Yearbook 00


Sönke Bartling
Home Institution Medizinische Hochschule Hannover Host Institution(s) 1) Surgical Planning Lab, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 2) General Electric Corporate Research & Development Niskayuna, NY Mentors: 1) Ron Kikinis, MD 2) Dr. Armin Pfoh, Rajiv Gupta, MD, PhD E-Mail soenkebartling@gmx.de
Research Topic see Abstract
Personal Reactions to the U.S. Experience Maybe we will discuss the U.S. Experience a bit more than other ex-BMEP-participants, due to the incident that made us the post 911 generation. The day before Sept. 11th I traveled down the same road from Maine that two of the terrorists had used 8 hours earlier. I could only find an expensive B&B on the outskirts of Boston in which to stay the first night. I was at Kinkos, a public internet access provider, searching for another place to stay, when I heard it from my chatting neighbor. "Huhhh!" she shouted, "Two missiles hit the WTC!" I tried cnn.com, n-tv.de, spiegel.de. None of these pages were answering. I was hoping that a local network error was the reason for the downed pages. The officer on duty at Kinkos destroyed these hopes: "We're closing, right now, due to the World Trade Center bombing." I could negotiate only a few minutes of www.gmx.de-time to send to my parents and to everybody whose email address I could remember in a hurry: "I am okay. I am secure in Boston. Till later, Soenke". Later I heard from some people that these email messages were for them the first that they had heard about the so-called terrorist attacks. Instinctively, all of the stranded BMEPers in Boston gathered at a house near Harvard Sq., where 4 of us found a place for a few nights. We were talking and shocked, the phone was ringing, the emails were checked by flittering fingers, and we tried to comprehend the situation. Slowly we received messages from all the others that they were alive. It was good to know, in the meantime, that we had a few people around us that we knew and could talk to. As I went to the local supermarket that afternoon, F-16 fighter planes flew 1000ft above my head. A-bomb scenarios were in my mind. At the register in the supermarket a woman's credit card was not working and she started to cry, because she thought that now the whole financial system had crashed. It took her one horrific minute to figure out that her card was broken. The next days were horrible: in a foreign country, with no place to stay, no possibility to go back home, a crashing stock exchange, anthrax threats, no phone, only expensive internet connections, and an unknown future. I think we arrived in Boston at the most ill-fated moment in the last 20 years, one day before September 11th.
Greatest Difficulties Encountered After one week in the post 9/11-chaos and expensive nights in the Bed & Breakfast, I took the first disadvantageous place to stay. It was dirty and a real mess, but at this time I was happy to have something. The cats and dogs were drinking out of the toilet and fed off of my plates. I hope you believe me, that this was only the tip of the iceberg. I established a nutrition system totally independent from luxury things like a clean kitchen and clean sinks. I ate at the small Indian grocery store around the corner (cheap rice), or in the cafeteria, enough for the whole evening. Now I know how nice is it to have a clean environment. I learned to love cleaning, and yes, I will never ever again be worried about cleaning. After 3 months, the mess was too much. I moved out, and I am now living happily in a 6 square meter room on an inflatable mattress. Due to the lack of heat, I bought an electric comforter, an electric heater and earplugs. (The earplugs are not for the prevention of a middle ear inflammation, but because of the noise of the electric heater!) And this for only 1000 DM monthly! However, my roommates are nice and our kitchen and living room are big. The best places in Boston to stay are in Cambridge, in the places around Harvard Sq., and in south Somerville. Cambridge is the student center, with bars and clubs. Also, from Cambridge the important research centers in the Boston area, MIT, Harvard and the Longwood Medical Center, are not too far away. The public transportation is awful and unscheduled, but it is the best in the US (My native reviewer, Jennifer, added here, "Soenke - the Boston metro is the OLDEST in the nation, not the best. New York City has the best public transportation system in the country"). After some time, it is possible to figure out which schedule is worth the paper it is printed on. At least a bicycle remains an option. If you have got enough money, buy a car, but parking is difficult in Boston. Indeed, Boston is a fascinating place. With its more the 25 colleges and universities, uncountable hospitals with uncountable physicians and even more research facilities and research companies, you will meet a lot of interesting people. If you go around open minded, a ride in the T (the subway) can end up in an interesting discussion with a stranger about quantum physics or big networks. After several weeks of getting used to the shock, the stay in Boston became nicer. The work in the lab was fun and interesting, and I found new friends and new roommates. I am sure that some of these friendships will last into a few stages of my further life. Everything was worth it, and I want to thank everybody who made this experience possible.
Most humorous incident The dating rules are a funny chapter. They are strange and some people take them really seriously, and, of course, some do not. It is a lot of fun to discuss the benefits or disadvantages for both sides. Make sure that you ask different American girls/boys about the dating rules.
Helpful Hints for Future Students - If you want to go out, make sure that you have your passport with you. For some reason, the German I. D. card doesn't count everywhere. - Open a bank account in the US. At Fleet it is free for students and the only thing you need is a passport. The best way to transfer money to the US is to get it with your EC card from your home account. Make sure that you get the maximum amount of money in each transfer, because the expenses are fixed prices. If you withdraw 1000 DM you pay only 5 DM, that is less then 1 percent. Right after withdrawing the money, put it on your local account. - Bring a credit card. - Make sure you get an email account with a lot of storage and a good web interface. Email is the most important way to communicate, especially in the beginning. - I had a B1-Visa. If you have any questions about what to tell the embassy and the custom officers, ask me! - Bring a German perforator, otherwise your documents will not fit after returning! - Join Europeanclub at Euroclub.mit.edu (housing, buy+sell, nice people, pub tour every Thursday.) - Forget the commercial internet services that try to convey places to stay. They've got professional liars who keep you and your credit card busy. - Be happy and don't touch the sharks in Maine, but make sure that you have experienced the flashing water. - Most important: Watch out for earth-nesting bumblebees!
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Abstract on Research Topic:
New Temporal Bone Imaging Techniques

