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Trans-arterial chemoperfusion for the treatment of liver metastases of breast cancer and colorectal cancer: Clinical results in palliative care patients

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World journal of Clinical Oncology 2017年第4期8卷 343-350页

作者： Tatjana Gruber-Rouh Marcel Langenbach Nagy NN Naguib Nour-Eldin M Nour-Eldin thomas j vogl Stephan Zangos Martin Beeres Institute for Diagnostic and Interventional Radiology University Hospital Frankfurt

AIM To evaluate the clinical value and efficiency of transarterial chemoperfusion(TACP) in patients with liver metastases from breast cancer(BC) and colorectal cancer(CRC).METHODS We treated 36 patients with liver metastases of BC(n = 19, 19 females) and CRC(n = 17; 8 females, 9 males) with repeated TACP. The treatment interval was 4 wk. TACP was performed with gemcitabine(1000 mg/m2) and mitomycin(10 mg/m2), administered within 1 h after positioning the catheter tip in the hepatic artery. Before treatment, the size, location, tumour volume, vascularization and number of liver tumours were evaluated using magnetic resonance imaging(MRI). Tumour response was evaluated according to the Response Evaluation Criteria in Solid Tumors *** TACP using gemcitabine and mitomycin for metastases from CRC and BC was performed without any serious side effects. The follow-up MRI showed a therapeutic response in 84.2% of the BC patients-stable disease 47.4% and partial response 36.8%. A progression was seen in 15.8%.CRC patients showed a therapeutic response in 52.9% of cases. A progression of the disease was documented in 47.1% of the patients with CRC. These data show that TACP in patients with liver metastases of BC leads to a significantly better therapeutic response compared with CRC patients(P = 0.042). The median survival time was 13.2 mo for the BC patients, which is significantly longer than for CRC patients at 9.3 mo(P = 0.001).CONCLUSION TACP for liver metastases of BC appears to be a safe and effective palliative treatment with improved outcomes in comparison to patients with CRC.

关键词： Colorectal neoplasms Breast neoplasms Neoplasm metastasis Neoplasms Drug therapy

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Magnetic resonance imaging-based interpretation of degenerative changes in the lower lumbar segments and therapeutic consequences

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World journal of Radiology 2015年第8期7卷 194-197页

作者： Adel Maataoui thomas j vogl M Fawad Khan Institute for Diagnostic and Interventional Radiology Goethe University

Intervertebral disc degeneration and facet joint osteoarthritis of the lumbar spine are, among others, wellknown as a cause of low back and lower extremity pain. Together with their secondary disorders they set a big burden on health care systems and economics worldwide. Despite modern imaging modalities, such as magnetic resonance imaging, for a large proportion of patients with low back pain(LBP) it remains difficult to provide a specific diagnosis. The fact that nearly all the lumbar structures are possible sources of LBP, may serve as a possible explanation. Furthermore, our clinical experience confirms, that imaging alone is not a sufficient approach explaining LBP. Here, the Oswestry Disability Index, as the most commonly used measure to quantify disability for LBP, may serve as an easy-toapply questionnaire to evaluate the patient's ability to cope with everyday life. For therapeutic purposes, among the different options, the lumbar facet joint intraarticular injection of corticosteroids in combination with an anaesthetic solution is one of the most frequently performed interventional procedures. Although widely used the clinical benefit of intra-articular steroid injections remains controversial. Therefore, prior to therapy, standardized diagnostic algorithms for an accurate assessment, classification and correlation of degenerative changes of the lumbar spine are needed.

关键词： Low back pain Spine Intervertebral disc disease Facet joint osteoarthritis Magnetic resonance imaging Oswestry Disability Index

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Enteroclysis:Current clinical value

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World journal of Radiology 2013年第7期5卷 253-258页

作者： Adel Maataoui thomas j vogl Volkmar jacobi M Fawad Khan Institute for Diagnostic and Interventional Radiology Goethe University 60590 Frankfurt am Main Germany

