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  1. Book: Validität der Magnetresonanztomographie bei der Diagnostik intraartikulärer Pathologien des Handgelenks

    Luitjens, Johanna

    Vergleich mit der Arthroskopie als Referenzstandard

    (Edition Scientifique)

    2021  

    Abstract: Intraartikuläre Pathologien des Handgelenks wie Läsionen der Ligamente oder des Gelenkknorpels gehen mit einer hohen Krankheitslast der Patienten einher (Parr et al. 1989). Eine suffiziente und präzise Diagnostik ist daher essenziell, um eine effiziente ... ...

    Series title Edition Scientifique
    Abstract Intraartikuläre Pathologien des Handgelenks wie Läsionen der Ligamente oder des Gelenkknorpels gehen mit einer hohen Krankheitslast der Patienten einher (Parr et al. 1989). Eine suffiziente und präzise Diagnostik ist daher essenziell, um eine effiziente Therapie sicherstellen zu können (Dasilva et al. 2017). Häufig kommt daher neben der klinischen Untersuchung und den nicht invasiven diagnostischen Methoden wie dem Röntgen, der CT und der MRT die invasive Arthroskopie als aktueller Goldstanda...
    Keywords Osteopathie ; Gelenke ; Arthroskopie
    Language German
    Size 88 p.
    Publisher VVB Laufersweiler Verlag
    Document type Book
    Note Hochschulschriften Medizin
    Format 148 x 210
    ISBN 9783835970038 ; 3835970038
    Database PDA

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  2. Article ; Online: Defining hip osteoarthritis feature prevalence, severity, and change using the Scoring of Hip Osteoarthritis with MRI (SHOMRI).

    Heerey, Joshua J / Souza, Richard B / Link, Thomas M / Luitjens, Johanna / Gassert, Felix / Kemp, Joanne L / Scholes, Mark J / Crossley, Kay M

    Skeletal radiology

    2024  

    Abstract: Objective: To define the reporting of Scoring Hip Osteoarthritis with MRI (SHOMRI) feature prevalence and severity, and to develop criteria to monitor feature change in longitudinal investigations.: Methods: Twenty-five participants (50 hips) of the ... ...

    Abstract Objective: To define the reporting of Scoring Hip Osteoarthritis with MRI (SHOMRI) feature prevalence and severity, and to develop criteria to monitor feature change in longitudinal investigations.
    Methods: Twenty-five participants (50 hips) of the femoroacetabular impingement and hip osteoarthritis cohort study underwent baseline and 2-year follow-up 3 T hip MRIs. Eight hip OA features were assessed using the SHOMRI. All MRIs were read paired with knowledge of timepoint by two blinded musculoskeletal radiologists. We provide definitions to report SHOMRI feature prevalence, severity, and longitudinal change.
    Results: We report clear definitions for SHOMRI feature prevalence, severity, and change. When we applied the definitions to the studied cohort, we could detect the prevalence, severity, and change of hip OA features. For example, 88% of hips had labral tears (34% graded as severe tears) and 76% had cartilage defects (42% graded as full thickness). Over 70% of hips had feature change over 2 years, highlighting the sensitivity of SHOMRI definitions to assess longitudinal change of hip OA features. Intra-reader reliability was almost perfect (weighted (w)-kappa 0.86 to 1.00), with inter-reader reliability substantial to almost perfect (w-kappa 0.80 to 1.00).
    Conclusion: This study is the first to provide definitions to report SHOMRI feature prevalence, severity, and change. The proposed definitions will enable comparison between hip MRI studies and improve our understanding of hip OA pathogenesis.
    Language English
    Publishing date 2024-03-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 527592-1
    ISSN 1432-2161 ; 0364-2348
    ISSN (online) 1432-2161
    ISSN 0364-2348
    DOI 10.1007/s00256-024-04628-0
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  3. Article ; Online: Diagnostic performance of traditional radiographic indices in detection of carpal collapse in Kienböck's disease.

    Luitjens, Johanna / Goller, Sophia Samira / Schmitt, Rainer / Erber, Bernd / Van Schoonhoven, Jörg / Hesse, Nina

    The Journal of hand surgery, European volume

    2023  Volume 48, Issue 7, Page(s) 619–624

    Abstract: Correctly identifying carpal collapse is important for adequate treatment of Kienböck's disease. This study aimed to assess the accuracy of traditional radiographic indices in detecting carpal collapse to differentiate between Lichtman stages IIIa and ... ...

