Joachim E Wildberger's research while affiliated with Maastricht Universitair Medisch Centrum and other places

Publications (361)

Article
Objectives: To assess the impact of low kilo-electronvolt (keV) virtual monoenergetic image (VMI) energies and iterative reconstruction on image quality of clinical photon-counting detector coronary CT angiography (CCTA). Methods: CCTA with PCD-CT (prospective ECG-triggering, 120 kVp, automatic tube current modulation) was performed in a high-en...
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Background: The aim of this study was to investigate whether sequential hybrid [18F]FDG PET/MRI can predict the final pathologic response to neoadjuvant chemo(targeted) therapy (NCT) in breast cancer. Methods: Sequential [18F]FDG PET/MRI was performed before, halfway through and after NCT, followed by surgery. Qualitative response evaluation was...
Article
Background: To provide a systematic review and meta-analysis that evaluates the diagnostic accuracy of contrast-enhanced mammography (CEM) compared to standard contrast-enhanced breast magnetic resonance imaging (breast MRI). Like breast MRI, CEM enables tumour visualization by contrast accumulation. CEM seems to be a viable substitute for breast M...
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Purpose: To provide an overview of existing literature on the association between late gadolinium enhancement (LGE) cardiac MRI and low voltage areas (LVA) obtained with electroanatomic mapping (EAM) or histopathology when assessing atrial fibrosis. Materials and methods: A systematic literature search was conducted in the PubMed, Embase, and Co...
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Objective Obesity is associated with cardiovascular disease (CVD) and CVD mortality. However, previous reports showed a paradoxical protective effect in patients with known CVD referred as “obesity paradox”. Therefore, the aim of the present study was to investigate the association of body mass index (BMI) with coronary artery calcification (CAC) i...
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Aims To evaluate the performance of various semi-automated techniques for quantification of myocardial infarct size on both conventional bright-blood and novel dark-blood late gadolinium enhancement (LGE) images using histopathology as reference standard. Methods and results In 13 Yorkshire pigs, reperfused myocardial infarction was experimentally...
Article
Objective: Different types of preclinical research tools used in the field of diagnostic imaging such as dynamic flow circulation phantoms have built the foundation for optimization and advancement of clinical procedures including new imaging techniques. The objective was to introduce a third-generation phantom, building on the limitations of earl...
Article
Objectives: The aim of this study was to evaluate the feasibility and quality of ultra-high-resolution coronary computed tomography angiography (CCTA) with dual-source photon-counting detector CT (PCD-CT) in patients with a high coronary calcium load, including an analysis of the optimal reconstruction kernel and matrix size. Materials and method...
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Gliomas are the most frequent primary tumors of the brain. They can be divided into grade II-IV astrocytomas and grade II-III oligodendrogliomas, based on their histomolecular profile. The prognosis and treatment is highly dependent on grade and well-identified prognostic and/or predictive molecular markers. Multi-parametric MRI, including diffusio...
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Carotid radiofrequency coils inside a PET/MRI system can result in PET quantification errors. We compared the performance of a dedicated PET/MRI carotid coil against a coil for MRI-only use. An 18F-fluorodeoxyglucose (18F-FDG) phantom was scanned without and with an MRI-only coil and with the PET/MRI coil. The decay-corrected normalized activity wa...
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Purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is regarded as a multisystemic disease. Patients with preexisting cardiovascular disease have an increased risk for a more severe disease course. This study aimed to investigate if a higher degree of coronary artery calcifications (CAC) on a standard chest computed tomography (C...
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(1) Background: Aorta hemodynamics have been associated with aortic remodeling, but the reproducibility of its assessment has been evaluated marginally in patients with thoracic aortic aneurysm (TAA). The current study evaluated intra- and interobserver reproducibility of 4D flow MRI-derived hemodynamic parameters (normalized flow displacement, flo...
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Objectives The aim of the study was to find the lowest possible tube current and the optimal iterative reconstruction (IR) strength in abdominal imaging. Material and methods Reconstruction software was used to insert noise, simulating the use of a lower tube current. A semi-anthropomorphic abdominal phantom (Quality Assurance in Radiology and Med...
