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Volumetric Assessment of Swallowing Muscles: A Comparison of CT and MRI Segmentation

Sporns, Kim ; Hanning, Uta ; Schmidt, Rene ; [et al.]

Georg Thieme Verlag KG ; 2018

In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 190, No. 05 ( 2018-05), p. 441-446

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In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 190, No. 05 ( 2018-05), p. 441-446

Abstract: Purpose Recent retrospective studies have proposed a high correlation between atrophy of swallowing muscles, age, severity of dysphagia and aspiration status based on computed tomography (CT). However, ionizing radiation poses an ethical barrier to research in prospective non-patient populations. Hence, there is a need to prove the efficacy of techniques that rely on noninvasive methods and produce high-resolution soft tissue images such as magnetic resonance imaging (MRI). The objective of this study was therefore to compare the segmentation results of swallowing muscles using CT and MRI. Methods Retrospective study of 21 patients (median age: 46.6; gender: 11 female) who underwent CT and MRI of the head and neck region within a time frame of less than 50 days because of suspected head and neck cancer using contrast agent. CT and MR images were segmented by two blinded readers using Medical Imaging Toolkit (MITK) and both modalities were tested (with the equivalence test) regarding the segmented muscle volumes. Adjustment for multiple testing was performed using the Bonferroni test and the potential time effect of the muscle volumes and the time interval between the modalities was assessed by a spearman correlation. The study was approved by the local ethics committee. Results The median volumes for each muscle belly of the digastric muscle derived from CT were 3051 mm3 (left) and 2969 mm3 (right), and from MRI they were 3218 mm3 (left) and 3027 mm3 (right). The median volume of the geniohyoid muscle was 6580 mm3 on CT and 6648 mm3 on MRI. The interrater reliability was high for all segmented muscles. The mean time interval between the CT and MRI examinations was 34 days (IQR 25; 41). The muscle differences of each muscle between the two modalities did not reveal significant correlation to the time interval between the examinations (digastric left r = 0.003 and digastric right r = –0.008; geniohyoid muscle r = 0.075). Conclusion CT-based segmentation and MRI-based segmentation of the digastric and geniohyoid muscle are equally feasible. The potential advantage of MRI for prospective studies is the absence of ionizing radiation. Key Points Citation Format

Type of Medium: Online Resource

ISSN: 1438-9029 , 1438-9010

URL: Article

DOI: 10.1055/s-0043-120529

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XA 10000

Language: English

Publisher: Georg Thieme Verlag KG

Publication Date: 2018

detail.hit.zdb_id: 2031079-1

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Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomised trial

Bendszus, Martin ; Fiehler, Jens ; Subtil, Fabien ; [et al.]

Elsevier BV ; 2023

In: The Lancet Vol. 402, No. 10414 ( 2023-11), p. 1753-1763

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In: The Lancet, Elsevier BV, Vol. 402, No. 10414 ( 2023-11), p. 1753-1763

Type of Medium: Online Resource

ISSN: 0140-6736

URL: Article

DOI: 10.1016/S0140-6736(23)02032-9

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XA 10000

Language: English

Publisher: Elsevier BV

Publication Date: 2023

detail.hit.zdb_id: 2067452-1

detail.hit.zdb_id: 3306-6

detail.hit.zdb_id: 1476593-7

SSG: 5,21

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Simplified Assessment of Lesion Water Uptake for Identification of Patients within 4.5 Hours of Stroke Onset: An Analysis of the MissPerfeCT Study

Sporns, Peter B. ; Höhne, Marco ; Meyer, Lennart ; [et al.]

