Maximilian F Reiser

University Hospital München, München, Bavaria, Germany

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Publications (785)1827.9 Total impact

  • M Treitl · M F Reiser · K M Treitl
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    ABSTRACT: Background: Despite enormous technical progress the results of endovascular treatment of the femoropopliteal vasculature are unsatisfactory and its role is still controversially discussed. In the past decade numerous new stent designs have come onto the market but it is unclear whether they have benefits with respect to patency rates. Objectives: Comparison of published data on patency rates and target lesion revascularization rates after use of different stent designs in the femoropopliteal vasculature. Material and methods: Analysis of 25 published studies and registries from 2006 to 2015 for classical open-cell stents, interwoven stents and partially or fully covered stents. Results and conclusion: The published data are heterogeneous and comparative studies for different stent designs are completely missing. Over the past decade the patency rates after femoropopliteal stenting could be improved. According to available data stenting of short lesions < 5 cm does not show any benefit compared to isolated balloon angioplasty. Primary stenting is now recommended for intermediate and longer lesions > 6.4 cm. Due to the heterogeneity of published data a clear benefit for a specific stent design is not obvious; however, data for interwoven stents are promising and show a tendency towards improved patency, at least for certain lesions. Randomized controlled comparative trials are needed to confirm this result.
    No preview · Article · Feb 2016 · Der Radiologe
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    ABSTRACT: Purpose: The purpose of this study was to propose and evaluate a new wavelet-based technique for classification of arterial and venous vessels using time-resolved cerebral CT perfusion data sets. Methods: Fourteen consecutive patients (mean age 73 yr, range 17–97) with suspected stroke but no pathology in follow-up MRI were included. A CT perfusion scan with 32 dynamic phases was performed during intravenous bolus contrast-agent application. After rigid-body motion correction, a Paul wavelet (order 1) was used to calculate voxelwise the wavelet power spectrum (WPS) of each attenuation-time course. The angiographic intensity A was defined as the maximum of the WPS, located at the coordinates T (time axis) and W (scale/width axis) within the WPS. Using these three parameters (A, T, W) separately as well as combined by (1) Fisher’s linear discriminant analysis (FLDA), (2) logistic regression (LogR) analysis, or (3) support vector machine (SVM) analysis, their potential to classify 18 different arterial and venous vessel segments per subject was evaluated. Results: The best vessel classification was obtained using all three parameters A and T and W [area under the curve (AUC): 0.953 with FLDA and 0.957 with LogR or SVM]. In direct comparison, the wavelet-derived parameters provided performance at least equal to conventional attenuation-time-course parameters. The maximum AUC obtained from the proposed wavelet parameters was slightly (although not statistically significantly) higher than the maximum AUC (0.945) obtained from the conventional parameters. Conclusions: A new method to classify arterial and venous cerebral vessels with high statistical accuracy was introduced based on the time-domain wavelet transform of dynamic CT perfusion data in combination with linear or nonlinear multidimensional classification techniques. © 2016 American Association of Physicists in Medicine
    No preview · Article · Feb 2016 · Medical Physics
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    ABSTRACT: Introduction Factors that determine the extent of the penumbra in the initial diagnostic workup using whole brain CT Perfusion (WB-CTP) remain unclear. The purpose of the current study was to determine a possible dependency of the initial mismatch size between cerebral blood flow (CBF) and cerebral blood volume (CBV) from time after symptom onset, leptomeningeal collateralization, and occlusion localization in acute middle cerebral artery (MCA) infarctions. Methods Out of an existing cohort of 992 consecutive patients receiving multiparametric CT scans including WB-CTP due to suspected stroke, we included patients who had (1) a witnessed time of symptom onset, (2) an infarction of the MCA territory as documented by follow-up imaging, and (3) an initial CBF volume of >10 ml. CBF and CBV lesion sizes, collateralization grade, and the site of occlusion were determined. Results We included 103 patients. Univariate analysis showed that time from symptom onset (168 +/− 91.2 min) did not correlate with relative or absolute mismatch volumes (p = 0.458 and p = 0.921). Higher collateralization gradings were associated with small absolute mismatch volumes (p = 0.004 and p < 0.001). Internal carotid artery (ICA) occlusions were associated with large absolute mismatch volumes (p = 0.004). Multivariate analysis confirmed that ICA occlusion was associated with large absolute mismatch volumes (p = 0.005), and high collateral grade was associated with small absolute mismatch volumes (p = 0.017). Conclusions There is no significant correlation between initial CTP mismatch and time after symptom onset. Predictors of mismatch size include the extent of the collaterals and a proximal location of the occlusion.
