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170 results on '"Künzel, Julian"'

5. Effects of undergraduate ultrasound education on cross-sectional image understanding and visual-spatial ability - a prospective study

Author

Weimer, Johannes, primary, Ruppert, Johannes, additional, Vieth, Thomas, additional, Weinmann-Menke, Julia, additional, Buggenhagen, Holger, additional, Künzel, Julian, additional, Rink, Maximilian, additional, Lorenz, Liv, additional, Merkel, Daniel, additional, Ille, Carlotta, additional, Yang, Yang, additional, Müller, Lukas, additional, Kloeckner, Roman, additional, and Weimer, Andreas, additional

Published
2024
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10. Clinical significance of panendoscopy in initial staging of oral squamous cell carcinoma and detection of synchronous second malignancies of the upper aerodigestive tract — Insights from a retrospective population-based cohort study

Author

Spoerl, Steffen, Gerken, Michael, Chamilos, Christos, Spoerl, Silvia, Fischer, René, Vielsmeier, Veronika, Künzel, Julian, Bohr, Christopher, Meier, Johannes K., Ettl, Tobias, Reichert, Torsten E., and Spanier, Gerrit

Published
2022
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11. Standardized Digital Image Analysis of PD-L1 Expression in Head and Neck Squamous Cell Carcinoma Reveals Intra- and Inter-Sample Heterogeneity with Therapeutic Implications.

Author

Deuss, Eric, Kürten, Cornelius, Fehr, Lara, Kahl, Laura, Zimmer, Stefanie, Künzel, Julian, Stauber, Roland H., Lang, Stephan, Hussain, Timon, and Brandau, Sven

Subjects
SQUAMOUS cell carcinoma, CANCER relapse, HEAD & neck cancer, DIGITAL diagnostic imaging, PROGRAMMED death-ligand 1, TUMOR markers, CANCER patients, DESCRIPTIVE statistics, METASTASIS, IMMUNOHISTOCHEMISTRY, DIGITAL image processing, PROPORTIONAL hazards models
Abstract

Simple Summary: PD-L1 expression determines patients' eligibility for immunotherapy. Current sampling does not consider the heterogeneity of PD-L1 expression in head and neck squamous cell carcinoma (HNSCC) within the primary tumor. Moreover, potential differences are not considered when comparing primary tumors and their associated metastases or local recurrences, hereby excluding potential responders to immunotherapy. Here, we investigated the inter-sample heterogeneity of PD-L1 expression by analyzing multiple samples from individual patients. Multisection staining revealed clinically relevant CPS changes, which would have potentially affected treatment decisions in 28.7% (intra-tumoral), 44.4% (tumor vs. metastases), and 61.5% (initial tumor vs. local recurrence) of patients, respectively, compared with single-region staining. Increased CPS in primary tumors and lymph node metastases were associated with improved 5-year overall survival. Our results suggest that multiple tumor sections should be evaluated in HNSCC patients when assessing PD-L1 expression prior to potential immunotherapy, particularly if the initial result was negative. For practical reasons, in many studies PD-L1 expression is measured by combined positive score (CPS) from a single tumor sample. This does not reflect the heterogeneity of PD-L1 expression in head and neck squamous cell carcinoma (HNSCC). We investigated the extent and relevance of PD-L1 expression heterogeneity in HNSCC analyzing primary tumors and recurrences (LRs), as well as metastases. Tumor tissue from 200 HNSCC patients was immunohistochemically stained for PD-L1 and analyzed using image-analysis software QuPath v3.4 with multiple specimens per patient. CPS was ≥20 in 25.6% of primary tumors. Intra-tumoral heterogeneity led to a therapeutically relevant underestimation of PD-L1 expression in 28.7% of patients, when only one specimen per patient was analyzed. Inter-tumoral differences in PD-L1 expression between primary tumors and lymph node metastasis (LNM) or LR occurred in 44.4% and 61.5% (CPS) and in 40.6% and 50% of cases (TPS). Overall survival was increased in patients with CPS ≥ 1 vs. CPS < 1 in primary tumors and LNM (hazard ratio: 0.46 and 0.35; p < 0.005); CPS in LR was not prognostic. Our analysis shows clinically relevant intra- and inter-sample heterogeneity of PD-L1 expression in HNSCC. To account for heterogeneity and improve patient selection for immunotherapy, multiple sample analyses should be performed, particularly in patients with CPS/TPS < 1. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Prospective Comparison of Handheld Ultrasound Devices from Different Manufacturers with Respect to B-Scan Quality and Clinical Significance for Various Abdominal Sonography Questions

