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  • Georg Thieme Verlag KG  (8)
  • English  (8)
  • 1
    Online Resource
    Online Resource
    Ultrasound-assisted catheter placement in CT-guided HDR brachytherapy for the local ablation of abdominal malignancies: Initial experience
    Georg Thieme Verlag KG ; 2019
    In:  RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 191, No. 01 ( 2019-01), p. 48-53
    Details
    In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 191, No. 01 ( 2019-01), p. 48-53
    Abstract: Ziel Evaluierung der Sicherheit und Machbarkeit der sonografisch assistierten Katheter-Anlage bei der interstitiellen High-dose-rate-Brachytherapie abdomineller Malignome. Material und Methoden In einer ersten Kohorte von 12 Patienten mit 16 abdominellen Tumoren (kolorektale Lebermetastasen n = 9; Nierenzellkarzinom n = 3; hepatozelluläres Karzinom n = 2; cholangiozelluläres Karzinom n = 2) erfolgte die initiale Punktion und Katheter-Anlage bei der CT-gestützten Brachytherapie soweit möglich unter sonografischer Führung. Die Durchführung des Eingriffs wurde prospektiv erfasst und der klinische Verlauf der Patienten dokumentiert. Die erhobenen Daten wurden deskriptiv ausgewertet und mit dem Mann-Whitney-U-Test analysiert. Ergebnisse Bei 12 von 16 Läsionen (Diameter 1,5 – 12,9 cm) konnte die initiale Punktion zur Katheter-Platzierung sonografisch erfolgreich ohne Zuhilfenahme der CT-Fluoroskopie vorgenommen werden, wodurch sich die mittlere Fluoroskopiezeit des gesamten Eingriffs signifikant verkürzen ließ (14,5 vs. 105,5 ; p = 0,006). Bei 8 Läsionen wurde die Sichtbarkeit im Ultraschall insgesamt besser bewertet als in der CT-Fluoroskopie (p = 0,2). Es traten keine Minor- oder Majorkomplikationen innerhalb von 30 Tagen auf. Schlussfolgerung Die ultraschallassistierte Katheter-Anlage könnte bei der interstitiellen, CT-gestützten Brachytherapie abdomineller Tumore sowohl zur verbesserten Katheter-Positionierung als auch zur Reduzierung der Strahlenexposition des medizinischen Personals beitragen. Kernaussagen Die ultraschallassistierte Katheter-Anlage bei der CT-geführten Brachytherapie abdomineller Tumore ist technisch machbar und sicher. Die Ultraschallpunktion könnte die Katheter-Positionierung verbessern. Eine signifikante Reduktion der Fluoroskopiezeit kann bei der Reduktion der Strahlenexposition des medizinischen Personals helfen. Zitierweise
    Type of Medium: Online Resource
    ISSN: 1438-9029 , 1438-9010
    URL: Article
    DOI: 10.1055/a-0636-4055
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2019
    detail.hit.zdb_id: 2031079-1
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  • 2
    Online Resource
    Online Resource
    Radioablation of Upper Abdominal Malignancies by CT-Guided, Interstitial HDR Brachytherapy: A Multivariate Analysis of Catheter Placement Assisted by Ultrasound Imaging
    Georg Thieme Verlag KG ; 2022
    In:  RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 194, No. 01 ( 2022-01), p. 62-69
    Details
    In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 194, No. 01 ( 2022-01), p. 62-69
    Abstract: Purpose To evaluate the use of ultrasound (US) during catheter placement in interstitial brachytherapy (iBT) of abdominal malignancies as an alternative to computed tomography (CT) fluoroscopy. Materials and Methods Catheter placement for CT-guided iBT was, if US visibility was sufficient, assisted by sonography in 52 consecutive patients with 82 lesions (liver N = 62; kidney N = 16; peritoneum N = 4) of various malignancies. We collected data on lesion visibility, location, depth, size, and dosimetry. Comparison of CT fluoroscopy versus US-assisted catheter placement was performed by Fisher’s exact test for frequencies and U-test for lesion visibility and dosimetric data. Factors predicting the utility of sonography were determined in a lesion-based multivariate regression analysis. A p-value 〈  0.05 was regarded as statistically significant. Results 150 catheters (1 to 6 per lesion; mean diameter 3.6 ± 2.4 cm) were implanted. CT fluoroscopy was used for 44 catheters, and US was used for 106 catheters. Lesion visibility assessed by 5-point Likert scale was significantly better in US (median 2 vs. 3; p = 0.011) and effective dose was significantly reduced if US guidance was applicable (median 1.75 vs. 8.19 mSv; p = 0.014). In a multivariate regression analysis, we identified increased lesion size and caudal location within the target organ to independently predict the utility of ultrasound in catheter placement for iBT. Conclusion Sonography is a helpful technique to assist CT-guided interstitial brachytherapy of upper abdominal malignancies. Especially for larger lesions localized in the lower liver segments or lower half of the kidney, superior visibility can be expected. As the effective dose of the patient is also reduced, radiation exposure of the medical staff may be indirectly lowered. Key Points:  Citation Format
