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16. Imaging modalities using magnetic nanoparticles – overview of the developments in recent years

Author

Schwarz Marc, Dörfler Arnd, Engelhorn Tobias, Struffert Tobias, Tietze Rainer, Janko Christina, Tripal Philipp, Cicha Iwona, Dürr Stephan, Alexiou Christoph, and Lyer Stefan

Subjects
magnetic particle imaging, magnetorelaxometry, multifunctional nanoparticles, nanoparticles, Technology, Chemical technology, TP1-1185, Physical and theoretical chemistry, QD450-801
Abstract

The use of nanoparticles in tumor imaging, molecular imaging, and drug delivery has significantly expanded in the last few years. The relatively new field of “theranostics” combines their capacity for drug delivery with their potential as contrast agents. Depending on the imaging modality used, several types of nanoparticles are available, such as gold for optical imaging or superparamagnetic iron oxide for magnetic resonance imaging. This review will give a short overview of the different types of nanoparticles as well as their development and potential application in recent years. Furthermore, it describes the research on classic imaging modalities as well as on new techniques to image nanoparticles in vivo and focuses on magnetic-based imaging modalities.

Published
2013
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19. Evaluation After Cochlear Implant Surgery

Author

Stock, Annika, Bozzato, Victoria, Kloska, Stephan P., Bozzato, Alessandro, Hoppe, Ulrich, Hornung, Joachim, Dörfler, Arnd, and Struffert, Tobias

Subjects
Cochlear implantation, Dyna-CT, Misplaced cochlear implant electrode array, Rehabilitation, otorhinolaryngologic diseases, Original Article, ddc:610, sense organs, Deafness, psychological phenomena and processes
Abstract

Purpose Assessment of the cochlear implant (CI) electrode array position using flat-detector computed tomography (FDCT) to test dependence of postoperative outcome on intracochlear electrode position. Methods A total of 102 patients implanted with 107 CIs underwent FDCT. Electrode position was rated as 1) scala tympani, 2) scala vestibuli, 3) scalar dislocation and 4) no deconvolution. Two independent neuroradiologists rated all image data sets twice and the scalar position was verified by a third neuroradiologist. Presurgical and postsurgical speech audiometry by the Freiburg monosyllabic test was used to evaluate auditory outcome after 6 months of speech rehabilitation. Results Electrode array position was assessed by FDCT in 107 CIs. Of the electrodes 60 were detected in the scala tympani, 21 in the scala vestibuli, 24 electrode arrays showed scalar dislocation and 2 electrodes were not placed in an intracochlear position. There was no significant difference in rehabilitation outcomes between scala tympani and scala vestibuli inserted patients. Rehabilitation was also possible in patients with dislocated electrodes. Conclusion The use of FDCT is a reliable diagnostic method to determine the position of the electrode array. In our study cohort, the electrode position had no significant impact on postoperative outcome except for non-deconvoluted electrode arrays.

Published
2020

20. Case Report: Take a Second Look: Covid-19 Vaccination-Related Cerebral Venous Thrombosis and Thrombotic Thrombocytopenia Syndrome

Author

Braun, Tobias, Viard, Maxime, Juenemann, Martin, Struffert, Tobias, Schwarm, Frank, Huttner, Hagen B., and Roessler, Florian C.

Subjects
Neurology, Covid-19-vaccination, ChAdOx1 nCoV-19 vaccine, Case Report, cerebral venous thrombosis, Neurology (clinical), vaccine-induced thrombotic thrombocytopenia, Neurology. Diseases of the nervous system, RC346-429, thrombotic thrombocytopenia syndrome
Abstract

We present two cases of ChAdOx1 nCov-19 (AstraZeneca)-associated thrombotic thrombocytopenia syndrome (TTS) and cerebral venous sinus thrombosis (CVST). At the time of emergency room presentation due to persistent headache, blood serum levels revealed reduced platelet counts. Yet, 1 or 4 days after the onset of the symptom, the first MR-angiography provided no evidence of CVST. Follow-up imaging, performed upon headache refractory to nonsteroidal pain medication verified CVST 2–10 days after initial negative MRI. Both the patients received combined treatment with intravenous immunoglobulins and parenteral anticoagulation leading to an increase of platelet concentration in both the individuals and resolution of the occluded cerebral sinus in one patient.

