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  1. Book ; Online ; Thesis: Einsatz der Magnetresonanztomographie für die Detektion periapikaler Entzündungsprozesse und assoziierter mukosaler Pathologien

    Burian, Egon [Verfasser] / Folwaczny, Matthias [Akademischer Betreuer]

    2024  

    Author's details Egon Burian ; Betreuer: Matthias Folwaczny
    Keywords Medizin, Gesundheit ; Medicine, Health
    Subject code sg610
    Language German
    Publisher Universitätsbibliothek der Ludwig-Maximilians-Universität
    Publishing place München
    Document type Book ; Online ; Thesis
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  2. Article ; Online: Visualization of clinically silent, odontogenic maxillary sinus mucositis originating from periapical inflammation using MRI: a feasibility study.

    Burian, Egon / Feuerriegel, Georg / Sollmann, Nico / Burian, Gintare / Palla, Benjamin / Griesbauer, Magdalena / Bumm, Caspar / Probst, Monika / Beer, Meinrad / Folwaczny, Matthias

    Clinical oral investigations

    2023  Volume 27, Issue 7, Page(s) 3705–3712

    Abstract: Objectives: Maxillary sinus mucositis is frequently associated with odontogenic foci. Periapical inflammation of maxillary molars and premolars cannot be visualized directly using radiation-based imaging. The purpose of this study was to answer the ... ...

    Abstract Objectives: Maxillary sinus mucositis is frequently associated with odontogenic foci. Periapical inflammation of maxillary molars and premolars cannot be visualized directly using radiation-based imaging. The purpose of this study was to answer the following clinical question: among patients with periapical inflammatory processes in the maxilla, does the use of magnetic resonance imaging (MRI), as compared to conventional periapical (AP) and panoramic radiography (OPT), improve diagnostic accuracy?
    Methods: Forty-two subjects with generalized periodontitis were scanned on a 3 T MRI. Sixteen asymptomatic subjects with mucosal swelling of the maxillary sinus were enrolled in the study. Periapical edema was assessed using short tau inversion recovery (STIR) sequence. Apical osteolysis and mucosal swelling were assessed by MRI, AP, and OPT imaging using the periapical index score (PAI). Comparisons between groups were performed with chi-squared tests with Yates' correction. Significance was set at p < 0.05.
    Results: Periapical lesions of maxillary premolars and molars were identified in 16 subjects, 21 sinuses, and 58 teeth. Bone edema and PAI scores were significantly higher using MRI as compared to OPT and AP (p < 0.05). Using the STIR sequence, a significant association of PAI score > 1 and the presence of mucosal swelling in the maxillary sinus was detected (p = 0.03).
    Conclusion: Periapical inflammation and maxillary mucositis could be visualized using STIR imaging. The use of MRI may help detect early, subtle inflammatory changes in the periapical tissues surrounding maxillary dentition. Early detection could guide diagnostic criteria, as well as treatment and prevention.
    MeSH term(s) Humans ; Maxillary Sinus/diagnostic imaging ; Maxillary Sinus/pathology ; Mucositis ; Feasibility Studies ; Inflammation/diagnostic imaging ; Inflammation/pathology ; Periapical Periodontitis/complications ; Magnetic Resonance Imaging ; Cone-Beam Computed Tomography/methods
    Language English
    Publishing date 2023-04-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1364490-7
    ISSN 1436-3771 ; 1432-6981
    ISSN (online) 1436-3771
    ISSN 1432-6981
    DOI 10.1007/s00784-023-04986-4
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  3. Article ; Online: Detection of caries lesions using a water-sensitive STIR sequence in dental MRI.

    Burian, Egon / Lenhart, Nicolas / Greve, Tobias / Bodden, Jannis / Burian, Gintare / Palla, Benjamin / Probst, Florian / Probst, Monika / Beer, Meinrad / Folwaczny, Matthias / Schwarting, Julian

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 663

    Abstract: In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic ... ...

