Publications by authors named "Constantin Roder"

Purpose: To share our clinical experience with conservative management of isolated spinal arterial aneurysms (ISAs) and to identify clinical scenarios where conservative management may be appropriate, in the context of a literature review.

Methods: We performed a retrospective review of spinal angiograms from two German neuroradiology centers and conducted a systematic literature review of reported ISA cases. We analyzed demographics, clinical presentation, imaging findings, treatments, and outcomes.

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: Postoperative MRI is crucial for detecting residual tumor, identifying complications, and planning subsequent therapy. This study evaluates accelerated deep learning reconstruction (DLR) versus standard clinical protocols for early postoperative MRI following tumor resection. : This study uses a multidisciplinary approach involving a neuroradiologist, neurosurgeon, neuro-oncologist, and radiotherapist to evaluate qualitative aspects using a 5-point Likert scale, the preferred reconstruction variant and potential residual tumor of DLR and conventional reconstruction (CR) of FLAIR, T1-weighted non-contrast and contrast-enhanced (T1), and coronal T2-weighted (T2) sequences for 1.

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Purpose: Breath-hold functional MRI (bh-fMRI) is able to quantify cerebrovascular reactivity. Vessel stenoses can lead to delayed hemodynamic responses. We aimed to investigate whether delay correction improves the quality of bh-fMRI compared to the diagnostic standard [O]water PET.

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Moyamoya disease (MMD) may lead to perfusion deficits, stroke and brain atrophy in the long-term. Our aim was to analyse whole-brain volumetry of a large cohort of Moyamoya disease patients compared to healthy controls. 3D T1w MRI sequences of adult Moyamoya disease patients treated at our centre between 2016 and 2022 without prior revascularization were analysed for whole-brain volumetry (AssemblyNet) and compared age-controlled to healthy controls.

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Background: The discovery of cellular tumor networks in glioblastoma, with routes of malignant communication extending far beyond the detectable tumor margins, has highlighted the potential of supramarginal resection strategies. Retrospective data suggest that these approaches may improve long-term disease control. However, their application is limited by the proximity of critical brain regions and vasculature, posing challenges for validation in randomized trials.

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Background: Concentric vessel-wall contrast enhancement (VW-CE) of the terminal carotid artery and its proximal branches may be linked to ischemic strokes, disease activity and progression in Moyamoya disease (MMD). The objective of this retrospective cohort study is to analyze the association between VW-CE and perioperative acute ischemic stroke (PAIS) occurring within 24 h after revascularization.

Methods: All previously untreated MMD patients who required revascularization and who had undergone preoperative MRI with VW-CE-sequences were included.

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Unlabelled: Diagnostic accuracy and therapeutic decision-making for IDH-mutant gliomas in tumor board reviews are based on MRI and multidisciplinary interactions.

Materials And Methods: This study explores the feasibility of deep learning-based reconstruction (DLR) in MRI for IDH-mutant gliomas. The research utilizes a multidisciplinary approach, engaging neuroradiologists, neurosurgeons, neuro-oncologists, and radiotherapists to evaluate qualitative aspects of DLR and conventional reconstructed (CR) sequences.

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Background: Facial palsy after vestibular schwannoma surgery is temporary in many cases but can significantly affect patients' quality of life. Physical training-initially guided and subsequently performed by the patient-is of paramount importance for recovery of facial nerve function. The introduction of medical application software (apps) might improve therapy by maintaining motivation for daily home-based training and surveilling patients' rehabilitation progress.

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Background: Glossopharyngeal neuralgia (GN) is a rare pain syndrome often underdiagnosed. This study aimed to assess the challenges in diagnosing GN and identify patients at risk of misdiagnosis.

Methods: Between 2010 and 2019, nine patients underwent microvascular decompression (MVD) of the glossopharyngeal nerve at two tertiary care hospitals.

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Article Synopsis
  • Starting a medical career involves more than just clinical knowledge; skills like communication, leadership, and career management are essential but often underrepresented in medical school training.!* -
  • A survey of 450 final-year medical students revealed that while they value these competencies, they feel inadequately prepared by their curriculum, particularly in leadership and career management skills.!* -
  • There is a strong interest among students (90.7%) for additional courses focused on these skills, suggesting a need for curriculum changes to better equip future physicians for their careers.!*
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Article Synopsis
  • Moyamoya syndrome (MMS) is linked to genetic disorders and arises from a mix of genetic mutations and modifiers, with a focus on whole-exome sequencing (WES) to identify these connections.
  • In a study of 13 patients, WES identified genetic conditions like neurofibromatosis type 1, Down syndrome, and others, confirming previously known modifier genes in some cases.
  • The research suggests that rare genetic variants associated with both MMS and conditions like pulmonary arterial hypertension could serve as new diagnostic tools and potential treatments in the future.
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Before revascularization, moyamoya patients require hemodynamic evaluation. In this study, we evaluated the scoring system , (PIRAMID). We also devised a new scoring system, (MARS-MMA), and compared the scoring systems with respect to the capability to predict impaired [O]water PET cerebral perfusion reserve capacity (CPR).

