M&M – Machine Learning and Musculoskeletal Imaging

As (more or less) young clinicians and researchers, we are an interdisciplinary group of people who work on advanced imaging methods to improve diagnostics and treatment guidance in a variety of fields. Our main goal is to refine imaging to improve patient care by bringing together profound clinical expertise, a deep understanding of imaging, a hands-on approach to engineering, and refined computer skills. Our main tools are our MRI scanners and the respective equipment, actual and artificial intelligence, and mechanical and computational models. Our main focus is musculoskeletal imaging, cancer detection, and superordinate machine learning frameworks.


Background: Why infinite imaging?

In the clinic, advanced medical imaging has revolutionized patient care over the last decades by earlier identification and refined graduation of diseases, by therapeutic decision-making, and by monitoring of treatment outcomes. One of the top developments in the field of medicine, advanced medical imaging offers great benefits to patients and doctors. However, every patient encounter in the clinic teaches us that we have come a long way, yet there is still room for medical, technical, and medical technology improvement. Please have a look at our current projects dealing with musculoskeletal imaging, cancer detection, and superordinate machine learning frameworks.


Affiliations

We are principally based at the Department of Diagnostic and Interventional Radiology of the University Hospital Aachen (Germany) in close proximity to neighbouring Belgium and the Netherlands. In addition, we are closely affiliated with the Department of Diagnostic and Interventional Radiology of the University Hospital Düsseldorf (Germany) and the Institute of Computer Vision (RWTH Aachen University). Moreover, we have numerous collaborations with local, national, and international partner institutions.


Funding

We are currently funded by the German Research Foundation, the Medical Faculties of RWTH Aachen University and Heinrich-Heine-University Düsseldorf, and the Foundation of Therapeutic Research.
 

Contact

Dr. med. Dipl.-Phys. Daniel Truhn
dtruhnukaachende

PD Dr med. Sven Nebelung
snebelungukaachende)

Team

Malin is a medical student at RWTH Aachen University and joined the group in 2020. She has a strong interest in the technical background of MRI and its clinical application alike. As part of her MD thesis she investigates the imaging correlates of joint functionality on the basis of MRI, in particular the response to loading after standardized ligament injuries. Her aim is to further standardize the MRI-based assessment of knee joint pathologies as surrogates of joint functionality and stability. Once she has finished her primary projects and MD thesis, she is looking forward to working on other projects regarding the clinical implementation of functional MRI techniques and dynamic examination conditions.

Lisa joined the team in 2016 as a medical student. After receiving her medical degree from RWTH Aachen University in 2019 she decided to make her way back to the roots – she moved back to southern Germany where she started her clinical career by specializing in internal medicine. The main focus of her research and soon-to-be-finished MD thesis is to evaluate meniscus functionality on the basis of advanced MRI techniques. She hopes that her research work will help to facilitate earlier diagnosis of meniscal pathologies.

Tobias has been a part of the team since 2017. He recently started his residency in orthopedics and trauma surgery at the University Hospital Aachen, Germany, with a strong interest in sports medicine and degenerative joint diseases. Within the framework of his MD thesis, his research has focused on the imaging correlates of cartilage functionality based on quantitative MRI mapping by using different enzyme exposure models. You can find his published research on Pubmed.

Marc joined the team in 2018 as a doctoral candidate working on post-traumatic changes in articular cartilage and their assessment based on quantitative MRI. As a medical student and student assistant, he was involved in numerous projects besides his soon-to-be-finished MD thesis. In 2020, he graduated at RWTH Aachen University and will soon follow his dream of becoming a clinical radiologist who can bring together his care for patients, interest in technological advances, and enthusiasm for research and science at the Department of Diagnostic and Interventional Radiology (University Hospital Aachen). Currently he is working on several projects on imaging of the lower limb.

Firas is a PhD candidate with a focus on applying machine learning techniques to medical image analysis. Prior to joining the group in 2020 he received his bachelor’s degree in Electrical Engineering at Hamburg University of Technology and his master’s degree at RWTH Aachen University. In his master thesis he conducted research on deep learning-based behaviour analysis that was followed up by an internship as a machine learning-engineer in the industry where he incorporated MRI knee segmentation algorithms into the workflow of clinical radiologists. His current work comprises automatic analysis and detection of pathologies on knee MRI scans and chest radiographs using artificial neural networks.

Niklas is a master student at RWTH Aachen University focused on computer sciences who joined the group in 2019. He has a strong interest in automatic measurements of medical images and image registration. He is currently part of a range of projects aiming to analyze the effects of ligament damage on knee joint stability and functionality. In the future, he would like to learn even more about image processing and artificial neural networks to further contribute to medical imaging.