Chapter
Contrast media (CM) application is important for the evaluation of the heart with both computed tomography (CT) and magnetic resonance imaging (MRI). In many hospitals around the world, CM is still used in a “one-size-fits-all” fashion, usually with a “safety margin” regarding CM volume, guaranteeing sufficient enhancement even in the heavier patie...
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Objective: The extent of aortic replacement during surgery for acute type A aortic dissection (ATAAD) is an important matter of debate. This meta-analysis aimed to evaluate the short and long term outcomes of a proximal aortic repair (PAR) vs. total arch replacement (TAR) in the treatment of ATAAD. Data Sources: A systematic search of PubMed and...
Article
Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires emergency surgery to avert fatal outcome. Conventional surgical procedures comprise excision of the entry tear and replacement of the proximal aorta with a synthetic vascular graft. In patients with DeBakey type I dissection, this approach leaves a chronically diss...
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Objectives Magnetic resonance venography (MRV) is underutilized in the evaluation of thrombus properties prior to endovascular treatment but may improve procedural outcomes. We therefore investigated the clinical impact of using a dedicated MRV scoring system to assess thrombus characteristics prior to endovascular intervention for iliofemoral deep...
Article
Background Late gadolinium enhancement (LGE) is a widely used cardiac magnetic resonance imaging (MRI) technique to diagnose a broad range of ischemic and non-ischemic cardiomyopathies. Since its development and validation against histology already more than two decades ago, the clinical utility of LGE and its span of applications have increased co...
Article
Background: In contrast-enhanced abdominal computed tomography (CT), radiation and contrast media (CM) injection protocols are closely linked to each other, and therefore a combination is the basis for achieving optimal image quality. However, most studies focus on optimizing one or the other parameter separately. Purpose: Reducing radiation dos...
Article
Purpose Resveratrol has shown promising anti-inflammatory effects in in vitro and animal studies. We aimed to investigate this effect on arterial inflammation in vivo. Methods This was an additional analysis of a double-blind randomized crossover trial which included eight male subjects with decreased insulin sensitivity who underwent an 18F-fluoro...
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Background Invasive coronary angiography (ICA) is still the reference test in suspected non-ST elevation myocardial infarction (NSTEMI), although a substantial number of patients do not have obstructive coronary artery disease (CAD). Early cardiovascular magnetic resonance (CMR) may be a useful gatekeeper for ICA in this setting. The main objective...
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Contrast-enhanced mammography (CEM) is a combination of standard mammography and iodinated contrast material administration. During the last decade, CEM has found its place in breast imaging protocols: after i.v. administration of iodinated contrast material, low-energy and high-energy images are retrieved in one acquisition using a dual-energy tec...
Article
Purpose In perfusion cardiovascular magnetic resonance (CMR), ischemic burden predicts adverse prognosis and is often used to guide revascularization. Ischemic scar tissue can cause stress perfusion defects that do not represent myocardial ischemia. Dark-blood late gadolinium enhancement (LGE) methods detect more scar than conventional bright-blood...
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For almost 20 years, late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been the reference standard for the non-invasive assessment of myocardial viability. Since the blood pool often appears equally bright as the enhanced scar regions, detection of subendocardial scar patterns can be challenging. Various novel LGE method...
Article
Cardiac magnetic resonance imaging (MRI) is widely applied for the noninvasive assessment of cardiac structure and function, and for tissue characterization. For more than 2 decades, 1.5 T has been considered the field strength of choice for cardiac MRI. Although the number of 3-T systems significantly increased in the past 10 years and numerous ne...
Article
Background: International guideline recommendations on safe use of contrast media (CM) are conflicting regarding the necessity to prewarm iodinated CM. Purpose: Aim of the study was to evaluate the effects of room temperature CM compared with prewarmed CM on image quality, safety, and patient comfort in abdominal computed tomography (CT). Metho...
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Citation: Ibrahim, A.; Refaee, T.; Primakov, S.; Barufaldi, B.; Acciavatti, R.J.; Granzier, R.W.Y.; Hustinx, R.; Mottaghy, F.M.; Woodruff, H.C.; Wildberger, J.E.; et al. Reply to Orlhac, F.; Buvat, I. Comment on "Ibrahim et al. The Effects of In-Plane Spatial Resolution on CT-Based Radiomic Features' Stability with and without ComBat Harmonization.
