Artificial Intelligence for Clinical Interpretation of Bedside Chest Radiographs

Radiology, vol. 307, pp. e220510

Abstract

Background Supine chest radiography for bedridden patients in intensive care units (ICUs) is one of the most frequently ordered imaging studies worldwide. Purpose To evaluate the diagnostic performance of a neural network–based model that is trained on structured semiquantitative radiologic reports of bedside chest radiographs. Materials and Methods For this retrospective single-center study, children and adults in the ICU of a university hospital who had been imaged using bedside chest radiography from January 2009 to December 2020 were reported by using a structured and itemized template. Ninety-eight radiologists rated the radiographs semiquantitatively for the severity of disease patterns. These data were used to train a neural network to identify cardiomegaly, pulmonary congestion, pleural effusion, pulmonary opacities, and atelectasis. A held-out internal test set (100 radiographs from 100 patients) that was assessed independently by an expert panel of six radiologists provided the ground truth. Individual assessments by each of these six radiologists, by two nonradiologist physicians in the ICU, and by the neural network were compared with the ground truth. Separately, the nonradiologist physicians assessed the images without and with preliminary readings provided by the neural network. The weighted Cohen κ coefficient was used to measure agreement between the readers and the ground truth. Results A total of 193 566 radiographs in 45 016 patients (mean age, 66 years ± 16 [SD]; 61% men) were included and divided into training (n = 122 294; 64%), validation (n = 31 243; 16%), and test (n = 40 029; 20%) sets. The neural network exhibited higher agreement with a majority vote of the expert panel (κ = 0.86) than each individual radiologist compared with the majority vote of the expert panel (κ = 0.81 to ≤0.84). When the neural network provided preliminary readings, the reports of the nonradiologist physicians improved considerably (aided vs unaided, κ = 0.87 vs 0.79, respectively; P < .001). Conclusion A neural network trained with structured semiquantitative bedside chest radiography reports allowed nonradiologist physicians improved interpretations compared with the consensus reading of expert radiologists. © RSNA, 2022 Supplemental material is available for this article. See also the editorial by Wielpütz in this issue.

Authors 21

1. Firas Khader Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

2. Tianyu Han Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Physics of Molecular Imaging Systems, Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany

3. Gustav Anton Müller‐Franzes Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Clinic for Surgical Intensive Medicine and Intermediate Care, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

4. Luisa Charlotte Huck Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

5. Philipp Schad Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

6. Sebastian Keil Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

7. Emona Barzakova Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

8. Maximilian Franz Schulze-Hagen Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

9. Federico Pedersoli Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

   Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

10. Volkmar Schulz Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Physics of Molecular Imaging Systems, Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany

11. Markus Zimmermann Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

12. Lina Nebelung Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen · Luisenhospital Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany

13. Jakob Nikolas Kather Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Medicine III, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

14. Karim Hamesch Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Medicine III, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

15. Christoph Haarburger Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Ocumeda AG, Erlen, Switzerland

16. Gernot Marx Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Clinic for Surgical Intensive Medicine and Intermediate Care, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

17. Johannes Stegmaier Aachen Institute of Imaging & Computer Vision Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Institute of Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany

18. Christiane Katharina Kuhl Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

19. Philipp Bruners Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

20. Sven Nebelung Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany

21. Daniel Truhn Aachen Department of Medicine III Department of Diagnostic and Interventional Radiology Physics of Molecular Imaging Systems Institute of Imaging and Computer Vision Clinic for Surgical Intensive Medicine and Intermediate Care Department of Inner Medicine

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., L.H., P.S., S.K., E.B., M.S.H., F.P., M.Z., C.K., P.B., S.N., D.T.), Department of Medicine III (J.K., K.H.), and Clinic for Surgical Intensive Medicine and Intermediate Care (G.M.), University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany; Physics of Molecular Imaging Systems, Experimental Molecular Imaging (T.H., V.S.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Department of Inner Medicine, Luisenhospital Aachen, Aachen, Germany (L.N.); and Ocumeda AG, Erlen, Switzerland (C.H.)

    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany