Torsten Diekhoff

Charité Universitätsmedizin Berlin | Charité · Institute of Radiology

Objectives: The aim of this study was to perform phantom measurements to prove the feasibility of single-source dual-energy computed tomography (DECT) of the extremities using a volume scan mode. In addition, we, for the first time, wanted to determine which concentrations of monosodium urate (MSU) in gout and calcium pyrophosphate (CP) in pseudog...

Objective of the study is to compare the diagnostic accuracy for detecting monosodium urate crystal deposits between dual-energy CT (DECT) and ultrasound (US). Sixty consecutive patients (49 men, mean age 62 years) with clinically suspected gout were included in this case-control study. DECT and US of feet, knees, hands and elbows were performed in...

In times of globalization there is an increasing use of English in the medical literature. The aim of this study was to analyze the influence of English-language articles in multi-language medical journals on their international recognition - as measured by a lower rate of self-citations and higher impact factor (IF). We analyzed publications in mu...

Die Differenzialdiagnose von Arthritiden und anderer Erkrankungen, die mit Gelenkbeschwerden einhergehen, ist oft selbst für erfahrene Radiologen schwierig. Dennoch gibt es einfache Zeichen, die den ausschlaggebenden Hinweis zur Diagnosestellung geben können. In enger Zusammenarbeit mit den klinisch tätigen Kollegen kann der Radiologe so wichtige t...

Purpose To examine whether incorporating anatomy-centred deep learning can improve generalisability and enable prediction of disease progression. Methods This retrospective multicentre study included conventional pelvic radiographs of four different patient cohorts focusing on axial spondyloarthritis collected at university and community hospitals...

Zusammenfassung Bildgebung spielt bei der der axialen Spondyloarthritis (axSpA) eine Schlüsselrolle. Um eine präzise Diagnostik und der damit verbundenen Therapie zu ermöglichen ist hier eine effektive interdisziplinäre Kommunikation zwischen der Radiologie und Rheumatologie entscheidend. Dabei ist die Bereitstellung wichtiger Informationen zur Pat...

Objectives To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP). Methods Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and mag...

Background: There is considerable practice variation in labelling, diagnosis and treatment of adults with sterile bone inflammation. We developed a expert consensus recommendations on the disease definition, diagnosis and treatment of this rare condition. Methods: Systematic literature review and Grading of Recommendations, Assessment, Developme...

Background Dual-energy computed tomography (DECT) is a noninvasive diagnostic tool for gouty arthritis. This study aimed to compare two postprocessing techniques for monosodium urate (MSU) detection: conventional two-material decomposition and material map-based decomposition. Methods A raster phantom and an ex vivo biophantom, embedded with four...

Applications of computed tomography (CT) in arthritis imaging have rapidly expanded in recent years due to ongoing technical developments. Dual-energy CT (DECT) has become indispensable in clinical practice, particularly for diagnosing gouty arthritis and assessing bony structural changes. Technological innovations such as low-dose CT and state-of-...

Objectives This study aims to establish expert consensus recommendations for clinical information on imaging requests in suspected/known axial spondyloarthritis (axSpA), focusing on enhancing diagnostic clarity and patient care through guidelines. Materials and methods A specialised task force was formed, comprising 7 radiologists, 11 rheumatologi...

Background A range of sacroiliac joint (SIJ) MRI protocols are used in clinical practice but not all were specifically designed for diagnostic ascertainment. This can be confusing and no standard diagnostic SIJ MRI protocol is currently accepted worldwide. Objective To develop a standardised MRI image acquisition protocol (IAP) for diagnostic asce...

Apply a modified Delphi-based approach and produce a practical, radiology-specific set of definitions for interpretation and standardization of the multiple MRI findings in axial spondyloarthritis (ax-SpA), specifically to aid the general radiologist with a musculoskeletal interest, working with gold standard basic MRI protocols. We report the resu...

Background Dual-energy computed tomography (DECT) is useful for detecting gouty tophi. While iodinated contrast media (ICM) might enhance the detection of monosodium urate crystals (MSU), higher iodine concentrations hamper their detection. Calculating virtual noncontrast (VNC) images might improve the detection of enhancing tophi. The aim of this...

Background Adults with sterile bone inflammation are variably labelled as Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis (SAPHO)-syndrome, chronic nonbacterial osteomyelitis, chronic recurrent multifocal osteomyelitis (CRMO), pustulotic arthro-osteitis, or sternocostoclavicular hyperostosis. A standardized diagnostic approach for this rare dis...