Preprint
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Objectives The objective of the study was to validate PCr/ATP ratios as an in vivo marker for cardiac mitochondrial function. Background Cardiac energy status, measured as PCr/ATP ratio with ³¹P-MRS in vivo, was shown to be a prognostic factor in heart failure and is lowered in cardiometabolic disease. As mitochondrial function is also hampered in...
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Aims To illustrate the practical and technical challenges along with the safety aspects when performing MRI-guided electrophysiological procedures in a pre-existing diagnostic MRI environment. Methods and results A dedicated, well-trained multidisciplinary interventional cardiac MRI team (iCMR team), consisting of electrophysiologists, imaging car...
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Background The incidence of pulmonary thromboembolism is high in SARS-CoV-2 patients admitted to the Intensive Care. Elevated biomarkers of coagulation (fibrinogen and D-dimer) and inflammation (c-reactive protein (CRP) and ferritin) are associated with poor outcome in SARS-CoV-2. Whether the time-course of fibrinogen, D-dimer, CRP and ferritin is...
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While handcrafted radiomic features (HRFs) have shown promise in the field of personalized medicine, many hurdles hinder its incorporation into clinical practice, including but not limited to their sensitivity to differences in acquisition and reconstruction parameters. In this study, we evaluated the effects of differences in in-plane spatial reso...
Article
Purpose In perfusion cardiovascular magnetic resonance (CMR), an ischemic burden ≥12.5% predicts adverse prognosis and is often used to guide revascularization. Ischemic scar tissue can cause matched stress perfusion defects that do not represent myocardial ischemia and therefore accurate detection of ischemic scar is crucial when estimating the my...
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Objectives: Degenerative thoracic aortic aneurysm (TAA) patients are known to be at risk of life-threatening acute aortic events. Guidelines recommend preemptive surgery at diameters of greater than 55 mm, although many patients with small aneurysms show only mild growth rates and more than half of complications occur in aneurysms below this thres...
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Objective High radiation exposure is a concern because of the association with cancer. The objective was to determine the probability of receiving a high radiation dose from CT (from one or more examinations within a 5-year period) and to assess the clinical context by evaluating clinical indications in the high-dose patient group. Design Observat...
Article
Background Despite tremendous improvement in molecular properties over the last century, intravascular injection of iodinated contrast material may still have systemic and hemodynamic consequences. Patients with pre-existing renal insufficiency may be at risk for acute kidney injury, which may be associated with an increased risk of the need for di...
Article
Materials and methods: Fifty consecutive patients with previous cardiac arrhythmias, scheduled for high-resolution 3D LGE MRI, were prospectively enrolled between October 2017 and February 2020. Free-breathing 3D dark-blood LGE MRI with high isotropic resolution (1.6 × 1.6 × 1.6 mm) was performed using a conventional fixed TI (n = 25) or a dynamic...
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Background The risk of pulmonary embolism (PE) in patients with Coronavirus Disease 2019 (COVID-19) is recognized. The prevalence of PE in patients with respiratory deterioration at the Emergency Department (ED), the regular ward, and the Intensive Care Unit (ICU) are not well-established. Objectives We aimed to investigate how often PE was presen...
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Background Personalized molecular radiotherapy based on theragnostics requires accurate quantification of the amount of radiopharmaceutical activity administered to patients both in diagnostic and therapeutic applications. This international multi-center study aims to investigate the clinical measurement accuracy of radionuclide calibrators for 7 r...
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Introduction: The course of the disease in SARS-CoV-2 infection in mechanically ventilated patients is unknown. To unravel the clinical heterogeneity of the SARS-CoV-2 infection in these patients, we designed the prospective observational Maastricht Intensive Care COVID cohort (MaastrICCht). We incorporated serial measurements that harbour aetiolo...
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Background: Low carnitine status may underlie the development of insulin resistance and metabolic inflexibility. Intravenous lipid infusion elevates plasma free fatty acid (FFA) concentration and is a model for simulating insulin resistance and metabolic inflexibility in healthy, insulin sensitive volunteers. Here, we hypothesized that co-infusion...
