Radiology Commons^™

Harmonization Of Multi-Site Diffusion Tensor Imaging Data For Cervical And Thoracic Spinal Cord At 1.5 T And 3 T Using Longitudinal Combat, Devon M. Middleton, Yutong Li, Andrew Chen, Russell Shinohara, Joshua Fisher, Laura Krisa, Mark Elliot, Scott H. Faro, John H. Woo, Adam E. Flanders, Feroze B. Mohamed

Department of Radiology Faculty Papers

MRI scanner hardware, field strengths, and sequence parameters are major variables in diffusion studies of the spinal cord. Reliability between scanners is not well known, particularly for the thoracic cord. DTI data was collected for the entire cervical and thoracic spinal cord in thirty healthy adult subjects with different MR vendors and field strengths. DTI metrics were extracted and averaged for all slices within each vertebral level. Metrics were examined for variability and then harmonized using longitudinal ComBat (longComBat). Four scanners were used: Siemens 3 T Prisma, Siemens 1.5 T Avanto, Philips 3 T Ingenia, Philips 1.5 T Achieva. Average …

Randomized Controlled Trial Of Mechanical Thrombectomy Vs Catheter-Directed Thrombolysis For Acute Hemodynamically Stable Pulmonary Embolism: Rationale And Design Of The Peerless Study, Carin F. Gonsalves, C Michael Gibson, Stefan Stortecky, Roger A Alvarez, Daren M Beam, James M Horowitz, Mitchell J Silver, Catalin Toma, John H Rundback, Stuart P Rosenberg, Craig D Markovitz, Thomas Tu, Wissam A Jaber

Department of Radiology Faculty Papers

BACKGROUND: The identification of hemodynamically stable pulmonary embolism (PE) patients who may benefit from advanced treatment beyond anticoagulation is unclear. However, when intervention is deemed necessary by the PE patient's care team, data to select the most advantageous interventional treatment option are lacking. Limiting factors include major bleeding risks with systemic and locally delivered thrombolytics and the overall lack of randomized controlled trial (RCT) data for interventional treatment strategies. Considering the expansion of the pulmonary embolism response team (PERT) model, corresponding rise in interventional treatment, and number of thrombolytic and nonthrombolytic catheter-directed devices coming to market, robust evidence is needed …

Microvascular Flow Imaging: A State-Of-The-Art Review Of Clinical Use And Promise., Muhammad Usman Aziz, John R Eisenbrey, Annamaria Deganello, Mohd Zahid, Kedar Sharbidre, Paul Sidhu, Michelle L Robbin

Department of Radiology Faculty Papers

Vascular imaging with color and power Doppler is a useful tool in the assessment of various disease processes. Assessment of blood flow, from infarction and ischemia to hyperemia, in organs, neoplasms, and vessels, is used in nearly every US investigation. Recent developments in this area are sensitive to small-vessel low velocity flow without use of intravenous contrast agents, known as microvascular flow imaging (MVFI). MVFI is more sensitive in detection of small vessels than color, power, and spectral Doppler, reducing the need for follow-up contrast-enhanced US (CEUS), CT, and MRI, except when arterial and venous wash-in and washout characteristics would …

Characterization Of Adnexal Masses Using Contrast-Enhanced Subharmonic Imaging: A Pilot Study., Lauren J. Delaney, Priscilla Machado, Mehnoosh Torkzaban, Andrej Lyshchik, Corinne Wessner, Christine H. Kim, Md, Norman G Rosenblum, Scott D. Richard, Kirk Wallace, Flemming Forsberg

Department of Radiology Faculty Papers

OBJECTIVES: This pilot study evaluated whether contrast-enhanced subharmonic imaging (SHI) could be used to characterize adnexal masses before surgical intervention.

METHODS: Ten women (with 12 lesions) scheduled for surgery of an ovarian mass underwent an SHI examination of their adnexal region using a modified LOGIQ E9 scanner (GE Healthcare, Waukesha, WI) with an endocavitary transducer, in which digital clips were acquired by pulse destruction-replenishment SHI across the lesions. Time-intensity curves were created offline to quantitatively evaluate SHI parameters (fractional tumor perfusion, peak contrast intensity, time to peak contrast enhancement, and area under the time-intensity curve), which were compared to pathologic …

Outpatient Facility-Based Order Variation In Combined Imaging., Adam C. Powell, Yan Wang, Gary L. Smith, James W. Long, Uday U. Deshmukh, David P. Friedman, Christopher G. Roth, Baskaran Sundaram

Department of Radiology Faculty Papers

OBJECTIVE: Combined computed tomography (CT) occurs when one anatomical area is simultaneously imaged both without and with contrast, or two overlapping anatomical areas are imaged concurrently. While this has been studied in a Traditional Medicare population, it has not been studied in other populations subject to prior authorization. This study explores between-facility variation in ordering and receiving orders to render combined CT in a mixed commercial and Medicare Advantage population.

METHODS: Orders for CT abdomen (without/with contrast), CT thorax (without/with contrast), and concurrent CT brain and sinus authorized by a prior authorization company from 2013-2017, pertaining to patients with commercial …

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 …

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 …

Parametric Mapping Of Contrasted Ovarian Transvaginal Sonography., Katrina Korhonen, Ryan Moore, Andrej Lyshchik, Arthur C. Fleischer

Department of Radiology Faculty Papers

The purpose of this study was to assess the accuracy of parametric analysis of transvaginal contrast-enhanced ultrasound (TV-CEUS) for distinguishing benign versus malignant ovarian masses. A total of 48 ovarian masses (37 benign and 11 borderline/malignant) were examined with TV-CEUS (Definity; Lantheus, North Billerica, MA; Philips iU22; Philips Medical Systems, Bothell, WA). Parametric images were created offline with a quantification software (Bracco Suisse SA, Geneva, Switzerland) with map color scales adjusted such that abnormal hemodynamics were represented by the color red and the presence of any red color could be used to differentiate benign and malignant tumors. Using these map …

Intrasheath Subluxation Of The Peroneal Tendons., Steven M Raikin, Ilan Elias, Levon N Nazarian

Department of Radiology Faculty Papers

BACKGROUND: Dislocation or subluxation of the peroneal tendons out of the peroneal groove under a torn or avulsed superior peroneal retinaculum has been well described. We identified a new subgroup of patients with intrasheath subluxation of these tendons within the peroneal groove and with an otherwise intact retinaculum.

METHODS: The cases of fifty-seven patients with painful snapping of the peroneal tendons posterior to the fibula were reviewed. Of these, forty-three had tendons that could be reproducibly subluxated out of the groove with a dorsiflexion-eversion maneuver of the ankle. Fourteen patients who could not subluxate the tendons out of the groove …