    Abstract In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic resonance imaging (MRI) for caries visualization. Fourteen patients with clinically suspected carious lesions, verified by standardized dental examination including DR and OPT, were imaged with 3D isotropic T2-weighted STIR (short tau inversion recovery) and T1 FFE Black bone sequences. Intensities of dental caries, hard tissue and pulp were measured and calculated as aSNR (apparent signal to noise ratio) and aHTMCNR (apparent hard tissue to muscle contrast to noise ratio) in both sequences. Imaging findings were then correlated to clinical examination results. In STIR as well as in T1 FFE black bone images, aSNR and aHTMCNR was significantly higher in carious lesions than in healthy hard tissue (p < 0.001). Using water-sensitive STIR sequence allowed for detecting significantly lower aSNR and aHTMCNR in carious teeth compared to healthy teeth (p = 0.01). The use of MRI for the detection of caries is a promising imaging technique that may complement clinical exams and traditional imaging.
    MeSH term(s) Humans ; Dental Caries/diagnostic imaging ; Dental Caries Susceptibility ; Magnetic Resonance Imaging ; Chromosome Inversion ; Health Status
    Language English
    Publishing date 2024-01-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-51151-2
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  4. Article ; Online: Artificial intelligence support in MR imaging of incidental renal masses: an early health technology assessment.

    Marka, Alexander W / Luitjens, Johanna / Gassert, Florian T / Steinhelfer, Lisa / Burian, Egon / Rübenthaler, Johannes / Schwarze, Vincent / Froelich, Matthias F / Makowski, Marcus R / Gassert, Felix G

    European radiology

    2024  

    Abstract: Objective: This study analyzes the potential cost-effectiveness of integrating an artificial intelligence (AI)-assisted system into the differentiation of incidental renal lesions as benign or malignant on MR images during follow-up.: Materials and ... ...

    Abstract Objective: This study analyzes the potential cost-effectiveness of integrating an artificial intelligence (AI)-assisted system into the differentiation of incidental renal lesions as benign or malignant on MR images during follow-up.
    Materials and methods: For estimation of quality-adjusted life years (QALYs) and lifetime costs, a decision model was created, including the MRI strategy and MRI + AI strategy. Model input parameters were derived from recent literature. Willingness to pay (WTP) was set to $100,000/QALY. Costs of $0 for the AI were assumed in the base-case scenario. Model uncertainty and costs of the AI system were assessed using deterministic and probabilistic sensitivity analysis.
    Results: Average total costs were at $8054 for the MRI strategy and $7939 for additional use of an AI-based algorithm. The model yielded a cumulative effectiveness of 8.76 QALYs for the MRI strategy and of 8.77 for the MRI + AI strategy. The economically dominant strategy was MRI + AI. Deterministic and probabilistic sensitivity analysis showed high robustness of the model with the incremental cost-effectiveness ratio (ICER), which represents the incremental cost associated with one additional QALY gained, remaining below the WTP for variation of the input parameters. If increasing costs for the algorithm, the ICER of $0/QALY was exceeded at $115, and the defined WTP was exceeded at $667 for the use of the AI.
    Conclusions: This analysis, rooted in assumptions, suggests that the additional use of an AI-based algorithm may be a potentially cost-effective alternative in the differentiation of incidental renal lesions using MRI and needs to be confirmed in the future.
    Clinical relevance statement: These results hint at AI's the potential impact on diagnosing renal masses. While the current study urges careful interpretation, ongoing research is essential to confirm and seamlessly integrate AI into clinical practice, ensuring its efficacy in routine diagnostics.
    Key points: • This is a model-based study using data from literature where AI has been applied in the diagnostic workup of incidental renal lesions. • MRI + AI has the potential to be a cost-effective alternative in the differentiation of incidental renal lesions. • The additional use of AI can reduce costs in the diagnostic workup of incidental renal lesions.
    Language English
    Publishing date 2024-02-23
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-024-10643-5
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  5. Book ; Online ; Thesis: Annexin-basierte optische Fluoreszenzbildgebung und Perfusions-MRT zum Monitoring der frühen Effekte einer Regorafenibtherapie im experimentellen humanen Kolonkarzinom

    Burian, Egon [Verfasser] / Cyran, Clemens [Akademischer Betreuer]

    2020  

    Author's details Egon Burian ; Betreuer: Clemens Cyran
    Keywords Medizin, Gesundheit ; Medicine, Health
    Subject code sg610
    Language German
    Publisher Universitätsbibliothek der Ludwig-Maximilians-Universität
    Publishing place München
    Document type Book ; Online ; Thesis
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  6. Article ; Online: Initial Raymond-Roy Occlusion Classification but not Packing Density Defines Risk for Recurrence after Aneurysm Coiling.

    Greve, Tobias / Sukopp, Maximilian / Wostrack, Maria / Burian, Egon / Zimmer, Claus / Friedrich, Benjamin

    Clinical neuroradiology

    2020  Volume 31, Issue 2, Page(s) 391–399

    Abstract: Purpose: After coil embolization of intracranial aneurysms, it is currently not well understood whether the initial coil packing density or the type of aneurysm residual perfusion, depicted by the modified Raymond-Roy occlusion classification, primarily ...

