Arbeitsgruppe Muskuloskelettale Radiologie

Die Muskuloskelettale Radiologie stellt einen wesentlichen klinischen sowie wissenschaftlichen Schwerpunkt unserer Klinik dar. Aus der täglichen klinisch-diagnostischen Arbeit am Patienten abgeleitete Fragestellungen werden durch die Arbeitsgruppe und in Kooperation mit zahlreichen Instituten und Kliniken innerhalb der Medizinischen Fakultät, der RWTH Aachen sowie mit anderen in- und ausländischen Forschungseinrichtungen bearbeitet.

Gegenstand der wissenschaftlichen Tätigkeit ist insbesondere die Bildgebung von Bandstrukturen sowie Knorpel- und Meniskusgewebe im Allgemeinen durch qualitative und quantitative Verfahren der Magnetresonanztomographie im Speziellen. Derzeit führen wir zahlreiche In-vitro-, In-situ- und In-vivo-Studien in diesen Themenbereichen durch, u.a. durch Messung des Geweberelaxationsverhaltens (mittels T1-, T1ρ-, T2- und T2*-Zeiten) zur Darstellung kompositioneller und ultrastruktureller Veränderungen der Gewebe und durch definierte mechanische Belastung. Zielsetzung ist hierbei, krankhafte Veränderungen der Gewebe durch eine Kombination von morphologischen und funktionellen Parametern genauer diagnostizieren zu können, sodass Gelenkerkrankungen, insbesondere Arthrose, frühzeitig auf der Basis von veränderter Gewebefunktionalität erkannt werden können.

Neben hochmodernen MRT-Techniken werden ausgereifte biomechanische Vorrichtungen, differenzierte Techniken der automatisierten Bildverarbeitung (Machine Learning) und Computer-basierte Simulationen (Computational Engineering) in enger Zusammenarbeit mit den technischen Instituten der RWTH Aachen entwickelt und zum Einsatz gebracht.

Weitere klinisch-wissenschaftliche Fragestellungen der Arbeitsgruppe betreffen Knie-, Hüft- und Schultergelenksverletzungen sowie die Akuttraumatologie der Wirbelsäule.

Mittelgeber sind hierbei RWTH-intern (z.B. START-Programm der Medizinischen Fakultät) und nationale Instanzen (z.B. Deutsche Forschungsgemeinschaft).

Research Group MSK-RAD

Musculoskeletal radiology is a major clinical and scientific focus of the Department of Diagnostic and Interventional Radiology. Research questions are derived from the daily clinical work with patients and are subsequently dealt with in cooperation with numerous institutes and departments within the Medical Faculty, within RWTH Aachen University and with numerous prestigious national and international research institutions.

The subject of our scientific work is the imaging assessment of ligaments, cartilage and meniscus in general and by qualitative and quantitative advanced MRI techniques in particular. We are currently conducting numerous in-vitro, in-situ and in-vivo studies in these areas, including the measurement of tissue relaxation behaviour (using T1, T1ρ, T2 and T2* times) to elucidate compositional and ultrastructural tissue features. Moreover, we study the tissue’s adaptations to mechanical stress through their imaging correlates. The aim is to diagnose pathological changes more accurately using a combination of morphological and functional imaging parameters. Perspectively, joint diseases, in particular osteoarthritis, may thus be detected at an early stage on the basis of altered tissue functionality.

In addition to state-of-the-art MRI techniques, we apply sophisticated biomechanical devices, differentiated techniques of automated image processing (machine learning) and computer-based simulations (computational engineering) that are developed and applied in close cooperation with the technical institutes of RWTH Aachen University.

Further clinical research questions concern knee, hip and shoulder joint injuries as well as acute traumatological questions of the spine.

Funding is provided both internally (by RWTH Aachen University, e.g. START Program of the Medical Faculty) and externally by national funding agencies (e.g. DFG - German Research Association).

Linka K, Schäfer A, Hillgärtner M, Itskov M, Knobe M, Kuhl C, Hitpass L, Truhn D, Thuering J, Nebelung S. Towards Patient-Specific Computational Modelling of Articular Cartilage on the Basis of Advanced Multiparametric MRI Techniques. Sci Rep. 2019 May 9;9(1):7172. doi: 10.1038/s41598-019-43389-y.

Nebelung S, Post M, Knobe M, Tingart M, Emans P, Thüring J, Kuhl C, Truhn D. Detection of Early-Stage Degeneration in Human Articular Cartilage by Multiparametric MR Imaging Mapping of Tissue Functionality. Sci Rep. 2019 Apr 11;9(1):5895. doi: 10.1038/s41598-019-42543-w.