Gustav studied electrical engineering at RWTH Aachen University. He developed deep learning methods for the classification of breast cancer when pursuing his bachelor thesis at the Institute of Imaging and Computer Vision (RWTH Aachen University). Following that, he investigated the effects of inter-rater segmentation variance on radiomics features during his master thesis. He joined the team in 2020 and is now a PhD candidate involved in several projects with the primary goal to establish and validate deep learning methods in clinical practice. Currently, he is working on the optimization of breast cancer screening by machine learning.

Sven is a clinical radiologist and imaging scientist with a focus on clinically motivated imaging research that aims to refine image acquisition and post-processing methodologies in close collaboration with clinical, engineers, imaging scientists and other researchers worldwide. After studying medicine at RWTH Aachen University, he completed his MD thesis on cartilage tissue engineering and joined the Department of Orthopedics (University Hospital Aachen) to receive orthopedic training during the surgical common trunk. After undertaking a period of research at the Institute of Anatomy (RWTH Aachen University) in 2015, he entered Radiology specialist training at the Department of Diagnostic and Interventional Radiology (University Hospital Aachen). When he received a generous research grant by the German Research Association (DFG) in 2019, he moved to Düsseldorf to join the Department of Diagnostic and Interventional Radiology (University Hospital Düsseldorf), where he is currently heading the research group Musculoskeletal Imaging. His recent publications are listed on Google Scholar and Pubmed. He also routinely reviews manuscripts for medical, technical, and interdisciplinary scientific journals.
Get in touch with Sven at snebelungukaachende.

Darius studies electrical engineering at RWTH Aachen University. Because of his strong interest in deep learning, especially in its application in medicine, he joined the group in 2019 to work on automated and deep learning-based algorithms for the analysis of lower extremity alignment and rotational abnormalities on MRI. After finishing his bachelor thesis, he continues to work on further refining these algorithms as a student assistant.

Manuel studied medicine and received his medical degree from RWTH Aachen University in 2019. He currently works as a resident physician at the Department of Diagnostic and Interventional Radiology (University Hospital Aachen) to undergo radiologic training. He joined the team in 2016 and the main focus of his research (originating in his soon-to-be-finished MD thesis) was and is to improve the detection of early degenerative joint diseases with quantitative MRI. He hopes that -someday- these findings will change his daily clinical work for the better.

Oliver is a physician and joined the group in 2018 as a medical student. Before starting his medical career in Germany, he studied medicine at Rīga Stradiņš University of Riga, Latvia. He currently works as a resident physician at the Department of Diagnostic and Interventional Radiology (University Hospital Aachen) and has a strong interest in the diagnostic and therapeutic possibilities of imaging in the context of modern medicine. The main focus of his (soon-to-be-finished) MD thesis is the application of pressure on human articular cartilage and its effects on quantitative MRI parameters. He hopes that his findings may help in the future diagnosis of different cartilage pathologies.

Philipp studied medicine at the University of Cologne. Since 2018, he has been working as a resident physician at the Department of Diagnostic and Interventional Radiology (University Hospital Aachen) and joined the team in 2019. Philipp is interested in the technical aspects and clinical application of MRI. He is also fascinated by the perspectives and chances that Artificial Intelligence brings to modern medicine, especially to clinical imaging. His current research is therefore focused on improving diagnostic imaging using machine learning-based methods.

Justus studied electrical engineering at RWTH Aachen University. He completed his bachelor and master theses at the Institute of Imaging and Computer Vision (RTWH Aachen University). During his bachelor thesis, he developed methods to improve robustness of active appearance models for face tracking by better initialization with machine learning. During his master thesis, he focused on implementing these statistical shape models in deep learning environments. Justus joined the team in 2019 and is now a PhD candidate at the Department of Diagnostic and Interventional Radiology (University Hospital Düsseldorf) and a research scientist at the Institute of Imaging and Computer Vision. He is involved in managing and overseeing several projects with a particular focus on musculoskeletal image acquisition and post processing.

Mazen studies electrical engineering at RWTH Aachen University and joined the group in 2019. He has a strong interest in digital image processing and machine learning and is currently working on image pre-processing and evaluation tasks as a student assistant. Once finishing his studies in 2021, Mazen wants to become an electrical engineer working in an interesting and application-oriented field of science such as biomedical engineering.

Praise is a master student in computer engineering at RWTH Aachen University and joined the team in 2019. She has a strong interest in artificial neural networks and is currently writing her master thesis on supervised learning techniques for small-region segmentations in medical images. She has worked on a variety of projects and has been involved in a variety of data post-processing tasks. Once finishing her master thesis, she looks forward to continuing to work on the application of deep learning frameworks and image processing techniques.