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Background: Pericardial fat (PF) has been suggested to directly act on cardiomyocytes, leading to diastolic dysfunction. The aim of this study was to investigate whether a higher PF volume is associated with a lower diastolic function in healthy subjects. Methods: 254 adults (40-70 years, BMI 18-35 kg/m2, normal left ventricular ejection fractio...
Poster
Indirect 13C measurements provide a large signal gain when compared to direct 13C-MRS. The regular J-difference editing (JDE) techniques are quite challenging to apply in the liver, as respiratory motion will result in imperfect subtraction of the huge overlapping 1H-[12C] signal, which hampers accurate quantification of the 1H-[13C] signals. Here,...
Article
The latest technical developments in CT have created the possibility for individualized scan protocols at variable kV settings. Lowering tube voltages closer to the K-edge of iodine increases attenuation. However, the latter is also influenced by patient characteristics such as total body weight. To maintain a robust contrast enhancement throughout...
Article
Objectives: The aim of the study was to reach homogeneous enhancement of the liver, irrespective of total body weight (TBW) or tube voltage. An easy-to-use rule of thumb, the 10-to-10 rule, which pairs a 10 kV reduction in tube voltage with a 10% decrease in contrast media (CM) dose, was evaluated. Materials and methods: A total of 256 patients...
Article
Computed tomography (CT) has evolved over decades, offering superb morphologic imaging with isotropic resolution at rapid acquisition times. The latest developments in hardware, such as photon-counting and ultrahigh-resolution detectors, together with breakthroughs in software technology have further improved spatial and temporal resolution while s...
Preprint
Full-text available
Background: Personalized molecular radiotherapy based on theranostics requires accurate quantification of the amount of radiopharmaceutical activity administered to patients both in diagnostic and therapeutic applications. This international multi-center study aims to investigate the clinical measurement accuracy of radionuclide calibrators for 7 r...
Preprint
Full-text available
Background: Personalized molecular radiotherapy based on theragnostics requires accurate quantification of the amount of radiopharmaceutical activity administered to patients both in diagnostic and therapeutic applications. This international multi-center study aims to investigate the clinical measurement accuracy of radionuclide calibrators for 7...
Article
Full-text available
Introduction Early differentiation between emergency department (ED) patients with and without corona virus disease (COVID-19) is very important. Chest CT scan may be helpful in early diagnosing of COVID-19. We investigated the diagnostic accuracy of CT using RT-PCR for SARS-CoV-2 as reference standard and investigated reasons for discordant result...
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Purpose Recently, we introduced a quantum coherence based method (ge‐HSQC) for indirect ¹³C‐MRS in the liver to track ¹³C‐labeled lipids into the hepatic lipid pool in vivo. This approach is more robust in case of respiratory motion, however, inherently leads to a signal loss of 50% when compared with a conventional J‐difference editing technique (...
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Objective Circulating biomarkers are useful in detection and monitoring of cardiovascular diseases. However, their role in aortic valve disease is unclear. Mechanisms are rapidly elucidated and sex differences are suggested to be involved. Therefore, we sought to identify biomarkers involved in aortic valve calcification (AVC) stratified by sex.Met...
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Background: Multidetector computed tomography (MDCT) plays a key role in patient assessment prior to transcatheter aortic valve implantation (TAVI). However, to date no consensus has been established on what is the optimal pre-procedural imaging protocol. Variability in pre-TAVI acquisition protocols may lead to discrepancies in aortic annulus mea...
Preprint
Background: The course of the disease in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in mechanically ventilated patients is unknown. To unravel the clinical heterogeneity of the SARS-CoV-2 infection in these patients, we designed the prospective observational Maastricht Intensive Care COVID cohort; MaastrICCht. We incorpo...
Preprint
Full-text available
Introduction Early differentiation between emergency department (ED) patients with and without corona virus disease (COVID-19) is very important. Chest CT scan may be helpful in early diagnosing of COVID-19. We investigated the diagnostic accuracy of CT using RT-PCR for SARS-CoV-2 as reference standard and investigated reasons for discordant result...
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Objective: As gonad shielding is currently under debate, this study evaluates the practice, from its introduction in about 1905 until today. Methods: The literature was searched for developments in shielding and insights into the effects of ionising radiation on gonads. Based on own pre-1927 dose reconstructions, reported doses after 1927, a 201...