    No preview · Article · Jan 2016 · Neuroradiology
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    Maximilian F. Reiser

    Preview · Article · Jan 2016 · European Radiology
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    ABSTRACT: Objective: The aim of this study was to investigate the effects of partial nephrectomy (PN) in kidneys with solid renal masses on the apparent diffusion coefficient (ADC) and on intravoxel incoherent motion (IVIM)-based parameters using diffusion-weighted magnetic resonance imaging (DWI). Methods: Fifteen patients with renal masses underwent DWI before and 1 week after PN on a clinical 3 T scanner using a single-shot echo planar imaging sequence with 10 diffusion weightings. Motion-corrected images were quantified using a monoexponential model fit to calculate ADCs and a segmented biexponential fit to calculate IVIM parameters f (perfusion fraction), Dslow and Dfast ("slow" and "fast" diffusion coefficients), as well as the pseudoflow (PF) Dfast × f. The median values derived from multislice (minimum of 3 slices) regions of interest encompassing the kidney cortex were used for statistical analysis. Estimated glomerular filtration rate values were calculated based on serum creatinine levels on each examination day using the Modification of Diet in Renal Disease formula. Results: The follow-up measurement yielded significantly lower values in the partially nephrectomized kidneys compared with contralateral kidneys for the parameters ADC (P = 0.002), Dfast (P = 0.43), f (P = 0.001), and PF (P = 0.0008). Comparing baseline and follow-up, partially nephrectomized kidneys showed a significant decrease for ADC (P = 0.01), Dfast (P = 0.43), f (P = 0.002), and PF (P = 0.002). Nonnephrectomized kidneys expressed a significant increase for ADC (P = 0.01) and PF (P = 0.01). Follow-up Modification of Diet in Renal Disease showed positive correlations with all DWI parameters in the partially nephrectomized kidneys (ADC: r = 0.63, P = 0.0004; Dfast: r = 0.59, P = 0.0009; f: r = 0.36, P = 0.018; PF: r = 0.60, P = 0.00075) except for Dslow. Conclusions: Our study suggests that quantitative parameters derived from DWI are highly indicative of renal function. Apparent diffusion coefficients showed substantial differences in the renal cortex after PN, whereas an IVIM analysis delivered additional insight into kidney physiology. Quantitative DWI, particularly perfusion-related IVIM parameters, therefore demonstrated great potential as truly noninvasive biomarker to obtain information about single kidney function.
    No preview · Article · Dec 2015 · Investigative Radiology
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    ABSTRACT: 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 insertion of closed-tip catheters for the introduction of thermometry probes before regional hyperthermia treatment at a single university centre from 2010 to 2015. Catheter placements were performed under local anaesthesia and intermittent CT fluoroscopy guidance. Technical success, complication rate, duration of catheter insertion and dose–length product (DLP) were analysed. Technical success was defined as intratumoural catheter placement suitable for subsequent thermometry. Results: A total of 35 procedures were performed on 35 patients (22 men, 13 women). In 34 out of 35 interventions catheters were inserted successfully; in one patient catheter placement was not feasible. No intra-interventional complications occurred. In six patients post-interventional complications were observed – two major (one abscess formation and one severe catheter dislocation) and four minor complications. Technical failure was observed in 11.4% of patients, especially catheter kinking. A total of 55 catheters were placed, with a mean number of 1.7 ± 0.7 per patient. Mean total DLP was 723.2 ± 355.9 mGy*cm. Conclusion: CT fluoroscopy-guided closed-tip catheter placement into high-risk soft tissue sarcomas was characterised by high technical success and relatively low complication rate. While major complications were rarely observed, catheter-kinking preventing successful thermometry represented the most frequent technical failure.