AIM: To retrospectively analyze changes in clinical indication, referring medical specialty and detected pathology for small bowel double-contrast examinations. METHODS: Two hundred and forty-one (n = 143 females; n = 98 males; 01.01.1990-31.12.1990) and 384 (n = 225 females; n = 159 males; 01.01.2004-31.12.2010) patients underwent enteroclysis, respectively. All exami- nations were performed in standardized double-contrast technique. After placement of a nasojejunal probe distal to the ligament of Treitz, radiopaque contrast media followed by Xray negative distending contrast media were administered. Following this standardized projections in all four abdominal quadrants were acquired. Depending on the detected pathology further documentation was carried out by focused imaging. Examination protocols were reviewed and compared concerning requesting unit, indication and final report. RESULTS: Two hundred and forty-one examinations in 1990 faced an average of 55 examinations per year from 2004-2010. There was an increase of examinations for gastroenterological (33.6% to 64.6%) andpediatric (0.4% to 7.8%) indications while internal (29.0% to 6.0% for inpatients and from 16.6% to 9.1% for outpatients) and surgical (12.4% to 7.3%) referrals significantly decreased. 'Follow-up of Crohn’s disease' (33.1%) and 'bleeding/tumor search' (15.1%) represented the most frequent clinical indications. A total of 34% (1990) and 53.4% (2004-2010) examinations yielded pathologic findings. In the period 01.01.2004 -31.12.2010 the largest proportion of pathological findings was found in patients with diagnosed Crohn’s disease (73.5%), followed by patients with abdominal pain (67.6% with history of surgery and 52.6% without history of surgery), chronic diarrhea (41.7%), suspected Crohn’s disease (39.5%) and search for gastrointestinal bleeding source/tumor (19.1%). The most common pathologies diagnosed by enteroclysis were 'changes in Crohn’s disease' (25.0%) and 'adhesions /strictures' (

关键词： Inflammatory bowel diseases Fluoroscopy Double-Balloon enteroscopy Magnetic resonance imag- ing Helical computed tomography

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Portal vein thrombosis and arterioportal shunts:Effects on tumor response after chemoembolization of hepatocellular carcinoma

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World journal of Gastroenterology 2011年第10期17卷 1267-1275页

作者： thomas j vogl Nour-Eldin Nour-Eldin Sally Emad-Eldin Nagy NN Naguib joerg Trojan Hans Ackermann Omar Abdelaziz Institute for Diagnostic and Interventional Radiology Johan Wolfgang Goethe University Hospital Diagnostic and Interventional Radiology Department Cairo University Hospital

AIM: To evaluate the effect of portal vein thrombosis and arterioportal shunts on local tumor response in advanced cases of unresectable hepatocellular carcinoma treated by transarterial chemoembolization. METHODS: A retrospective study included 39 patients (mean age: 66.4 years, range: 45-79 years, SD: 7) with unresectable hepatocellular carcinoma (HCC) who were treated with repetitive transarterial chemoembolization (TACE) in the period between March 2006 and October 2009. The effect of portal vein thrombosis (PVT) (in 19 out of 39 patients), the presence of arterioportal shunt (APS) (in 7 out of 39), the underlying liver pathology,Child-Pugh score, initial tumor volume, number of tumors and tumor margin definition on imaging were correlated with the local tumor response after TACE. The initial and end therapy local tumor responses were evaluated according to the response evaluation criteria in solid tumors (RECIST) and magnetic resonance imaging volumetric measurements. RESULTS: The treatment protocols were well tolerated by all patients with no major complications. Local tumor response for all patients according to RECIST criteria were partial response in one patient (2.6%), stable disease in 34 patients (87.1%), and progressive disease in 4 patients (10.2%). The MR volumetric measurements showed that the PVT, APS, underlying liver pathology and tumor margin definition were statistically significant prognostic factors for the local tumor response (P = 0.018, P = 0.008, P = 0.034 and P = 0.001, respectively). The overall 6-, 12- and 18-mo survival rates from the initial TACE were 79.5%, 37.5% and 21%, respectively. CONCLUSION: TACE may be exploited safely for palliative tumor control in patients with advanced unresectable HCC; however, tumor response is significantly affected by the presence or absence of PVT and APS.

关键词： Hepatocellular carcinoma Transarterialchemoembolization Portal Shunt Thrombosis

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Association between facet joint osteoarthritis and the Oswestry Disability Index

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World journal of Radiology 2014年第11期6卷 881-885页

作者： Adel Maataoui thomas j vogl Marcus Middendorp Konstantinos Kafchitsas M Fawad Khan Institute for Diagnostic and Interventional Radiology Goethe University60590 Frankfurt/MainGermany Department of Nuclear Medicine Goethe University60590 Frankfurt/MainGermany Spine Surgery Asklepios Clinic Lindenlohe92421 SchwandorfGermany