David is a medical student at RWTH Aachen University and joined the team in 2020. He has a strong interest in both the technical background and clinical application of MRI. In his MD thesis, he focuses on the use of quantitative MRI sequences in detecting early osteoarthritis of the human knee joint by dismantling the complex interplay of biomechanical and biochemical factors that affect the disease. The overarching goal of his research is to develop a greater understanding of how changes in the imaging parameters correlate to cartilage defects and degeneration. After finishing his primary project, he is looking forward to working on further projects regarding clinical implementation of functional MRI techniques, and starting a career in clinical radiology.

Daniel is a physicist, imaging scientist, and clinical radiologist with a dedicated focus on machine learning and magnetic resonance imaging. After studying physics at RWTH Aachen University and Imperial College in London, he continued to satisfy his thirst for knowledge by studying medicine at RWTH Aachen University. In 2013, he completed his MD thesis on the compatibility of positron emission tomography and magnetic resonance imaging and joined the Department of Diagnostic and Interventional Radiology (University Hospital Aachen) to become a board-certified clinical radiologist in 2019. Besides his clinical work, he pursued his research interests in machine learning as a fellow at the Institute of Imaging and Computer Vision (RWTH Aachen University) for two years before returning to the clinic where he currently heads the interdisciplinary research group “Infinite Imaging Research”. His research focuses on bringing machine learning-methods into clinical practice and on bridging the gaps between research possibilities and clinical applicability. His recent publications are listed on Pubmed. He also routinely reviews manuscripts for medical, technical, and interdisciplinary scientific journals.
Get in touch with Daniel at dtruhnukaachende.

Eva studies medicine at RWTH Aachen University and joined the group in 2019. She is interested in the diagnostic possibilities of MRI, in particular in the context of the musculoskeletal system. She is currently working on several projects dealing with stress MRI and the human knee joint. After completing her MD thesis, she is currently supporting a range of projects as a student assistant.

Ken Tonio joined the group for his MD thesis in 2017. He studied medicine at RWTH Aachen University and at the University of Bologna(Italy) and graduated in November 2019. He received part of his practical training in Uganda, Australia and Switzerland. His medical interest is in the field of hemato-oncology, specifically in diseases of the hematopoietic and lymphoid tissues. During the 2020 COVID-19 pandemic he supported local health authorities in Berlin tracking chains of infections and containing the spread of the disease. In his about-to-be- finished MD thesis he assessed the influence of static and dynamic compression on the T1ρ relaxation characteristics of human articular cartilage. He hopes that his basic research work will help to facilitate earlier diagnosis of osteoarthritis by combining quantitative MRI with loading.

Research

As a major clinical and scientific focus of the Department of Diagnostic and Interventional Radiology (University Hospital Aachen), our research questions are derived from the daily clinical work with patients and are subsequently dealt with in cooperation with numerous local, national, and international institutes across a variety of disciplines.The group’s overarching premise is the translational use of advanced image acquisition and post-processing techniques to benefit our patients. Often termed “from bench to bedside”, we take this approach seriously to make sure our techniques work on tissue samples, cadaveric joints and extremities before we implement them for clinical use and validation on volunteers and patients.


What exactly are we working on?

  1. Detection of early osteoarthritis, a widespread clinical condition with huge individual and socioeconomic disease burden, at a potentially reversible stage. Just talk to virtually anyone above the age of 70 to learn more about the need of improved diagnostics and therapies….
  2. Functional imaging of tissues and joints to get an insight into their status and function. Just look at your car’s broken shock absorber with its limited use. Same applies to cartilage, meniscus, ligaments and so on…
  3. Artificial Intelligence-assisted image acquisition and processing to improve, standardize, and streamline diagnostic processes. Just imagine a fatigued radiologist who hasn’t slept for a while looking at your study – besides sleeping well, he/she could use some smart assistance when assessing your images…
  4. Further clinical research questions as they come along concern knee, hip and shoulder joint injuries, traumatological questions of the spine, and medical education.


What exact tools are we using?

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.


Who exactly pays for our research?

Funding is provided both internally (by RWTH Aachen University and the Heinrich-Heine-University) and externally by national funding agencies (e.g. DFG - German Research Association).
 

Get in touch with this group at dtruhnukaachende or snebelungukaachende.

Machine learning has recently entered the world of medical imaging and clearly offers the potential to revolutionize modern imaging. It refers to any algorithm that draws conclusions from data and learns and improves automatically when fed with more training data.
In radiology, data are mostly images and machine-learning algorithms are often colloquially referred to as “artificial intelligence” (AI). Prominent people have speculated that training of radiologists should be stopped, as machine learning is going to replace radiologists until 2021 (Read more on: Why Ai will not replace radiologists.). Well, 2021 has come and radiologists are still around and evaluating their patient’s images. Naturally, radiologists consider themselves as indispensable and this view is shared by many others, too. “Artificial intelligence” will most likely complement human intelligence and AI clearly offers the potential to make radiologists more efficient, improve the diagnostic quality - by standardizing workflow and guiding radiologists to potential findings - and to uncover hitherto unknown relations by mining from “big data”. Thus, our research focuses on how machine learning algorithms can be brought into clinical practice and how they can support clinicians, both radiologist (if they are still around) and others.