Background Active inflammatory changes, such as bone marrow edema or osteitis detected through magnetic resonance imaging (MRI) of the sacroiliac joints (SIJ), are widely considered hallmarks of axial spondyloarthritis (axSpA). This imaging is commonly used for diagnosing and classifying this condition. However, recent studies suggest that bone mar...

Whereas previous projects attempted to standardize imaging in patients with axial spondyloarthritis (axSpA), few studies have been published about the need for specific details regarding the image acquisition and lesions that may be less familiar to general radiologists. This work reports consensus recommendations developed by the Assessment of Spo...

The knee is one of the most commonly affected joints in the course of inflammatory arthropathies, such as crystal-induced and autoimmune inflammatory arthritis. The latter group includes systemic connective tissue diseases and spondyloarthropathies. The different pathogenesis of these entities results in their varied radiologic images. Some lead qu...

Objectives Radiography and MRI of the sacroiliac joints (SIJ) are relevant for the diagnosis and classification of patients with axial spondyloarthritis (axSpA). This study aimed to evaluate the impact of clinical information (CI) on the accuracy of imaging interpretation. Methods Out of 109 patients referred because of suspicion of axSpA with com...

Sacroiliitis is commonly seen in patients with axial spondyloarthritis, in whom timely diagnosis and treatment are crucial to prevent irreversible structural damage. Imaging has a prominent place in the diagnostic process and several new imaging techniques have been examined for this purpose. We present a summary of updated evidence-based practice...

Objective Reliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT. Methods This post hoc analysis included 163 subjects with low back pain. Eighty-nine...

Objective Conventional magnetic resonance imaging (MRI) uses T1-weighted and short-tau inversion recovery (STIR) sequences to characterize bone marrow in axial spondyloarthritis. However, quantification is restricted to estimating the extent of lesions because signal intensities are highly variable both within individuals and across patients and MR...

Background: The Computed Tomography Syndesmophyte Score (CTSS) was developed as a reliable and sensitive tool to assess syndesmophytes in low-dose CT images of the entire spine in patients with axial spondyloarthritis (axSpA). The original paper provided sparce examples of the CTSS grades. Objectives: Provide an atlas tailored to assist readers in...

Objective To evaluate progression from nonradiographic (nr‐) to radiographic axial spondyloarthritis (r‐axSpA) over 5 years in patients with recently diagnosed (≤1 year) axSpA fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Methods A prospsective, observational study (Patients with Axial Spondyl...

Objectives The aim of the study was to investigate computed tomography-based thermography (CTT) for ablation zone prediction in microwave ablation (MWA). Methods CTT was investigated during MWA in an in vivo porcine liver. For CTT, serial volume scans were acquired every 30 s during ablations and every 60 s immediately after MWA. After the procedu...

Background Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the sacroiliac joints (SIJs) and the spine. Imaging plays a crucial role in the diagnosis of axSpA, with magnetic resonance imaging (MRI) and radiography being the primary modalities used in clinical practice. New bone formation occurs in both the spine...

Objectives Sex-specific differences in the presentation of axial spondyloarthritis (axSpA) may contribute to a diagnostic delay in women. The aim of this study was to investigate the diagnostic performance of MRI findings comparing men and women. Methods Patients with back pain from six different prospective cohorts (n=1194) were screened for incl...

Objectives: Reporting diagnostic confidence (DC) in axial spondyloarthritis (axSpA) imaging is recommended by the ASAS guidelines. Our aim was to investigate whether self-reported DC predicts diagnostic accuracy in axSpA imaging using X-ray (XR), computed tomography (CT) and magnetic resonance imaging (MRI). Methods: We performed a post hoc anal...

The diagnosis of axial spondyloarthritis depends on direct visualization of the sacroiliitis in addition to clinical assessment and determination of the histocompatibility antigen HLA-B27. While the value of conventional radiographic images has meanwhile been described in many studies as insufficient to diagnose the disease at an early stage, magne...

Objective The assessment of inflammatory and structural lesions in the sacroiliac joint (SIJ) is crucial in axial spondyloarthritis (axSpA). HLA-B27 status plays an important role in axSpA diagnosis and has been linked to MRI lesion burden in the general population. We aimed to investigate the sex-specific influence of HLA-B27 status on inflammator...

Objectives Crystal deposits in ligaments of the wrist are typical findings in patients with calcium pyrophosphate deposition (CPPD) disease. CPPD crystals trigger inflammation and ultimately result in ligament tears with scapholunate (SL) advanced collapse (SLAC). This study aimed to investigate carpal instabilities in patients with CPPD using four...