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Moyamoya disease (MMD) is a rare stenoocclusive cerebral vasculopathy often treated by neurosurgical revascularization using extracranial-intracranial bypasses to prevent ischemic or hemorrhagic events. Little is known about the vascular risk profile of adult MMD patients compared to the general population. We therefore analyzed 133 adult MMD patients and compared them with data from more than 22,000 patients from the German Health Update database.

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Background And Objectives: The underlying pathophysiological cause of moyamoya angiopathy (MMA) is still unclear. High-resolution vessel wall imaging has become a useful tool. The aim was to study vessel wall contrast-enhancement (VW-CE) as an imaging marker to predict disease progression in MMA.

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Background: Little is known about the growth dynamics of untreated glioblastoma and its possible influence on postoperative survival. Our aim was to analyze a possible association of preoperative growth dynamics with postoperative survival.

Methods: We performed a retrospective analysis of all adult patients surgically treated for newly diagnosed glioblastoma at our center between 2010 and 2020.

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Article Synopsis
  • The study investigates the effectiveness of vessel-encoded arterial spin labeling (VE-ASL) in visualizing blood flow from individual arteries in the brain, compared to the traditional method of digital subtraction angiography (DSA).
  • A review of data from 20 VE-ASL and DSA sets involving 17 patients with Moyamoya angiopathy showed a high level of agreement between the two imaging techniques.
  • The findings suggest that VE-ASL is a reliable non-invasive alternative for assessing cerebral blood flow contributions, making it particularly useful both before and after revascularization surgery.
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Background And Objectives: Patients with Moyamoya disease (MMD) have an above-average incidence of neuropsychological impairment and psychiatric comorbidities such as depression. Prevalence and correlation with preoperative imaging findings were identified in previous studies, and a reduced health-related quality of life (HRQOL) has been shown. This study investigates changes in neuropsychological performance and HRQOL after revascularization.

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Purpose: Individuals with drug-resistant epilepsy may benefit from epilepsy surgery. In nonlesional cases, where no epileptogenic lesion can be detected on structural magnetic resonance imaging, multimodal neuroimaging studies are required. Breath-hold-triggered BOLD fMRI (bh-fMRI) was developed to measure cerebrovascular reactivity in stroke or angiopathy and highlights regional network dysfunction by visualizing focal impaired flow increase after vasodilatory stimulus.

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Introduction: Glioblastoma (GBM) is a tumor with rapid growth and a possible relationship to elevated intracranial pressure (ICP). High ICP may not always be associated with clinical signs. A non-invasive technique for assessment of ICP is measuring the optic nerve sheath diameter (ONSD).

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In children with bladder/prostate (BP) and perianal rhabdomyosarcoma (RMS), we use a hybrid treatment concept for those suitable, combining organ-preserving tumor resection and high-dose rate brachytherapy (HDR-BT). This treatment concept has been shown to improve outcomes. However, it is associated with specific challenges for the clinicians.

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Purpose: Prospective data suggested a superiority of intraoperative MRI (iMRI) over 5-aminolevulinic acid (5-ALA) for achieving complete resections of contrast enhancement in glioblastoma surgery. We investigated this hypothesis in a prospective clinical trial and correlated residual disease volumes with clinical outcome in newly diagnosed glioblastoma.

Methods: This is a prospective controlled multicenter parallel-group trial with two center-specific treatment arms (5-ALA and iMRI) and blinded evaluation.

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Background: Poor-grade aneurysmal subarachnoid hemorrhage (SAH) is associated with poor neurological outcome and high mortality. A major factor influencing morbidity and mortality is brain swelling in the acute phase. Decompressive craniectomy (DC) is currently used as an option in order to reduce intractably elevated intracranial pressure (ICP).

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Purpose: Patients with Moyamoya Angiopathy (MMA) require hemodynamic assessment to evaluate the risk of stroke. Hemodynamic evaluation by use of breath-hold-triggered fMRI (bh-fMRI) was proposed as a readily available alternative to the diagnostic standard [O]water PET. Recent studies suggest voxel-wise hemodynamic delay correction in hypercapnia-triggered fMRI.

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Current data show that resilience is an important factor in cancer patients’ well-being. We aim to explore the resilience of patients with lower grade glioma (LGG) and the potentially influencing factors. We performed a cross-sectional assessment of adult patients with LGG who were enrolled in the LoG-Glio registry.

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