AIM:To investigate the correlation of facet joint osteoarthritis(FjOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of 47.3 *** MRIs of the lumbar spine were performed on a 1.5 Tesla scanner(Magnetom Avanto,Siemens AG,Erlangen,Germany) using a dedicated receive only spine *** initial blinding,each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal *** total 2364 facet joints were *** changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the *** index is scored from 0 to 100 and interpreted as follows:0%-20%,minimaldisability; 20%-40%,moderate disability; 40%-60%,severe disability; 60%-80%,crippled; 80%-100%,patients are ***’s coefficient of rank correlation was used for statistical analysis,with significance set at P joints at lumbar levels L4/5 and L5/S1 were analysed in 591 *** was present in 97%(L4/L5) and 98%(L5/S1).At level L4/5(left/right) 17/15(2.9%/2.5%) were described as grade 0,146/147(24.7%/24.9%) as grade 1,290/302(49.1%/51.1%) as grade 2 and 138/127(23.4%/21.5%) as grade *** level L5/S1(left/right) 10/11(1.7%/1.9%) were described as grade 0,136/136(23.0%/23.0%) as grade 1,318/325(53.8%/55.0%) as grade 2 and 127/119(21.5%/20.1%) as grade *** the ODI scores,patients’ disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%.The majority of patients(48.39%) had moderate functional disability(21%-40%).There was no significant correlation between FjOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1.A weak positive correlation was evaluated between ODI and FjOA on the right side of lumbar level L5/***:The missing correlat

关键词： Spine Facet joint osteoarthritis Magnetic resonance imaging Low back pain Oswestry Disability Index

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Correlation of lumbar lateral recess stenosis in magnetic resonance imaging and clinical symptoms

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World journal of Radiology 2017年第5期9卷 223-229页

作者： Annina SplettstoBer M Fawad Khan Bernd Zimmermann thomas j vogl Hanns Ackermann Marcus Middendorp Adel Maataoui Radprax MVZ Institute for Diagnostic and Interventional Radiology Goethe University Institute of Biostatistics and Mathematical Modeling Goethe University Department of Nuclear Medicine Goethe University

AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled *** magnetic resonance images(MRI) the lateral recesses(LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale(Grade 0-3) as normal,not deviated,deviated or *** symptoms and disability were assessed using *** Spearman's rank correlation coefficient was used for statistical analysis(P < 0.05).RESULTS Approximately half of the LR revealed stenosis(grade 1-3;52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root *** ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%.We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1,each bilaterally(L4/5 left:rho < 0.105,P < 0.01;L4/5 right:rho < 0.111,P < 0.01;L5/S1 left:rho 0.128,P < 0.01;L5/S1 right:rho < 0.157,P < 0.001).CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis,this study showed only a weak correlation of LRS on MRI and clinical *** can be attributed to a number of reasons outlined in this study,underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.

关键词： Low back pain Lumbar spine Magnetic resonance imaging Lateral recess stenosis Oswestry Disability Score Lumbar spinal canal stenosis

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门脉高压急性上消化道出血急诊TIPSS治疗(附一例报告)

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影像诊断与介入放射学 1996年第1期5卷 41-42页

作者：王晓白 thomas j vogl 暨南大学医学院附属医院影像科 510630 德国洪堡大学(Humboldt

TIPSS已成为肝硬化合并食管、胃底静脉曲张及顽固性腹水行之有效的疗法。但食管、胃底静脉曲张出血在保守治疗无效的情况下行急诊TIPSS手术有一定危险性,以下报告1例与同道交流经验。患者,男性,20岁,一年前因交通事故严重烧伤而行肢体... 详细信息

TIPSS已成为肝硬化合并食管、胃底静脉曲张及顽固性腹水行之有效的疗法。但食管、胃底静脉曲张出血在保守治疗无效的情况下行急诊TIPSS手术有一定危险性,以下报告1例与同道交流经验。患者,男性,20岁,一年前因交通事故严重烧伤而行肢体截除术。由于在治疗过程中使用Halothan导致肝脏受损,并诱发自身免疫性肝炎,且发展为肝硬化合并食管、胃底静脉曲张,肝功能Chicd B级。曾发生两次上消化道大出血,

关键词：门脉高血压上消化道出血 TIPSS

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Evaluation of Multiparametric MRI of the Prostate: Impact of Standardized Examination Protocols and the Endorectal Coil

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Open journal of Medical Imaging 2020年第1期10卷 30-41页

作者： Finn Rampoldt Frank Huebner Stephan Zangos Andreas Bucher jan-Erik Scholtz Moritz Kaup Sebastian Fischer thomas j. vogl Boris Bodelle Department of Diagnostic and Interventional Radiology Goethe University of Frankfurt Frankfurt Germany

