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Biomedical subjects

Franz Kainberger

Publications and source records attributed to Franz Kainberger.

At least 19 recordsLinked to original sources
PubMed2006

[Sports injury of the spine: imaging diagnosis].

Sports injuries, especially those due to trend sports, and overuse resulting from monotonous repetitive movement patterns may cause various spinal abnormalities. Indications for diagnostic imaging should be established more readily in this group of young patients than in adults, as there is a higher probability to find morphologic abnormalities. This diagnostic strategy should also be applied for MRI and CT investigations. Image findings should be interpreted with view on kinetic chains related to distinct sporting activities.

Athletic Injuries↗
PubMed2006

Accuracy of treatment planning based on stereolithography in computer assisted surgery.

Three-dimensional stereolithographic models (SL models), made of solid acrylic resin derived from computed-tomography (CT) data, are an established tool for preoperative treatment planning in numerous fields of medicine. An innovative approach, combining stereolithography with computer-assisted point-to-point navigation, can support the precise surgical realization of a plan that has been defined on an SL model preoperatively. The essential prerequisites for the application of such an approach are: (1) The accuracy of the SL models (including accuracy of the CT scan and correspondence of the model with the patient's anatomy) and (2) the registration method used for the transfer of the plan from the SL model to the patient (i.e., whether the applied registration markers can be added to the SL model corresponding to the markers at the patient with an accuracy that keeps the "cumulative error" at the end of the chain of errors, in the order of the accuracy of contemporary navigation systems). In this study, we focus on these two topics: By applying image-matching techniques, we fuse the original CT data of the patient with the corresponding CT data of the scanned SL model, and measure the deviations of defined parameter (e.g., distances between anatomical points). To evaluate the registration method used for the planning transfer, we apply a point-merge algorithm, using four marker points that should be located at exactly corresponding positions at the patient and at connective bars that are added to the surface of the SL model. Again, deviations at defined anatomical structures are measured and analyzed statistically. Our results prove sufficient correspondence of the two data sets and accuracy of the registration method for routine clinical application. The evaluation of the SL model accuracy revealed an arithmetic mean of the relative deviations from 0.8% to 5.4%, with an overall mean deviation of 2.2%. Mean deviations of the investigated anatomical structures ranged from 0.8 mm to 3.2 mm. An overall mean (comprising all structures) of 2.5 mm was found. The fiducial registration error of the point-merge algorithm ranged from 1.0 mm to 1.4 mm. The evaluated chain of errors showed a mean deviation of 2.5 mm. This study verifies that preoperative planning on SL models and intraoperative transfer of this plan with computer assisted navigation is a suitable and sufficiently reliable method for clinical applications.

Algorithms↗
PubMed2005

Diffusion weighted imaging of bone marrow pathologies.

Diffusion weighted imaging of non-CNS tissue has attracted much attention during the last years. Its capability of probing the microstructure of a biologic tissue at a sub-millimeter range is used to evaluate its diffusion capacity, which is tissue specific and can be used for tissue characterization. Processes involving bone marrow where the primary target for DWI during the last years. Most experience has been gained for differentiating benign from pathologic vertebral compression fractures, which can be reliably done when quantitative diffusion measurements are available. However, preliminary results exist indicating that this non-invasive technique may be a potential tool for therapy monitoring, which will revise the management of cancer patients. Moreover, this will be the first non-invasive and quantifiable tool for evaluating the effectiveness of modern tumor treatment. In this article, we will give an overview on the current status of DWI in the evaluation of bone marrow alterations; on currently available DWI techniques and a short out-look on future aspects of DWI in bone marrow pathologies.

Bone Marrow Diseases↗
PubMed2005

Musculoskeletal ultrasound including definitions for ultrasonographic pathology.

Ultrasound (US) has great potential as an outcome in rheumatoid arthritis trials for detecting bone erosions, synovitis, tendon disease, and enthesopathy. It has a number of distinct advantages over magnetic resonance imaging, including good patient tolerability and ability to scan multiple joints in a short period of time. However, there are scarce data regarding its validity, reproducibility, and responsiveness to change, making interpretation and comparison of studies difficult. In particular, there are limited data describing standardized scanning methodology and standardized definitions of US pathologies. This article presents the first report from the OMERACT ultrasound special interest group, which has compared US against the criteria of the OMERACT filter. Also proposed for the first time are consensus US definitions for common pathological lesions seen in patients with inflammatory arthritis.

Arthritis, Rheumatoid↗
PubMed2004

Extracorporeal shockwave treatment is effective in calcific tendonitis of the shoulder. A randomized controlled trial.