Michalik R, Pauer T, Brill N, Knobe M, Tingart M, Jahr H, Truhn D, Nebelung S. Quantitative Articular Cartilage Sub-Surface Defect Assessment Using Optical Coherence Tomography: An In-Vitro Study. Ann Anat. 2019 Jan;221:125-134. doi: 10.1016/j.aanat.2018.10.001. Epub 2018 Oct 9.

Thüring J, Linka K, Itskov M, Knobe M, Hitpaß L, Kuhl C, Truhn D, Nebelung S. Multiparametric MRI and Computational Modeling in the Assessment of Human Articular Cartilage Properties – A Comprehensive Approach. BioMed Res Int. 2018 May 15; 2018:9460456.

Nebelung S, Sondern B, Jahr H, Tingart M, Knobe M, Thüring J, Kuhl C, Truhn D. Non-invasive T1ρ mapping of the human cartilage response to loading and unloading. Osteoarthritis Cartilage. 2018 Feb;26(2):236-244.

Nebelung S, Post M, Raith S, Fischer H, Knobe M, Braun B, Prescher A, Tingart M, Thüring J, Bruners P, Jahr H, Kuhl C, Truhn D. Functional in situ assessment of human articular cartilage using MRI: a whole-knee joint loading device. Biomech Model Mechanobiol. 2017 Jul 6.

Nebelung S, Tingart M, Pufe T, Kuhl C, Jahr H, Truhn D. Ex vivo quantitative multiparametric MRI mapping of human meniscus degeneration. Skeletal Radiol. 2016 Dec;45(12):1649-1660.

Nebelung S, Sondern B, Oehrl S, Tingart M, Rath B, Pufe T, Raith S, Fischer H, Kuhl C, Jahr H, Truhn D. Functional MRI Mapping of Human Articular Cartilage Response to Loading. Radiology. 2017 Feb;282(2):464-474. doi: 10.1148/radiol.2016160053.

Brill N, Wirtz M, Merhof D, Tingart M, Jahr H, Truhn D, Schmitt R, Nebelung S. Polarization-Sensitive Optical Coherence Tomography-Based Imaging, Parameterization and Quantification of Human Cartilage Degeneration. J Biomed Opt. 2016 Jul 1; 21(7): 76013.

Nebelung S, Brill N, Tingart M, Pufe T, Kuhl C, Jahr H, Truhn D. Quantitative OCT and MRI biomarkers for the differentiation of cartilage degeneration. Skeletal Radiol. 2016 Apr; 45(4): 505-16.

Nebelung S, Brill N, Müller F, Tingart M, Pufe T, Merhof D, Schmitt R, Jahr H, Truhn D. Towards Optical Coherence Tomography-Based Elastographic Evaluation of Human Cartilage. J Mech Behav Biomed. 2016; 56: 106-119.

Brill N, Riedel J, Schmitt R, Tingart M, Truhn D, Pufe T, Jahr H, Nebelung S. 3D Human cartilage surface characterization by optical coherence tomography. Phys Med Biol. 2015; 60(19): 7747-7762.

De Bont F, Brill N, Schmitt R, Tingart M, Rath B, Pufe T, Jahr H (*), Nebelung S (*). Evaluation of single-impact-induced cartilage degeneration by Optical coherence tomography. BioMed Research International. 2015; Article ID 486794.

(*) contributed equally

Brill N, Riedel J, Rath B, Tingart M, Jahr H, Betsch M, Quack V, Pufe T, Schmitt R, Nebelung S. Optical coherence tomography-based parameterization and quantification of articular cartilage surface integrity. Biomedical Optics Express. 2015; 6 (7): 2398-2411.

Nebelung S, Marx U, Brill N, Quack V, Tingart M, Schmitt R, Rath B, Jahr H. Three-Dimensional Imaging and Analysis of Human Cartilage Degeneration Using Optical Coherence Tomography. J Orthop Res 2015; 33(5): 651-659.

Nebelung S, Marx U, Brill N, Arbab D, Quack V, Jahr H, Tingart M, Zhou B, Stoffel M, Schmitt R, Rath B. Morphometric Grading of Osteoarthritis by Optical Coherence Tomography – An ex vivo study. J Orthop Res 2014; 32(10): 1381-1388.

Nebelung W, Reichwein F, Nebelung S. A simplified arthroscopic bone graft transfer technique in chronic glenoid bone deficiency. Knee Surg Sports Traumatol Arthrosc. 2014 May 7.

Nebelung S, Gavenis K, Rath B, Tingart M, Ladenburger A, Stoffel M, Zhou B  Mueller-Rath R. Continuous cyclic compressive loading modulates biological and mechanical properties of collagen hydrogels seeded with human chondrocytes. Biorheology. 2011;48(5):247-61.

