Radiology Commons^™

Following The Growth Of Sarah's Baby: An Ipe Activity For Medical Nutrition & Diagnostic Sonography Students, Tanya M. Custer, Megan Timmerman, Cynthia M. Schmidt, Teresa L. Hartman, Harlan Sayles, Kathryn Wampler, Lea Lambing, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Objectives: Interprofessional education (IPE) involves collaborative learning among students from different professions. While acceptance of these types of activities is increasing, there are opportunities to expand the number of health care professions involved in IPE. The purpose of this study was to explore student perceptions and outcomes after participation in a Diagnostic Medical Sonography (DMS) and Medical Nutrition Education (MNE) interprofessional education activity centered around a clinical case study on fetal growth. Subjects & Methods: The IPE activity was administered to four student cohorts from academic years to 2015-2016 to 2018-2019. Participants included 66 students (n=39 DMS and n=27 MNE). …

Timing Of Postoperative Magnetic Resonance Imaging (Mri) Following Glioma Resection: Shattering The 72 Hour Window, Syed Sarmad Bukhari, Muhammad Shahzad Shamim, Fatima Mubarak

Section of Neurosurgery

Extent of enhancing tumour resection is correlated with progression free survival following glioma surgery. Historically, a contrast enhanced MRI has been recommended within 72 hours following surgery to evaluate for residual disease. This theoretical window was established amidst conflicting evidence to avoid reactive enhancement. Recent studies with better designs and better imaging quality have sought to challenge this window with a more pragmatic method of evaluating residual disease.

Including Ultrasound Scans In Antenatal Care In Low-Resource Settings: Considering The Complementarity Of Obstetric Ultrasound Screening And Maternity Waiting Homes In Strengthening Referral Systems In Low-Resource, Rural Settings, David L. Swanson, Holly L. Franklin, Jonathan O. Swanson, Robert L. Goldenberg, Elizabeth M. Mcclure, Waseem Mirza, David Muyodi, Lester Figueroa, Farnaz Naqvi, Sarah Saleem

Department of Radiology

Recent World Health Organization (WHO) antenatal care recommendations include an ultrasound scan as a part of routine antenatal care. The First Look Study, referenced in the WHO recommendation, subsequently shows that the routine use of ultrasound during antenatal care in rural, low-income settings did not improve maternal, fetal or neonatal mortality, nor did it increase women's use of antenatal care or the rate of hospital births. This article reviews the First Look Study, reconsidering the assumptions upon which it was built in light of these results, a supplemental descriptive study of interviews with patients and sonographers that participated in the …

Endovascular Management Of Free Floating Common Carotid Thrombi, Kevin Carr Md, Zachary Thwing Md, Ravishankar Shivashankar Md, Yafell Serulle Md

Radiology

• The incidence of symptomatic free-floating thrombi of the common carotid artery (CCA) is as low as 0.24-5% incidence in stroke victims. Patients are predisposed to a prothrombotic state
• Historical management options were limited to surgical and medical options both with individual attendant risk profiles
• Large thrombi can present with various degrees of clinical severity
• The endovascular approach is a viable tool to manage these patients

Polyhydramnios Among Women In A Cluster-Randomized Trial Of Ultrasound During Prenatal Care Within Five Low And Low-Middle Income Countries: A Secondary Analysis Of The First Look Study, Melissa Bauserman, Robert Nathan, Adrien Lokangaka, Elizabeth M. Mcclure, Janet Moore, Daniel Ishoso, Antoinette Tshefu, Lester Figueroa, Sarah Saleem, Waseem Mirza

Community Health Sciences

Background: In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes.
Methods: We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site …

Diffusion Tensor Imaging Findings In Pediatric Patients With Mild Traumatic Brain Injury, Tshea Dowers, B L. Bartnik, Barbara Holshouser, Stephen Ashwal, Samuel Barnes

Brenda Bartnik-Olson, PhD

Approximately 14% of school age children with sports-related concussions (SRC) remain symptomatic 3 months after injury. Previous studies have used diffusion tensor imaging (DTI) to detect white matter tract changes in regions of interest in symptomatic patients; however data in the pediatric population remains limited. This study was undertaken to determine whether DTI metrics can provide valuable information in pediatric mTBI patients with persistent symptoms.