Korean Stroke Society ; 2022

In: Journal of Stroke Vol. 24, No. 3 ( 2022-09-30), p. 390-395

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In: Journal of Stroke, Korean Stroke Society, Vol. 24, No. 3 ( 2022-09-30), p. 390-395

Abstract: Background and Purpose Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether a simple method of computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours. Methods This retrospective analysis of the MissPerfeCT study (August 2009 to November 2017) includes consecutive patients with known onset of symptoms from seven tertiary stroke centers. We developed a simplified algorithm based on region of interest (ROI) measurements to quantify water uptake of the ischemic lesion and thereby quantify time of symptom onset within and beyond 4.5 hours. Perfusion CT was used to identify ischemic brain tissue, and its density was measured in non-contrast CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake. Results Of 263 patients, 204 (77.6%) had CT within 4.5 hours. Water uptake was significantly lower in patients with stroke onset within (6.7%; 95% confidence interval [CI] , 6.0% to 7.4%) compared to beyond 4.5 hours (12.7%; 95% CI, 10.7% to 14.7%). The area under the curve for distinguishing these patient groups according to percentage water uptake was 0.744 with an optimal cut-off value of 9.5%. According to this cut-off the positive predictive value was 88.8%, sensitivity was 73.5%, specificity 67.8%, negative predictive value was 42.6%. Conclusions Ischemic stroke patients with unknown time of symptom onset can be identified as being within a timeframe of 4.5 hours using a ROI-based method to assess water uptake on admission non-contrast head CT.

Type of Medium: Online Resource

ISSN: 2287-6391 , 2287-6405

URL: Article

DOI: 10.5853/jos.2022.00220

Language: English

Publisher: Korean Stroke Society

Publication Date: 2022

detail.hit.zdb_id: 2814366-8

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Multicenter Study for the Treatment of Sidewall versus Bifurcation Intracranial Aneurysms with Use of Woven EndoBridge (WEB)

Adeeb, Nimer ; Dibas, Mahmoud ; Diestro, Jose Danilo Bengzon ; [et al.]

Radiological Society of North America (RSNA) ; 2022

In: Radiology Vol. 304, No. 2 ( 2022-08), p. 372-382

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In: Radiology, Radiological Society of North America (RSNA), Vol. 304, No. 2 ( 2022-08), p. 372-382

Type of Medium: Online Resource

ISSN: 0033-8419 , 1527-1315

URL: Article

DOI: 10.1148/radiol.212006

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XA 10000

Language: English

Publisher: Radiological Society of North America (RSNA)

Publication Date: 2022

detail.hit.zdb_id: 80324-8

detail.hit.zdb_id: 2010588-5

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Does Device Selection Impact Recanalization Rate and Neurological Outcome? : An Analysis of the Save ChildS Study

Sporns, Peter B. ; Straeter, Ronald ; Minnerup, Jens ; [et al.]

Ovid Technologies (Wolters Kluwer Health) ; 2020

In: Stroke Vol. 51, No. 4 ( 2020-04), p. 1182-1189

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In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 4 ( 2020-04), p. 1182-1189

Abstract: The recent Save ChildS study provides multicenter evidence for the use of mechanical thrombectomy in children with large vessel occlusion arterial ischemic stroke. However, device selection for thrombectomy may influence rates of recanalization, complications, and neurological outcomes, especially in pediatric patients of different ages. We, therefore, performed additional analyses of the Save ChildS data to investigate a possible association of different thrombectomy techniques and devices with angiographic and clinical outcome parameters. Methods— The Save ChildS cohort study (January 2000–December 2018) analyzed data from 27 European and United States stroke centers and included all pediatric patients ( 〈 18 years), diagnosed with arterial ischemic stroke who underwent endovascular recanalization. Patients were grouped into first-line contact aspiration (A Direct Aspiration First Pass Technique [ADAPT]) and non-ADAPT groups as well as different stent retriever size groups. Associations with baseline characteristics, recanalization rates (modified Treatment in Cerebral Infarction), complication rates, and neurological outcome parameters (Pediatric National Institutes of Health Stroke Scale after 24 hours and 7 days; modified Rankin Scale and Pediatric Stroke Outcome Measure at discharge, after 6 and 24 months) were investigated. Results— Seventy-three patients with a median age of 11.3 years were included. Currently available stent retrievers were used in 59 patients (80.8%), of which 4×20 mm (width×length) was the most frequently chosen size (36 patients =61%). A first-line ADAPT approach was used in 7 patients (9.6%), and 7 patients (9.6%) were treated with first-generation thrombectomy devices. In this study, a first-line ADAPT approach was neither associated with the rate of successful recanalization (ADAPT 85.7% versus 87.5% No ADAPT) nor with the complication rate or the neurological outcome. Moreover, there were no associations of stent retriever sizes with rates of recanalization, complication rates, or outcome parameters. Conclusions— Our study suggests that neurological outcomes are generally good regardless of any specific device selection and suggests that it is important to offer thrombectomy in eligible children regardless of technique or device selection. Registration— URL: https://www.drks.de/ ; Unique identifier: DRKS00016528.

