Medical Specialties Commons^™

A Narrative Review On Contrast-Enhanced Ultrasound In Aortic Endograft Endoleak Surveillance., Sriharsha Gummadi, John R. Eisenbrey, Andrej Lyshchik

Department of Radiology Faculty Papers

Endovascular repair of abdominal aortic aneurysms have been performed successfully since 1991. However, 20% to 50% of these patients may develop an endoleak or continued aneurysmal sac expansion or perfusion despite stent graft coverage. Current recommendations suggest lifelong surveillance with computed tomographic angiography (CTA) at least 1 month after intervention and yearly after that. In select patients with a stable aneurysm sac on computed tomography performed 1 year after treatment, future screening could be performed with ultrasonography. However, color Doppler ultrasound can fail to detect as many as 31% of endoleaks. Contrast-enhanced ultrasound (CEUS) provides an alternative approach to excluded …

Advances In Modern Clinical Ultrasound, Sriharsha Gummadi, Md, John R. Eisenbrey, Phd, Jingzhi Li, Md, Zhaojun Li, Md, Flemming Forsberg, Phd, Andrej Lyshchik, Md, Ji-Bin Liu, Md

Department of Radiology Faculty Papers

Advances in modern clinical ultrasound include developments in ultrasound signal processing, imaging techniques and clinical applications. Improvements in ultrasound processing include contrast and high-fidelity ultrasound imaging to expand B-mode imaging and microvascular (or microluminal) discrimination. Similarly, volumetric sonography, automated or intelligent ultrasound, and fusion imaging developed from the innate limitations of planar ultrasound, including user-operator technical dependencies and complex anatomic spatial prerequisites. Additionally, ultrasound techniques and instrumentation have evolved towards expanding access amongst clinicians and patients. To that end, portability of ultrasound systems has become paramount. This has afforded growth into the point-of-care ultrasound and remote or tele-ultrasound arenas. In …

Trans-Lymphatic Contrast-Enhanced Ultrasound In Combination With Blue Dye Injection Is Feasible For Detection And Biopsy Of Sentinel Lymph Nodes In Breast Cancer, Xiangmei Chen, Md, Jieyu Zhong, Md, Zhengming Hu, Md, Wei Wei, Md, Weihua Yin, Md, Ligang Cui, Md, Ji-Bin Liu, Md, Desheng Sun, Md

Department of Radiology Faculty Papers

Objective: The best method for sentinel lymph node biopsy (SLNB) in early-staged breast cancer (EBC) remains controversial. This study aimed to evaluate a novel method by combining trans-lymphatic contrast-enhanced ultrasound (TLCEUS) with blue dye injection as a guidance of SLNB.

Methods: TLCEUS was performed in 88 patients with newly diagnosed EBC. Methylene blue dye was percutaneously injected into enhanced sentinel lymph nodes (SLNs) under ultrasound guidance, followed by standard SLNB and axillary lymph node dissection. Enhancement patterns and the arriving time (AT) of contrast agent within SLNs were evaluated. Histopathological examination of dissected nodes was performed to confirm metastasis.

Results: …

Progress Of In-Stent Restenosis After Vertebral Artery Ostium Stenosis And Imaging Assessments, Jingzhi Li, Md, John R. Eisenbrey, Phd, Yang Hua, Md

Department of Radiology Faculty Papers

Stenting has become one of the primary procedure to treat vertebral artery ostium stenosis patients. Postoperative in­stent restenosis (ISR) of the stenting is still one of the unsolved issues and requires systematic and further investigation. Through imaging assessments, ISR could be identified and evaluated in clinical practice and researches.

A Glance At Imaging Bladder Cancer., Ebru Salmanoglu, Ethan J. Halpern, Edouard J. Trabulsi, Sung Kim, Mathew L. Thakur

Department of Radiology Faculty Papers

Purpose: Early and accurate diagnosis of Bladder cancer (BCa) will contribute extensively to the management of the disease. The purpose of this review was to briefly describe the conventional imaging methods and other novel imaging modalities used for early detection of BCa and outline their pros and cons.

Methods: Literature search was performed on Pubmed, PMC, and Google scholar for the period of January 2014 to February 2018 and using such words as "bladder cancer, bladder tumor, bladder cancer detection, diagnosis and imaging".

Results: A total of 81 published papers were retrieved and are included in the review. For patients …

Subdermal Ultrasound Contrast Agent Injection For Sentinel Lymph Node Identification: An Analysis Of Safety And Contrast Agent Dose In Healthy Volunteers., Priscilla Machado, Maria Stanczak, Ji-Bin Liu, Jason N. Moore, John R. Eisenbrey, Laurence Needleman, Walter K. Kraft, Flemming Forsberg

Department of Radiology Faculty Papers

Objectives—Mapping of the lymphatic chain for identification of the sentinel lymph node (SLN) is an important aspect of predicting outcomes for breast cancer patients, and it is usually performed as an intraoperative procedure using blue dye and/or radiopharmaceuticals agents. Recently the use of contrast-enhanced ultrasound (CEUS) has been proposed as an alternative imaging technique for this mapping. The objective of this study was to evaluate the use of subdermal administration of the ultrasound contrast agent Sonazoid (GE Healthcare) in terms of patient safety and to select the dose to be used for lymphatic applications in humans.

