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Papers by Beatrice Steiniger

Pediatric Radiology

Background Various imaging modalities, such as multi-detector computed tomography (CT) and cone b... more Background Various imaging modalities, such as multi-detector computed tomography (CT) and cone beam CT are commonly used in infants for the diagnosis of hearing loss and surgical planning of implantation hearing aid devices, with differing results. Objective We compared three different imaging modalities available in our institution, including a high-class CT scanner, a mid-class CT scanner and an angiography system with a cone beam CT option, for image quality and radiation exposure in a phantom study. Materials and methods While scanning an anthropomorphic phantom imitating a 1-year-old child with vendor-provided routine protocols, organ doses, surface doses and effective doses were determined for these three modalities with thermoluminescent dosimeters. The image quality was evaluated using the signal difference to noise ratio (SDNR) and the spatial resolution of a line-pair insert in the phantom head. The dose efficiency, defined as the ratio of SDNR and effective dose, was als...

Clinical Neuroradiology, 2021

Purpose The most common protocols in the initial diagnostic of acute ischemic stroke do not asses... more Purpose The most common protocols in the initial diagnostic of acute ischemic stroke do not assess cardiogenic or aortic causes of embolism. These are usually evaluated later by transthoracic (TTE) or transesophageal (TEE) echocardiography. This study aimed to evaluate the feasibility of a diagnostic tool for thoracic cardiovascular thrombi according to the first experience with a new extended cardio-stroke protocol (Big 5—Jena eCS protocol) in acute stroke patients. Methods Retrospective analyses of the tomography scans database of the Jena University Hospital were performed. We included a total of 67 patients in the feasibility analyses, based on the evaluation of three outcomes. Results Primary outcome: the Big 5—Jena eCS protocol was able to detect thoracic cardiovascular thrombi in a total of 20 patients in different locations including the arch of the aorta, the aortic valve, the left atrium, the left atrial appendage, the left ventricle, and the pulmonary arteries. Secondary ...

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2020

Background The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for ... more Background The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for all concerned. This review provides guidance on how to assess such a situation and how to determine the dose to the unborn child. In general, the use of X-rays in pregnant women in radiology should be avoided. If possible, alternatives should be used, or examinations postponed to a time after the pregnancy. This review gives a summary of the procedure for determining the radiation exposure of a pregnant woman. Method Based on the previous report of 2002 and the literature on prenatal radiation exposure published thereafter, the DGMP/DRG report on the procedure for the assessment of prenatal radiation exposure was adapted to the current state of science and technology. Results Typically, only relatively low radiation exposures of less than 20 mSv occur for the unborn child in X-ray diagnostics in the vast majority of cases. At these dose level the additional risk of damage to the embryo o...

Human Movement Science, 2018

Muscles work most effectively along their anatomically defined action vector(s) which has implica... more Muscles work most effectively along their anatomically defined action vector(s) which has implications in training and therapeutics. Action vectors can easily be identified in extremity muscles and smaller muscles of the trunk, but are less clear in larger trunk muscles. Trunk muscle exercises and diagnostics have traditionally relied on tasks in the sagittal planea practice that is being reconsidered. Therefore, this study aimed at identifying main force directions (MFDs) of major trunk muscles expressed in terms of deviation from the sagittal plane. 20 healthy male subjects underwent graded isometric submaximal static load applications on their trunk by application of simultaneous and incremental tilting and rotating from vertical to horizontal at rotational angles of 45°starting from 0°(forward tilting) around 360°with only the lower body secured. Surface EMG (SEMG) from six trunk muscles on each body side was recorded. The MFD of each trunk muscle was estimated by considering SEMG amplitudes of all rotational angles, separately for all tilt angles, and was expressed as angular deviation from sagittal plane. The calculated MFDs of trunk muscles deviated from sagittal plane to differing extents. Mean MFD angle was smallest (more parallel to sagittal plane) for rectus abdominis muscle (± 14°), becoming more lateral for external oblique (OE, ± 32°) and internal oblique abdominal muscles (OI, ± 47°). As tilt angle increased, MFD angles increased for OE, but decreased for OI. Iliocostalis muscle showed an almost laterally directed MFD with systematic dependency on body side (−90°for left and +75°for right side). Both paravertebral muscles (longissimus and multifidus muscles) showed almost identical MFD angles of about ± 145°and varied the least with tilt angle. All trunk muscles' MFDs deviate from sagittal plane and, in addition to flexing and extending, have both bending and/or rotational capabilities. MFDs of oblique abdominal muscles are systematically altered by tilt angle in accordance with their more divergent fiber directionality. The results provide a basis for specifically targeted diagnostics and training of trunk muscles.

