Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren最新文献

Coronary artery disease (CAD) remains one of the leading causes of death in Germany. Since outpatient reimbursement for cardiac computed tomography angiography (CCTA) became available in 2024, non-invasive diagnostics have gained importance. CT-derived fractional flow reserve (FFR-CT) may increase the specificity of CCTA and reduce invasive procedures.In this retrospective analysis, 640 consecutive patients with coronary stenosis >25% were included in outpatient CCTA. Among them, 107 underwent additional FFR-CT. After propensity score matching, two cohorts of 105 patients each were available for comparison. The primary endpoint was the positive predictive value (PPV) for hemodynamically relevant stenoses.Based on propensity score matching, FFR-CT showed a PPV of 88% compared to 73% in the group without FFR-CT. Patients with nonpathological FFR-CT results were mainly managed conservatively, whereas pathological values led to revascularization in more than 70%. In the control group without FFR-CT, invasive coronary angiographies without coronary intervention were significantly more frequent (27%). Correlation between FFR-CT and invasive FFR was strong (r = 0.92; ICC = 0.95).Integration of FFR-CT in outpatient CCTA seems to improve diagnostic accuracy and reduce invasive procedures. It has the potential to combine anatomical and functional information and optimize treatment decisions in stable CAD. · FFR-CT has the potential to increase diagnostic accuracy and reduce invasive coronary angiographies.. · FFR-CT has a higher positive predictive value than CCTA.. · The correlation between FFR-CT and invasive FFR was high.. · In cases of pathological FFR-CT, revascularization was performed in >70% of patients. · Rottländer D, Fischer C, Mohsen Y et al. Value of CT-derived Fractional Flow Reserve in the Context of Outpatient Cardiac CT in Germany: A Propensity Score Matched Analysis. Rofo 2025; DOI 10.1055/a-2760-5485.

According to the text of the Lung Cancer Screening Ordinance on the permissibility of using low-dose computed tomography to screen smokers (LuKrFrühErkV, §7 Quality Assurance, 1), the "radiation protection officer must establish and operate a comprehensive quality assurance system. This must take account of organizational, medical, and technical aspects, in particular [...] 2. the diagnostic image quality of the computed tomography scan, 3. the physical-technical parameters for the acquisition of the computed tomography scan [...]". The German Radiological Society (DRG) considers itself responsible for making recommendations regarding the implementation of such a quality assurance system, in order to provide users with legal certainty and ensure patient safety. The DRG's Physics and Technology Working Group has thus identified the main issues regarding quality assurance for technology, outlined the related challenges, and proposed potential areas for future investigation and resolution (see sections I-V). Existing quality assurance measures for technology must be checked for their suitability with regard to a low-dose screening program and adapted, if necessary. Complex additional constancy tests and the use of special (anthropomorphic) phantoms are not currently considered necessary. The tasks of manufacturers and medical physicists were refined further, and it was recommended that reference centers should be established as soon as possible. · Constancy testing methods for CT are largely sufficient for lung cancer screening.. · Daily air calibration is recommended to ensure consistent image quality.. · Anthropomorphic phantoms are not currently required for quality assurance.. · Manufacturers must provide protocols that meet LuKrFrühErkV requirements.. Eßeling R, Konrad M, Prokesch H et al. Requirements for Physico-Technical Quality Assurance in the Framework of Early Detection of Lung Cancer. Rofo 2026; DOI 10.1055/a-2597-0689.

The well-known "hand with gunshot" X-ray bearing the signature of M.I. Pupin from Columbia College New York is widely recognized in the literature as being the first radiograph acquired with the use of an intensifying screen.Personal research in the New York City daily newspapers from 1896 and at Columbia University allowed us to establish that Pupin took two X-rays of a "hand with gunshot" in a patient on February 15 and 19, 1896. The first X-ray is preserved among the Pupin papers at Columbia University, and the second radiograph was published in an American magazine in March 1896. In 1974, the original radiographic plate of the X-ray performed on February 19 was discovered. In 1930 or shortly before, Pupin signed a contemporary X-ray of a "hand with gunshot", which is incompatible with the historical X-rays. This X-ray was made public in 1931,1965, and 1969, with the false claim that it was the first X-ray acquired using an intensifying screen in 1896.The "hand with gunshot" X-ray signed by Pupin around 1930 is a crude forgery of the X-ray he made on February 19, 1896. This X-ray has since been published many times and has been erroneously taken in good faith for the original. The historical X-rays remained ignored. · This paper establishes that the renowned "hand with gunshot" X-ray signed by M.I. Pupin is a forgery.. · Monville J-F., Dondelinger RF. Rectification: the well-known "hand with gunshot" radiograph signed by M.I. Pupin (1858-1935) and published in 1931 is a forgery. Rofo 2025; DOI 10.1055/a-2742-1763.