Author

Merkel, Daniel, primary, Züllich, Tim Felix, additional, Schneider, Christoph, additional, Yousefzada, Masuod, additional, Beer, Diana, additional, Ludwig, Michael, additional, Weimer, Andreas, additional, Künzel, Julian, additional, Kloeckner, Roman, additional, and Weimer, Johannes Matthias, additional

Published
2023
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14. Digital Transformation in Musculoskeletal Ultrasound: Acceptability of Blended Learning

Author

Weimer, Andreas Michael, primary, Berthold, Rainer, additional, Schamberger, Christian, additional, Vieth, Thomas, additional, Balser, Gerd, additional, Berthold, Svenja, additional, Stein, Stephan, additional, Müller, Lukas, additional, Merkel, Daniel, additional, Recker, Florian, additional, Schmidmaier, Gerhard, additional, Rink, Maximilian, additional, Künzel, Julian, additional, Kloeckner, Roman, additional, and Weimer, Johannes, additional

Published
2023
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19. Undergraduate ultrasound education at an Universityhospital- Evaluation of the development and implementation of training concepts over the last 6 years

Author

Weimer, Johannes Matthias, additional, Strelow, Kai-Uwe, additional, Buggenhange, Holger, additional, Weimer, Andreas, additional, Dirks, Klaus, additional, Börner, Norbert, additional, Rink, Maximilian, additional, Künzel, Julian, additional, Ille, Carlotta, additional, Weinmann-Menke, Julia, additional, and Müller, Lukas, additional

Published
2023
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21. Evaluation of a structured training concept for sonography peer-tutors

Author

Schiestl, Lina, additional, Ille, Carlotta, additional, Müller, Lukas, additional, Büchner, Hans, additional, Strelow, Kai-Uwe, additional, Buggenhange, Holger, additional, Weimer, Andreas, additional, Börner, Norbert, additional, Künzel, Julian, additional, Lorenz, LIV-Annebritt, additional, Weinmann-Menke, Julia, additional, and Weimer, Johannes Matthias, additional

Published
2023
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25. Long-Term Effectiveness and Sustainability of Integrating Peer-Assisted Ultrasound Courses into Medical School—A Prospective Study

Author

Weimer, Johannes Matthias, primary, Widmer, Nina, additional, Strelow, Kai-Uwe, additional, Hopf, Paula, additional, Buggenhagen, Holger, additional, Dirks, Klaus, additional, Künzel, Julian, additional, Börner, Norbert, additional, Weimer, Andreas Michael, additional, Lorenz, Liv Annebritt, additional, Rink, Maximilian, additional, Bellhäuser, Henrik, additional, Schiestl, Lina Judit, additional, Kloeckner, Roman, additional, Müller, Lukas, additional, and Weinmann-Menke, Julia, additional

Published
2023
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28. Development and Integration of DOPS as Formative Tests in Head and Neck Ultrasound Education: Proof of Concept Study for Exploration of Perceptions

Author

Weimer, Johannes Matthias, primary, Rink, Maximilian, additional, Müller, Lukas, additional, Dirks, Klaus, additional, Ille, Carlotta, additional, Bozzato, Alessandro, additional, Sproll, Christoph, additional, Weimer, Andreas Michael, additional, Neubert, Christian, additional, Buggenhagen, Holger, additional, Ernst, Benjamin Philipp, additional, Symeou, Luisa, additional, Lorenz, Liv Annebritt, additional, Hollinderbäumer, Anke, additional, and Künzel, Julian, additional

Published
2023
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29. Lateral neck cyst surgery without ipsilateral tonsillectomy: a retrospective analysis

Author

Schwan, Franziska E., Künzel, Julian, Weber, Florian, Vielsmeier, Veronika, Bohr, Christopher, and Andorfer, Kornelia E. C.