    Abstract Purpose: After coil embolization of intracranial aneurysms, it is currently not well understood whether the initial coil packing density or the type of aneurysm residual perfusion, depicted by the modified Raymond-Roy occlusion classification, primarily effects the rate of aneurysm recurrence. We hypothesized that these factors interact and only one remains an independent risk factor.
    Methods: In this single center retrospective study, 440 patients with intracranial ruptured and unruptured aneurysms between 2010 and 2017 were screened. A total of 267 patients treated with stand-alone coiling, with or without stent or balloon assistance were included (age 54.1 ± 12.2 years, sex 70.4% female). Flow diverter or Woven EndoBridge (WEB) device implantation were exclusion criteria.
    Results: Using a binary logistic regression model, independent risk factors for aneurysm recurrence were postinterventional modified Raymond-Roy occlusion classification class (Odds ratio [OR] 1.747, 95% confidence interval [CI] 1.231-2.480) and aneurysm diameter (OR 1.145, CI 1.032-1.271). A trend towards a higher recurrence in ruptured aneurysms did not reach significance (OR 1.656, CI 0.863-3.179). Aneurysm localization, packing density, and neck width were not independently associated with aneurysm recurrence.
    Conclusion: Independent risk factors for aneurysm recurrence after coil embolization with and without stent or balloon assistance were aneurysm diameter and postinterventional grading within the modified Raymond-Roy occlusion classification. Packing density interacted with the latter and was not independently associated to recurrence.
    MeSH term(s) Adult ; Aged ; Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/therapy ; Embolization, Therapeutic ; Endovascular Procedures ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/therapy ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Stents ; Treatment Outcome
    Language English
    Publishing date 2020-07-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2234662-4
    ISSN 1869-1447 ; 0939-7116 ; 1869-1439
    ISSN (online) 1869-1447
    ISSN 0939-7116 ; 1869-1439
    DOI 10.1007/s00062-020-00926-x
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    Zs.A 3413: Show issues Location:
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  7. Article ; Online: Magnetic resonance imaging based computer-guided dental implant surgery-A clinical pilot study.

    Probst, Florian Andreas / Schweiger, Josef / Stumbaum, Maria Juliane / Karampinos, Dimitrios / Burian, Egon / Probst, Monika

    Clinical implant dentistry and related research

    2020  Volume 22, Issue 5, Page(s) 612–621

    Abstract: Background: Computer-guided implant surgery is currently based on radiographic techniques exposing patients to ionizing radiation.: Purpose: To assess, whether computer-assisted 3D implant planning with template-guided placement of dental implants ... ...

    Abstract Background: Computer-guided implant surgery is currently based on radiographic techniques exposing patients to ionizing radiation.
    Purpose: To assess, whether computer-assisted 3D implant planning with template-guided placement of dental implants based on magnetic resonance imaging (MRI) is feasible.
    Materials and methods: 3-Tesla MRI was performed in 12 subjects as a basis for prosthetically driven virtual planning and subsequent guided implant surgery. To evaluate the transferability of the virtually planned implant position, deviations between virtually planned and resulting implant position were studied. Matching of occlusal surfaces was assessed by comparing surface scans with MRI-derived images. In addition, the overall image quality and the ability of depicting anatomically important structures were rated.
    Results: MRI-based guided implant surgery with subsequent prosthetic treatment was successfully performed in nine patients. Mean deviations between virtually planned and resulting implant position (error at entry point 0.8 ± 0.3 mm, error at apex 1.2 ± 0.6 mm, angular deviation 4.9 ± 3.6°), mean deviation of occlusal surfaces between surface scans and MRI-based tooth reconstructions (mean 0.254 ± 0.026 mm) as well as visualization of important anatomical structures were acceptable for clinical application.
    Conclusion: Magnetic resonance imaging (MRI) based computer-assisted implant surgery is a feasible and accurate procedure that avoids exposure to ionizing radiation.
    MeSH term(s) Computer-Aided Design ; Computers ; Cone-Beam Computed Tomography ; Dental Implantation, Endosseous ; Dental Implants ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Patient Care Planning ; Pilot Projects ; Surgery, Computer-Assisted
    Chemical Substances Dental Implants
    Language English
    Publishing date 2020-09-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2094300-3
    ISSN 1708-8208 ; 1523-0899
    ISSN (online) 1708-8208
    ISSN 1523-0899
    DOI 10.1111/cid.12939
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    Zs.A 5945: Show issues Location:
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  8. Article ; Online: MRI-detected intraosseous bone marrow edema recedes after effective therapy of periodontitis.