    Abstract Correctly identifying carpal collapse is important for adequate treatment of Kienböck's disease. This study aimed to assess the accuracy of traditional radiographic indices in detecting carpal collapse to differentiate between Lichtman stages IIIa and IIIb. In 301 patients, carpal height ratio, revised carpal height ratio, Ståhl index and radioscaphoid angle were measured on plain radiographs by two blinded observers. As a reference standard, Lichtman stages were determined by an expert radiologist using CT and MR imaging. The interobserver agreement was excellent. In the differentiation between Lichtman stages IIIa and IIIb, measurements of indices showed moderate to good sensitivity (0.60-0.95) and low specificity (0.09-0.69) using normal cut-off values from the literature, while receiver operating curve analysis revealed poor area under the curve (58-66%). Traditional radiographic indices showed poor diagnostic performance in detecting carpal collapse in Kienböck's disease and did not reach sufficient accuracy in the differentiation between Lichtman stages IIIa and IIIb.
    MeSH term(s) Humans ; Carpal Bones/diagnostic imaging ; Lunate Bone/diagnostic imaging ; Magnetic Resonance Imaging ; Osteonecrosis/diagnostic imaging ; Radiography ; Wrist Joint
    Language English
    Publishing date 2023-02-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2272801-6
    ISSN 2043-6289 ; 1753-1934
    ISSN (online) 2043-6289
    ISSN 1753-1934
    DOI 10.1177/17531934231153966
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  4. Article ; Online: Effects of T

    Bhattacharjee, Rupsa / Thahakoya, Rafeek / Luitjens, Johanna / Han, Misung / Roach, Koren E / Jiang, Fei / Souza, Richard B / Pedoia, Valentina / Majumdar, Sharmila

    Journal of magnetic resonance imaging : JMRI

    2023  

    Abstract: Background: The polyarticular nature of Osteoarthritis (OA) tends to manifest in multi-joints. Associations between cartilage health in connected joints can help identify early degeneration and offer the potential for biomechanical intervention. Such ... ...

    Abstract Background: The polyarticular nature of Osteoarthritis (OA) tends to manifest in multi-joints. Associations between cartilage health in connected joints can help identify early degeneration and offer the potential for biomechanical intervention. Such associations between hip and knee cartilages remain understudied.
    Purpose: To investigate T
    Study type: Prospective.
    Subjects: Twenty-eight subjects (age 55.1 ± 12.8 years, 15 females) with none-to-moderate hip-OA while no radiographic knee-OA.
    Field strength/sequence: 3-T, bilateral hip, and knee: 3D-proton-density-fat-saturated (PDFS) Cube and Magnetization-Prepared-Angle-Modulated-Partitioned-k-Space-Spoiled-Gradient-Echo-Snapshots (MAPSS).
    Assessment: Ages of subjects were categorized into Group-1 (≤40), Group-2 (41-50), Group-3 (51-60), Group-4 (61-70), Group-5 (71-80), and Group-6 (≥81). Hip T
    Statistical tests: For Intra-and-Inter-limb, 5 optimum predictors out of 13 (Hip subregional T
    Results: LME-model
    Data conclusion: Significant positive and negative T
    Evidence level: 1 TECHNICAL EFFICACY: Stage 1.
    Language English
    Publishing date 2023-09-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1146614-5
    ISSN 1522-2586 ; 1053-1807
    ISSN (online) 1522-2586
    ISSN 1053-1807
    DOI 10.1002/jmri.29009
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  5. Article: Synthetic Inflammation Imaging with PatchGAN Deep Learning Networks.

    Tolpadi, Aniket A / Luitjens, Johanna / Gassert, Felix G / Li, Xiaojuan / Link, Thomas M / Majumdar, Sharmila / Pedoia, Valentina

    Bioengineering (Basel, Switzerland)

    2023  Volume 10, Issue 5

    Abstract: ... ...

    Abstract Background
    Language English
    Publishing date 2023-04-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2746191-9
    ISSN 2306-5354
    ISSN 2306-5354
    DOI 10.3390/bioengineering10050516
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  6. Article ; Online: Is hip capsule morphology associated with hip pain in patients without another structural correlate?