What exactly are we working on?

Deriving Patients Diagnoses from Images:
Machine-learning algorithms can be trained on specific questions such as: “Is there a tear of the cruciate ligaments?” or “Is there a malignant breast lesion in the MRI?”. University hospitals such as ours acquire vast amounts of images and reports describing the diagnoses are written by experienced radiologists all the time. We build upon this database to develop our algorithms.

Automated detection of breast carcinoma (left), partial tear of the cruciate ligament (middle) and visualization of where the neural network focuses on its attention (right).


Using Machine Learning to Generate New Tools:
Image interpretation is intrinsically limited by what the human mind perceives. The human mind is well adapted to intuitive pattern recognition, less so to quantitative analyses. We use machine learning to generate and present data that is usually not accessible to radiologists such as quantitative measures of the relative positions of anatomic structures to each other (e.g. bones), average thickness, volume, and surface area (e.g. of articular cartilage), and texture patterns across 2D images or 3D volumes.

Automated segmentation of bones (right) and 3D render of the segmented volumes (left).


Advance Machine Learning Methodically:
Machine learning in medicine requires vast amounts of data. The problem is that medical images are highly sensitive and cannot be shared easily to create even larger databases. We work on creating “artificial” radiological images that can be shared without disclosing patient-specific and sensitive information or that can also be used to generate new tools for teaching clinicians on how to interpret radiological images.

From left to right: real x-ray without pathology, real x-ray with cardiomegaly, artificially generated x-ray without pathology and artificially generated x-ray with cardiomegaly.

Transition from a non-pathological x-ray to cardiomegaly (left) and effusion (right) respectively. Both x-rays are not real but have been generated by neural networks.


What is our goal ?
We want to advance machine learning algorithms so that they can bring real clinical benefit to the clinician, the patient, and the entire health infrastructure. To this end, we collaborate closely with fellow clinical radiologists, other clinical disciplines, imaging and big data scientists as well as others.


Who pays for our research ?
Funding is provided both internally (by the Departments of Diagnostic and Interventional Radiology in Aachen and Düsseldorf) and externally by national funding agencies (e.g. DFG).


Get in touch with this group at dtruhnukaachende or snebelungukaachende.

Publications

Cremerius C, Gradl-Dietsch G, Beeres FJP, Link B-, Hitpaß L, Nebelung S, Horst K, Weber CD, Neuerburg C, Eschbach D, Bliemel C, Knobe M,
Team-based learning for teaching musculoskeletal ultrasound skills: a prospective randomised trial.
In: European journal of trauma and emergency surgery : official publication of the European Trauma Society

Wilms LM, Radke KL, Abrar DB, Latz D, Schock J, Frenken M, Windolf J, Antoch G, Filler TJ, Nebelung S,
Micro- and Macroscale Assessment of Posterior Cruciate Ligament Functionality Based on Advanced MRI Techniques.
In: Diagnostics (Basel, Switzerland)

Wollschläger LM, Radke KL, Schock J, Kotowski N, Latz D, Kanschik D, Filler TJ, Caspers S, Antoch G, Windolf J, Abrar DB, Nebelung S,
The MRI posterior drawer test to assess posterior cruciate ligament functionality and knee joint laxity.
In: Scientific reports

van Knegsel KP, Ganse B, Haefeli PC, Migliorini F, Scaglioni MF, van de Wall BJM, Kim BS, Link BC, Beeres FJP, Nebelung S, Schoeneberg C, Hildebrand F, Gueorguiev B, Knobe M,
Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation.
In: Medicina (Kaunas, Lithuania)

Tietz E, Truhn D, Müller-Franzes G, Berres ML, Hamesch K, Lang SA, Kuhl CK, Bruners P, Schulze-Hagen M,
A Radiomics Approach to Predict the Emergence of New Hepatocellular Carcinoma in Computed Tomography for High-Risk Patients with Liver Cirrhosis.
In: Diagnostics (Basel, Switzerland)

Kurt B, Buendgens L, Wirtz TH, Loosen SH, Schulze-Hagen M, Truhn D, Brozat JF, Abu Jhaisha S, Hohlstein P, Koek G, Weiskirchen R, Trautwein C, Tacke F, Hamesch K, Koch A,
Serum Perilipin 2 (PLIN2) Predicts Multiple Organ Dysfunction in Critically Ill Patients.
In: Biomedicines