Purpose: The aim of the present study was to evaluate the patient population, different MRI examination protocols and the patient’s acceptance of the endorectal coil in the diagnosis of prostate cancer regarding the current discussion in PI-RADS v2.1. Material and Methods: In our institute, 256 patients were examined with different protocols and separated into six groups. The value of the different MRI protocols was identified by analyzing sensitivity, specificity, negative predictive value and positive predictive value. The patient population was tested for statistically significant differences in their characteristics to detect a distortion of the results. The patients’ acceptance of endorectal coil was evaluated by a query. Results: In total 4.7% of the patients would not recommend a MRI examination because of subjective physical strain and 65.6% of all patients subjectively saw a benefit in the examination in regard to an optimal diagnostic process. The protocol groups reached a sensitivity from 66.7% - 100%, a specificity from 40% - 75%, a positive predictive value from 33.3% - 80% and a negative predictive value from 66.7% - 100%. Conclusion: MRI of the prostate is a safe and comfortable tool with high sensitivity and negative predictive value and the potential of ruling out a clinically significant prostate cancer. However, a general recommendation for the use of biparametric MRI could not be given, considering a higher sensitivity could be performed when using dynamic contrast-enhanced MRI or spectroscopy.

关键词： Prostate Imaging Prostate Cancer Multiparametricmri

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Theory and classification of mass extinction causation

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National Science Review 2024年第1期11卷 16-36页

作者： thomas j.Algeo jun Shen State Key Laboratory of Biogeology and Environmental Geology China University of Geosciences—Wuhan State Key Laboratory of Geological Processes and Mineral Resources China University of Geosciences—Wuhan Department of Geosciences University of Cincinnati

Theory regarding the causation of mass extinctions is in need of systematization, which is the focus of this contribution. Every mass extinction has both an ultimate cause, i.e. the trigger that leads to various climato-environmental changes, and one or more proximate cause(s), i.e. the specific climato-environmental changes that result in elevated biotic mortality. With regard to ultimate causes, strong cases can be made that bolide(i.e. meteor) impacts, large igneous province(LIP) eruptions and bioevolutionary events have each triggered one or more of the Phanerozoic Big Five mass extinctions, and that tectono-oceanic changes have triggered some second-order extinction events. Apart from bolide impacts, other astronomical triggers(*** flares, gamma bursts and supernova explosions) remain entirely in the realm of speculation. With regard to proximate mechanisms, most extinctions are related to either carbon-release or carbon-burial processes, the former being associated with climatic warming, ocean acidification, reduced marine productivity and lower carbonate δ13C values, and the latter with climatic cooling, increased marine productivity and higher carbonate δ13C values. Environmental parameters such as marine redox conditions and terrestrial weathering intensity do not show consistent relationships with carbon-cycle *** this context, mass extinction causation can be usefully classified using a matrix of ultimate and proximate factors. Among the Big Five mass extinctions, the end-Cretaceous biocrisis is an example of a bolide-triggered carbon-release event, the end-Permian and end-Triassic biocrises are examples of LIP-triggered carbon-release events, and the Late Ordovician and Late Devonian biocrises are examples of bioevolution-triggered carbon-burial events. Whereas the bolide-impact and LIP-eruption mechanisms appear to invariably cause carbon release, bioevolutionary triggers can result in variable carbon-cycle changes, e.g. carbon burial durin

关键词： biocrisis ultimate cause proximate cause bolide large igneous province bioevolutionary event

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Different imaging techniques in the head and neck:Assets and drawbacks

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World journal of Radiology 2010年第6期2卷 224-229页

作者： thomas j vogl Marc Harth Petra Siebenhandl Department of Diagnostic and Interventional Radiology Clinic of Johann Wolfgang Goethe-University60590 Frankfurt/MainGermany

In this review,the gold standard imaging techniques for the head and neck and the latest upcoming techniques are presented,by comparing computed tomography(CT),magnetic resonance imaging and positron emission tomography-CT,as well as ultrasound,depending on the examined *** advantages and disadvantages of each examination protocol are *** article illustrates the connection between the imaging technique and the examined ***,the head and neck area is divided into different sections such as bony structures,nervous system,mucous membranes and squamous epithelium,glandular tissue,and lymphatic tissue and ***,the latest techniques in the field of head and neck imaging such as multidetector CT,dual-energy CT,flash CT,magnetic resonance angiography,spectroscopy,and diffusion tensor tractography using 3 tesla magnetic resonance are discussed.

关键词： Magnetic resonance imaging Computed tomography Positron emission tomography Head and neck Tumors Bones

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