Medicine and Health Sciences Commons^™

Hyperbaric Oxygen Therapy For Alzheimer’S Dementia With Positron Emission Tomography Imaging: A Case Report, Paul G. Harch, Edward F. Fogarty

Radiology Faculty Publications

A 58-year-old female was diagnosed with Alzheimer’s dementia (AD) which was rapidly progressive in the 8 months prior to initiation of hyperbaric oxygen therapy (HBOT). 18Fluorodeoxyglucose (18FDG) positron emission tomography (PET) brain imaging demonstrated global and typical metabolic deficits in AD (posterior temporal-parietal watershed and cingulate areas). An 8-week course of HBOT reversed the patient’s symptomatic decline. Repeat PET imaging demonstrated a corresponding 6.5–38% regional and global increase in brain metabolism, including increased metabolism in the typical AD diagnostic areas of the brain. Continued HBOT in conjunction with standard pharmacotherapy maintained the patient’s symptomatic level of function over an ensuing …

Waardenburg Syndrome And Left Persistent Superior Vena Cava, Driss Raissi, Alexander Christie, Kimberly Applegate

Radiology Faculty Publications

Waardenburg syndrome (WS) is a rare genetic disorder secondary to neural crest cell developmental abnormalities. It is predominantly described as an auditory-pigmentary syndrome with diverse patient presentation, typically involving congenital sensorineural hearing loss and pigmentation abnormalities of the skin, hair, and iris. Other developmental abnormalities that may be associated with this syndrome are Hirschsprung's disease and a myriad of cardiovascular congenital defects. We present a case of a young girl with WS who found to have a persistent left superior vena cava (PLSVC) draining into the coronary sinus. The prevalence of PLSVC is increased in patients with chromosomal and genetic …

Upper Gastrointestinal Bleed Embolization With Onyx®: The "Tattoo Effect", Driss Raissi, Qian Yu, S. Houssam Mardini

Radiology Faculty Publications

Endoscopic intervention is well validated for the control of upper gastrointestinal bleeding (UGIB). In cases of refractory bleeding, transarterial embolization is a safe and effective alternative. Ethylene vinyl alcohol (EVOH) commonly known as Onyx^® is an inherently black liquid embolic approved for use in cerebrovascular arteriovenous malformations and is increasingly used as an embolic agent in multiple peripheral and visceral territories. Onyx^® has a uniquely undesirable property of causing black color discoloration when used in peripheral applications adjacent to the skin akin to a "tattoo effect." Knowledge of the agents used by the interventional radiologist, clinical correlation, and …

The "Lightning Bolt" Sign On Computed Tomography During Percutaneous Renal Mass Cryoablation, Qian Yu, Driss Raissi

Radiology Faculty Publications

Ice‑ball fracture is a rare and often overlooked entity that may lead to intraprocedural hemorrhage after percutaneous cryoablation of renal masses. There is scant literature on ice‑ball fractures associated with percutaneous renal cryoablation. Immediate recognition of the lightning bolt sign during intraprocedural computed tomography can help identify patients who may have developed this complication.

Ultrasound-Guided Introital Drainage Of Pyometrocolpos, I Kim, Ranjith Vellody, Hans G. Pohl, Karun Sharma, Kabir Yadav

Radiology Faculty Publications

Pyometrocolpos can be caused by congenital malformations such as distal vaginal atresia and imperforate hymen. Patients usually present with obstructive urinary tract infections, acute kidney injury, or sepsis. Percutaneous drainage of the infected fluid can help treat the patient; however, recurrence is of concern. In this case report, we present a case of a child with recurrent pyometrocolpos due to distal vaginal atresia despite initial percutaneous drainage. To our knowledge, this is the first report of ultrasound-guided introital drainage of pyometrocolpos with relief of symptoms obviating the need for repeat drainage or immediate surgery. © 2017

Successful Embolization Of A Enterocutaneous Fistula Tract With Onyx 34 Following Low Anterior Resection For Rectal Cancer., Hamza Rahimi, Anthony C Venbrux, Vincent Obias

Radiology Faculty Publications

Enterocutaneous fistulas (ECFs) can be one of the complications found after surgical intervention for rectal cancer. Interventional modalities consisting of surgical, endoscopic, and radiological methods are often implemented to treat postoperative symptomatic complications. We present the case of 61-year-old Caucasian man who presented to us with a recent diagnosis of rectal cancer that had invaded the levators as well as anteriorly into the prostate, and who underwent low anterior resection with a diverting loop ileostomy. The patient was found to have a persistent presacral abscess due to an ECF tract. This case highlights the off-label use of ethylene-vinyl alcohol copolymer …

Design And Development Of A Phantom For Tomosynthesis With Potential For Automated Analysis Via The Cloud., David Goodenough, Josh Levy, Hildur Olafsdottir, Ingvi Olafsson

Radiology Faculty Publications

This paper describes Development of a Phantom for Tomosynthesis with Potential for Automated Analysis via the Cloud. Several studies are underway to investigate the effectiveness of Tomosynthesis Mammographic Image Screening, including the large TMIST project as funded by the National Cancer Institute https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/tmist. The development of the phantom described in this paper follows initiatives from the FDA, the AAPM TG245 task group, and European Reference Organization (EUREF) for Quality Assured Breast Screening and Diagnostic Services Committee report noting, that no formal endorsement nor recommendation for use has been sought, or granted by any of these groups. This paper reports on …

