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  • 1
    Online Resource
    Online Resource
    Elsevier BV ; 2022
    In:  European Journal of Radiology Vol. 151 ( 2022-06), p. 110327-
    In: European Journal of Radiology, Elsevier BV, Vol. 151 ( 2022-06), p. 110327-
    Type of Medium: Online Resource
    ISSN: 0720-048X
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2005350-2
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  • 2
    In: European Radiology, Springer Science and Business Media LLC, Vol. 33, No. 3 ( 2022-11-02), p. 2039-2051
    Abstract: Cardiac involvement in Anderson-Fabry disease (AFD) results in myocardial lipid depositions. An early diagnosis can maximize therapeutic benefit. Thus, this study aims to investigate the potential of cardiac MRI (CMR) based parameters of left atrial (LA) function and strain to detect early stages of AFD. Methods Patients ( n = 58, age 40 (29–51) years, 31 female) with genetically proven AFD had undergone CMR including left ventricular (LV) volumetry, mass index (LVMi), T1, and late gadolinium enhancement, complemented by LA and LV strain measurements and atrial emptying fractions. Patients were stratified into three disease phases and compared to age and sex-matched healthy controls (HC, n = 58, age 41 [26–56] years, 31 female). Results A total of 19 early-, 20 intermediate-, and 19 advanced-phase patients were included. LV and LA reservoir strain was significantly impaired in all AFD phases, including early disease (both p 〈 0.001). In contrast, LA volumetry, T1, and LVMi showed no significant differences between the early phase and HC ( p 〉 0.05). In the intermediate phase, LVMi and T1 demonstrated significant differences. In advanced phase, all parameters except active emptying fractions differed significantly from HC. ROC curve analyses of early disease phases revealed superior diagnostic confidence for the LA reservoir strain (AUC 0.88, sensitivity 89%, specificity 75%) over the LV strain (AUC 0.82). Conclusions LA reservoir strain showed impairment in early AFD and significantly correlated with disease severity. The novel approach performed better in identifying early disease than the established approach using LVMi and T1. Further studies are needed to evaluate whether these results justify earlier initiation of therapy and help minimize cardiac complications. Key Points • Parameters of left atrial function and deformation showed impairments in the early stages of Anderson-Fabry disease and correlated significantly with the severity of Anderson-Fabry disease. • Left atrial reservoir strain performed superior to ventricular strain in detecting early myocardial involvement in Anderson-Fabry disease and improved diagnostic accuracies of approaches already using ventricular strain. • Further studies are needed to evaluate whether earlier initiation of enzyme replacement therapy based on these results can help minimize cardiac complications from Anderson-Fabry disease.
    Type of Medium: Online Resource
    ISSN: 1432-1084
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1472718-3
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  • 3
    In: Academic Radiology, Elsevier BV, Vol. 29 ( 2022-04), p. S40-S48
    Type of Medium: Online Resource
    ISSN: 1076-6332
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 4
    In: Imaging, Akademiai Kiado Zrt., ( 2023-07-25)
    Abstract: To compare intra-individual percentage diameter stenosis (PDS) measurements of coronary artery stenoses between energy-integrating detector computed tomography (EID-CT) and a clinical photon-counting detector computed tomography (PCD-CT) systems using similar acquisition and reconstruction settings. Methods Patients ( n = 23, mean age of 65 ± 12.1 years, out of these 16 (69.6%) male) were imaged on a conventional EID- and a clinical PCD-CT system with a median of 5.5 (3.0–12.5) days apart. Sequential CCTA scans were acquired and reconstructed using similar settings, including a vascular Bv36 kernel, a tube voltage of 110 kVp for EID-CT vs 120 kVp for PCD-CT, a slice thickness of 0.5 for EID-CT vs 0.6 for PCD-CT, and an iterative reconstruction strength of 3 on EID-CT vs a virtual monoenergetic reconstruction at 55 keV and quantum iterative reconstruction level of 