Subjects
Branchiogenic cyst · Lateral neck cyst · Lymphoepithelial cyst · Tonsillectomy, ddc:610, Otorhinolaryngology, 610 Medizin, General Medicine
Abstract

Purpose Several theories have been proposed regarding the origin of lateral neck cysts (LNC). Besides complete surgical resection ipsilateral tonsillectomy and dissection of a tract or its remnants is sometimes recommended. In this retrospective trial we wanted to evaluate if patients, who received LNC resection only, develop complications or recurrence to justify this surgical strategy. Methods Patients who received LNC resection between 2004 and 2017 at the Ear Nose and Throat Department of a university hospital were included. Data was collected from the clinic database and through a structured telephone interview. Results A total of 126 patients met the inclusion criteria. In this collective, the diagnosis of a lateral neck cyst was confirmed histologically. Mean age at time of operation was 38 years (± 14.6). The median follow-up time was 7 years (range 3–18). None of the participants experienced recurrent unilateral pharyngitis or tonsillitis during follow-up. Furthermore, there was no case of postoperative peritonsillar, neck phlegmon or neck abscess. No patient reported recurrence of LNC. Conclusions Sole complete resection of LNCs is sufficient to avoid postoperative infections and recurrences. Therefore, ipsilateral tonsillectomy and tract dissection is not necessary in routine cases of LNC surgery.

Published
2022

30. Structured Reporting of Head and Neck Sonography Achieves Substantial Interrater Reliability

Author

Weimer, Johannes Matthias, primary, Künzel, Julian, primary, Ernst, Benjamin Philipp, additional, Dörsching, Carla, additional, Bozzato, Alessandro, additional, Gabrielpillai, Jennis, additional, Becker, Sven, additional, Froelich, Matthias Frank, additional, Kramer, Benedikt, additional, Sproll, Christoph, additional, Schapher, Mirco, additional, Goncalves, Miguel, additional, Mansour, Naglaa, additional, Hofauer, Benedikt, additional, Sommer, Wieland H, additional, and von Scotti, Felix, additional

Published
2023
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35. The Use of Contrast-Enhanced Sonography for Therapy Monitoring of Metastatic Lymph Nodes: A Systematic Review

Author

Rink, Maximilian, Jung, Ernst-Michael, and Künzel, Julian

Subjects
ddc:610, contrast-enhanced ultrasound, CEUS, therapy monitoring, solid carcinoma, head and neck squamous carcinoma, lymph node metastasis, 610 Medizin
Abstract

Metastatic cervical lymph nodes are a frequent finding in head and neck squamous cell carcinoma (HNSCC). If a non-surgical approach is primarily chosen, a therapy response evaluation of the primary tumor and the affected lymph nodes is necessary in the follow-up. Supplementary contrast-enhanced ultrasound (CEUS) can be used to precisely visualize the microcirculation of the target lesion in the neck, whereby malignant and benign findings differ in their uptake behavior. The same applies to many other solid tumors. For various tumor entities, it has already been shown that therapy monitoring is possible through regular contrast-enhanced sonography of the primary tumor or the affected lymph nodes. Thus, in some cases, maybe in the future, a change in therapy strategy can be achieved at an early stage in the case of non-response or, in the case of therapy success, a de-escalation of subsequent (surgical) measures can be achieved. In this paper, a systematic review of the available studies and a discussion of the potential of therapy monitoring by means of CEUS in HNSCC are presented.

Published
2023
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37. Multiparametric Ultrasound of Cervical Lymph Node Metastases in Head and Neck Cancer for Planning Non-Surgical Therapy

Author

Künzel, Julian, Brandenstein, Moritz, Zeman, Florian, Symeou, Luisa, Platz Batista da Silva, Natascha, and Jung, Ernst Michael

Subjects
ddc:610, CEUS, shear wave elastography, perfusion, neck metastases, superficial lymph nodes, Clinical Biochemistry, 610 Medizin
Abstract

Background: We aimed to evaluate multiparametric ultrasound, to achieve a better understanding of the baseline characteristics of suspected cervical lymph node metastases in head and neck cancer before induction chemotherapy or chemoradiation. Methods: From February 2020 to April 2021, our complete ultrasound examination protocol was carried out on clinically evident malignant lymph nodes of histologically proven HNSCC in the pre-therapeutic setting. Results: A total of 13 patients were eligible for analysis. Using elastography, irregular clear hardening in areas in the center of the lymph node could be detected in all cases. Elastographic Q-analysis showed a significantly softer cortex compared to the center and surrounding tissue. The time–intensity curve analysis showed high values for the area under the curve and a short time-to-peak (fast wash-in) in all cases compared to the surrounding tissue. A parametric evaluation of contrast enhanced the ultrasound in the early arterial phase and showed an irregular enhancement from the margin in almost all investigated lymph nodes. These results show that the implementation of comprehensive, multiparametric ultrasound is suitable for classifying suspected lymph node metastasis more precisely than conventional ultrasound alone in the pre-therapeutic setting of HNSCC. Thus, these parameters may be used for improvements in the re-staging after chemoradiation or neoadjuvant therapy monitoring, respectively.