Strahlentherapie und Onkologie, 2016

Purpose This project compares the different patient-related quality assurance systems for intensi... more Purpose This project compares the different patient-related quality assurance systems for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques currently used in the central Germany area with an independent measuring system. Materials and methods The participating institutions generated 21 treatment plans with different combinations of treatment planning systems (TPS) and linear accelerators (LINAC) for the QUASIMODO (Quality ASsurance of Intensity MODulated radiation Oncology) patient model. The plans were exposed to the ArcCHECK measuring system (Sun Nuclear Corporation, Melbourne, FL, USA). The dose distributions were analyzed using the corresponding software and a point dose measured at the isocenter with an ionization chamber. Results According to the generally used criteria of a 10 % threshold, 3 % difference, and 3 mm distance, the majority of plans investigated showed a gamma index exceeding M. Sc. Dipl.-Ing.

CardioVascular and Interventional Radiology, 2020

Purpose To assess radiation exposure in men undergoing prostate artery embolization (PAE) for the... more Purpose To assess radiation exposure in men undergoing prostate artery embolization (PAE) for the treatment for symptomatic, benign prostatic hyperplasia depending on growing experience of interventional radiologists over a 4-year period. Methods A total of 250 consecutive patients underwent PAE at a single center. Data on radiation exposure [dose area product (DAP), effective dose (ED), entrance skin dose (ESD), and fluoroscopy time (FT)] were retrospectively evaluated. Primary outcomes of interest were patient radiation exposure in five consecutive groups of 50 patients each and Pearson correlation with the number of patients treated. Results Median DAP, ED, and ESD during prostate artery embolization were significantly higher in the first compared to the second 50 patients (56 298 µGym2 vs. 24 709 µGym2, p

Pediatric Radiology

Background Various imaging modalities, such as multi-detector computed tomography (CT) and cone b... more Background Various imaging modalities, such as multi-detector computed tomography (CT) and cone beam CT are commonly used in infants for the diagnosis of hearing loss and surgical planning of implantation hearing aid devices, with differing results. Objective We compared three different imaging modalities available in our institution, including a high-class CT scanner, a mid-class CT scanner and an angiography system with a cone beam CT option, for image quality and radiation exposure in a phantom study. Materials and methods While scanning an anthropomorphic phantom imitating a 1-year-old child with vendor-provided routine protocols, organ doses, surface doses and effective doses were determined for these three modalities with thermoluminescent dosimeters. The image quality was evaluated using the signal difference to noise ratio (SDNR) and the spatial resolution of a line-pair insert in the phantom head. The dose efficiency, defined as the ratio of SDNR and effective dose, was als...

Clinical Neuroradiology, 2021

Purpose The most common protocols in the initial diagnostic of acute ischemic stroke do not asses... more Purpose The most common protocols in the initial diagnostic of acute ischemic stroke do not assess cardiogenic or aortic causes of embolism. These are usually evaluated later by transthoracic (TTE) or transesophageal (TEE) echocardiography. This study aimed to evaluate the feasibility of a diagnostic tool for thoracic cardiovascular thrombi according to the first experience with a new extended cardio-stroke protocol (Big 5—Jena eCS protocol) in acute stroke patients. Methods Retrospective analyses of the tomography scans database of the Jena University Hospital were performed. We included a total of 67 patients in the feasibility analyses, based on the evaluation of three outcomes. Results Primary outcome: the Big 5—Jena eCS protocol was able to detect thoracic cardiovascular thrombi in a total of 20 patients in different locations including the arch of the aorta, the aortic valve, the left atrium, the left atrial appendage, the left ventricle, and the pulmonary arteries. Secondary ...