Nebelung S, Gavenis K, Luering C, Zhou B, Mueller-Rath R, Stoffel M, Tingart M, Rath B. Simultaneous anabolic and catabolic responses of human chondrocytes seeded in collagen hydrogels to long-term continuous dynamic compression. Ann Anat. 2012 Jul;194(4):351-8.

Nebelung S, Deitmer G, Gebing R, Reichwein F, Nebelung W. Anterior cruciate ligament reconstruction using biodegradable transfemoral fixation at 5-year follow-up: clinical and magnetic resonance imaging evaluation. Knee Surg Sports Traumatol Arthrosc 2012;20:2279-86.

Nebelung S, Deitmer G, Gebing R, Reichwein F, Nebelung W. Improved outcomes after ACL reconstruction with quadrupled hamstring autografts and additional bone plug augmentation at 5-year follow-up. Int Orthop 2013;37:399-405.

Nebelung S, Deitmer G, Gebing R, Reichwein F, Nebelung W. High Incidence of Tunnel Widening after Anterior Cruciate Ligament Reconstruction with Transtibial Femoral Tunnel Placement. Arch Orthop Trauma Surg 2012;132:1653-63.

Ganse B, Böhle F, Pastor T, Gueorguiev B, Altgassen S, Gradl G, Kim BS, Modabber A, Nebelung S, Hildebrand F, Knobe M. Microcirculation After Trochanteric Femur Fractures: A Prospective Cohort Study Using Non-invasive Laser-Doppler Spectrophotometry. Front Physiol. 2019 Mar 25;10:236. doi: 10.3389/fphys.2019.00236. eCollection 2019.

Jahr H, Gunes S, Kuhn AR, Nebelung S, Pufe T. Bioreactor-Controlled Physoxia Regulates TGF-β Signaling to Alter Extracellular Matrix Synthesis by Human Chondrocytes. Int J Mol Sci. 2019 Apr 6;20(7). pii: E1715. doi: 10.3390/ijms20071715.

Knobe M, Bettag S, Kammerlander C, Altgassen S, Maier KJ, Nebelung S, Prescher A, Horst K, Pishnamaz M, Herren C, Mundt M, Stoffel M, Markert B, Gueorguiev B. Is bone-cement augmentation of screw-anchor fixation systems superior in unstable femoral neck fractures? A biomechanical cadaveric study. Injury. 2018 Oct 30.

Gradl-Dietsch G, Hitpaß L, Gueorguiev B, Nebelung S, Schrading S, Knobe M. [Undergraduate Curricular Training in Musculoskeletal Ultrasound by Student Teachers: The Impact of Peyton's Four-Step Approach]. Z Orthop Unfall. 2018 Oct 12. doi: 10.1055/a-0715-2435. German.

Carow JB, Carow J, Gueorguiev B, Klos K, Herren C, Pishnamaz M, Weber CD, Nebelung S, Kim BS, Knobe M. Soft tissue micro-circulation in the healthy hindfoot: a cross-sectional study with focus on lateral surgical approaches to the calcaneus. Int Orthop. 2018 Jun 22. doi: 10.1007/s00264-018-4031-7.

Klos K, Gueorguiev B, Carow JB, Modabber A, Nebelung S, Kim BS, Horst K, Weber CD, Knobe M. Soft tissue microcirculation around the healthy Achilles tendon: a cross-sectional study focusing on the Achilles tendon and dorsal surgical approaches to the hindfoot. J Orthop Surg Res. 2018 Jun 7;13(1):142.

Herren C, Reijnen M, Pishnamaz M, Lichte P, Andruszkow H, Nebelung S, Siewe J, Hildebrand F, Kobbe P. Incidence and Risk Factors for Facet Joint Violation in Open Versus Minimally Invasive Procedures During Pedicle Screw Placement in Patients with Trauma. World Neurosurg. 2018 Apr;112:e711-e718. doi: 10.1016/j.wneu.2018.01.138.

Knobe M, Altgassen S, Maier KJ, Gradl-Dietsch G, Kaczmarek C, Nebelung S, Klos K, Kim BS, Gueorguiev B, Horst K, Buecking B. Screw-blade fixation systems in Pauwels three femoral neck fractures: a biomechanical evaluation. Int Orthop. 2017 Aug 6. doi: 10.1007/s00264-017-3587-y.

Linka K, Itskov M, Truhn D, Nebelung S, Thüring J. T2 MR imaging vs. computational modeling of human articular cartilage tissue functionality. J Mech Behav Biomed Mater. 2017 Jul 19. pii: S1751-6161(17)30309-0.

Kösters AK, Ganse B, Gueorguiev B, Klos K, Modabber A, Nebelung S, Kim BS, Knobe M. Effects of low-intensity pulsed ultrasound on soft tissue micro-circulation in the foot. Int Orthop. 2017 Jul 22. doi: 10.1007/s00264-017-3574-3.

