increase the FLR is the associating liver partition and portal vein ligation for staged hepatecto...

The S3 guideline on hepatocellular carcinoma has been expanded to include malignant biliary carcinoma (synonym cholangiocarcinoma [CCA]). Magnetic resonance imaging (MRI) with additional magnetic resonance cholangiopancreatography (MRCP) is the imaging modality of choice to evaluate local findings. Use of gadolinium ethoxybenzyl diethylenetriamine...

Background Catheter-directed thrombolysis (CDT) is an effective and safe endovascular method used in critical limb ischemia and many other thromboembolic events. Ultrasound-assisted catheter-directed thrombolysis (US-CDT) is an emerging technique considered to accelerate thrombolysis and therefore is supposed to improve outcome. Purpose To evaluat...

Trans-arterial radioembolization (TARE) is increasingly evaluated for unresectable intrahepatic cholangiocarcinoma (ICC). Not all ICC patients benefit equally well from TARE. Therefore, we sought to evaluate variables predicting progression-free survival (PFS) and overall survival (OS). Patients with non-resectable ICC underwent TARE and were treat...

Introduction Port implantations at the forearm are associated with an increased risk of relevant vein thrombosis. Therefore, with this study we sought to identify the responsible risk factors to improve technical quality of the method. Methods This is a retrospective analysis of 313 patients with port implantation at the forearm in 2019. Then, exp...

Purpose To analyze the quality of endovascular aortic aneurysm repair using the data of the DeGIR quality management system. Comparison of data between 2011 and 2019. Materials and Methods A retrospective analysis of all data registered in the DeGIR quality management system of the year 2019 was performed regarding the treatment quality for endovas...

Purpose Peripheral artery disease (PAD) is a common condition with high socio-economic relevance. Therefore, qualified nationwide provision of interventional treatments of PAD is important for maintaining a high quality medical service in Germany. Materials and Methods All data on revascularization procedures from the quality management system of t...

Purpose In recent years, there has been mounting evidence on the clinical importance of body composition, particularly obesity and sarcopenia, in various patient populations. However, the relevance of these pathologic conditions remains controversial, especially in the field of traumatology. Computed tomography-based measurements allow clinicians t...

Background: Liver transplantation (LT) presents a curative treatment option in patients with early stage hepatocellular carcinoma (HCC) who are not eligible for resection or ablation therapy. Due to a risk of up 30% for waitlist drop-out upon tumor progression, bridging therapies are used to halt tumor growth. Transarterial chemoembolization (TACE...

Background and aims: Systemic treatment with sorafenib has been the standard of care (SOC) in patients with advanced Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) for more than a decade. TACE has been reported to allow better local tumor control in selected patients with BCLC stage C HCC. Methods: A retrospective an...

Purpose A multidisciplinary expert panel convened to formulate state-of-the-art recommendations for optimisation of selective internal radiation therapy (SIRT) with yttrium-90 (⁹⁰Y)-resin microspheres. Methods A steering committee of 23 international experts representing all participating specialties formulated recommendations for SIRT with ⁹⁰Y-re...

Background Transcatheter arterial chemoembolization (TACE) and biliary interventions are common procedures.Objectives In this retrospective study, the radiation exposure of patients undergoing hepatic intervention will be analyzed and compared depending on the type and objective of the intervention.Materials and methodsThis is an analysis of 7003 d...

Purpose Acute bleeding is a life-threatening condition that can be effectively treated minimally invasively by interventional radiologists using transcatheter vessel occlusion (TCVO). The purpose of this study was to evaluate the availability of TCVO performed by interventional radiologists in Germany based on the DeGIR registry. Materials and Meth...

ZUSAMMENFASSUNG Trotz großer Fortschritte in der Diagnostik sowie der systemischen und chirurgischen Therapie belegt das hepatozelluläre Karzinom (HCC) den vierten Platz unter den tumorassoziierten Todesfällen. Der diagnostische Stellenwert der Ultraschalluntersuchung der Leber besteht in erster Linie in der HCC-Früherkennung bei Risikopatienten. D...