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2020

Background The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for ... more Background The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for all concerned. This review provides guidance on how to assess such a situation and how to determine the dose to the unborn child. In general, the use of X-rays in pregnant women in radiology should be avoided. If possible, alternatives should be used, or examinations postponed to a time after the pregnancy. This review gives a summary of the procedure for determining the radiation exposure of a pregnant woman. Method Based on the previous report of 2002 and the literature on prenatal radiation exposure published thereafter, the DGMP/DRG report on the procedure for the assessment of prenatal radiation exposure was adapted to the current state of science and technology. Results Typically, only relatively low radiation exposures of less than 20 mSv occur for the unborn child in X-ray diagnostics in the vast majority of cases. At these dose level the additional risk of damage to the embryo o...

Human Movement Science, 2018

Muscles work most effectively along their anatomically defined action vector(s) which has implica... more Muscles work most effectively along their anatomically defined action vector(s) which has implications in training and therapeutics. Action vectors can easily be identified in extremity muscles and smaller muscles of the trunk, but are less clear in larger trunk muscles. Trunk muscle exercises and diagnostics have traditionally relied on tasks in the sagittal planea practice that is being reconsidered. Therefore, this study aimed at identifying main force directions (MFDs) of major trunk muscles expressed in terms of deviation from the sagittal plane. 20 healthy male subjects underwent graded isometric submaximal static load applications on their trunk by application of simultaneous and incremental tilting and rotating from vertical to horizontal at rotational angles of 45°starting from 0°(forward tilting) around 360°with only the lower body secured. Surface EMG (SEMG) from six trunk muscles on each body side was recorded. The MFD of each trunk muscle was estimated by considering SEMG amplitudes of all rotational angles, separately for all tilt angles, and was expressed as angular deviation from sagittal plane. The calculated MFDs of trunk muscles deviated from sagittal plane to differing extents. Mean MFD angle was smallest (more parallel to sagittal plane) for rectus abdominis muscle (± 14°), becoming more lateral for external oblique (OE, ± 32°) and internal oblique abdominal muscles (OI, ± 47°). As tilt angle increased, MFD angles increased for OE, but decreased for OI. Iliocostalis muscle showed an almost laterally directed MFD with systematic dependency on body side (−90°for left and +75°for right side). Both paravertebral muscles (longissimus and multifidus muscles) showed almost identical MFD angles of about ± 145°and varied the least with tilt angle. All trunk muscles' MFDs deviate from sagittal plane and, in addition to flexing and extending, have both bending and/or rotational capabilities. MFDs of oblique abdominal muscles are systematically altered by tilt angle in accordance with their more divergent fiber directionality. The results provide a basis for specifically targeted diagnostics and training of trunk muscles.

Strahlentherapie und Onkologie, 2016

Purpose This project compares the different patient-related quality assurance systems for intensi... more Purpose This project compares the different patient-related quality assurance systems for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques currently used in the central Germany area with an independent measuring system. Materials and methods The participating institutions generated 21 treatment plans with different combinations of treatment planning systems (TPS) and linear accelerators (LINAC) for the QUASIMODO (Quality ASsurance of Intensity MODulated radiation Oncology) patient model. The plans were exposed to the ArcCHECK measuring system (Sun Nuclear Corporation, Melbourne, FL, USA). The dose distributions were analyzed using the corresponding software and a point dose measured at the isocenter with an ionization chamber. Results According to the generally used criteria of a 10 % threshold, 3 % difference, and 3 mm distance, the majority of plans investigated showed a gamma index exceeding M. Sc. Dipl.-Ing.

CardioVascular and Interventional Radiology, 2020

Purpose To assess radiation exposure in men undergoing prostate artery embolization (PAE) for the... more Purpose To assess radiation exposure in men undergoing prostate artery embolization (PAE) for the treatment for symptomatic, benign prostatic hyperplasia depending on growing experience of interventional radiologists over a 4-year period. Methods A total of 250 consecutive patients underwent PAE at a single center. Data on radiation exposure [dose area product (DAP), effective dose (ED), entrance skin dose (ESD), and fluoroscopy time (FT)] were retrospectively evaluated. Primary outcomes of interest were patient radiation exposure in five consecutive groups of 50 patients each and Pearson correlation with the number of patients treated. Results Median DAP, ED, and ESD during prostate artery embolization were significantly higher in the first compared to the second 50 patients (56 298 µGym2 vs. 24 709 µGym2, p