Schrammen PL, Ghaffari Laleh N, Echle A, Truhn D, Schulz V, Brinker TJ, Brenner H, Chang-Claude J, Alwers E, Brobeil A, Kloor M, Heij LR, Jäger D, Trautwein C, Grabsch HI, Quirke P, West NP, Hoffmeister M, Kather JN,
Weakly supervised annotation-free cancer detection and prediction of genotype in routine histopathology.
In: The Journal of pathology

Link BC, van Veelen NM, Boernert K, Kittithamvongs P, Beeres FJP, de Boer HH, Migliorini F, Nebelung S, Knobe M, Ruchholtz S, Babst R, Jiamton C,
The radiographic relationship between the cortical overlap view (COV) and the tip of the greater trochanter.
In: Scientific reports

Said O, Schock J, Abrar DB, Schad P, Kuhl C, Nolte T, Knobe M, Prescher A, Truhn D, Nebelung S,
In-Situ Cartilage Functionality Assessment Based on Advanced MRI Techniques and Precise Compartmental Knee Joint Loading through Varus and Valgus Stress.
In: Diagnostics (Basel, Switzerland)

Ciba M, Winkelmeyer EM, Schock J, Schad P, Kotowski N, Nolte T, Wollschläger LM, Knobe M, Prescher A, Kuhl C, Truhn D, Nebelung S,
Comprehensive Assessment of Medial Knee Joint Instability by Valgus Stress MRI.
In: Diagnostics (Basel, Switzerland)

Frenken M, Schleich C, Radke KL, Müller-Lutz A, Benedikter C, Franz A, Antoch G, Bittersohl B, Abrar DB, Nebelung S,
Imaging of exercise-induced spinal remodeling in elite rowers.
In: Journal of science and medicine in sport

Knobe M, Iselin LD, van de Wall BJM, Lichte P, Hildebrand F, Beeres FJP, Link BC, Gueorguiev B, Nebelung S, Ganse B, Migliorini F, Klos K, Babst R, Haefeli PC,
Reduced pre-operative skin oxygen saturation predicts revision after open reduction and internal fixation in calcaneal fractures : A reduced pre-operative oxygen saturation as measured by laser-Doppler spectrophotometry in 8 mm depth is associated with revision surgery after open reduction and internal fixation of calcaneal fractures through an extended lateral approach.
In: International orthopaedics

Said O, Schock J, Krämer N, Thüring J, Hitpass L, Schad P, Kuhl C, Abrar D, Truhn D, Nebelung S,
Correction to: An MRI‑compatible varus-valgus loading device for whole‑knee joint functionality assessment based on compartmental compression: a proof‑of‑concept study.
In: Magma (New York, N.Y.)

Han T, Nebelung S, Pedersoli F, Zimmermann M, Schulze-Hagen M, Ho M, Haarburger C, Kiessling F, Kuhl C, Schulz V, Truhn D,
Advancing diagnostic performance and clinical usability of neural networks via adversarial training and dual batch normalization.
In: Nature communications

Li J, Nebelung S, Schock J, Rath B, Tingart M, Liu Y, Siroros N, Eschweiler J,
A Novel Combined Level Set Model for Carpus Segmentation from Magnetic Resonance Images with Prior Knowledge aligned in Polar Coordinate System.
In: Computer methods and programs in biomedicine

Radke KL, Wollschläger LM, Nebelung S, Abrar DB, Schleich C, Boschheidgen M, Frenken M, Schock J, Klee D, Frahm J, Antoch G, Thelen S, Wittsack HJ, Müller-Lutz A,
Deep Learning-Based Post-Processing of Real-Time MRI to Assess and Quantify Dynamic Wrist Movement in Health and Disease.
In: Diagnostics (Basel, Switzerland)

Winkelmeyer EM, Schock J, Wollschläger LM, Schad P, Huppertz MS, Kotowski N, Prescher A, Kuhl C, Truhn D, Nebelung S,
Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability.
In: Diagnostics (Basel, Switzerland)

Rompen IF, Knobe M, Link BC, Beeres FJP, Baumgaertner R, Diwersi N, Migliorini F, Nebelung S, Babst R, van de Wall BJM,
Cement augmentation for trochanteric femur fractures: A meta-analysis of randomized clinical trials and observational studies.
In: PloS one

Wollschläger LM, Nebelung S, Schleich C, Müller-Lutz A, Radke KL, Frenken M, Boschheidgen M, Prost M, Antoch G, Konieczny MR, Abrar DB,
Evaluating Lumbar Intervertebral Disc Degeneration on a Compositional Level Using Chemical Exchange Saturation Transfer: Preliminary Results in Patients with Adolescent Idiopathic Scoliosis.
In: Diagnostics (Basel, Switzerland)