    No preview · Article · Dec 2015 · International Journal of Hyperthermia
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    ABSTRACT: Introduction: Whole-body magnetic resonance (MR) imaging is increasingly implemented in population-based cohorts and clinical settings. However, to quantify the variability introduced by the different scanners is essential to make conclusions about clinical and biological data, and relevant for internal/external validity. Thus, we determined the interscanner and intrascanner variability of different 3 T MR scanners for whole-body imaging. Methods: Thirty volunteers were enrolled to undergo multicentric, interscanner as well intrascanner imaging as part of the German National Cohort pilot studies. A comprehensive whole-body MR protocol was installed at 9 sites including 7 different MR scanner models by all 4 major vendors. A set of quantitative, organ-specific measures (n = 20; eg, volume of brain's gray/white matter, pulmonary trunk diameter, vertebral body height) were obtained in blinded fashion. Reproducibility was determined using mean weighted relative differences and intraclass correlation coefficients. Results: All participants (44 ± 14 years, 50% female) successfully completed the imaging protocol except for two because of technical issues. Mean scan time was 2 hours and 32 minutes and differed significantly across scanners (range, 1 hour 59 minutes to 3 hours 12 minutes). A higher reproducibility of obtained measurements was observed for intrascanner than for interscanner comparisons (intraclass correlation coefficients, 0.80 ± 0.17 vs 0.60 ± 0.31, P = 0.005, respectively). In the interscanner comparison, mean relative difference ranged from 1.0% to 53.2%. Conversely, in the intrascanner comparison, mean relative difference ranged from 0.1% to 15.6%. There were no statistical differences for intrascanner and interscanner reproducibility between the different organ foci (all P ≥ 0.24). Conclusions: While whole-body MR imaging-derived, organ-specific parameters are generally associated with good to excellent reproducibility, smaller differences are obtained when using identical MR scanner models by a single vendor.
    No preview · Article · Dec 2015 · Investigative radiology
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    ABSTRACT: We aimed to investigate the overall prevalence and possible factors influencing the occurrence of crossed cerebellar diaschisis after acute middle cerebral artery infarction using whole-brain CT perfusion. A total of 156 patients with unilateral hypoperfusion of the middle cerebral artery territory formed the study cohort; 352 patients without hypoperfusion served as controls. We performed blinded reading of different perfusion maps for the presence of crossed cerebellar diaschisis and determined the relative supratentorial and cerebellar perfusion reduction. Moreover, imaging patterns (location and volume of hypoperfusion) and clinical factors (age, sex, time from symptom onset) resulting in crossed cerebellar diaschisis were analysed. Crossed cerebellar diaschisis was detected in 35.3% of the patients with middle cerebral artery infarction. Crossed cerebellar diaschisis was significantly associated with hypoperfusion involving the left hemisphere, the frontal lobe and the thalamus. The degree of the relative supratentorial perfusion reduction was significantly more pronounced in crossed cerebellar diaschisis-positive patients but did not correlate with the relative cerebellar perfusion reduction. Our data suggest that (i) crossed cerebellar diaschisis is a common feature after middle cerebral artery infarction which can robustly be detected using whole-brain CT perfusion, (ii) its occurrence is influenced by location and degree of the supratentorial perfusion reduction rather than infarct volume (iii) other clinical factors (age, sex and time from symptom onset) did not affect the occurrence of crossed cerebellar diaschisis.
    Full-text · Article · Dec 2015 · Journal of Cerebral Blood Flow & Metabolism
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    ABSTRACT: Objective: To investigate annexin-based optical fluorescence imaging (OI) for monitoring regorafenib-induced early cell death in experimental colon carcinomas in rats, validated by perfusion MRI and multiparametric immunohistochemistry. Materials and methods: Subcutaneous human colon carcinomas (HT-29) in athymic rats (n = 16) were imaged before and after a one-week therapy with regorafenib (n = 8) or placebo (n = 8) using annexin-based OI and perfusion MRI at 3 Tesla. Optical signal-to-noise ratio (SNR) and MRI tumor perfusion parameters (plasma flow PF, mL/100mL/min; plasma volume PV, %) were assessed. On day 7, tumors underwent immunohistochemical analysis for tumor cell apoptosis (TUNEL), proliferation (Ki-67), and microvascular density (CD31). Results: Apoptosis-targeted OI demonstrated a tumor-specific probe accumulation with a significant increase of tumor SNR under therapy (mean Δ +7.78±2.95, control: -0.80±2.48, p = 0.021). MRI detected a significant reduction of tumor perfusion in the therapy group (mean ΔPF -8.17±2.32 mL/100 mL/min, control -0.11±3.36 mL/100 mL/min, p = 0.036). Immunohistochemistry showed significantly more apoptosis (TUNEL; 11392±1486 vs. 2921±334, p = 0.001), significantly less proliferation (Ki-67; 1754±184 vs. 2883±323, p = 0.012), and significantly lower microvascular density (CD31; 107±10 vs. 182±22, p = 0.006) in the therapy group. Conclusions: Annexin-based OI allowed for the non-invasive monitoring of regorafenib-induced early cell death in experimental colon carcinomas, validated by perfusion MRI and multiparametric immunohistochemistry.