    Type of Medium: Online Resource
    ISSN: 1438-9029 , 1438-9010
    URL: Article
    DOI: 10.1055/a-1545-4983
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2031079-1
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  • 3
    Online Resource
    Online Resource
    Sarcopenia does not limit overall survival in patients with colorectal liver metastases undergoing interstitial brachytherapy
    Georg Thieme Verlag KG ; 2023
    In:  RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 195, No. 03 ( 2023-03), p. 217-223
    Details
    In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 195, No. 03 ( 2023-03), p. 217-223
    Abstract: Purpose Several studies report an association of sarcopenia with survival in oncologic patients. The aim of this study is to assess the influence of sarcopenia on overall survival (OS) in patients with colorectal liver metastases undergoing interstitial brachytherapy (iBT) Methods We identified 144 patients with colorectal liver metastases from our database from 2014–2017. Computed tomography (CT) chest scans at the L3 level were retrospectively analyzed. Psoas muscle area (PMA), psoas muscle index (PMI), and skeletal muscle gauge (SMG) were measured on the CT scan before treatment. Parameters were associated with overall survival. Results 116 patients were included. Median overall survival was 27 months. Median PMA was 13.79 cm2, median PMI 4.51 cm2/m2. Neither PMA (HR 1.036, 95 % CI 0.996–1.078, p = 0.080), PMI (HR 1.068, 95 % CI 0.922–1.238, p = 0.382), nor SMG (HR 1.00, 95 % CI 0.998–1.003, p = 0.955) were significantly associated with overall survival. Conclusion Sarcopenic patients undergoing iBT for colorectal liver metastases did not show decreased overall survival. If confirmed by comparative studies, sarcopenia may serve as a biomarker for treatment decision in patients with CRLM. Key points: Sarcopenia is not a risk factor for survival in patients with CLRM undergoing iBT. Citation Format
    Type of Medium: Online Resource
    ISSN: 1438-9029 , 1438-9010
    URL: Article
    DOI: 10.1055/a-1936-2937
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2031079-1
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  • 4
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    Online Resource
    Image Quality Assessment for Low-Dose-CT in Hybrid SPECT/CT Imaging
    Georg Thieme Verlag KG ; 2018
    In:  Nuklearmedizin Vol. 57, No. 04 ( 2018-08), p. 153-159
    Details
    In: Nuklearmedizin, Georg Thieme Verlag KG, Vol. 57, No. 04 ( 2018-08), p. 153-159
    Abstract: Objectives: Low-dose-computed tomography (LD-CT) is used in nuclear medicine hybrid imaging (e.g., SPECT/CT) for attenuation correction of emission data and anatomical correlation of findings. However, there are currently no standards for image quality (e. g., detectability) comparable to those for diagnostic CT. Therefore, the aim of this explorative study was to evaluate retrospective LDCT data in terms of CT image quality and detectability of anatomical structures. Methods: Two readers blindly scored abdominal LD-CT images (n = 40 patients) in terms of detectability (n = 20 structures/patient), image quality, and readers’ confidence in scoring the image quality for a clinically hybrid imaging protocol. Results were analysed by ANOVA to identify factors (e. g., anatomical structures) that influenced performance scores. The inter-rater agreement was evaluated by determining the chance-corrected Cohen’s Kappa coefficient. Results: Image noise was acceptable for anatomical correlation in 96.1 % of the readings with an almost perfect inter-rater agreement (KBP = 0.85). A detectability of at least 80 % was observed in 13/20 (KBP ≥ 0.7) and 90 % in 9/20 (KBP ≥ 0.85) of the structures analysed by both readers. The confidence of both readers in scoring image quality was at least sufficient in 98.8 % of the examined patients (KBP = 0.95). Conclusion: Although LD-CT protocols commonly used in hybrid imaging have a poor image quality not suitable for primary CT diagnostics, they enable detection of a variety of anatomical structures. LDCT can therefore also be referenced in the associated reports for anatomical correlation of findings from SPECT imaging.