Purpose: To test combined dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and 18F-FDG positron emission tomography (FDG-PET)-derived parameters for prediction of histopathological grading in a rat Diethyl Nitrosamine (DEN)-induced hepatocellular carcinoma (HCC) model. Methods: 15 male Wistar rats, aged 10 weeks were treated with o...

Purpose Retrospective evaluation of stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma (HCC). Methods We retrospectively analyzed 36 patients (45 lesions) treated between 2011 and 2017. Twenty-seven had previous treatments. Current treatment consisted of SBRT alone (n = 15) or selective transarterial chemoemboliza...

Purpose To observe the technical and clinical outcome as well as safety of CT fluoroscopy-guided drain placement in the multimodal clinical complication management of superinfected gastric leakage after sleeve gastrectomy. Materials and Methods All consecutive patients who underwent CT fluoroscopy-guided drain placement to treat superinfected posto...

ZUSAMMENFASSUNG Trotz großer Fortschritte in der Diagnostik sowie der systemischen und chirurgischen Therapie belegt das hepatozelluläre Karzinom (HCC) den vierten Platz unter den tumorassoziierten Todesfällen. Der diagnostische Stellenwert der Ultraschalluntersuchung der Leber besteht in erster Linie in der HCC-Früherkennung bei Risikopatienten. D...

Purpose: To evaluate the rate and types of complications after minimally invasive radiological central vein port implantation without ultrasound guidance. Materials and methods: We retrospectively evaluated 8654 patients who underwent port implantations in the subclavian vein without ultrasound guidance in our institution from 1998 to 2014 with...

Objective Hepatocellular carcinoma (HCC) is a major cause of death worldwide and its incidence is expected to increase globally. Aim of this study was to assess whether the implementation of screening policies and the improvement of treatment options translated into a real-world survival benefit in HCC patients. Design 4078 patients diagnosed with...

Zusammenfassung Die Radioembolisation von Lebertumoren kombiniert eine interstitielle Strahlentherapie mit Betastrahlern mit einer arteriellen Mikroembolisation durch Glas- oder Harzpartikel. Als Radionuklid wird seit einigen Jahren 90Y und seit Kurzem auch 166Ho angewandt. Im Gegensatz zu 90Y sendete 166Ho auch Gammastrahlung aus, die für die SPEC...

Background: Temperature distributions resulting from hyperthermia treatment of patients with high-risk soft-tissue sarcoma (STS) were quantitatively evaluated and globally compared with thermal simulations performed by a treatment planning system. The aim was to test whether the treatment planning system was able to predict correct temperature dist...

The purpose of our study was to determine cutoff values for baseline cholinesterase (CHE) and bilirubin levels prognostic for outcome after radioembolization (RE) in patients with primary liver tumors. In this retrospective single-center study, a threshold for baseline levels of CHE and bilirubin was determined based on overall survival (OS) of pat...

Background/aims: The recently proposed Munich-transarterial chemoembolisation-score (M-TACE) was tailored to suit hepatocellular Carcinoma (HCC) patients evaluated for TACE. M-TACE outperformed the established HCC-staging-systems and successfully passed external validation. Modifications of staging-systems through the rearrangement of stages or by...

PurposeRadioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation. Methods This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received...

Background: To report our experience with SBRT in primary and secondary liver tumors. Methods: We retrospectively analysed 55 patients (70 lesions) with a median follow-up of 10 months (range 1-57) treated from 2011 to 2016. All patients had not been eligible for other local treatment options. Median age was 64 years and 64% were male. 27 patien...

Purpose: We aimed to assess the safety and technical outcome of computed tomography (CT) fluoroscopy-guided osteoplasty with or without prior percutaneous radiofrequency ablation (RFA) in patients with painful osteolyses. Methods: We performed a retrospective analysis of 29 patients with painful extraspinal and spinal osteolyses (16 women, 13 me...