Published
2021

23. Clinical Comparison of FD-CT and MS-CT in Aneurysmal Subarachnoid Haemorrhage: A Single Center Experience.

Author

Eisenhut, Felix, Heidelbach, Cornelius, Heynold, Elisabeth, Manhart, Michael, Struffert, Tobias, Brandner, Sebastian, Doerfler, Arnd, and Lang, Stefan

Subjects
SUBARACHNOID hemorrhage, HYDROCEPHALUS, INTRACRANIAL aneurysms, CEREBRAL hemorrhage, INTRAVENTRICULAR hemorrhage, MULTIDETECTOR computed tomography
Abstract

Single-center comparison of postinterventional multislice computed tomography (MS-CT) and flat-detector computed tomography (FD-CT) in patients with subarachnoid haemorrhage (SAH) and endovascularly treated cerebral aneurysms with a focus on detection of posttherapeutical complications. Patients with endovascularly treated aneurysmal SAH undergoing both MS-CT and FD-CT within 24 h after intervention were included. Datasets were compared regarding image quality (IQ) as well as qualitative (detection of SAH, intracerebral haemorrhage [ICH], intraventricular haemorrhage [IVH], external ventricular drain [EVD] position, acute obstructive hydrocephalus [AOH]) and quantitative (cella media distance [CMD], modified Graeb score [GS]) parameters. 410 patients with endovascularly treated aneurysmal SAH were included. IQ was equal between MS-CT and FD-CT. FD-CT allowed equal detection of SAH and ICH in comparison to MS-CT. FD-CT allowed excellent detection of IVH and delineation of EVD position with strong agreement to MS-CT findings. FD-CT allowed equal detection of AOH in comparison to MS-CT. There was no significant difference of CMD and GS between FD-CT and MS-CT. Postinterventional FD-CT yields equivalent diagnostic value in patients with endovascular treated SAH as MS-CT. Enabling reliable detection of SAH-associated complications within the angiosuite, FD-CT might be an efficient and safe imaging modality in these clinical emergencies. [ABSTRACT FROM AUTHOR]

Published
2022
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26. MRT-Veränderungen nach Protonentherapie in Kombination mit Tumor Treating Fields bei Glioblastompatienten

Author

Goett, Hanna, Jensen, Alexandra, Struffert, Tobias, Uhl, Eberhard, and Stein, Marco

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Tumor treating fields (TTFields) are an approved treatment modality for glioblastoma (GBM) with significant improvement of progression free survival and overall survival. Growing evidence suggest, that proton therapy increase early magnetic resonance imaging (MRI) changes. The aim of this[for full text, please go to the a.m. URL], 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Published
2021
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27. Stent-Assisted Coiling Using Leo+ Baby Stent

Author

Luecking, Hannes, Struffert, Tobias, Goelitz, Philipp, Engelhorn, Tobias, Brandner, Sebastian, Kuramatsu, Joji B., Lang, Stefan, Schmidt, Manuel, and Doerfler, Arnd