    Preview · Article · Sep 2015 · PLoS ONE
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    ABSTRACT: Purpose: To evaluate the use of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) during free breathing for the detection of acute pulmonary embolism (PE). Materials and Methods: Eighteen subjects underwent free-breathing DCE MRI at 1.5T, eight of whom were patients with acute PE, as confirmed by routine computed tomography pulmonary angiography (CTPA). The remaining 10 subjects were healthy volunteers with no history or signs of pulmonary disease. From all DCE MRI data, maps of relative signal enhancement were calculated and assessed for the presence or absence of perfusion defects in each lung by two readers. Interreader variability, sensitivity, and specificity of free-breathing DCE MRI for the detection of PE were calculated using CTPA as the gold standard. Results: Of the 16 patient's lungs, 15 were affected by acute PE according to CTPA. In patients and volunteers, DCE MRI sensitivity was 93% and 87% for readers 1 and 2, with specificities of 95% and 90%, respectively. Interreader agreement was substantial, with κ = 0.77 (95% confidence interval: 0.44–1.0). Conclusion: Free-breathing DCE MRI may have potential use for the assessment of PE, and does not require patient cooperation in breath-holding.
    No preview · Article · Sep 2015 · Journal of Magnetic Resonance Imaging
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    ABSTRACT: The purpose of this study was to evaluate differences of plaque composition and morphology within the same patient in different vascular beds using non-invasive MR-plaque imaging. 28 patients (67.8 ± 7.4 years, 8 females) with high Framingham general cardiovascular disease 10-year risk score and mild-to-moderate atherosclerosis were consecutively included in the study. All subjects underwent a dedicated MRI-plaque imaging protocol using TOF and T1w and T2w black-blood-sequences with fat suppression at 1.5 T. The scan was centered on the carotid bulb of the carotid arteries and on the most stenotic lesion of the ipsilateral femoral artery, respectively. Plaques were classified according to the American Heart Association (AHA) lesion type classification and area measurements of lumen, wall and the major plaque components, such as calcification, necrotic core and hemorrhage were determined in consensus by two blinded reviewers using dedicated software (Cascade, Seattle, USA). Plaque components were recorded as maximum percentages of the wall area. Carotid arteries had larger maximum wall and smaller minimum lumen areas (p < 0.001) than femoral arteries, whereas no significant difference was find with respect to the max. NWI (p = 0.87). Prevalence of lipid-rich AHA lesion type IV/V and complicated AHA lesion type VI with hemorrhage/thrombus/fibrous cap rupture was significantly higher in the carotid arteries compared to the femoral arteries. Plaque composition as percentage of the vessel wall differed significantly between carotid and femoral arteries: Max. %necrotic core and max. %hemorrhage were significantly higher in the carotid arteries compared to the femoral arteries (p = 0.001 and p = 0.02, respectively). Max. %calcification did not differ significantly. Average stenotic degree of carotid arteries at duplex was 49.7 ± 12.5 (%). Non-invasive MR plaque-imaging is able to visualize differences in plaque composition across the vascular tree. We observed significant differences in quantitative and qualitative plaque features between carotid and femoral arteries within the same patient, which in the future could help to improve risk stratification in patients with atherosclerosis.
    No preview · Article · Aug 2015 · The international journal of cardiovascular imaging
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    ABSTRACT: 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 different materials in an in vitro setting. A total of 28 peripheral stents of different materials (nitinol, cobalt-chromium-nickel, tantalum, V4A) and surface treatments (electropolish, mechanical polish, no polish) were tested in vitro. Corrosion was accelerated by applying a constant voltage of 3.5 V and amperage of 1.16 mA in 0.9% NaCl. Nitinol stents showed the lowest susceptibility to corrosion and the longest period without damage. The Memotherm II® (BARD Angiomed®) was the only stent that showed neither macroscopic nor microscopic damages. The worst performing material was cobalt-chromium-nickel, which showed corrosion damages about ten times earlier compared to nitinol. Considering the reasons for termination of the test, nitinol stents primarily showed length deficits, while V4A and tantalum stents showed fractures. Cobalt-chromium-nickel stents had multiple fractures or a complete lysis in equal proportions. When placed in direct contact, nitinol stents showed best corrosion resistance, regardless of what material they were combined with. In terms of polishing treatments, electropolished stents performed the best, mechanical-polished stents and those without polishing treatment followed. The analysis of corrosion behavior may be useful to select the right stent fulfilling the individual needs of the patient within a large number of different stents.