Authors:
S. Bartling, R. Gupta1, Th. Rodt3, B. P. Weber4, H. Becker3, A. Pfoh1, Ch. Guttmann2, R. Kikinis2 1General Electric Corporate R&D, Schenectady, NY, USA 2 Surgical Planning Lab, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA 3Department of Neuroradiology, Medical School, Hannover, GERMANY 4Department of Othorhinolaryngology, Medical School, Hannover, Germany

Purpose:
The temporal bone, with its tiny structures is still a challenge for the diagnostic imaging. Therefore I describe new radiological techniques on the temporal bone with focus on new acquisition techniques and advanced computer-based post-processing methods. Further I discuss what might be their influence in the diagnostic process.
1) A new, experimental Volume-CT (VCT) scanner, developed by General Electric, promises far submillimetric resolution and less beam hardening artifacts. Beam hardening artifacts make CT useless, if metal is implanted.
2) New MRI sequences increase the resolution and image contrast, while reducing the scanning time.
3) The registration, fusion and complex combination of MRI and CT could increase the diagnostic benefit from both modalities.

Materials & Methods:
1) Four isolated temporal bone specimens were dissected from the skull. Different changes to simulate pathologies and implantations were performed. They were scanned in the VCT and a GE Lightspeed Qx/I scanner. Obtained slices were compared regarding the image quality, resolution, shown anatomical details, shown lesions and the beam-hardening artifacts.
2) Five healthy subjects were scanned in a GE Signa 1.5T scanner using a single-slab 3DFSE T2-weighted sequence with a 3 in. surface coil. The total imaging time was 15 minutes. To obtain the long echo train and heavily T2-weighted image contrast, we used hard excitation and refocusing RF pulses, with variable flip angle.
3) Different algorithms were evaluated to fuse and register CT and MRI of the temporal bone.

Results:
1) In the resulting images, the following structures, with clarity rivaling an anatomical atlas, were visualized. For example, the internal structure of the semicircular canals, the vestibule and the cochlea were visible in the VCT. Both laser-drilled lesions were visualized in the VCT. In comparison, only the bigger lesion in the incus could be seen in the multislice scanner. Using VCT, the implanted middle and inner ear hardware was visualized with minimal beam hardening artifacts and with unprecedented clarity. Individual electrodes in the chochlear implant could be seen in the volumetric images.
2) The fluidfilled membraneous labyrinthine and the nerves in the internal acoustic canal (IAC) were seen with higher resolution and better contrast, while the scanning time is comparable with former sequences.
3) The nerves of the IAC, displayed by the MRI, could be seen relative to the bony IAC, displayed by CT. The fluidfilled membraneous labyrinthine, only shown in the MRI, could be assessed relative to the bony labyrinthine, only shown in CT. Differences between the development of both labyrinthines could be assessed in malformations.

Conclusion:
1) This study demonstrated that VCT, employing a digital flat-panel detector, images the inner and middle ear anatomy with unprecedented clarity and detail. Various lesions and hardware are better visualized using VCT as compared with a state-of-the-art multi-slice CT. Far submillimetric, isotropic resolutions lead to 400 slices only in the temporal bone. New ways to access the volumetric dataset are necessary. Browsing the slices is no more feasible. 3D imaging is one solution.
2) Higher resolution and shorter scanning time increases the value of MRI in the temporal bone imaging. Further, this resolution could make the angio-MRI of the inner ear possible, and this could lead to new radiological correlations to deafness.
3) Combination of the soft tissues of the MRI and bony structures of the CT in one slice, allows the physician a more exact localization of pathologies, which are often diagnosed only in one of these modalities.

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