Subjects
ddc:610
Abstract

Background Stent-assisted coiling is well-established for treatment of cerebral aneurysms. The technique enables treatment of wide-neck, bifurcation and recurrent aneurysms with high packing rates. While described in extenso for laser cut stents, the results of patients treated with the Leo+ Baby (Balt, Montmorency, France) braided microstent are presented. Material and Methods Patients were included if treated with a Leo+ Baby and with digital subtraction angiography (DSA) follow-up available of at least 6 months. Data were evaluated for successful deployment, aneurysm occlusion according to the modified Raymond-Roy classification (MRRC), stent patency and procedure-related morbidity and mortality. Results A total of 81 patients were included and Leo+ Baby deployment was successful in all cases. Coils were used in 80 cases. In 1 case 2 stents were used stent-in-stent without additional coiling. Initial aneurysm occlusion rates were MRRCi1 51.9%, MRRCi2 11.1%, MRRCi3a 24.7% and MRRCi3b 12.3%. Occlusion rates after 6 months were MRRC6m1 78.9%, MRRC6m2 3.9%, MRRC6m3a 6.6% and MRRC6m3b 10.5%. Procedure-related morbidity was 1 case of acute stent thrombosis successfully treated with tirofiban and 1 case with transient hemiparesis due to stent thrombosis after 4 months. There was 1 case of coil-associated subarachnoid hemorrhage (SAH) which caused prolonged hospitalization. No procedure-related mortality was observed. Conclusion The results confirm that stent-assisted coiling with the Leo+ Baby stent is safe and efficient for treatment of wide neck or recurrent cerebral aneurysms. Spontaneous progressive aneurysm occlusion over 6 months supports the theory of considerable flow-modulating effects of Leo+ Baby.

Published
2021

28. Case Report: A Well-Hidden Cause for Myelopathy

Author

Braun, Tobias, Schulz, Eva, Viard, Maxime, AlhajOmar, Omar, Struffert, Tobias, Gattenlöhner, Stefan, Yenigün, Mesut, Juenemann, Martin, and Justus Liebig University Giessen

Subjects
spinal cord syndrome, ddc:610, neurosarcoidosis, myelopathy, bone marrow sarcoidosis, case report, Neurology. Diseases of the nervous system, RC346-429
Abstract

Introduction: Sarcoidosis is a rare, systemic inflammatory disease and can involve multiple organs, especially the lungs and lymph nodes. The nervous system is affected in

Published
2021

42. Clinical Evaluation of an Innovative Metal-Artifact-Reduction Algorithm in FD-CT Angiography in Cerebral Aneurysms Treated by Endovascular Coiling or Surgical Clipping.

Author

Eisenhut, Felix, Schmidt, Manuel Alexander, Kalik, Alexander, Struffert, Tobias, Feulner, Julian, Schlaffer, Sven-Martin, Manhart, Michael, Doerfler, Arnd, and Lang, Stefan

Subjects
DIGITAL subtraction angiography, INTRACRANIAL aneurysms, CEREBRAL angiography, COMPUTED tomography, ALGORITHMS
Abstract

Treated cerebral aneurysms (IA) require follow-up imaging to ensure occlusion. Metal artifacts complicate radiologic assessment. Our aim was to evaluate an innovative metal-artifact-reduction (iMAR) algorithm for flat-detector computed tomography angiography (FD-CTA) regarding image quality (IQ) and detection of aneurysm residua/reperfusion in comparison to 2D digital subtraction angiography (DSA). Patients with IAs treated by endovascular coiling or clipping underwent both FD-CTA and DSA. FD-CTA datasets were postprocessed with/without iMAR algorithm (MAR+/MAR−). Evaluation of all FD-CTA and DSA datasets regarding qualitative (IQ, MAR) and quantitative (coil package diameter/CPD) parameters was performed. Aneurysm occlusion was assessed for each dataset and compared to DSA findings. In total, 40 IAs were analyzed (ncoiling = 24; nclipping = 16). All iMAR+ datasets demonstrated significantly better IQ (pIQ coiling < 0.0001; pIQ clipping < 0.0001). iMAR significantly reduced the metal-artifact burden but did not affect the CPD. iMAR significantly improved the detection of aneurysm residua/reperfusion with excellent agreement with DSA (naneurysm detection MAR+/MAR−/DSA = 22/1/26). The iMAR algorithm significantly improves IQ by effective reduction of metal artifacts in FD-CTA datasets. The proposed algorithm enables reliable detection of aneurysm residua/reperfusion with good agreement to DSA. Thus, iMAR can help to reduce the need for invasive follow-up in treated IAs. [ABSTRACT FROM AUTHOR]

Published
2022
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