    Luitjens, Johanna / Gassert, Felix G / Patwardhan, Vasant / Bhattacharjee, Rupsa / Joseph, Gabby B / Zhang, Alan L / Souza, Richard B / Majumdar, Sharmila / Link, Thomas M

    European radiology

    2024  

    Abstract: Objective: The goals of this study were (i) to assess the association between hip capsule morphology and pain in patients without any other MRI abnormalities that would correlate with pain and (ii) to investigate whether hip capsule morphology in hip ... ...

    Abstract Objective: The goals of this study were (i) to assess the association between hip capsule morphology and pain in patients without any other MRI abnormalities that would correlate with pain and (ii) to investigate whether hip capsule morphology in hip pain patients is different from that of controls.
    Methods: In this study, 76 adults with hip pain who did not show any structural abnormalities on MRI and 46 asymptomatic volunteers were included. Manual segmentation of the anterior and posterior hip capsules was performed. Total and mean anterior hip capsule area, posterior capsule area, anterior-to-posterior capsule area ratio, and medial-to-lateral area ratio in the anterior capsule were quantified. Differences between the pain and control groups were evaluated using logistic regression models.
    Results: Patients with hip pain showed a significantly lower anterior-to-posterior area ratio as compared with the control group (p = 0.002). The pain group's posterior hip capsule area was significantly larger than that of controls (p = 0.001). Additionally, the ratio between the medial and lateral sections of the anterior capsule was significantly lower in the pain group (p = 0.004).
    Conclusions: Patients with hip pain are more likely to have thicker posterior capsules and a lower ratio of the anterior-to-posterior capsule area and thinner medial anterior capsules with a lower ratio of the medial-to-lateral anterior hip capsule compartment, compared with controls.
    Clinical relevance statement: During MRI evaluations of patients with hip pain, morphology of the hip capsule should be assessed. This study aims to be a foundation for future analyses to identify thresholds distinguishing normal from abnormal hip capsule measurements.
    Key points: • Even with modern image modalities such as MRI, one of the biggest challenges in handling hip pain patients is finding a structural link for their pain. • Hip capsule morphologies that correlated with hip pain showed a larger posterior hip capsule area and a lower anterior-to-posterior capsule area ratio, as well as a smaller medial anterior capsule area with a lower medial-to-lateral anterior hip capsule ratio. • The hip capsule morphology is correlated with hip pain in patients who do not show other morphology abnormalities in MRI and should get more attention in clinical practice.
    Language English
    Publishing date 2024-01-03
    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/s00330-023-10307-w
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  7. 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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  8. Article ; Online: Carpal Instability: II. Imaging.

    Hesse, Nina / Schmitt, Rainer / Luitjens, Johanna / Grunz, Jan-Peter / Haas-Lützenberger, Elisabeth Maria

    Seminars in musculoskeletal radiology

    2021  Volume 25, Issue 2, Page(s) 304–310

    Abstract: Beyond clinical examination, the various forms of carpal instability are assessed with radiologic methods and arthroscopy. For this purpose, the imaging demand for spatial and contrast resolution is particularly high because of the small ligamentous ... ...

    Abstract Beyond clinical examination, the various forms of carpal instability are assessed with radiologic methods and arthroscopy. For this purpose, the imaging demand for spatial and contrast resolution is particularly high because of the small ligamentous structures involved. The entities of carpal instability are classified into degrees of severity. Early (dynamic) forms of instability can either be indirectly detected with X-ray stress views and cineradiography or by direct visualization of ruptured ligaments in high-resolution magnetic resonance (MR) imaging and MR or computed tomography (CT) arthrography, with the latter the standard of reference in imaging. Advanced (static) forms of carpal instability are sufficiently well detected on radiographs; visualization of early carpal osteoarthritis is superior on CT. To prevent disability of the hand, the radiologist has to provide an early and precise diagnosis. This case-based review highlights the imaging procedures suitable for detection and classification of carpal instability.
    MeSH term(s) Arthrography ; Humans ; Joint Instability/diagnostic imaging ; Ligaments, Articular/diagnostic imaging ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Wrist Joint/diagnostic imaging
    Language English
    Publishing date 2021-08-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1360919-1
    ISSN 1098-898X ; 1089-7860
    ISSN (online) 1098-898X
    ISSN 1089-7860
    DOI 10.1055/s-0041-1730398
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  9. Article ; Online: Additional MRI for initial M-staging in pancreatic cancer: a cost-effectiveness analysis.