    Schwarting, Julian / Probst, Florian Andreas / Griesbauer, Magdalena / Robl, Teresa / Burian, Egon / Wiestler, Benedikt / Brunner, Teresa / Malenova, Yoana / Bumm, Caspar / Folwaczny, Matthias / Probst, Monika

    European radiology

    2023  

    Abstract: Objectives: T2 STIR MRI sequences can detect preclinical changes associated with periodontal inflammation, i.e. intraosseous edema in the tooth-supporting bone. In this study, we assessed whether MRI can be used for monitoring periodontal disease.: ... ...

    Abstract Objectives: T2 STIR MRI sequences can detect preclinical changes associated with periodontal inflammation, i.e. intraosseous edema in the tooth-supporting bone. In this study, we assessed whether MRI can be used for monitoring periodontal disease.
    Material and methods: In a prospective cohort study, we examined 35 patients with periodontitis between 10/2018 and 04/2019 by using 3D isotropic T2-weighted short tau inversion recovery (STIR) and Fast Field Echo T1-weighted Black bone sequences. All patients received standardized clinical exams before and three months after non-surgical periodontal therapy. Bone marrow edema extent was quantified in the STIR sequence at 922 sites before and after treatment. Results were compared with standard clinical findings. Non-parametric statistical analysis was performed.
    Results: Non-surgical periodontal treatment caused significant improvement in mean probing depth (p < 0.001) and frequency of bleeding on probing (p < 0.001). The mean depth of osseous edema per site was reduced from a median [IQR] of 2 [1, 3] mm at baseline to 1 [0, 3] mm, (p < 0.001). Periodontal treatment reduced the frequency of sites with edema from 35 to 24% (p < 0.01).
    Conclusion: The decrease of periodontal bone marrow edema, as observed with T2 STIR MR imaging, is indicative of successful periodontal healing.
    Clinical relevance statement: T2 STIR hyperintense bone marrow edema in the periodontal bone decreases after treatment and can therefore be used to evaluate treatment success. Furthermore, MRI reveals new options to depict hidden aspects of periodontitis.
    Key points: • T2 STIR hyperintense periodontal intraosseous edema was prospectively investigated in 35 patients with periodontitis before and after treatment and compared to clinical outcomes. • The frequency of affected sites was reduced from 35 to 24% (p < 0.001), and mean edema depth was reduced from a median [IQR] of 2 [1, 3] mm at baseline to 1 [0, 3] mm 3 months after treatment. (p < 0.001). • T2 STIR sequences can be used to monitor the posttreatment course of periodontitis.
    Language English
    Publishing date 2023-10-19
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-023-10327-6
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  9. Article ; Online: Development and Validation of a Deep Learning Algorithm to Differentiate Colon Carcinoma From Acute Diverticulitis in Computed Tomography Images.

    Ziegelmayer, Sebastian / Reischl, Stefan / Havrda, Hannah / Gawlitza, Joshua / Graf, Markus / Lenhart, Nicolas / Nehls, Nadja / Lemke, Tristan / Wilhelm, Dirk / Lohöfer, Fabian / Burian, Egon / Neumann, Philipp-Alexander / Makowski, Marcus / Braren, Rickmer

    JAMA network open

    2023  Volume 6, Issue 1, Page(s) e2253370

    Abstract: Importance: Differentiating between malignant and benign etiology in large-bowel wall thickening on computed tomography (CT) images can be a challenging task. Artificial intelligence (AI) support systems can improve the diagnostic accuracy of ... ...