Background: To investigate the influence of iodinated contrast medium (ICM) on detection of monosodium urate (MSU) with dual-energy computed tomography (DECT) in two types of phantoms and demonstrate an example patient for clinical illustration. Methods: Approval is by the institutional review board, and written informed consent was obtained. A...

Computed tomography (CT)-based Thermography (CTT) is currently being investigated as a non-invasive temperature monitoring method during ablation procedures. Since multiple CT scans with defined time intervals were acquired during this procedure, interscan motion artifacts can occur between the images, so registration is required. The aim of this s...

Background The knowledge of factors influencing the susceptibility to and extent of changes at the sacroiliac joints (SIJs) are of great importance in the understanding of pathophysiological processes in axial spondyloarthritis (axSpA) [1] . Recent studies showed that previous delivery and the HLA-B27 status have a special role in the expression of...

Background Early and accurate diagnosis is essential for the further outcome of patients with axial spondyloarthritis (axSpA). The confident interpretation of image data sets plays a special role in the clinical practice is crucial for diagnosing axSpA. Therefore, the own assessment of the diagnostic confidence (DC) in the evaluation of images play...

Background: Osteitis condensans ilii (OCI) is a relatively rare benign disease of the lower anterior sacroiliac joint (SIJ) region that can cause symptoms such as low back pain (LBP), lateral hip pain and nonspecific hip or thigh pain. Its exact pathoetiology remains to be clarified. The aim of this study is to determine the prevalence of OCI in p...

Diagnostic imaging of epicondylitis is primarily performed using widely available, radiation-free ultrasound. The dynamic examination allows a rapid point-of-care assessment. Typical imaging findings of epicondylitis include intratendinous hypoechogenic foci at the humeral origin, ossification at the enthesis, intratendinous calcifications, or (par...

Objective: MRI findings of the sacroiliac joint space in axial spondyloarthritis (axSpA) include inflammation and fat metaplasia inside an erosion; the latter is also termed "backfill". We compared such lesions with CT to better characterize them whether they represent new bone formation. Methods: We identified patients with axSpA who underwent...

Background: To assess the ability of low-dose dual-energy computed tomography (ld-DECT) virtual non-calcium (VNCa) images for detecting bone marrow pathologies of the sacroiliac joints (SIJs) in patients with axial spondyloarthritis (axSpA). Material and Methods: Sixty-eight patients with suspected or proven axSpA underwent ld-DECT and MRI of the S...

The sacroiliac joint (SIJ) is an anatomically complex joint which, as a functional unit with the pelvis and spine, is of decisive biomechanical importance for the human body. It is also a commonly overlooked source of lower back pain. Like the entire bony pelvis, the SIJ exhibits major sexual dimorphisms; thus, the sex-dependent evaluation of this...

Purpose of review: Pelvic radiography in which structural lesions characteristic of sacroiliitis can be detected, is recommended as the first imaging modality when axial spondyloarthritis (axSpA) is suspected clinically. However, cross-sectional modalities like computed tomography (CT) and magnetic resonance imaging (MRI) are superior to radiograp...

Objectives This study was undertaken to analyze the prevalence of spondyloarthritis (SpA) in patients with acute anterior uveitis (AAU), to identify parameters associated with the presence of SpA, and to evaluate the performance of referral algorithms for identifying patients with a high probability of having SpA. Methods Prospectively recruited c...

Background During the current severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, computed tomography (CT) has become widely used in patients with suspected or known coronavirus disease 2019 (COVID-19). This prospective observational study in 28 invasively ventilated and 18 non-invasively ventilated patients with confirmed S...

The objectives of this study were to investigate the mean collagen content of the atlanto-axial joint (AAJ) ligaments in a cohort without inflammatory disease and to analyze clinical confounders such as age, sex, and presence of ligamentous calcifications. A total of 153 patients who underwent dual-energy computed tomography (DECT) due to various r...

Dual-energy computed tomography (DECT) is an imaging technique that combines nondestructive morphological cross-sectional imaging of objects and the quantification of their chemical composition. However, its potential to assist investigations in paleontology has not yet been explored. This study investigates quantitative DECT for the nondestructive...

Lumbosacral transitional vertebrae (LSTV) are common congenital variances with a prevalence found in the population up to 35.6%. The literature demonstrates an influence of LSTV on bony pelvic anatomy. The influence on the anatomical acetabular orientation, which is important for cup positioning in total hip arthroplasty, has not yet been described...

The possibility of detection of structural damage on magnetic resonance imaging (MRI) of sacroiliac joints raises the question of whether MRI can substitute radiographs for diagnostic evaluation and to a further extent for classification of axial spondyloarthritis (axSpA). In this viewpoint, we will argue that it is time to replace conventional rad...