Aim: The aim of this study was to retrospectively analyze the prognostic value of combined Tc-macroaggregated albumin (MAA) SPECT/CT and [F]-fluoroethylcholine (FEC) PET/CT before radioembolization for survival of patients with intermediate-stage hepatocellular carcinoma. Methods: Twenty-four patients with known hepatocellular carcinoma Barcelon...

Background: Recent scientific work proved that knowledge about body composition beyond the body mass index is essential. Both adipose tissue and muscular status are determining risk factors of morbidity and mortality. Analysis of single cross-sectional computed tomography (CT) images, acquired during routine care only to prevent additional radiati...

To predict outcome of (90)Y radioembolization (RE) in patients with intrahepatic tumors from pre-therapeutic baseline parameters and to identify predictive variables using a machine-learning approach based on random survival forests (RSF). Materials and Methods: In this retrospective study, 366 patients with primary (n = 92) or secondary (n = 274)...

Background: Allocation of patients with hepatocellular carcinoma (HCC) to the adequate therapy is determined by both tumor burden and liver function. The Barcelona Clinic Liver Cancer (BCLC) staging system and therapeutic algorithm recommends transarterial chemoembolization (TACE) based on the best evidence available to patients with intermediate-...

Purpose: To determine pre-therapeutic predictive factors for overall survival (OS) after yttrium (Y)-90 radioembolization (RE). Methods: We retrospectively analyzed the pre-therapeutic characteristics (sex, age, tumor entity, hepatic tumor burden, extrahepatic disease [EHD] and liver function [with focus on bilirubin and cholinesterase level]) o...

Background: Radioembolization (RE) with (90)yttrium ((90)Y) resin microspheres generally employs a sandwich technique with separate sequential administration of contrast medium (CM), followed by vehicle (e.g., glucose 5% [G5] solution), then (90)Y resin microspheres (in G5), then G5, and then CM again to avoid contact of CM and microspheres under...

Purpose: Calcified nodules ("CN") are responsible for up to 5% of coronary-infarcts and, therefore, classified as minor criteria of "vulnerable" atherosclerotic plaque. We sought to evaluate prevalence and distribution of CN in carotid arteries in correlation with clinical symptoms. Methods: 178 consecutive patients with unilateral ischemic stro...

Background: In unclear pancreatic lesions, a tissue sample can confirm or exclude the suspected diagnosis and help to provide an optimal treatment strategy to each patient. To date only one small study reported on the outcome of computed tomography (CT) fluoroscopy-guided biopsies of the pancreas. Purpose: To evaluate technical success and diagn...

Currently methods to reduce radiation and contrast media application in endovascular repair of aortic aneurysms (EVAR) are investigated. First positive results for real-time contrast medium-enhanced ultrasonography (CEUS) guided endovascular aortic repair have been reported. A combination with image fusion of CEUS and preoperative multi-slice compu...

Objective: To evaluate various embolization particles on their physical properties with special regard on morphological variability and elasticity. Methods: 8 embolization particles (EmboCept®, Contour SE® Microspheres, Embosphere® Micorspheres 400 μm, 500 μm, 1300 μm, Embozene® Microspheres, DC Beads®, Embozene Tandem®) were evaluated and gradu...

Obesity leads to better survival in critically ill patients. Although there are several studies confirming this thesis, the “obesity paradox” is still surprising from the clinician’s perspective. One explanation for the “obesity paradox” is the fact that the body mass index (BMI), which is used in almost all clinical evaluations to determine weight...

Echte Aneurysmen und Pseudoaneurysmen der Viszeralarterien stellen eine heterogene Gruppe von Gefäßpathologien in Bezug auf Ätiologie, Klinik sowie Lokalisation dar und sind bei Ruptur eine wichtige Differenzialdiagnose des akuten Abdomens. Die Lokalisation der Viszeralaneurysmen verteilt sich zu 60 – 80 % auf die A. splenica, zu 20 % auf die A. he...