Diffusion Tensor Imaging Findings In Pediatric Patients With Mild Traumatic Brain Injury, Tshea Dowers, B L. Bartnik, Barbara Holshouser, Stephen Ashwal, Samuel Barnes

Samuel Barnes, PhD

Approximately 14% of school age children with sports-related concussions (SRC) remain symptomatic 3 months after injury. Previous studies have used diffusion tensor imaging (DTI) to detect white matter tract changes in regions of interest in symptomatic patients; however data in the pediatric population remains limited. This study was undertaken to determine whether DTI metrics can provide valuable information in pediatric mTBI patients with persistent symptoms.

Retrospective Evaluation Of Weight Loss In Maine Medical Center Cancer Institute (Mmcci) Patients Receiving Radiation Treatment For Head And Neck Cancer, Julian Johnson, David Debartolo-Stone, Jessica Moore, Ruth Hanselman, Stephen Tyzik, Suneela Nayak, Amy Sparks

Operations Transformation

Treatment for head and neck cancer often results in weight loss as a side effect. One option to mitigate this weight loss is placement of a percutaneous endoscopic gastrostomy (PEG) tube placement. Radiation oncologists at a academic tertiary medical center discuss the option of PEG placement during patient consultation.

A retrospective evaluation of weight loss in patients receiving radiation was conducted over a two-year period. The goal of this data collection was to create a standard for oncology consultations regarding PEG tube placement.

Baseline metrics and a root cause analysis drove subsequent data collection steps. After analyzing the raw data, …

Labrad : Vol 45, Issue 2 - July 2019, Aga Khan University Hospital, Karachi

LABRAD

• Novel Molecular Technique for Identifying Respiratory Tract Pathogens
• Role of Serum Galactomannan (GM) Assay in Diagnosing Invasive Aspergillosis (IA)
• Factor VIII Inhibitor – A Diagnostic Approach
• PET/CT Hybrid Imaging Technology at Aga Khan University Hospital
• Diagnostic Tests for Von Willebrand Disease
• Iron Deficiency Anemia
• Sweat Testing for Diagnosis of Cystic Fibrosis
• Flow Cytometric Identification of Abnormal B-Cells
• Direct Immunofluorescence in Bullous Skin Disorders
• Radiology-Pathology Correlation; Orthopedic Pathology
• Fecal Elastase: A Marker For Exocrine Pancreatic Function
• Edward Syndrome: Rare Autosomal Aneuploidy
• Sirolimus in Renal Transplant
• Latest Trends in Clinical Laboratory Science Technology
• Radiology-Neuropathology Correlation
• Nuchal Translucency Scan
• Bio-risk Management System in …

Increased 18f-Fdg-Pet Uptake In Granulomatosis With Polyangiitis: Case Report And Review Of The Literature, Rama El-Yafawi, Patricia Cantlin, Thomas E. Van Der Kloot

Journal of Maine Medical Center

We present an unusual case of granulomatosis with polyangiitis (GPA), which initially presented as a large lung mass, without renal or other systemic features. The lung mass was most concerning for malignancy, and positron emission tomography (PET) further supported this concern, with intense uptake in the mass as well as in mediastinal and hilar lymph nodes. Biopsies however were non-diagnostic, and the patient developed acute kidney injury with active urinary sediment, leading to a definitive diagnosis of GPA. With supportive care and treatment directed at GPA, she was ultimately able to discontinue hemodialysis, and the lung mass resolved. This case …

A Comparative Study Of Short-Term Efficacy And Safety For Thyroid Micropapillary Carcinoma Patients After Microwave Ablation Or Surgery., Jianming Li, Yujiang Liu, Ji-Bin Liu, Peipei Yang, Xiangdong Hu, Linxue Qian

Department of Radiology Faculty Papers

Background: Although papillary thyroid microcarcinoma (PTMC) has a high incidence and excellent clinical outcome, debate continues as to the therapeutic approach that would be most appropriate after confirming the diagnosis.