    Type of Medium: Online Resource
    ISSN: 0029-5566 , 2567-6407
    URL: Article
    DOI: 10.3413/Nukmed-0953-17-12
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
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  • 5
    Online Resource
    Online Resource
    Cone-beam computed tomography – adding a new dimension to ERCP
    Georg Thieme Verlag KG ; 2015
    In:  Endoscopy Vol. 47, No. 07 ( 2015-2-12), p. 654-657
    Details
    In: Endoscopy, Georg Thieme Verlag KG, Vol. 47, No. 07 ( 2015-2-12), p. 654-657
    Type of Medium: Online Resource
    ISSN: 0013-726X , 1438-8812
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.1055/s-005-29370
    DOI: 10.1055/s-00000012
    DOI: 10.1055/s-0034-1391483
    RVK:
    XA 41100
    RVK:
    YC 4905
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2015
    detail.hit.zdb_id: 2026213-9
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  • 6
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    Online Resource
    Time course and local distribution of skin exposure of hand and fingers from [68Ga]Ga-DOTA-NOC synthesis using a self-shielded module
    Georg Thieme Verlag KG ; 2020
    In:  Nuklearmedizin Vol. 59, No. 04 ( 2020-08), p. 308-315
    Details
    In: Nuklearmedizin, Georg Thieme Verlag KG, Vol. 59, No. 04 ( 2020-08), p. 308-315
    Abstract: Aim The study examined the local dose distribution as well as the time course of skin exposure of hand and fingers from [68Ga]Ga-DOTA-NOC synthesis using a self-shielded synthesis module. Methods A compact calibrated electronic dosimeter (ED) with a miniaturized probe was used for real-time measurements of skin dose equivalent Hp (0.07) (reference point: left and right index finger). A time resolved assessment of exposure during radiotracer production was performed. Additionally, thermoluminescence dosimeters (TLD) were used to determine local dose distribution for five different positions (e. g. fingertips). Cumulated Hp (0.07) estimated by ED was analysed and correlated with the measurements obtained by a TLD positioned close to the ED. Results The cumulative skin exposure from the production process measured by ED, was 74.7 ± 32.7 µSv/GBq and 40.1 ± 14.3 µSv/GBq for the right and left hand, respectively. The exposure recorded by the ED was in the average 19.4 % ± 40.0 % (median = 21.3 %) lower compared to the results from TLD. Highest exposure was recorded during synthesis (guided hand: 24.5 ± 12.2 µSv/GBq) and measuring of product yield including preparation of probes for quality control (guided hand: 36.1 ± 12.7 µSv/GBq). The highest local exposure was measured by a TLD close to the tip of the index finger of the guiding hand (range: 773–1257 µS/GBq). Conclusion The chosen methodology using ED, proved to be a good concept for identifying procedure steps with an increased exposure level and to determine the time course of skin exposure and to identify procedure steps for further optimization of handling. Furthermore, miniaturized electronic dosimeters may be used for online surveillance of local exposure rates at hands and fingers.
    Type of Medium: Online Resource
    ISSN: 0029-5566 , 2567-6407
    URL: Article
    DOI: 10.1055/a-1134-4374
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
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  • 7
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    Road Map fluoroscopy successfully guides endoscopic interventions in the esophagus
    Georg Thieme Verlag KG ; 2017
    In:  Endoscopy International Open Vol. 05, No. 07 ( 2017-07), p. E608-E612
    Details
    In: Endoscopy International Open, Georg Thieme Verlag KG, Vol. 05, No. 07 ( 2017-07), p. E608-E612
    Abstract: Background and study aims Road Map (RM) fluoroscopy is a radiological technique that enables visualization of anatomic structures using image subtraction at peak opacification. RM fluoroscopy has never previously been evaluated for use in endoscopy. The aim of this study was to evaluate the usefulness of RM in guiding endoscopic intervention in the esophagus. Patients and methods This was a monocentric observational trial of consecutive patients with esophageal strictures in a university hospital. Twenty-seven investigations using RM were performed in 24 patients undergoing esophageal endoscopy. Indications for the procedure were balloon dilatation (n = 7 including 2 pneumatic balloon dilatations for treatment of achalasia), bougie dilatation (n = 7) and diagnostic endoscopy (n = 1). In addition, 12 stents, 7 partially covered and 5 fully covered, were placed using RM as a guide for determination of stent length and diameter. Stents were deployed under RM guidance. Results In all procedures, RM successfully guided the intervention. Endoscopic control endoscopy confirmed adequate stent placement in all cases. The feeling of resistance during bougie dilation matched the RM-predicted location of the stenosis. With the help of RM imaging, dilatation balloons were easily centered inside the stenosis and thus slipping of the balloon was avoided. There were no adverse events. Conclusion RM allows permanent and accurate radiographic imaging of stenoses and esophageal anatomic changes. It is an easy and safe method of guiding endoscopic interventions that require radiological imaging.
    Type of Medium: Online Resource
    ISSN: 2364-3722 , 2196-9736
    URL: Article
    DOI: 10.1055/s-0043-111719
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2017
    detail.hit.zdb_id: 2761052-4
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  • 8
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    Online Resource
    Erratum: Sarcopenia does not limit overall survival in patients with colorectal liver metastases undergoing interstitial brachytherapy
    Georg Thieme Verlag KG ; 2023
    In:  RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 195, No. 03 ( 2023-03), p. e1-e1
    Details
    In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 195, No. 03 ( 2023-03), p. e1-e1
    Type of Medium: Online Resource
    ISSN: 1438-9029 , 1438-9010
    URL: Article
    DOI: 10.1055/a-2030-6723
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2031079-1
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