3 on PCD-CT. Radiation dose, contrast volume, and injection parameters were matched as similarly as possible between the systems. PDS measurements were performed according to the coronary artery disease reporting and data system (CAD-RADS) by two trained readers and compared between the different modalities using the Wilcoxon rank sum test, Spearman correlation, and Bland-Altman analysis. Results PCD-CT measured significantly lower PDS values than EID-CT [PDS EID-CT : 45.1% (35.1%–64.0%) vs. PDS PCD-CT 44.2% (32.4%–61.0%), P 〈 0.0001]. This difference led to a mean bias of 1.8 (LoA −3.0/6.5) with an excellent ICC (0.99) value among EID- and PCD-CT. The mean intra-individual deviation between the examinations was 1.8% between the scanners. This led to CAD-RADS re-classification in 3/23 cases (13.0%, new-lower class) for the first reader, and in 4/23 cases (13.0%, new-lower and 4.4%, new-higher class) for the second reader. Inter-reader agreement between the two readers for each stenosis was very strong (ICC = 0.98). Conclusions Coronary artery stenosis measurements from PCD-CT correlate strongly to EID-CT-based measurements, despite the tendency of the measurement from PCD-CT being lower. This difference led to a change in CAD-RADS classification in 17.4% of patients. The effects on clinical decision-making, downstream testing, and prognosis have to be evaluated in future studies.
    Type of Medium: Online Resource
    ISSN: 2732-0960
    Language: Unknown
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2023
    detail.hit.zdb_id: 3077362-3
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  • 5
    In: The International Journal of Cardiovascular Imaging, Springer Science and Business Media LLC
    Type of Medium: Online Resource
    ISSN: 1875-8312
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2008950-8
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  • 6
    In: European Radiology, Springer Science and Business Media LLC, Vol. 31, No. 10 ( 2021-10), p. 7219-7230
    Abstract: To compare volumetric and functional parameters of the atria derived from highly accelerated compressed sensing (CS)–based cine sequences in comparison to conventional (Conv) cine imaging. Methods CS and Conv cine sequences were acquired in 101 subjects (82 healthy volunteers (HV) and 19 patients with heart failure with reduced ejection fraction (HFrEF)) using a 3T MR scanner in this single-center study. Time-volume analysis of the left (LA) and right atria (RA) were performed in both sequences to evaluate atrial volumes and function (total, passive, and active emptying fraction). Inter-sequence and inter- and intra-reader agreement were analyzed using correlation, intraclass correlation (ICC), and Bland-Altman analysis. Results CS-based cine imaging led to a 69% reduction of acquisition time. There was significant difference in atrial parameters between CS and Conv cine, e.g., LA minimal volume (LAVmin) (Conv 24.0 ml (16.7–32.7), CS 25.7 ml (19.2–35.2), p   〈  0.0001) or passive emptying fraction (PEF) (Conv 53.9% (46.7–58.4), CS 49.0% (42.0–54.1), p   〈  0.0001). However, there was high correlation between the techniques, yielding good to excellent ICC (0.76–0.99) and small mean of differences in Bland-Altman analysis (e.g. LAVmin − 2.0 ml, PEF 3.3%). Measurements showed high inter- (ICC  〉  0.958) and intra-rater (ICC  〉  0.934) agreement for both techniques. CS-based parameters (PEF AUC = 0.965, LAVmin AUC = 0.864) showed equivalent diagnostic ability compared to Conv cine imaging (PEF AUC = 0.989, LAVmin AUC = 0.859) to differentiate between HV and HFrEF. Conclusion Atrial volumetric and functional evaluation using CS cine imaging is feasible with relevant reduction of acquisition time, therefore strengthening the role of CS in clinical CMR for atrial imaging. Key Points • Reliable assessment of atrial volumes and function based on compressed sensing cine imaging is feasible. • Compressed sensing reduces scan time and has the potential to overcome obstacles of conventional cine imaging. • No significant differences for subjective image quality, inter- and intra-rater agreement, and ability to differentiate healthy volunteers and heart failure patients were detected between conventional and compressed sensing cine imaging.