Radiology is at the center of the digital transformation of the healthcare system. As a highly digital field, radiology is well-suited for the early implementation and critical evaluation of innovative technologies, such as artificial intelligence (AI). This review aims to comprehensively and distinctly present the opportunities and challenges of digital transformation in radiology, focusing on clinical applications, research, and promoting young talents.This narrative review is based on selective evaluation of relevant scientific literature and publications from the last 10 years. Relevant German- and English-language articles on the digital transformation of radiology were considered, particularly those addressing digital infrastructure, artificial intelligence, ethical and regulatory frameworks, and education and training.Digitalization offers significant opportunities for radiology. In addition to advancing imaging procedures and automating image analysis with AI, digitalization optimizes workflows, enables personalized diagnostics, and fosters new care models, such as teleradiology. However, there are also key challenges: Data protection issues, a lack of standardization, insufficient validation, and regulatory hurdles are hindering its widespread implementation in hospitals. To future-proof radiology, it is essential to promote young talent and incorporate digital skills in the curriculum. · Due to its digital structure, radiology is particularly well-suited to integrating new medical technologies.. · Some AI-powered applications have been adopted in everyday clinical practice but they require further validation.. · A key task for the future is systematically training prospective radiologists in digital skills.. · Hoffmann E, Bannas P, Bayerl N et al. Digital Transformation and Artificial Intelligence in Radiology: Challenges and Opportunities for Clinical Practice, Research, and the Next Generation. Rofo 2025; DOI 10.1055/a-2741-9717.

There is a lack of clear recommendations regarding enteral contrast agent administration in the context of abdominal computed tomography (CT). A survey among members of the German Radiological Society (DRG) identified a very heterogeneous and indication-specific approach in the clinical routine. The goal of this study is to develop generally applicable recommendations.Recommendations for enteral contrast agent administration were developed by members of the Abdominal Workgroup within the DRG, using methodology comparable to that of an S1 guideline with informal consensus. Relevant clinical indications were systematically identified, categorized, and assessed considering current evidence in the literature and guidelines.There are specific clinical scenarios in which enteral contrast is indicated. Respective recommendations are presented in terms of good clinical practice (GCP). In this context, especially the administration of positive enteral contrast agents for abdominal CT examination is obsolete for many clinical indications. · For many indications, enteral contrast agent administration is not necessary. · In the case of esophageal or gastric tumors, enteral contrast should be achieved using the "hydro-technique". · Positive enteral contrast agents are primarily recommended for diagnosis of gastrointestinal fistulas and anastomoses. · Stadelmann J, Grenacher L, Juchems MS et al. Enteral contrast administration in abdominal computed tomography - Expert recommendations from the Abdominal Workgroup of the German Roentgen Society. Rofo 2025; DOI 10.1055/a-2750-0204.

In this overview we summarize the current state of scientific knowledge on the epidemiology, etiology, clinical symptoms and therapy of post-COVID disease.The study is based on a search of the scientific literature available on PubMed and on our own clinical experience in the post-COVID outpatient clinic.The prevalence of post-COVID disease varies greatly depending on the survey method used. The symptoms of post-COVID are manifold, but fatigue, cardiopulmonary complaints, cognitive deficit, and pain syndromes are prominent. There are currently no surefire symptoms or specific markers that prove the presence of the disease. Therefore, diagnosis is often based on an exclusion of other diagnoses, which requires good interdisciplinary cooperation. Therapy for post-COVID disease is also not specific but is always individual and symptom-oriented. There have been various attempts to explain the pathogenesis of post-COVID, but the mechanisms behind the development of the condition have not yet been conclusively clarified. Persistence of the virus or of viral proteins may cause protracted infection or autoimmunity. Infection and inflammation of the endothelium of the small vessels and the hypercoagulation associated with this may lead to local cytokine dysregulation and organ damage. Further clarification of the pathogenesis of post-COVID and the establishment of effective diagnostic tools and therapeutic approaches are urgently needed. · Post-COVID is a commonly reported condition with variable symptoms. · Interdisciplinary exclusion of other diagnoses and therapy planning are important. · Clarification of pathogenesis and establishment of diagnostic markers are urgently needed. · Reisinger EC, Geerdes-Fenge H, Wossidlo C et al. Long/Post-Covid - An Interdisciplinary Challenge. Rofo 2025; 197: 1388-1393.