    Abstract Importance: Differentiating between malignant and benign etiology in large-bowel wall thickening on computed tomography (CT) images can be a challenging task. Artificial intelligence (AI) support systems can improve the diagnostic accuracy of radiologists, as shown for a variety of imaging tasks. Improvements in diagnostic performance, in particular the reduction of false-negative findings, may be useful in patient care.
    Objective: To develop and evaluate a deep learning algorithm able to differentiate colon carcinoma (CC) and acute diverticulitis (AD) on CT images and analyze the impact of the AI-support system in a reader study.
    Design, setting, and participants: In this diagnostic study, patients who underwent surgery between July 1, 2005, and October 1, 2020, for CC or AD were included. Three-dimensional (3-D) bounding boxes including the diseased bowel segment and surrounding mesentery were manually delineated and used to develop a 3-D convolutional neural network (CNN). A reader study with 10 observers of different experience levels was conducted. Readers were asked to classify the testing cohort under reading room conditions, first without and then with algorithmic support.
    Main outcomes and measures: To evaluate the diagnostic performance, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for all readers and reader groups with and without AI support. Metrics were compared using the McNemar test and relative and absolute predictive value comparisons.
    Results: A total of 585 patients (AD: n = 267, CC: n = 318; mean [SD] age, 63.2 [13.4] years; 341 men [58.3%]) were included. The 3-D CNN reached a sensitivity of 83.3% (95% CI, 70.0%-96.6%) and specificity of 86.6% (95% CI, 74.5%-98.8%) for the test set, compared with the mean reader sensitivity of 77.6% (95% CI, 72.9%-82.3%) and specificity of 81.6% (95% CI, 77.2%-86.1%). The combined group of readers improved significantly with AI support from a sensitivity of 77.6% to 85.6% (95% CI, 81.3%-89.3%; P < .001) and a specificity of 81.6% to 91.3% (95% CI, 88.1%-94.5%; P < .001). Artificial intelligence support significantly reduced the number of false-negative and false-positive findings (NPV from 78.5% to 86.4% and PPV from 80.9% to 90.8%; P < .001).
    Conclusions and relevance: The findings of this study suggest that a deep learning model able to distinguish CC and AD in CT images as a support system may significantly improve the diagnostic performance of radiologists, which may improve patient care.
    MeSH term(s) Male ; Humans ; Middle Aged ; Artificial Intelligence ; Deep Learning ; Retrospective Studies ; Algorithms ; Tomography, X-Ray Computed ; Diverticulitis ; Carcinoma ; Colon
    Language English
    Publishing date 2023-01-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.53370
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  10. Article: Long-term reproducibility of opportunistically assessed vertebral bone mineral density and texture features in routine clinical multi-detector computed tomography using an automated segmentation framework.

    Bodden, Jannis / Dieckmeyer, Michael / Sollmann, Nico / Rühling, Sebastian / Prucker, Philipp / Löffler, Maximilian T / Burian, Egon / Subburaj, Karupppasamy / Zimmer, Claus / Kirschke, Jan S / Baum, Thomas

    Quantitative imaging in medicine and surgery

    2023  Volume 13, Issue 9, Page(s) 5472–5482

    Abstract: Background: To investigate reproducibility of texture features and volumetric bone mineral density (vBMD) extracted from trabecular bone in the thoracolumbar spine in routine clinical multi-detector computed tomography (MDCT) data in a single scanner ... ...

    Abstract Background: To investigate reproducibility of texture features and volumetric bone mineral density (vBMD) extracted from trabecular bone in the thoracolumbar spine in routine clinical multi-detector computed tomography (MDCT) data in a single scanner environment.
    Methods: Patients who underwent two routine clinical thoraco-abdominal MDCT exams at a single scanner with a time interval of 6 to 26 months (n=203, 131 males; time interval mean, 13 months; median, 12 months) were included in this observational study. Exclusion criteria were metabolic and hematological disorders, bone metastases, use of bone-active medications, and history of osteoporotic vertebral fractures (VFs) or prior diagnosis of osteoporosis. A convolutional neural network (CNN)-based framework was used for automated spine labeling and segmentation (T5-L5), asynchronous Hounsfield unit (HU)-to-BMD calibration, and correction for the intravenous contrast medium phase. Vertebral vBMD and six texture features [variance
    Results: SRE, LRE, RLN, and RP exhibited substantial reproducibility with RMSCV-values below 2%, for both sexes and at all spine levels, while vBMD was less reproducible (RMSCV =11.9-16.2%). Entropy showed highest variability (RMSCV =4.34-7.69%) due to statistically significant increases [range, mean ± standard deviation: (4.40±5.78)% to (8.36±8.66)%, P<0.001]. RMSCV of variance
    Conclusions: Opportunistic assessment of texture features in a single scanner environment using the presented CNN-based framework yields substantial reproducibility, outperforming vBMD reproducibility. Lowest scan-rescan variability was found for higher-order texture features. Further studies are warranted to determine, whether microarchitectural changes to the trabecular bone may be assessed through texture features.
    Language English
    Publishing date 2023-08-09
    Publishing country China
    Document type Journal Article
    ZDB-ID 2653586-5
    ISSN 2223-4306 ; 2223-4292
    ISSN (online) 2223-4306
    ISSN 2223-4292
    DOI 10.21037/qims-23-19
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