    No preview · Article · Aug 2015 · Diagnostic and interventional radiology (Ankara, Turkey)
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    ABSTRACT: 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 complementary information. Therefore, agents consisting of gas bubbles, as used in ultrasound imaging for example, are of particular interest. In this work, we investigate an experimental contrast agent based on microbubbles consisting of a polyvinyl-alcohol shell with an iron oxide coating, which was originally developed for multimodal imaging and drug delivery. Its performance as a possible contrast medium for small-animal angiography was examined using a mouse carcass to realistically consider attenuating and scattering background signal. Subtraction images of dark field, phase contrast and attenuation were acquired for a concentration series of 100%, 10% and 1.3% to mimic different stages of dilution in the contrast agent in the blood vessel system. The images were compared to the gold-standard iodine-based contrast agent Solutrast, showing a good contrast improvement by microbubbles in dark-field imaging. This study proves the feasibility of microbubble-based dark-field contrast-enhancement in presence of scattering and attenuating mouse body structures like bone and fur. Therefore, it suggests a strong potential of the use of polymer-based microbubbles for small-animal dark-field angiography.
    Full-text · Article · Jul 2015 · PLoS ONE
  • Olaf Dietrich · Tobias Geith · Maximilian F Reiser · Andrea Baur-Melnyk
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    ABSTRACT: Diffusion-weighted MRI (DWI) of the vertebral bone marrow is a clinically important tool for the characterization of bone-marrow pathologies and, in particular, for the differentiation of benign (osteoporotic) and malignant vertebral compression fractures. DWI of the vertebral bone marrow is, however, complicated by some unique MR and tissue properties of vertebral bone marrow. Due to both the spongy microstructure of the trabecular bone and the proximity of the lungs, soft tissue, or large vessels, substantial magnetic susceptibility variations occur, which severely reduce the magnetic field homogeneity as well as the transverse relaxation time T(*) 2 , and thus complicate MRI in particular with echoplanar imaging (EPI) techniques. Therefore, alternative diffusion-weighting pulse sequence types such as single-shot fast-spin-echo sequences or segmented EPI techniques became important alternatives for quantitative DWI of the vertebral bone marrow. This review first describes pulse sequence types that are particularly important for DWI of the vertebral bone marrow. Then, data from 24 studies that made diffusion measurements of normal vertebral bone marrow are reviewed; summarizing all results, the apparent diffusion coefficient (ADC) of normal vertebral bone marrow is typically found to be between 0.2 and 0.6 × 10(-3) mm(2) /s. Finally, DWI of vertebral compression fractures is discussed. Numerous studies demonstrate significantly greater ADCs in osteoporotic fractures (typically between 1.2 and 2.0 × 10(-3) mm(2) /s) than in malignant fractures or lesions (typically 0.7-1.3 × 10(-3) mm(2) /s). Alternatively, several studies used the (qualitative) image contrast of diffusion-weighted acquisitions for differentiation of lesion etiology: a very good lesion differentiation can be achieved, particularly with diffusion-weighted steady-state free precession sequences, which depict malignant lesions as hyperintense relative to normal-appearing vertebral bone marrow, in contrast to hypointense or isointense osteoporotic lesions. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    No preview · Article · Jun 2015 · NMR in Biomedicine
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    Preview · Article · Jun 2015
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    ABSTRACT: Acceleration of the image acquisition is an ever important technique in dynamic contrast-enhanced (DCE) MRI. Conventional parallel imaging is limited by the SNR loss at higher acceleration factors and by potential reconstruction artefacts. A recently introduced method, CAIPIRINHA, promises a more robust image reconstruction by modifying the k-space sampling schema. In the present study, we perform phantom measurements to identify the optimal CAIPIRINHA sampling pattern for a 3D DCE MRI perfusion measurement with coverage of the entire neurocranium at high temporal resolution, and we demonstrate the application of CAIPIRINHA acceleration for cerebral DCE MRI in patient measurements.
    No preview · Conference Paper · Jun 2015
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    ABSTRACT: The purpose of this study was to analyze the influence of the regularization parameters on the results of quantitative susceptibility mapping using the superfast dipole inversion (SDI) technique. SDI is performed in the Fourier domain by multiplication with an SDI kernel, which depends on two regularization parameters for the regularization (1) of the Laplace operator inversion and (2) of the unit dipole inversion (in the Fourier domain). Both parameters were varied and the susceptibility of the substantia nigra and the red nucleus were assessed. The results showed a substantial variation of the susceptibility depending on the regularization.