BACKGROUND: Calcific tendonitis of the shoulder is often associated with chronic pain and impairment of function. Extracorporeal shockwave therapy (ESWT) is considered to be a treatment option. We compared the effects of two different ESWT regimens. METHODS: 43 patients (57 shoulders) with symptomatic calcific tendonitis of the shoulder for more than six months were included in a double-blinded study. Thirty-one shoulders were treated at the area of maximum pain with application of 2 x 2000 impulses of 0.28 mJ/mm2 at an interval of two weeks (treatment group) and 26 shoulders with 2 x 2000 impulses of < 0.07 mJ/mm2 at an interval of two weeks (control group), without pretreatment analgesia. Shoulder function (Constant score) and pain (visual analogue scale, VAS) were assessed before treatment and at one week, three months and seven months after treatment. Shoulder X-rays were performed at the 3- and 7-month follow-up visits. RESULTS: Improvement in Constant score was significantly higher in the treatment group at all follow-up visits (p < 0.05). Seven months post-treatment, calcifications dissolved completely in 19% of the treatment group and 8% of the control group, and a > 50% reduction was observed in 19% and 8% respectively. With regard to reduction of pain, there was significant improvement in the treatment group compared with the control group at the 1-week follow-up (p < 0.05). However, at the 3-month and 7-month visits, no significant between-group difference in pain could be detected. CONCLUSION: As applied, ESWT with an energy flux density of 0.28 mJ/mm2 led to a significantly greater improvement in shoulder function and a slightly higher, nonsignificant, rate of > 50% disintegration of calcific deposits compared with the control group. However, this did not result in reduction of pain.

Activities of Daily Living↗
PubMed2004

Neoadjuvant radiochemotherapy of oral cavity and oropharyngeal cancer: evaluation of tumor response by CT differs from histopathologic response assessment in a significant fraction of patients.

BACKGROUND: Our aim was to compare and assess the predictive value of CT and histopathologic grading of tumor regression at primary tumor sites in patients with squamous cell carcinoma of the oral cavity and oropharynx after neoadjuvant (preoperative) radiochemotherapy (RCT). METHODS: We investigated 55 patients with carcinomas of the oral cavity and oropharynx who underwent RCT before curative surgery. Two blinded observers measured RCT-induced reduction of tumor volume in pretherapeutic and posttherapeutic CT scans. Volume changes were compared with histopathologic findings obtained at surgery. RESULTS: Histopathologic response evaluation revealed 31 complete remissions, 12 cases of partial response, and 12 nonresponders. We performed a logistic regression analysis to evaluate whether measured volume reduction could predict the likelihood of belonging to a certain response group. Taken together, we found 35 correct, 12 false-negative, and seven false-positive predictions. CONCLUSIONS: The extent of remission as assessed by CT scans 4 to 5 weeks after completion of neoadjuvant RCT leads to false predictions in a significant percentage of patients.

Adult↗
PubMed2004

Differential diagnosis of rheumatic diseases using conventional radiography.

The approach to the differential diagnosis of rheumatic diseases using conventional radiography is systematic and module-oriented, which, with respect to future developments, forms the basis for computer-assisted diagnosis (CAD). The indications follow consensus-based referral criteria and attempts should be made to raise the evidence level of the recommendations. Investigation techniques have been improved in the last few years with the use of digital radiography. New imaging technologies may be available in the future that will achieve at least the same quality of images, while exposing patients to a significantly lower radiation dose. The interpretation of radiographical signs could be enhanced through a correlation with other imaging modalities. Computer-assisted techniques with image processing tools for automated measurements, lesion detection and in the form of expert systems are under development. With conventional radiography embedded in CAD systems, promising options will be available to enhance the differential diagnosis of rheumatic diseases.

Arthrography↗
PubMed2003

Computer-aided placement of endosseous oral implants in patients after ablative tumour surgery: assessment of accuracy.

The objective of this study was to evaluate the feasibility and accuracy of a novel surgical computer-aided navigation system for the placement of endosseous implants in patients after ablative tumour surgery. Pre-operative planning was performed by developing a prosthetic concept and modifying the implant position according to surgical requirements after high-resolution computed tomography (HRCT) scans with VISIT, a surgical planning and navigation software developed at the Vienna General Hospital. The pre-operative plan was transferred to the patients intraoperatively using surgical navigation software and optical tracking technology. The patients were HRCT-scanned again to compare the position of the implants with the pre-operative plan on reformatted CT-slices after matching of the pre- and post-operative data sets using the mutual information-technique. A total of 32 implants was evaluated. The mean deviation was 1.1 mm (range: 0-3.5 mm). The mean angular deviation of the implants was 6.4 degrees (range: 0.4 degrees - 17.4 degrees, variance: 13.3 degrees ). The results demonstrate, that adequate accuracy in placing endosseous oral implants can be delivered to patients with most difficult implantologic situations.

Dental Implantation, Endosseous↗
PubMed2003

Sézary syndrome and seronegative polyarthritis: treatment with extracorporeal photochemotherapy.