Schopper C, Keck K, Zderic I, Migliorini F, Link BC, Beeres FJP, Babst R, Nebelung S, Eschbach D, Knauf T, Ganse B, Schoeneberg C, Hildebrand F, Gueorguiev B, Knobe M,
Screw-blade fixation systems for implant anchorage in the femoral head: Horizontal blade orientation provides superior stability.
In: Injury

Truhn D, Zwingenberger KT, Schock J, Abrar DB, Radke KL, Post M, Linka K, Knobe M, Kuhl C, Nebelung S,
No pressure, no diamonds? - Static vs. dynamic compressive in-situ loading to evaluate human articular cartilage functionality by functional MRI.
In: Journal of the mechanical behavior of biomedical materials

Schock J, Truhn D, Abrar DB, Merhof D, Conrad S, Post M, Mittelstrass F, Kuhl C, Nebelung S,
Automated Analysis of Alignment in Long-Leg Radiographs by Using a Fully Automated Support System Based on Artificial Intelligence.
In: Radiology. Artificial intelligence

Huppertz MS, Schock J, Radke KL, Abrar DB, Post M, Kuhl C, Truhn D, Nebelung S,
Longitudinal T2 Mapping and Texture Feature Analysis in the Detection and Monitoring of Experimental Post-Traumatic Cartilage Degeneration.
In: Life (Basel, Switzerland)

Liebl M, Pedersoli F, Zimmermann M, Schulze-Hagen M, Truhn D, Sieben P, von Stillfried S, Tschinaev A, Heinzel A, Kuhl CK, Bruners P, Isfort P,
Induction of Contralateral Hepatic Hypertrophy by Unilobar Yttrium-90 Transarterial Radioembolization versus Portal Vein Embolization: An Animal Study.
In: Journal of vascular and interventional radiology : JVIR

Frenken M, Nebelung S, Schleich C, Müller-Lutz A, Radke KL, Kamp B, Boschheidgen M, Wollschläger L, Bittersohl B, Antoch G, Konieczny MR, Abrar DB,
Non-Specific Low Back Pain and Lumbar Radiculopathy: Comparison of Morphologic and Compositional MRI as Assessed by gagCEST Imaging at 3T.
In: Diagnostics (Basel, Switzerland)

Bähr FS, Gess B, Müller M, Romanzetti S, Gadermayr M, Kuhl C, Nebelung S, Schulz JB, Dohrn MF,
Semi-Automatic MRI Muscle Volumetry to Diagnose and Monitor Hereditary and Acquired Polyneuropathies.
In: Brain sciences

Linka K, Thüring J, Rieppo L, Aydin RC, Cyron CJ, Kuhl C, Merhof D, Truhn D, Nebelung S,
Machine learning-augmented and microspectroscopy-informed multiparametric MRI for the non-invasive prediction of articular cartilage composition.
In: Osteoarthritis and cartilage

Abrar DB, Schleich C, Frenken M, Vordenbäumen S, Richter J, Schneider M, Ostendorf B, Nebelung S, Sewerin P,
DGEMRIC in the Assessment of Pre-Morphological Cartilage Degeneration in Rheumatic Disease: Rheumatoid Arthritis vs. Psoriatic Arthritis.
In: Diagnostics (Basel, Switzerland)

Proske A, Link BC, Beeres FJP, Nebelung S, Füchtmeier B, Knobe M,
[Erratum to: Residency program under scrutiny (part 2)-How do residents prepare for emergency operations?]
In: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen

Proske A, Link BC, Beeres F, Nebelung S, Füchtmeier B, Knobe M,
[Residency program under scrutiny (part 2)-How do residents prepare for emergency operations?]
In: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen

Abrar DB, Schleich C, Radke KL, Frenken M, Stabinska J, Ljimani A, Wittsack HJ, Antoch G, Bittersohl B, Hesper T, Nebelung S, Müller-Lutz A,
Detection of early cartilage degeneration in the tibiotalar joint using 3 T gagCEST imaging: a feasibility study.
In: Magma (New York, N.Y.)

Müller-Lutz A, Kamp B, Nagel AM, Ljimani A, Abrar D, Schleich C, Wollschläger L, Nebelung S, Wittsack HJ,
Sodium MRI of human articular cartilage of the wrist: a feasibility study on a clinical 3T MRI scanner.
In: Magma (New York, N.Y.)