    No preview · Conference Paper · May 2015
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    ABSTRACT: This study evaluated the cost-effectiveness of different noninvasive imaging strategies in patients with possible basilar artery occlusion. A Markov decision analytic model was used to evaluate long-term outcomes resulting from strategies using computed tomographic angiography (CTA), magnetic resonance imaging, nonenhanced CT, or duplex ultrasound with intravenous (IV) thrombolysis being administered after positive findings. The analysis was performed from the societal perspective based on US recommendations. Input parameters were derived from the literature. Costs were obtained from United States costing sources and published literature. Outcomes were lifetime costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios, and net monetary benefits, with a willingness-to-pay threshold of $80 000 per QALY. The strategy with the highest net monetary benefit was considered the most cost-effective. Extensive deterministic and probabilistic sensitivity analyses were performed to explore the effect of varying parameter values. In the reference case analysis, CTA dominated all other imaging strategies. CTA yielded 0.02 QALYs more than magnetic resonance imaging and 0.04 QALYs more than duplex ultrasound followed by CTA. At a willingness-to-pay threshold of $80 000 per QALY, CTA yielded the highest net monetary benefits. The probability that CTA is cost-effective was 96% at a willingness-to-pay threshold of $80 000/QALY. Sensitivity analyses showed that duplex ultrasound was cost-effective only for a prior probability of ≤0.02 and that these results were only minimally influenced by duplex ultrasound sensitivity and specificity. Nonenhanced CT and magnetic resonance imaging never became the most cost-effective strategy. Our results suggest that CTA in patients with possible basilar artery occlusion is cost-effective. © 2015 The Authors.
    Full-text · Article · May 2015 · Stroke
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    Preview · Article · May 2015
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    ABSTRACT: The objective of this study was to assess the potential of grating-based phase-contrast computed tomography (gb-PCCT) for the detection and characterization of human coronary artery disease in an experimental ex vivo validation study. The study was approved by the institutional review board, and informed consent was obtained from all patients. Specimens were examined using a conventional low-coherence x-ray tube (40 kV) and a Talbot-Lau grating interferometer. Histopathologic assessment was used as the standard of reference. Signal characteristics of calcified, fibrous (FIB), and lipid-rich (LIP) tissue were visually and quantitatively assessed by phase-contrast Hounsfield units (HU). Conventional absorption-based HU values were also measured. Conservative measurements of diagnostic accuracy for the detection and differentiation of plaque components as well as quantitative measurements of vessel dimensions were obtained, and receiver operating characteristic curve analysis for plaque differentiation was performed. A total of 15 coronary arteries from 5 subjects were available for analysis (386 sections). Calcified, FIB, and LIP displayed distinct gb-PCCT signal criteria. The diagnostic accuracy of gb-PCCT was high with sensitivity, specificity, and negative and positive predictive values of 0.89 or greater for all plaque components with good interrater agreement (к ≥ 0.88). In addition, quantitative measurements of vessel dimensions in gb-PCCT were strongly correlated with measurements obtained from histopathology (Pearson R ≥ 0.86). Finally, phase-contrast Hounsfield units were superior to conventional HU in differentiating FIB and LIP (receiver operating characteristic analysis, 0.86 vs. 0.77, respectively; P < 0.05). In an ex vivo setting, gb-PCCT provides improved differentiation and quantification of coronary atherosclerotic plaque and may thus serve as a tool for nondestructive histopathology.
    No preview · Article · May 2015 · Investigative radiology

Publication Stats

18k Citations
1,827.90 Total Impact Points


  • 2003-2016
    • University Hospital München
      München, Bavaria, Germany
  • 1997-2016
    • Ludwig-Maximilians-University of Munich
      • Department of Clinical Radiology
      München, Bavaria, Germany
  • 2008-2015
    • Technische Universität München
      München, Bavaria, Germany
    • University of Rochester
      • Department of Imaging Sciences
      Rochester, New York, United States
  • 2011
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2009
    • Universität Heidelberg
      • Faculty of Medicine Mannheim and Clinic Mannheim
      Heidelberg, Baden-Wuerttemberg, Germany
  • 2006-2007
    • University of Wisconsin, Madison
      • Department of Radiology
      Mississippi, United States
  • 2004
    • Brown University
      Providence, Rhode Island, United States
  • 2002
    • Huazhong University of Science and Technology
      Wu-han-shih, Hubei, China
  • 2001
    • Tongji Medical University
  • 1992-1993
    • University of Bonn
      • Radiologische Klinik
      Bonn, North Rhine-Westphalia, Germany