We describe a patient with therapy-resistant cutaneous T-cell lymphoma, Sézary syndrome variant, in association with concurrent polyarthritis and vitiligo, who was successfully treated with extracorporeal photochemotherapy (ECP). The combination of Sézary syndrome with seronegative rheumatoid arthritis is rare. In our patient the T-cell lymphoma was refractory to standard treatments that included psoralen-UVA, lymph node irradiation, and polychemotherapy. ECP has been shown to be effective in the treatment of selected cases of Sézary syndrome. There is a strong suggestion that ECP as a monotherapy can provide a significant benefit for other T-cell-mediated diseases including rheumatoid arthritis. In spite of a disease duration of 10 years, a very low CD8 cell count (2% of lymphocytes), a very high CD4 cell count (94%), and multiple unsuccessful chemotherapeutic trials before initiation of ECP, our patient achieved a long-lasting complete remission of both diseases with normalization of the CD4+ and CD8+ T-lymphocyte subsets. Concurrent developing vitiligo was unaffected by ECP.

Arthritis↗
PubMed2003

Quantification and clinical relevance of head motion during computed tomography.

OBJECTIVE: To quantify the 3-dimensional translation and rotation components of head motion during computed tomography and to analyze the influence of such motion on perceptible artifacts and distortion of volume image data sets. METHODS: Using high-precision optoelectronic motion-capture technology, changes in patient head position during axial CT scanning were registered in 20 cases and 2 phantoms with a spatial relative resolution better than 0.003 cm. Statistical analysis was performed on a base of 6-dimensional measurement-vectors, each with 3 translation and 3 rotation values. Because of the recording frequency of the tracking system, more than 80000 values were included in a statistical analysis. RESULTS: All 20 patients had head motion during the CT scanning, with only 4 of 20 patients showing perceptible motion artifacts. The frequency, the extent, and the direction of the movements did not correlate with either the observations made by the radiologic staff or with the patient's subjective estimation of comfort. Translation movements of the head during CT accounted for a maximum of 0.5 cm and rotations of more than 2 degrees without perceptible motion artifacts. The extent of positional changes of the head was found to correlate with the duration of scanning (Pearson's correlation coefficient: 0.647 for translation shifts, 0.453 for rotation shifts). The mean direction of head motion could be characterized predominantly as a rotation around the longitudinal axis of the body (xy plane) at a significance level of 0.01. CONCLUSION: Computed tomography evaluations of the head performed without rigid fixation suffer a spatial distortion of the volume image data sets, caused by interimage motion. The absence of motion artifacts is not correlated with the absence of motion.

Adolescent↗
PubMed2003

[Diagnosis and therapy of diseases of the endocrine system: new trends in nuclear medicine].

Diagnosis and therapy of endocrine disorders in nuclear medicine has been improved through the implementation of new techniques especially with positron emission tomography (PET). In modern concepts of parathyroid gland surgery an exact anatomic localisation of adenomas is necessary, which may be achieved with MIBI-Scintigraphy being the most sensitive method in primary hyperparathyroidism. The optimal access to localise adenomas is the investigation with combined SPECT/X-CT systems. The use of such systems for diagnosing neuroendocrine tumors of the gastrointestinal system may also be helpful. For neoplasms of the adrenal gland PET systems could be used to differentiate between benign and malignant entities or to detect primary tumours. In case of incidentalomas J131-Norcholesterol and MIGB-scintigraphy has been proven helpful. Indications for nuclear medicine studies to detect abnormalities of the hypothalamic-hypophyseal system are established rarely.

Endocrine System Diseases↗
PubMed2003

[Imaging of the parathyroid gland].

Diseases of the parathyroid gland are rare and are especially in case of hyperparathyroidism associated with hyperacalcaemia. Enlarged glands are, therefore, generally not detected with imaging modalities. The aim of imaging studies is to locialize abnormal glands. Ultrasound is the modality of choice for the primary investigation followed by nuclear medicine studies. Computed tomography or angiography with vein sampling should only be performed if the results of other investigations are equivocal. Magnetic resonance imaging is performed rarely in Austria with its high prevalence of endemic goiter.

Adenoma↗
PubMed2003

[Demineralising osteopathies: new aspects of diagnostic imaging].

The wide use of multimodal radiologic analysis of bone tissue has led to a new concept of the term osteopenia towards grouping the various osteopathies as demineralizing osteopathies. With bone densitometry measurements both high precision and accuracy can be achieved, whereas conventional radiographs provide insights into the architecture of the bone to better advantage. By using both modalities discrepancies of the radiological reports with the final diagnosis may be avoided. Despite ongoing success in techniques of semi-automated data analysis and reporting the radiological and the clinical assessment of bone diseases are still an indispensable part of establishing the diagnosis.

Absorptiometry, Photon↗
PubMed2003

[Hybrid imaging for endocrine diseases: new perspectives].

Hybrid Imaging, also termed dual modality imaging, is the technique of fusionizing and interpreting images, that are gained from two different modalities constructed in one unit. Therefore, hybrid imaging may be regarded as a form of image fusion. Clinical applications in the field of endocrinology are the localization of neuroendocrine tumors and of lesions of the adrenal or the parathyroid glands. Significant diagnostic impact can be gained with this technique influencing the certainty of radiological reports.

Endocrine System Diseases↗