Abrar DB, Schleich C, Brinks R, Goertz C, Schneider M, Nebelung S, Sewerin P,
Differentiating rheumatoid and psoriatic arthritis: a systematic analysis of high-resolution magnetic resonance imaging features-preliminary findings.
In: Skeletal radiology

Abrar DB, Schleich C, Brinks R, Goertz C, Frenken M, Schneider M, Nebelung S, Sewerin P,
Introduction of a Simplified Psoriatic Arthritis Magnetic Resonance Imaging Score (sPsAMRIS): A Potential Tool for Treatment Monitoring in Peripheral Psoriatic Arthritis.
In: Diagnostics (Basel, Switzerland)

Han T, Nebelung S, Haarburger C, Horst N, Reinartz S, Merhof D, Kiessling F, Schulz V, Truhn D,
Breaking medical data sharing boundaries by using synthesized radiographs.
In: Science advances

Said O, Schock J, Krämer N, Thüring J, Hitpass L, Schad P, Kuhl C, Abrar D, Truhn D, Nebelung S,
An MRI-compatible varus-valgus loading device for whole-knee joint functionality assessment based on compartmental compression: a proof-of-concept study.
In: Magma (New York, N.Y.)

Hafner T, Post M, Said O, Schad P, Schock J, Abrar DB, Knobe M, Kuhl C, Truhn D, Nebelung S,
Identifying the imaging correlates of cartilage functionality based on quantitative MRI mapping - The collagenase exposure model.
In: Acta biomaterialia

Schad P, Wollenweber M, Thüring J, Schock J, Eschweiler J, Palm G, Radermacher K, Eckstein F, Prescher A, Kuhl C, Truhn D, Nebelung S,
Magnetic resonance imaging of human knee joint functionality under variable compressive in-situ loading and axis alignment.
In: Journal of the mechanical behavior of biomedical materials

Abrar DB, Schleich C, Tsiami S, Müller-Lutz A, Radke KL, Holthausen N, Frenken M, Boschheidgen M, Antoch G, Mucke J, Sewerin P, Braun J, Nebelung S, Baraliakos X,
Functional MR imaging beyond structure and inflammation-radiographic axial spondyloarthritis is associated with proteoglycan depletion of the lumbar spine.
In: Arthritis research & therapy

Hafner T, Schock J, Post M, Abrar DB, Sewerin P, Linka K, Knobe M, Kuhl C, Truhn D, Nebelung S,
A serial multiparametric quantitative magnetic resonance imaging study to assess proteoglycan depletion of human articular cartilage and its effects on functionality.
In: Scientific reports

Haarburger C, Müller-Franzes G, Weninger L, Kuhl C, Truhn D, Merhof D,
Radiomics feature reproducibility under inter-rater variability in segmentations of CT images.
In: Scientific reports

Schulze-Hagen M, Truhn D, Duong F, Keil S, Pedersoli F, Kuhl CK, Lurje G, Neumann U, Isfort P, Bruners P, Zimmermann M,
Correlation Between Sarcopenia and Growth Rate of the Future Liver Remnant After Portal Vein Embolization in Patients with Colorectal Liver Metastases.
In: Cardiovascular and interventional radiology

Abrar DB, Schleich C, Nebelung S, Frenken M, Ullrich T, Radke KL, Antoch G, Vordenbäumen S, Brinks R, Schneider M, Ostendorf B, Sewerin P,
Proteoglycan loss in the articular cartilage is associated with severity of joint inflammation in psoriatic arthritis-a compositional magnetic resonance imaging study.
In: Arthritis research & therapy

Kuhl CK, Truhn D,
The Long Route to Standardized Radiomics: Unraveling the Knot from the End.
In: Radiology

Thüring J, Rippel O, Haarburger C, Merhof D, Schad P, Bruners P, Kuhl CK, Truhn D,
Multiphase CT-based prediction of Child-Pugh classification: a machine learning approach.
In: European radiology experimental

Nolte T, Gross-Weege N, Doneva M, Koken P, Elevelt A, Truhn D, Kuhl C, Schulz V,
Spiral blurring correction with water-fat separation for magnetic resonance fingerprinting in the breast.
In: Magnetic resonance in medicine

Abrar DB, Schleich C, Nebelung S, Frenken M, Radke KL, Vordenbäumen S, Brinks R, Schneider M, Ostendorf B, McGonagle D, Sewerin P,
High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis.
In: Arthritis research & therapy

Nebelung S, Dötsch L, Shah D, Abrar DB, Linka K, Knobe M, Sewerin P, Thüring J, Kuhl C, Truhn D,
Functional MRI Mapping of Human Meniscus Functionality and its Relation to Degeneration.
In: Scientific reports

Truhn D, Brill N, Braun B, Merhof D, Kuhl C, Knobe M, Thüring J, Nebelung S,
A multi-purpose force-controlled loading device for cartilage and meniscus functionality assessment using advanced MRI techniques.
In: Journal of the mechanical behavior of biomedical materials

Bläsius FM, Link BC, Beeres FJP, Iselin LD, Leu BM, Gueorguiev B, Klos K, Ganse B, Nebelung S, Modabber A, Eschbach D, Weber CD, Horst K, Knobe M,
Impact of surgical procedures on soft tissue microcirculation in calcaneal fractures: A prospective longitudinal cohort study.
In: Injury