    Type of Medium: Online Resource
    ISSN: 0938-7994 , 1432-1084
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1472718-3
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  • 7
    In: ESC Heart Failure, Wiley, Vol. 7, No. 5 ( 2020-10), p. 2544-2552
    Abstract: The purpose of this retrospective single‐centre study was to evaluate the non‐invasive detection of endomyocardial biopsy (EMB)‐established chronic myocardial inflammation in patients with heart failure with reduced ejection fraction (HFrEF) using T1 and T2 mapping. Methods and results The study population consisted of 52 retrospectively identified HFrEF patients who underwent EMB and cardiac magnetic resonance imaging at 3 Tesla. EMB was defined according to the position statement of the European Society of Cardiology and served as reference to identify inflammation in all patients. A control group of healthy volunteers with prior cardiac magnetic resonance imaging studies ( n  = 58) was also identified. Global and segmental T1 and T2 values as well as septal measurements and tissue heterogeneity parameters were calculated. Out of the 52 patients with HFrEF, 33 patients had myocardial inflammation detected by EMB, while 19 patients were EMB negative for inflammation. Mean left ventricular ejection fraction was 31% in both groups ( P  = 0.97). Global T1 and T2 values in HFrEF patients were significantly higher compared with healthy controls (T1 1275 ± 69 ms vs. 1,175 ± 44 ms, P   〈  0.001; T2 40.0 ± 3.4 ms vs. 37.9 ± 1.6 ms, P   〈  0.001). The distribution of T1 and T2 values between patients with and without EMB‐proven chronic myocardial inflammation was not statistically different when regarding global (T1 1292 ± 71 ms vs. 1266 ± 67 ms, P  = 0.26; T2 40.0 ± 2.6 ms vs. 40.0 ± 3.9 ms, P  = 1.0), septal (T1 1299 ± 63 ms vs. 1289 ± 76 ms, P  = 0.76; T2 40.1 ± 3.5 ms vs 40.0 ± 6.4 ms, P  = 0.49) or maximum segmental values (T1 1414 ± 111 ms vs. 1363 ± 88 ms, P  = 0.15; T2 47.3 ± 5.2 ms vs. 48.8 ± 11.8 ms, P  = 0.53). Mean absolute deviation of segmental T1 and T2 values and log‐transformed pixel‐wise standard deviation as parameters of tissue heterogeneity did not reveal statistical significant differences between inflammation‐positive and inflammation‐negative HFrEF patients (all P   〉  0.4). Conclusions Conventionally performed quantitative T1 and T2 mapping values significantly correlated with prevalence of HFrEF but did not discriminate HFrEF patients with or without chronic myocardial inflammation in our cohort. This suggests that EMB is the preferred method to detect chronic myocardial inflammation in HFrEF.