Background MRI is frequently used for early diagnosis of axial spondyloarthritis (axSpA). However, evaluation is time-consuming and requires profound expertise because noninflammatory degenerative changes can mimic axSpA, and early signs may therefore be missed. Deep neural networks could function as assistance for axSpA detection. Purpose To creat...

The objective of this study was to investigate subtraction images from different polychromatic and virtual monochromatic reconstructions of dual-energy computed tomography (CT) for the detection of inflammation (synovitis/tenosynovitis or peritendonitis) in patients with hand arthritis. In this IRB-approved prospective study, 35 patients with acute...

Purpose of Review Recent technical advances in computed tomography (CT) such as low-dose CT and dual-energy techniques open new applications for this imaging modality in clinical practice and for research purposes. This article will discuss the latest innovations and give a perspective on future developments. Recent Findings Low-dose CT has increa...

Background Patients (pts) with axial spondyloarthritis (axSpA) are classified into radiographic axSpA (r-axSpA) and non-radiographic axSpA (nr-axSpA) based on the presence or absence of radiographic sacroiliitis. Approximately 20% to 80% of newly diagnosed axSpA pts have nr-axSpA and 8% to 40% progress to r-axSpA over the next 2 to 10 years. Objec...

Background Magnetic resonance tomography (MRI) plays a key role in the early diagnosis of axial spondyloarthritis (axSpA). However, the detection of changes indicative of axSpA requires specific expertise, which poses a challenge to non-specialized centers. Deep learning (an advanced machine learning method) based on training an artificial neural n...

Background Anatomical variation of the sacroiliac (SI) joints is more common among patients with LBP than healthy controls; increased biomechanical strain to the joint may play a role in axial spondyloarthritis (axSpA). Objectives To assess the association of lesions joint shape variation on inflammatory lesions on SI joint magnetic resonance imag...

Background Several magnetic resonance imaging (MRI) findings of the sacroiliac joint space in axial spondyloarthritis (axSpA) were previously described such as inflammation or fatty metaplasia inside an erosion, i.e. “backfill”. However, it is incompletely understood if one or all of these changes represent calcified bone matrix. Objectives This s...

Background Conventional magnetic resonance imaging (MRI) uses T1-weighted and short-tau inversion recovery (STIR) sequences to characterize bone marrow lesions in axial spondyloarthritis. However, quantification is restricted to the extent of marrow lesions because signal intensities are highly variable within and across patients and scanners. Furt...

Background Patients with acute anterior uveitis (AAU) have an increased risk for concomitant spondyloarthritis (SpA). Different referral strategies have been proposed to identify AAU patients with high probability of SpA, among them an Assessment of SpondyloArthritis international Society(ASAS)-based referral strategy focusing on patients with chro...

Background Rheumatology education today can be very diverse, and you can find everything from structured textbooks to YouTube channels to social media accounts. Peer-reviewed content is still recognized as a very high-quality source of information. App-based content has the advantage of bundling information in one place, always available on the go....

Background In 2009, ASAS published a ‘Definition of active sacroiliitis on MRI for classification of axial spondyloarthritis (axSpA)’. This definition relied on two MRI sequences to make this determination – semicoronal T1 and STIR. Since then, this approach has frequently been used for diagnosis, even though that was never the intent of the defini...

Background Clinicians face uncertainties in their daily practice when requesting imaging examinations for patients with suspected axial spondyloarthritis (axSpA) or when producing an imaging report because the requirements and desired information of radiologists and rheumatologists / orthopedics alike are sometimes not completely known or understoo...

Background Gender-specific differences in patients with axial spondyloarthritis (axSpA) are often seen in the clinical presentation and may differ in MRI findings ¹ . Male axSpA patients tend to show structural changes earlier, whereas in female axSpA patients the peripheral joints are more often affected ² . This can lead to a delay in axSpA diagn...

Objectives: To assess the impact of joint shape variations on inflammatory lesions on sacroiliac (SI) joint magnetic resonance imaging (MRI) in patients with axial spondyloarthritis (axSpA). Methods: A total of 1194 patients from four different prospective cohorts were evaluated with 684 (57.3%) having sufficient imaging data for inclusion avail...

Purpose Even though spinal infections are associated with high mortality and morbidity, their therapy remains challenging due to a lack of established classification systems and widely accepted guidelines for surgical treatment. This study’s aim therefore was to propose a comprehensive classification system for spinal instability based on the Spina...