Truhn D, Sondern B, Oehrl S, Tingart M, Knobe M, Merhof D, Kuhl C, Thüring J, Nebelung S,
Differentiation of human cartilage degeneration by functional MRI mapping-an ex vivo study.
In: European radiology

Nebelung S, Post M, Knobe M, Shah D, Schleich C, Hitpass L, Kuhl C, Thüring J, Truhn D,
Human articular cartilage mechanosensitivity is related to histological degeneration - a functional MRI study.
In: Osteoarthritis and cartilage

Gadermayr M, Li K, Müller M, Truhn D, Krämer N, Merhof D, Gess B,
Domain-specific data augmentation for segmenting MR images of fatty infiltrated human thighs with neural networks.
In: Journal of magnetic resonance imaging : JMRI

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.
In: Zeitschrift fur Orthopadie und Unfallchirurgie

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.
In: Scientific reports

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.
In: Scientific reports

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.
In: Frontiers in physiology

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.
In: International journal of molecular sciences

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.
In: Injury

Truhn D, Schrading S, Haarburger C, Schneider H, Merhof D, Kuhl C,
Radiomic versus Convolutional Neural Networks Analysis for Classification of Contrast-enhancing Lesions at Multiparametric Breast MRI.
In: Radiology

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.
In: Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft

Truhn D, Kuhl CK, Ciritsis A, Barabasch A, Kraemer NA,
A New Model for MR Evaluation of Liver Function with Gadoxetic Acid, Including Both Uptake and Excretion.
In: European radiology

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.
In: International orthopaedics

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.
In: Journal of orthopaedic surgery and research

Thüring J, Linka K, Itskov M, Knobe M, Hitpaß L, Kuhl C, Truhn D, Nebelung S,
Multiparametric MRI and Computational Modelling in the Assessment of Human Articular Cartilage Properties: A Comprehensive Approach.
In: BioMed research international

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.
In: World neurosurgery

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.
In: Osteoarthritis and cartilage

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.
In: International orthopaedics

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.
In: Biomechanics and modeling in mechanobiology

Nebelung S, Rath B, Tingart M, Kuhl C, Schrading S,
[Chondral and osteochondral defects : Representation by imaging methods].
In: Der Orthopade

Kuhl CK, Bruhn R, Krämer N, Nebelung S, Heidenreich A, Schrading S,
Abbreviated Biparametric Prostate MR Imaging in Men with Elevated Prostate-specific Antigen.
In: Radiology

Linka K, Itskov M, Truhn D, Nebelung S, Thüring J,
T2 MR imaging vs. computational modeling of human articular cartilage tissue functionality.
In: Journal of the mechanical behavior of biomedical materials

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.
In: International orthopaedics

Nebelung S, Sondern B, Oehrl S, Tingart M, Rath B, Pufe T, Raith S, Fischer H, Kuhl C, Jahr H, Truhn D,
Functional MR Imaging Mapping of Human Articular Cartilage Response to Loading.
In: Radiology

Nebelung S, Tingart M, Pufe T, Kuhl C, Jahr H, Truhn D,
Ex vivo quantitative multiparametric MRI mapping of human meniscus degeneration.
In: Skeletal radiology

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.
In: BMC medical education

Ciritsis A, Truhn D, Hansen NL, Otto J, Kuhl CK, Kraemer NA,
Correction: Positive Contrast MRI Techniques for Visualization of Iron-Loaded Hernia Mesh Implants in Patients.
In: PloS one

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.
In: BMC musculoskeletal disorders

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.
In: Journal of biomedical optics

Ciritsis A, Truhn D, Hansen NL, Otto J, Kuhl CK, Kraemer NA,
Positive Contrast MRI Techniques for Visualization of Iron-Loaded Hernia Mesh Implants in Patients.
In: PloS one

Nebelung W, Reichwein F, Nebelung S,
A simplified arthroscopic bone graft transfer technique in chronic glenoid bone deficiency.
In: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

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.
In: Skeletal radiology

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.
In: Journal of the mechanical behavior of biomedical materials

Jahr H, Brill N, Nebelung S,
Detecting early stage osteoarthritis by optical coherence tomography?
In: Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals

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.
In: Physics in medicine and biology

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.
In: BMC musculoskeletal disorders

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].
In: Die Rehabilitation

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.
In: BioMed research international

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.
In: Biomedical optics express

Nebelung S, Brill N, Marx U, Quack V, Tingart M, Schmitt R, Rath B, Jahr H,
Three-dimensional imaging and analysis of human cartilage degeneration using Optical Coherence Tomography.
In: Journal of orthopaedic research : official publication of the Orthopaedic Research Society