Procedural Competency Training During Diagnostic Radiology Residency: Time To Go Beyond “See One, Do One, Teach One”!, Driss Raissi, Qiong Han, Michael A. Winkler, Edward J. Escott

Radiology Faculty Publications

Objectives: Achieving procedural competency during diagnostic radiology residency can impact the radiologist's future independent practice after graduation, especially in a private practice setting. However, standardized procedure competency training within most radiology residency programs is lacking, and overall procedural skills are still mainly acquired by the traditional “see one, do one, teach one” methodology. We report the development of a simple standardized procedural training protocol that can easily be adopted by residency programs currently lacking any form of structured procedural training.

Materials and Methods: An ad hoc resident procedural competency committee was created in our radiology residency program. A procedural certification …

A Review Of Clinical Radioprotection And Chemoprotection For Oral Mucositis., Bryan Oronsky, Sharad Goyal, Michelle M Kim, Pedro Cabrales, Michelle Lybeck, Scott Caroen, Neil Oronsky, Erica Burbano, Corey Carter, Arnold Oronsky

Radiology Faculty Publications

The first tenet of medicine, "primum non nocere" or "first, do no harm", is not always compatible with oncological interventions e.g., chemotherapy, targeted therapy and radiation, since they commonly result in significant toxicities. One of the more frequent and serious treatment-induced toxicities is mucositis and particularly oral mucositis (OM) described as inflammation, atrophy and breakdown of the mucosa or lining of the oral cavity. The sequelae of oral mucositis (OM), which include pain, odynodysphagia, dysgeusia, decreased oral intake and systemic infection, frequently require treatment delays, interruptions and discontinuations that not only negatively impact quality of life but also tumor control …

Renal Granulomatosis Post Intravesical Bacillus Calmette-Guerin Therapy For Non-Muscle-Invasive Bladder Cancer, Karen Tran-Harding, Rashmi T. Nair, Halemane S. Ganesh

Radiology Faculty Publications

Intravesical Bacillus Calmette–Guerin (BCG) immunotherapy is a proven, effective treatment for intermediate- and high-risk non-muscle-invasive bladder cancer. Minor side effects are common and expected but systemic effects can occur in < 5% of treated patients. We present a rare case of a 49-year-old male that presented with fever and chills after 3 weeks of intravesical BCG therapy post transurethral resection of bladder tumor. New renal lesions were present on contrast-enhanced computed tomography scan which was histologically proven to be necrotizing renal granulomatosis.

Bleeding Stomal Varices In Portal Hypertension, Karen Tran-Harding, Michael A. Winkler, Driss Raissi

Radiology Faculty Publications

We report a case of a 50-year-old man with a history of liver cirrhosis and colon cancer post end colostomy presenting to the emergency department with stomal bleeding and passage of clots into the colostomy bag. The patient was treated with transjugular intrahepatic portosystemic shunt (TIPS) and concomitant embolization of the stomal varices via the TIPS shunt using N-butyl cyanoacrylate mixed with ethiodol. Although stomal variceal bleeding is uncommon, this entity can have up to 40% mortality upon initial presentation, given the challenges in diagnosis and management. Currently, there are no established standard treatments for stomal variceal bleeding. In addition, …

Radiation Dose Measurements In A 256-Slice Computed Tomography Scanner, Victor J. Weir, Jie Zhang

Radiology Faculty Publications

Purpose: The purpose of this study is to compare computed tomography (CT) radiation dose measurement methods proposed by TG111, International Electrotechnical Commission (IEC), and a direct dose profile integral (DPI) measurement method. Methods: Pencil and Farmer ion chambers are used for integrating dose profiles at different beam widths in a 60 cm long body phantom. Resulting DPI is used to calculate CT dose index (CTDI) at each beam width. Measurements are also done for a pencil chamber inserted into a 15 cm body phantom at the reference beam width. The reference measurement is scaled with pencil chamber measurements in air …

Patient And Hospital Characteristics Predictive Of Inferior Vena Cava Filter Usage In Venous Thromboembolism Patients: A Study From The 2013 To 2014 Nationwide Readmissions Database, Amie Goodin, Ming Chen, Driss Raissi, Qiong Han, Hong Xiao, Joshua Brown

Radiology Faculty Publications

To examine the association between patient and hospital characteristics and inferior vena cava filter (IVCF) utilization in patients with venous thromboembolism (VTE).

The 2013 to 2014 Nationwide Readmissions Database was used to define a cohort of patients with VTE aged ≥ 18 after a primary VTE diagnosis. Comorbidities of interest were classified via diagnosis codes and IVCF placement was identified via procedure code. Chi square analysis tested differences between patient and hospital-level characteristics and whether or not IVCFs were placed. A hierarchical logistic regression model estimated the relationship between patient-level factors (demographics, socioeconomic status, comorbidities), hospital-level factors (bed size, teaching …