Methods—This study …

Contrast-Enhanced Ultrasound Identifies Early Extrahepatic Collateral Contributing To Residual Hepatocellular Tumor Viability After Transarterial Chemoembolization., Sriharsha Gummadi, Maria Stanczak, Andrej Lyshchik, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

The mainstay of treatment for unresectable hepatocellular carcinoma is locoregional therapy including percutaneous ablation and transarterial chemo- and radioembolization. While monitoring for tumor response after transarterial chemoembolization is crucial, current imaging strategies are suboptimal. The standard of care is contrast-enhanced magnetic resonance imaging or computed tomography imaging performed at least 4 to 6 weeks after therapy. We present a case in which contrast-enhanced ultrasound identified a specific extra-hepatic collateral from the gastroduodenal artery supplying residual viable tumor and assisting with directed transarterial management.

Evaluation Of Hepatocellular Carcinoma Transarterial Chemoembolization Using Quantitative Analysis Of 2d And 3d Real-Time Contrast Enhanced Ultrasound., Kibo Nam, Maria Stanczak, Andrej Lyshchik, Priscilla Machado, Yuko Kono, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

Quantitative 2D and 3D contrast-enhanced ultrasound (CEUS) was assessed to evaluate early transarterial chemoembolization (TACE) treatment response. Seventeen patients scheduled for TACE for the treatment of hepatocellular carcinoma participated in the study. 2D and 3D CEUS were performed for each patient at three time points: Prior to TACE, 1-2 weeks post TACE, and 1 month post TACE. Peak-intensities of the tumor and surrounding liver tissue were calculated from 2D and 3D data before and after TACE and used to evaluate tumor treatment response. Residual tumor percentages were calculated from 2D and 3D CEUS acquired 1-2 weeks and 1 month post …

Electrophysiological Signatures Of Spatial Boundaries In The Human Subiculum., Sang Ah Lee, Jonathan F. Miller, Andrew J. Watrous, Michael R. Sperling, Ashwini Sharan, Gregory A. Worrell, Brent M. Berry, Joshua P. Aronson, Kathryn A. Davis, Robert E. Gross, Bradley Lega, Sameer Sheth, Sandhitsu R. Das, Joel M. Stein, Richard Gorniak, Daniel S. Rizzuto, Joshua Jacobs

Department of Radiology Faculty Papers

Environmental boundaries play a crucial role in spatial navigation and memory across a wide range of distantly related species. In rodents, boundary representations have been identified at the single-cell level in the subiculum and entorhinal cortex of the hippocampal formation. Although studies of hippocampal function and spatial behavior suggest that similar representations might exist in humans, boundary-related neural activity has not been identified electrophysiologically in humans until now. To address this gap in the literature, we analyzed intracranial recordings from the hippocampal formation of surgical epilepsy patients (of both sexes) while they performed a virtual spatial navigation task and compared …

Age Related Diffusion And Tractography Changes In Typically Developing Pediatric Cervical And Thoracic Spinal Cord, Mahdi Alizadeh, Joshua Fisher, Sona Saksena, Phd, Yusra Sultan, Chris Conklin, Phd, Devon Middleton, Laura Krisa, Phd, Jürgen Finsterbusch, Adam Flanders, Scott H. Faro, M. J. Mulcahey, Feroze Mohamed, Phd

Department of Radiology Faculty Papers

Background and objective: Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) are two techniques that can measure white matter integrity of the spinal cord. Recently, DTI indices have been shown to change with age. The purpose of this study is (a) to evaluate the maturational states of the entire pediatric spinal cord using DTI and DTT indices including fractional anisotropy (FA), mean diffusivity (MD), mean length of white matter fiber tracts and tract density and (b) to analyze the DTI and DTT parameters along the entire spinal cord as a function of spinal cord levels and age. Method: A …

Delayed Hepatic Rupture Post Ultrasound-Guided Percutaneous Liver Biopsy: A Case Report., Jia-Yan Huang, Qiang Lu, Ji-Bin Liu

Department of Radiology Faculty Papers

RATIONALE: Hemorrhage, one of complications after liver biopsy, is often identified immediately after the procedure while delayed liver rupture is relatively rare.

PATIENT CONCERNS: A 45-year-old woman was diagnosed with undetermined liver cirrhosis and abnormal liver function. To determine the etiology and severity of liver cirrhosis, ultrasound-guided liver biopsy was arranged. The patients did not complain any pain during the procedure. Ultrasound examination on postoperative day1 (POD 1) and MRI on POD 3 showed no evidence of hematoma and ascites. On POD 7, however, the patient was taken to the hospital with a sudden onset of pain in the right …

Subharmonic And Endoscopic Contrast Imaging Of Pancreatic Masses: A Pilot Study., Flemming Forsberg, Maria Stanczak, Andrej Lyshchik, David E. Loren, Patrick O'Kane, Ali Siddiqui, Thomas E. Kowalski, Cynthia Miller, Traci Fox, Ji-Bin Liu, John R. Eisenbrey

Department of Radiology Faculty Papers

OBJECTIVES: To use subharmonic imaging (SHI) to depict the vascularity of pancreatic masses compared to contrast-enhanced endoscopic ultrasound (EUS) and pathologic results.

METHODS: Sixteen patients scheduled for biopsy of a pancreatic mass were enrolled in an Institutional Review Board-approved study. Pulse-inversion SHI (transmitting/receiving at 2.5/1.25 MHz) was performed on a LOGIQ 9 system (GE Healthcare, Milwaukee, WI) with a 4C transducer, whereas contrast harmonic EUS (transmitting/receiving at 4.7/9.4 MHz) was performed with a radial endoscope (GF-UTC180; Olympus Corporation, Tokyo, Japan) connected to a ProSound SSD α-10 scanner (Hitachi Aloka, Tokyo, Japan). Two injections of the contrast agent Definity (Lantheus Medical …