Published
2022

39. Professional Standards in Medical Ultrasound – EFSUMB Position Paper (Long Version) – General Aspects

Author

Wüstner, Matthias, additional, Radzina, Maija, additional, Calliada, Fabrizio, additional, Cantisani, Vito, additional, Havre, Roald Flesland, additional, Jenderka, Klaus-Vitold, additional, Kabaalioğlu, Adnan, additional, Kocian, Milan, additional, Kollmann, Christian, additional, Künzel, Julian, additional, Lim, Adrian, additional, Maconi, Giovanni, additional, Mitkov, Vladimir, additional, Popescu, Alina, additional, Saftoiu, Adrian, additional, Sidhu, Paul S., additional, and Jenssen, Christian, additional

Published
2022
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40. Professional Standards in Medical Ultrasound – EFSUMB Position Paper (Short Version) – General Aspects

Author

Wüstner, Matthias, additional, Radzina, Maija, additional, Calliada, Fabrizio, additional, Cantisani, Vito, additional, Havre, Roald Flesland, additional, Jenderka, Klaus-Vitold, additional, Kabaalioğlu, Adnan, additional, Kocian, Milan, additional, Kollmann, Christian, additional, Künzel, Julian, additional, Lim, Adrian, additional, Maconi, Giovanni, additional, Mitkov, Vladimir, additional, Popescu, Alina, additional, Saftoiu, Adrian, additional, Sidhu, Paul S., additional, and Jenssen, Christian, additional

Published
2022
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49. Cytokine Profiles of Head and Neck Squamous Cell Carcinoma Undergoing Dual Immunotherapy With Cetuximab and Pembrolizumab Identify Interferon Gamma-Induced Protein 10 as Novel Biomarker

Author

Berszin, Michael, Michaelides, Ioannis, Siemert, Julia, Röhl, Louisa, Wellhausen, Jana, Wald, Theresa, Bohr, Christopher, Künzel, Julian, Gradistanac, Tanja, Dietz, Andreas, Zebralla, Veit, Pirlich, Markus, Wiegand, Susanne, and Wichmann, Gunnar

Subjects
Cancer Research, Oncology, interferon-gamma induced protein 10 (IP-10), CXCL10 (C-X-C motif ligand 10), interferon-gamma (IFN-g), vascular endothelial growth factor A (VEGF), interleukin 6 (IL-6), head and neck squamous cell carcinoma (HNSCC), ex vivo chemo-sensitivity assay, colony formation, ddc:610
Abstract

BackgroundPembrolizumab and cetuximab are antibodies under investigation in head and neck squamous cell carcinoma (HNSCC) either as single agents or combined with cisplatin and other chemotherapeutic drugs, e.g., 5-fluorouracil and/or docetaxel. However, also the combination of both antibodies may have potential in recurrent/metastatic (R/M) HNSCC, in particular in cisplatin-resistant or -refractory cases or patients with comorbid disease, e.g. patients with impaired renal function.MethodsTo clarify potential benefit that may result from such combination, we used the FLAVINO assay, a short-time ex vivo assay to compare responsiveness of HNSCC to pembrolizumab, cetuximab and both combined regarding colony formation of epithelial cells of biopsy-derived tumor samples and their cytokine production within three days either without or with stimulation with 10 ng/mL interferon gamma (IFN-γ). Vascular endothelial growth factor A (VEGF), monocyte chemoattractant protein 1 (MCP-1 or CCL2), interleukin 6 (IL-6), IL-8, IFN-γ, and interferon gamma-induced protein 10 (IP-10 or CXCL10) in supernatants were measured by ELISA.ResultsWe detected huge heterogeneity in response to cetuximab, pembrolizumab and both combined with and without IFN-γ stimulation. Moreover, we detected a link between IFN-γ induced IP-10 release and improved outcome in those HNSCC patients who were capable to respond to IFN-γ and pembrolizumab, cetuximab and both combined with a further increase in IP-10 production. We derived an “IP-10 score” that independent from clinical characteristics of HNSCC patients and therapy regimens applied was able to predict their outcome.ConclusionsThe heterogeneity in the ex vivo response of cetuximab, pembrolizumab and both combined with and without IFN-γ stimulation identifies subgroups of HNSCC patients with deviating OS.

Published
2022

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