Objective: Our study primary aim was to compare the need for peri-interventional on-demand analgesia when water for injection (WFI) was replaced with glucose-5% (G5) for (90)Yttrium-resin-microspheres administration. Methods: 41 patients who received 77 radioembolization (RE) procedures with G5 (2014-2015) were retrospectively matched with 41 pa...

Objectives Our aim was to provide further evidence for the efficacy/safety of radioembolization using yttrium-90-resin microspheres for unresectable chemorefractory liver metastases from colorectal cancer (mCRC). Methods We followed 104 consecutively treated patients until death. Overall survival (OS) was calculated from the day of the first radioe...

Purpose: The aim of this study was to evaluate the clinical and functional outcomes in patients who underwent selective interventional embolization of renal pseudoaneurysms or arteriovenous fistulas at our center. Materials and Methods: Our retrospective analysis included all consecutive patients who received selective transcatheter embolization of...

Objectives: The present study evaluates safety, efficacy and prognostic factors for (90)Y-Yttrium microsphere radioembolization (RE) of unresectable liver metastases from breast cancer (BRCLM). Methods: 81 patients were treated with RE. Acute toxicity was monitored through daily physical examination and serum tests until three days after RE; lat...

Purpose: This study was designed to assess technical success and complications in patients with high-risk soft tissue sarcomas undergoing CT fluoroscopy-guided closed-tip catheter placement before treatment with combined chemotherapy and regional hyperthermia. Materials and methods: This retrospective study comprised all patients referred for in...

Methods: 17 patients underwent (18)F-2-fluoro-2-deoxy-D-glucose ((18)F-FDG) PET/CT before and three months after radioembolization for LMPAC. Overall survival (OS), progression-free survival (PFS), and time to intrahepatic progression (TTPliver) were among other factors correlated with metabolic response revealed by declining SUVpeak and total les...

Methods: 34 HCC patients undergoing 78 FEC-PET/CT scans were identified for this study. Patients with initial or follow-up metastastic disease (n = 9) were excluded at the time-point of the metastatic occurrence as well as patients with negative alpha-fetoprotein (AFP; n = 1) resulting in 24 patients and 57 scans that were eligible. All patients w...

Evaluation of (99m)Tc-labelled MAA uptake in scintigraphy/SPECT to analyse the predictive value for Y-90 SIR-Spheres therapy. We included 502 patients (55% male; mean age 62±11 years), who received (90)Y- radioembolization between 2005 and 2013 due to primary and secondary liver malignancies [colorectal cancer (CRC; n = 195, 38.8%), neuroendocrine...

Clinical cases of stent-fractures show that corrosion behavior might play a role in these fractures. Implanted in vivo, especially in combination with other implanted foreign materials, these metallic products are exposed to special conditions, which can cause a process of corrosion. Here, we aimed to test the corrosion potential of stents made of...

After edovascular repair of infrarenal aortic aneurysms (EVAR) endoleaks may occur necessitating further therapy. Therefore a reliable method for follow-up imaging after EVAR for detection and control of endoleaks is of high importance. Contrast-enhanced sonography (CEUS) does not require the application of nephrotoxid contrast media and does not s...

The investigation of dedicated contrast agents for x-ray dark-field imaging, which exploits small-angle scattering at microstructures for contrast generation, is of strong interest in analogy to the common clinical use of high-atomic number contrast media in conventional attenuation-based imaging, since dark-field imaging has proven to provide comp...

To evaluate the in vivo response by detecting the anti-angiogenic and invasion-inhibiting effects of a triple-combination-therapy in an experimental-small-animal-squamous-cell-carcinoma-model using the "flash-replenishment" (FR) method to assess tissue hemodynamics via contrast-enhanced-ultrasound (CEUS). Human hypopharynx-carcinoma-cells were subc...