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Background: Nitroglycerin is proposed as an agent to reduce tumour hypoxia by improving tumour perfusion. We investigated the potential of nitroglycerin as a radio-sensitizer in non-small cell lung cancer (NSCLC) and the potential of functional imaging for patient selection. Material and methods: Trial NCT01210378 is a single arm phase II trial,...
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Objectives To derive conversions of antiquated exposure data into modern equivalents and to apply these in the assessment of the skin dose of pelvic radiographs since 1896. Methods The literature 1896–2018 was searched for implicit and explicit dose information. The early implicit dose data contained now obsolete descriptions of radiation quality...
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Background: Vagus nerve activation impacts inflammation. Therefore, we hypothesized that vagal nerve stimulation (VNS) influenced arterial wall inflammation as measured by 18F-FDG uptake. Results: Ten patients with left-sided VNS for refractory epilepsy were studied during stimulation (VNS-on) and in the hours after stimulation was switched off...
Preprint
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In large population-based cohort studies, magnetic resonance imaging (MRI) is often used to study the structure and function of the brain. Advanced MRI techniques such as diffusion-tensor (dMRI) or resting-state functional MRI (rs-fMRI) can be used to study connections between distinct brain regions. However, brain connectivity measures are likely...
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Background: Type 2 diabetes patients and individuals at risk of developing diabetes are characterized by metabolic inflexibility and disturbed glucose homeostasis. Low carnitine availability may contribute to metabolic inflexibility and impaired glucose tolerance. Here, we investigated whether carnitine supplementation improves metabolic flexibili...
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Acute aortic syndromes comprise a group of potentially fatal conditions that result from weakening of the aortic vessel wall. Pre-emptive surgical intervention is currently reserved for patients with severe aortic dilatation, although abundant evidence describes the occurrence of dissection and rupture in aortas with diameters below surgical thresh...
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Purpose We aimed to investigate the influence of both hypothyroidism and thyroid-stimulating hormone (TSH) suppression on vascular inflammation, as assessed with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT). Methods Ten thyroid carcinoma patients underwent an ¹⁸F-FDG PET/CT during post-thyroidectomy...
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Background: The prevalence of valvular aortic stenosis (AS) increases as the population ages. Echocardiographic measurements of peak jet velocity (Vpeak ), mean pressure gradient (Pmean ), and aortic valve area (AVA) determine AS severity and play a pivotal role in the stratification towards valvular replacement. A multimodality imaging approach m...
Poster
Synopsis Non-alcoholic fatty liver (NAFL) has become a major threat to metabolic health. Animal studies have suggested that disturbances in choline metabolism may be linked to the development of NAFL. However, to date, human data on the link of choline and NAFL is scarce. The trimethylammonium (TMA) group of choline can be detected with H-MRS at 3....
Poster
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1H-MRS is extensively used to measure the hepatic lipid content. Conventionally, the water resonance is used as an internal reference, thereby assuming a constant T decay of water across individuals to estimate absolute hepatic lipid content. However, the T values reported in literature for 3T vary widely, which might be due to different subject po...
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Objective To compare the effect of contrast medium iodine concentration on contrast enhancement, heart rate, and injection pressure when injected at a constant iodine delivery rate in coronary CT angiography (CTA). Methods One thousand twenty-four patients scheduled for coronary CTA were prospectively randomized to receive one of four contrast med...
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Background Rupture of a vulnerable carotid atherosclerotic plaque is an important underlying cause of ischemic stroke. Increased leaky plaque microvasculature may contribute to plaque vulnerability. These immature microvessels may facilitate entrance of inflammatory cells into the plaque. The objective of the present study is to investigate whether...
Article
Objectives: Clinical guidelines recommend prophylactic intravenous fluids for patients with estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m to prevent adverse postcontrast outcomes. These patients represent a small minority of the population receiving intravascular iodinated contrast material, and data are not readily availa...
Article
Purpose: To evaluate conditions for minimizing staff dose in interventional radiology, and to provide an achievable level for radiation exposure reduction. Materials and methods: Comprehensive phantom experiments were performed in an angiography suite to evaluate the effects of several parameters on operator dose, such as patient body part, radi...