    Gassert, Felix G / Ziegelmayer, Sebastian / Luitjens, Johanna / Gassert, Florian T / Tollens, Fabian / Rink, Johann / Makowski, Marcus R / Rübenthaler, Johannes / Froelich, Matthias F

    European radiology

    2021  Volume 32, Issue 4, Page(s) 2448–2456

    Abstract: Objective: Pancreatic cancer is portrayed to become the second leading cause of cancer-related death within the next years. Potentially complicating surgical resection emphasizes the importance of an accurate TNM classification. In particular, the ... ...

    Abstract Objective: Pancreatic cancer is portrayed to become the second leading cause of cancer-related death within the next years. Potentially complicating surgical resection emphasizes the importance of an accurate TNM classification. In particular, the failure to detect features for non-resectability has profound consequences on patient outcomes and economic costs due to incorrect indication for resection. In the detection of liver metastases, contrast-enhanced MRI showed high sensitivity and specificity; however, the cost-effectiveness compared to the standard of care imaging remains unclear. The aim of this study was to analyze whether additional MRI of the liver is a cost-effective approach compared to routinely acquired contrast-enhanced computed tomography (CE-CT) in the initial staging of pancreatic cancer.
    Methods: A decision model based on Markov simulation was developed to estimate the quality-adjusted life-years (QALYs) and lifetime costs of the diagnostic modalities. Model input parameters were assessed based on evidence from recent literature. The willingness-to-pay (WTP) was set to $100,000/QALY. To evaluate model uncertainty, deterministic and probabilistic sensitivity analyses were performed.
    Results: In the base-case analysis, the model yielded a total cost of $185,597 and an effectiveness of 2.347 QALYs for CE-MR/CT and $187,601 and 2.337 QALYs for CE-CT respectively. With a net monetary benefit (NMB) of $49,133, CE-MR/CT is shown to be dominant over CE-CT with a NMB of $46,117. Deterministic and probabilistic survival analysis showed model robustness for varying input parameters.
    Conclusion: Based on our results, combined CE-MR/CT can be regarded as a cost-effective imaging strategy for the staging of pancreatic cancer.
    Key points: • Additional MRI of the liver for initial staging of pancreatic cancer results in lower total costs and higher effectiveness. • The economic model showed high robustness for varying input parameters.
    MeSH term(s) Cost-Benefit Analysis ; Humans ; Magnetic Resonance Imaging/methods ; Pancreatic Neoplasms/diagnostic imaging ; Quality-Adjusted Life Years ; Tomography, X-Ray Computed
    Language English
    Publishing date 2021-11-27
    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/s00330-021-08356-0
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  10. Article: Carpal Instability: II. Imaging

    Hesse, Nina / Schmitt, Rainer / Luitjens, Johanna / Grunz, Jan-Peter / Haas-Lützenberger, Elisabeth Maria

    Seminars in Musculoskeletal Radiology

    (Hand and Wrist Imaging)

    2021  Volume 25, Issue 02, Page(s) 304–310

    Abstract: Beyond clinical examination, the various forms of carpal instability are assessed with radiologic methods and arthroscopy. For this purpose, the imaging demand for spatial and contrast resolution is particularly high because of the small ligamentous ... ...

    Series title Hand and Wrist Imaging
    Abstract Beyond clinical examination, the various forms of carpal instability are assessed with radiologic methods and arthroscopy. For this purpose, the imaging demand for spatial and contrast resolution is particularly high because of the small ligamentous structures involved. The entities of carpal instability are classified into degrees of severity. Early (dynamic) forms of instability can either be indirectly detected with X-ray stress views and cineradiography or by direct visualization of ruptured ligaments in high-resolution magnetic resonance (MR) imaging and MR or computed tomography (CT) arthrography, with the latter the standard of reference in imaging. Advanced (static) forms of carpal instability are sufficiently well detected on radiographs; visualization of early carpal osteoarthritis is superior on CT. To prevent disability of the hand, the radiologist has to provide an early and precise diagnosis. This case-based review highlights the imaging procedures suitable for detection and classification of carpal instability.
    Keywords computed tomography arthrography ; cineradiography ; instability ; magnetic resonance imaging ; magnetic resonance arthrography
    Language English
    Publishing date 2021-04-01
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1360919-1
    ISSN 1098-898X ; 1089-7860
    ISSN (online) 1098-898X
    ISSN 1089-7860
    DOI 10.1055/s-0041-1730398
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