Patency of renal and visceral vessels after open thoracoabdominal aortic replacement.

Objective In thoracoabdominal aortic aneurysms (TAAAs), a paradigm shift is observed from open surgery toward total endovascular aortic repair using fenestrated and branched endografts. Whereas outcome after open replacement in terms of mortality and paraplegia has been evaluated extensively, no studies exist addressing long-term patency of visceral and renal vessels. To enable comparison of target vessel patency between open and endovascular treatment, we analyzed our series of open TAAA replacements. Methods Our vascular surgery database was screened for patients who received open TAAA replacement between 1998 and 2012, and patient records were analyzed retrospectively. All available imag…

Augmented Reality Visualisation Concepts to Support Intraoperative Distance Estimation

The estimation of distances and spatial relations between surgical instruments and surrounding anatomical structures is a challenging task for clinicians in image-guided surgery. Using augmented reality (AR), navigation aids can be displayed directly at the intervention site to support the assessment of distances and reduce the risk of damage to healthy tissue. To this end, four distance-encoding visualisation concepts were developed using a head-mounted optical see-through AR setup and evaluated by conducting a comparison study. Results suggest the general advantage of the proposed methods compared to a blank visualisation providing no additional information. Using a Distance Sensor concep…

Unterscheiden sich die Erwartungen und Einstellungen zu Anwendungen der Künstlichen Intelligenz zwischen Radiologen und IT-Experten?

Multimodal Deep Learning for Prognosis Prediction in Renal Cancer

BackgroundClear-cell renal cell carcinoma (ccRCC) is common and associated with substantial mortality. TNM stage and histopathological grading have been the sole determinants of a patient’s prognosis for decades and there are few prognostic biomarkers used in clinical routine. Management of ccRCC involves multiple disciplines such as urology, radiology, oncology, and pathology and each of these specialties generates highly complex medical data. Here, artificial intelligence (AI) could prove extremely powerful to extract meaningful information to benefit patients.ObjectiveIn the study, we developed and evaluated a multimodal deep learning model (MMDLM) for prognosis prediction in ccRCC.Desig…

Multidetector Computed Tomography Angiography (MD-CTA) of Coronary Artery Bypass Grafts – Update 2017

Coronary artery bypass grafting (CABG) is still an important therapeutic approach in the treatment especially of advanced coronary artery disease. In this study, we elucidate the current role of multidetector computed tomography angiography (MD-CTA) in imaging patients after CABG surgery.This study is based on recent reports in the literature (2007 - 2016) on imaging of CABG using 64-slice MD-CT scanners and beyond. We included 13 reports that compared ECG-gated MD-CTA with conventional invasive coronary angiography (ICA) as the reference standard for the assessment of graft patency and for the detection of 50 % stenoses. These studies had to provide absolute values for true-positive, true-…

Tuberkulose 2019 – eine Herausforderung auch für die Radiologie

Überlebensvorhersage für Patienten mit nicht-resezierbarem intrahepatischen Cholangiokarzinom unter Chemotherapie: Vergleich von Tumormarkern und Bildgebung

Accuracy of a Chatbot (Ada) in the Diagnosis of Mental Disorders: Comparative Case Study With Lay and Expert Users

Background Health apps for the screening and diagnosis of mental disorders have emerged in recent years on various levels (eg, patients, practitioners, and public health system). However, the diagnostic quality of these apps has not been (sufficiently) tested so far. Objective The objective of this pilot study was to investigate the diagnostic quality of a health app for a broad spectrum of mental disorders and its dependency on expert knowledge. Methods Two psychotherapists, two psychology students, and two laypersons each read 20 case vignettes with a broad spectrum of mental disorders. They used a health app (Ada—Your Health Guide) to get a diagnosis by entering the symptoms. Interrater …

Attitudes Toward Artificial Intelligence Among Radiologists, IT Specialists, and Industry

Objectives We investigated the attitudes of radiologists, information technology (IT) specialists, and industry representatives on artificial intelligence (AI) and its future impact on radiological work. Materials and Methods During a national meeting for AI, eHealth, and IT infrastructure in 2019, we conducted a survey to obtain participants’ attitudes. A total of 123 participants completed 28 items exploring AI usage in medicine. The Kruskal-Wallis test was used to identify differences between radiologists, IT specialists, and industry representatives. Results The strongest agreement between all respondents occurred with the following: plausibility checks are important to understand the d…

Effect of fluid resuscitation on cerebral integrity: A prospective randomised porcine study of haemorrhagic shock.

BACKGROUND The treatment of haemorrhagic shock is a challenging task. Colloids have been regarded as standard treatment, but their safety and benefit have been the subject of controversial debates. Negative effects, including renal failure and increased mortality, have resulted in restrictions on their administration. The cerebral effects of different infusion regimens are largely unknown. OBJECTIVES The current study investigated the impact of gelatine-polysuccinate, hydroxyethyl starch (HES) and balanced electrolyte solution (BES) on cerebral integrity, focusing on cerebral inflammation, apoptosis and blood flow in pigs. DESIGN Randomised experimental study. SETTING University-affiliated …

Early results of a low-profile stent-graft for thoracic endovascular aortic repair

Purpose To assess outcomes of a low-profile thoracic stent-graft in the treatment of thoracic aortic pathologies. Methods A retrospective analysis of all consecutive patients with aortic thoracic pathologies treated with the RelayPro device in two university hospitals between October 2018 and July 2019. Results 23 patients (65% men; mean age 63.4 ± 15 years) were treated. Pathologies included aortic dissections (n = 10), 5 residual type A (22%) and 5 type B (22%), 6 degenerative aortic aneurysms (26%), 4 penetrating aortic ulcers (17%), and aortic erosion, intramural hematoma and aortic rupture (n = 1 and 4% in each case). Two cases (9%) were emergent and two urgent. Proximal landing was a…

Structured reporting of CT scans of patients with trauma leads to faster, more detailed diagnoses: An experimental study.

This study aimed to determine whether structured reports (SRs) reduce reporting time and/or increase the level of detail for trauma CT scans compared to free-text reports (FTRs).Eight radiology residents used SRs and FTRs to describe 14 whole-body CT scans of patients with polytrauma in a simulated emergency room setting. Each resident created both a brief report and a detailed report for each case using one of the two formats. We measured the time to complete the detailed reports and established a scoring system to objectively measure report completeness and the level of detail. Scoring sheets divided the CT findings into main and secondary criteria. Finally, the radiological residents com…

Towards data-driven medical imaging using natural language processing in patients with suspected urolithiasis.

Abstract Objective The majority of radiological reports are still written as free text and lack structure. Further evaluation of free-text reports is difficult to achieve without a great deal of manual effort, and is not possible in everyday clinical practice. This study aims to automatically capture clinical information and positive hit rates from narrative radiological reports of suspected urolithiasis using natural language processing (NLP). Methods Narrative reports of low dose computed tomography (CT) of the retroperitoneum from April 2016 to July 2018 (n = 1714) were analyzed using NLP. These free-text reports were automatically structured based on RadLex concepts. Manual feedback was…

Workflow-centred open-source fully automated lung volumetry in chest CT

Aim To develop a robust open-source method for fully automated extraction of total lung capacity (TLC) from computed tomography (CT) images and to demonstrate its integration into the clinical workflow. Materials and methods Using only open-source software, an algorithm was developed based on a region-growing method that does not require manual interaction. Lung volumes calculated from reconstructions with different kernels (TLCCT) were assessed. To validate the algorithm calculations, the results were correlated to TLC measured by pulmonary function testing (TLCPFT) in a subgroup of patients for which this information was available within 3 days of the CT examination. Results A total of 28…