Type of Medium: Online Resource

ISSN: 0039-2499 , 1524-4628

URL: Article

DOI: 10.1161/STROKEAHA.119.028221

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XA 10000

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2020

detail.hit.zdb_id: 1467823-8

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Adolescent Tuning of Association Cortex in Human Structural Brain Networks

Váša, František ; Seidlitz, Jakob ; Romero-Garcia, Rafael ; [et al.]

Oxford University Press (OUP) ; 2018

In: Cerebral Cortex Vol. 28, No. 1 ( 2018-01-01), p. 281-294

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In: Cerebral Cortex, Oxford University Press (OUP), Vol. 28, No. 1 ( 2018-01-01), p. 281-294

Type of Medium: Online Resource

ISSN: 1047-3211 , 1460-2199

URL: Article

DOI: 10.1093/cercor/bhx249

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2018

detail.hit.zdb_id: 1483485-6

SSG: 12

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Association Between Net Water Uptake and Functional Outcome in Patients With Low ASPECTS Brain Lesions : Results From the I-LAST Study

Broocks, Gabriel ; Meyer, Lukas ; Elsayed, Sarah ; [et al.]

Ovid Technologies (Wolters Kluwer Health) ; 2023

In: Neurology Vol. 100, No. 9 ( 2023-02-28), p. e954-e963

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In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 9 ( 2023-02-28), p. e954-e963

Abstract: The effect of mechanical thrombectomy (MT) on functional outcome in patients with ischemic stroke with low ASPECTS is still uncertain. ASPECTS rating is based on the presence of ischemic hypoattenuation relative to normal; however, the degree of hypoattenuation, which directly reflects net uptake of water, is currently not considered an imaging biomarker in stroke triage. We hypothesized that the effect of thrombectomy on functional outcome in low ASPECTS patients depends on early lesion water uptake. Methods For this multicenter observational study, patients with anterior circulation stroke with ASPECTS ≤5 were consecutively analyzed. Net water uptake (NWU) was assessed as a quantitative imaging biomarker in admission CT. The primary end point was the rate of favorable functional outcome defined as modified Rankin Scale score 0–3 at day 90. The effect of recanalization on functional outcome was analyzed according to the degree of NWU within the early infarct lesion. Results A total of 254 patients were included, of which 148 (58%) underwent MT. The median ASPECTS was 4 (interquartile range [IQR] 3–5), and the median NWU was 11.4% (IQR 8.9%–15.1%). The rate of favorable outcome was 27.6% in patients with low NWU ( 〈 11.4%) vs 6.3% in patients with high NWU (≥11.4%; p 〈 0.0001). In multivariable logistic regression analysis, NWU was an independent predictor of outcome, whereas vessel recanalization (modified thrombolysis in cerebral infarction ≥2b) was only significantly associated with better outcomes if NWU was lower than 12.6%. In inverse-probability weighting analysis, recanalization was associated with 20.7% ( p = 0.01) increase in favorable outcome in patients with low NWU compared with 9.1% ( p = 0.06) in patients with high NWU. Discussion Early NWU was independently associated with clinical outcome and might serve as an indicator of futile MT in low ASPECTS patients. NWU could be tested as a tool to select low ASPECTS patients for MT. Trial Registration Information The study is registered within the ClinicalTrials.gov Protocol Registration and Results System (NCT04862507).

Type of Medium: Online Resource

ISSN: 0028-3878 , 1526-632X

URL: Article

DOI: 10.1212/WNL.0000000000201601

RVK:

XA 10000

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2023

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Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke : The Save ChildS Study

Sporns, Peter B. ; Sträter, Ronald ; Minnerup, Jens ; [et al.]