Kuhl CK, Bruhn R, Krämer N, Nebelung S, Heidenreich A, Schrading S. Abbreviated Biparametric Prostate MR Imaging in Men with Elevated Prostate-specific Antigen. Radiology. 2017 Jul 20:170129. doi: 10.1148/radiol.2017170129.

Gradl-Dietsch G, Lübke C, Horst K, Simon M, Modabber A, Sönmez TT, Münker R, Nebelung S, Knobe M. Peyton's four-step approach for teaching complex spinal manipulation techniques - a prospective randomized trial. BMC Med Educ. 2016 Nov 3;16(1):284.

Arslan E, Nellesen T, Bayer A, Prescher A, Lippross S, Nebelung S, Jahr H, Jaeger C, Huebner WD, Fischer H, Stoffel M, Shakibaei M, Pufe T, Tohidnezhad M. Effect of platelet mediator concentrate (PMC) on Achilles tenocytes: an in vitro study. BMC Musculoskelet Disord. 2016 Jul 22;17:307. doi: 10.1186/s12891-016-1160-2.

Beckmann R, Lippross S, Hartz C, Tohidnezhad M, Ferreira MS, Neuss-Stein S, Seekamp A,  Nebelung S, Kweider N, Rath B, Jahr H, Pufe T, Varoga DJ. Abrasion arthroplasty increases mesenchymal stem cell content of postoperative joint effusions. BMC Musculoskelet Disord. 2015; 16(1): 250 ff.

Quack V, Ippendorf AV, Betsch M, Schenker H, Nebelung S, Rath B, Tingart M, Lüring C. [Multidisciplinary Rehabilitation and Fast-track Rehabilitation after Knee Replacement: Faster, Better, Cheaper? A Survey and Systematic Review of Literature]. Rehabilitation. 2015; 54(4): 245-251.

Stoffel M, Yi JH, Weichert D, Zhou B, Nebelung S, Muller-Rath R, et al. Bioreactor cultivation and remodelling simulation for cartilage replacement material. Med Eng Phys. 2012 Jan;34(1):56-63.

Nebelung S, Rath B, Tingart M, Kuhl C, Schrading S. Chondrale und osteochondrale Defekte: Darstellung mittels bildgebender Verfahren. Orthopäde, September 2017, DOI: 10.1007/s00132-017-3472-9

Jahr H, Brill N, Nebelung S. Detecting early stage osteoarthritis by Optical Coherence Tomography? Biomarkers. 2015 Dec; 20(8):590-6.

Nebelung S, Ladenburger A, Gavenis K, Stoffel M, Andereya S, Muller-Rath R. [Tissue engineering of cartilage replacement material - mechanical stimulation in the in-vitro cultivation of human chondrocytes]. Z Orthop Unfall. 2011;149: 52-60.

Nebelung S, Müller-Rath R. [Tendinitis calcarea]. OrthopUnfallchPraxis. 2013; 1(2): 22-27. 

Ladenburger A, Nebelung S, Buschmann C, Strake M, Ohnsorge JA, Radermacher K, de la Fuente M. Zero-dose C-arm-navigation (ZDCAN) as a tool for education: radiation dose reduction in lumbar interventional techniques. Journal of Bone & Joint Surgery, British Volume 2012;94-B:46.

Quack V, Gutheiß D, Betsch M, Schenker H, Nebelung S, Rath B, Tingart M, Heller KD, Lüring C. [Umfrage im Verband leitender Orthopäden und Unfallchirurgen – Aktuelle Situation leitender Ärzte in Deutschland]. Z Orthop Unfall. 2015; 153(2): 123-126.

Yi JH, Stoffel M, Weichert D, Nebelung S, Rath B. Experimental and theoretical investigation on soft tissue remodelling enhanced by cell activity. Proceedings in Applied Mathematics and Mechanics, in: Alber HD, Kraynyukova N, Tropea C (eds) 83rd Annual Meeting of the International Association of Applied Mathematics and Mechanics (GAMM). 2012; 12 (1): 87-88

Yi JH, Stoffel M, Weichert D, Nebelung S, Rath B. Experimental and numerical investigations on engineering tissue enhanced by mechanical stimulation. Proceedings in Applied Mathematics and Mechanics, in: Brenn G, Holzapfel GA, Schanz M, Steinbach O (eds) 82nd Annual Meeting of the International Association of Applied Mathematics and Mechanics (GAMM). 2011; 11 (1): 91-92

Marx U, Schmitt R, Nebelung S, Tingart M, Luring C, Rath B. In vitro observation of cartilage-degeneration progression by Fourier-domain OCT. Advanced Biomedical and Clinical Diagnostic Systems X. Proceedings of the SPIE, Volume 8214, pp. 82140X-82140X-7 (2012)

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