    Type of Medium: Online Resource
    ISSN: 2055-5822 , 2055-5822
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2814355-3
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  • 8
    In: Diagnostics, MDPI AG, Vol. 13, No. 13 ( 2023-06-26), p. 2172-
    Abstract: Persistent or recurrent cardiovascular symptoms have been identified as one of the hallmarks of long-COVID or post-acute sequelae of SARS-CoV-2 infection (PASC). The purpose of this study was to determine the prevalence and extent of cardiac abnormalities in patients referred for cardiac MRI due to clinical evidence of PASC. To investigate this, two tertiary care hospitals identified all patients who were referred for cardiac MRI under the suspicion of PASC in a 2-year period and retrospectively included them in this study. Patients with previously known cardiac diseases were excluded. This resulted in a total cohort of 129 patients (63, 51% female; age 41 ± 16 years). The majority of patients (57%) showed normal cardiac results. No patient had active myocarditis or an acute myocardial infarction. However, 30% of patients had evidence of non-ischemic myocardial fibrosis, which exceeds the prevalence in the normal adult population and suggests that a possible history of myocarditis might explain persistent symptoms in the PASC setting.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 9
    In: Diagnostics, MDPI AG, Vol. 13, No. 11 ( 2023-06-01), p. 1937-
    Abstract: (1) Background: Photon-counting detector (PCD) CT offers a wide variety of kernels and sharpness levels for image reconstruction. The aim of this retrospective study was to determine optimal settings for coronary CT angiography (CCTA). (2) Methods: Thirty patients (eight female, mean age 63 ± 13 years) underwent PCD-CCTA in a high-pitch mode. Images were reconstructed using three different kernels and four sharpness levels (Br36/40/44/48, Bv36/40/44/48, and Qr36/40/44/48). To analyze objective image quality, the attenuation, image noise, contrast-to-noise ratio (CNR), and vessel sharpness were quantified in proximal and distal coronaries. For subjective image quality, two blinded readers assessed image noise, visually sharp reproduction of coronaries, and the overall image quality using a five-point Likert scale. (3) Results: Attenuation, image noise, CNR, and vessel sharpness significantly differed across kernels (all p 〈 0.001), with the Br-kernel reaching the highest attenuation. With increasing kernel sharpness, image noise and vessel sharpness increased, whereas CNR continuously decreased. Reconstruction with Br-kernel generally had the highest CNR (Br 〉 Bv 〉 Qr), except Bv-kernel had a superior CNR at sharpness level 40. Bv-kernel had significantly higher vessel sharpness than Br- and Qr-kernel (p 〈 0.001). Subjective image quality was rated best for kernels Bv40 and Bv36, followed by Br36 and Qr36. (4) Conclusion: Reconstructions with kernel Bv40 are beneficial to achieve optimal image quality in spectral high-pitch CCTA using PCD-CT.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 10
    In: Cancer Imaging, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-07-21)
    Abstract: Excellent image quality is crucial for workup of hepatocellular carcinoma (HCC) in patients with liver cirrhosis because a signature tumor signal allows for non-invasive diagnosis without histologic proof. Photon-counting detector computed tomography (PCD-CT) can enhance abdominal image quality, especially in combination with a novel iterative reconstruction algorithm, quantum iterative reconstruction (QIR). The purpose of this study was to analyze the impact of different QIR levels on PCD-CT imaging of HCC in both phantom and patient scans. Methods Virtual monoenergetic images at 50 keV were reconstructed using filtered back projection and all available QIR levels (QIR 1–4). Objective image quality properties were investigated in phantom experiments. The study also included 44 patients with triple-phase liver PCD-CT scans of viable HCC lesions. Quantitative image analysis involved assessing the noise, contrast, and contrast-to-noise ratio of the lesions. Qualitative image analysis was performed by three raters evaluating noise, artifacts, lesion conspicuity, and overall image quality using a 5-point Likert scale. Results Noise power spectra in the phantom experiments showed increasing noise suppression with higher QIR levels without affecting the modulation transfer function. This pattern was confirmed in the in vivo scans, in which the lowest noise levels were found in QIR-4 reconstructions, with around a 50% reduction in median noise level compared with the filtered back projection images. As contrast does not change with QIR, QIR-4 also yielded the highest contrast-to-noise ratios. With increasing QIR levels, rater scores were significantly better for all qualitative image criteria (all p   〈  .05). Conclusions Without compromising image sharpness, the best image quality of iodine contrast optimized low-keV virtual monoenergetic images can be achieved using the highest QIR level to suppress noise. Using these settings as standard reconstruction for HCC in PCD-CT imaging might improve diagnostic accuracy and confidence.
    Type of Medium: Online Resource
    ISSN: 1470-7330
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2104862-9
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