American Medical Association (AMA) ; 2020

In: JAMA Neurology Vol. 77, No. 1 ( 2020-01-01), p. 25-

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In: JAMA Neurology, American Medical Association (AMA), Vol. 77, No. 1 ( 2020-01-01), p. 25-

Type of Medium: Online Resource

ISSN: 2168-6149

URL: Article

DOI: 10.1001/jamaneurol.2019.3403

Language: English

Publisher: American Medical Association (AMA)

Publication Date: 2020

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Some Work and Some Play: Microscopic and Macroscopic Approaches to Labor and Leisure

Niyogi, Ritwik K. ; Shizgal, Peter ; Dayan, Peter ; [et al.]

Public Library of Science (PLoS) ; 2014

In: PLoS Computational Biology Vol. 10, No. 12 ( 2014-12-4), p. e1003894-

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In: PLoS Computational Biology, Public Library of Science (PLoS), Vol. 10, No. 12 ( 2014-12-4), p. e1003894-

Type of Medium: Online Resource

ISSN: 1553-7358

URL: Article

DOI: 10.1371/journal.pcbi.1003894

DOI: 10.1371/journal.pcbi.1003894.g001

DOI: 10.1371/journal.pcbi.1003894.g002

DOI: 10.1371/journal.pcbi.1003894.g003

DOI: 10.1371/journal.pcbi.1003894.g004

DOI: 10.1371/journal.pcbi.1003894.g005

DOI: 10.1371/journal.pcbi.1003894.g006

DOI: 10.1371/journal.pcbi.1003894.g007

DOI: 10.1371/journal.pcbi.1003894.t001

DOI: 10.1371/journal.pcbi.1003894.s001

DOI: 10.1371/journal.pcbi.1003894.s002

DOI: 10.1371/journal.pcbi.1003894.s003

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2014

detail.hit.zdb_id: 2193340-6

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Transradial versus transfemoral access for embolization of intracranial aneurysms with the Woven EndoBridge device: a propensity score–matched study

Dibas, Mahmoud ; Adeeb, Nimer ; Diestro, Jose Danilo Bengzon ; [et al.]

Journal of Neurosurgery Publishing Group (JNSPG) ; 2022

In: Journal of Neurosurgery Vol. 137, No. 4 ( 2022-10-01), p. 1064-1071

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In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 137, No. 4 ( 2022-10-01), p. 1064-1071

Abstract: Transradial access (TRA) is commonly utilized in neurointerventional procedures. This study compared the technical and clinical outcomes of the use of TRA versus those of transfemoral access (TFA) for intracranial aneurysm embolization with the Woven EndoBridge (WEB) device. METHODS This is a secondary analysis of the Worldwide WEB Consortium, which comprises multicenter data related to adult patients with intracranial aneurysms who were managed with the WEB device. These aneurysms were categorized into two groups: those who were treated with TRA or TFA. Patient and aneurysm characteristics and technical and clinical outcomes were compared between groups. Propensity score matching (PSM) was used to match groups according to the following baseline characteristics: age, sex, subarachnoid hemorrhage, aneurysm location, bifurcation aneurysm, aneurysm with incorporated branch, neck width, aspect ratio, dome width, and elapsed time since the last follow-up imaging evaluation. RESULTS This study included 682 intracranial aneurysms (median [interquartile range] age 61.3 [53.0–68.0] years), of which 561 were treated with TFA and 121 with TRA. PSM resulted in 65 matched pairs. After PSM, both groups had similar characteristics, angiographic and functional outcomes, and rates of retreatment, thromboembolic and hemorrhagic complications, and death. TFA was associated with longer procedure length (median 96.5 minutes vs 72.0 minutes, p = 0.006) and fluoroscopy time (28.2 minutes vs 24.8 minutes, p = 0.037) as compared with TRA. On the other hand, deployment issues were more common in those treated with TRA, but none resulted in permanent complications. CONCLUSIONS TRA has comparable outcomes, with shorter procedure and fluoroscopy time, to TFA for aneurysm embolization with the WEB device.

Type of Medium: Online Resource

ISSN: 0022-3085 , 1933-0693

URL: Article

DOI: 10.3171/2021.12.JNS212293

RVK:

XA 10000

RVK:

XA 55270

Language: Unknown

Publisher: Journal of Neurosurgery Publishing Group (JNSPG)

Publication Date: 2022

detail.hit.zdb_id: 2026156-1

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