Methods: We retrospectively analyzed the medical records of 311 patients with T1aN0M0 PTMC between January 2013 and September 2018. In all, 168 underwent microwave ablation (MWA), and 143 underwent surgery. MWA was performed using extensive ablation with hydrodissection. The surgery comprised thyroid lobectomy (TL) with unilateral central lymph node dissection (CND). We examined clinical outcomes during mean follow-up periods of 824 ± 452 days for the TL group and 753 …

A Transfer Learning Approach For Malignant Prostate Lesion Detection On Multiparametric Mri, Quan Chen, Shiliang Hu, Peiran Long, Fang Lu, Yujie Shi, Yunpeng Li

Radiation Medicine Faculty Publications

Purpose: In prostate focal therapy, it is important to accurately localize malignant lesions in order to increase biological effect of the tumor region while achieving a reduction in dose to noncancerous tissue. In this work, we proposed a transfer learning–based deep learning approach, for classification of prostate lesions in multiparametric magnetic resonance imaging images. Methods: Magnetic resonance imaging images were preprocessed to remove bias artifact and normalize the data. Two state-of-the-art deep convolutional neural network models, InceptionV3 and VGG-16, were pretrained on ImageNet data set and retuned on the multiparametric magnetic resonance imaging data set. As lesion appearances differ by …

Solutions To Reduce Unnecessary Imaging., David C. Levin, Vijay M. Rao

Department of Radiology Faculty Papers

No abstract provided.

Scanning For Qi: Resident And Sonographer Driven Improvement Of Radiology Resident Ultrasound Technique, Brian Blumhof, Md, Corinne Wessner, Bs, Rdms, Rvt, Kristen Mcclure, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objective

The aim of this structural QI project is to improve the educational ultrasound curriculum , thus improving overall resident confidence and technical ability in acquiring diagnostic quality sonographic images.

Comparing resident confidence levels and performance against their initial benchmarks as well as against yearly cohorts, we plan to create a long standing addition to the radiology residency at Jefferson, with plans to include additional ultrasound examinations as the curriculum becomes more robust.

Stakeholders include not only the radiology residency, which would benefit from improved resident education and knowledge, but also the hospital and ultimately patients, who stand to benefit …

Neuroimaging Protocol In Patients Presenting With Spontaneous Intracerebral Hemorrhage, Kevin Hines, Md, Nikolaos Mouchtouris, Md, Karim Hafazalla, Jacob M. Mazza, Phillip Phan, Giuliana Labella, Muhammad Athar, Md, Adam Flanders, Md, Pascal Jabbour, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Introduction

While lacking evidence based recommendations, most institutions must evaluate spontaneous intracerebral hemorrhages (sICH) for hematoma expansion (HE). If unrecognized, it can be a devastating complication. However, because of the lack of general recommendations for serial imaging, many hospitals, including Thomas Jefferson, have arbitrarily instituted 6 hour an 24 hour stability head CT’s to evaluate for HE.

In our project, we examine the impact of this imaging protocol on the safety and quality of patient care and provide revised recommendations for imaging in sICH at Thomas Jefferson University Hospital and Jefferson Hospital for Neuroscience.

Does Specific Labelling Of Chest Radiographs To Confirm The Position Of Peripherally Inserted Central Venous Catheters Decrease Turn Around Time?, Patrick Lee, Md, Maansi R. Parekh, Md, Paras Lakhani, Md, Achala Donuru, Md, Baskaran Sundaram, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objectives

The primary objective of the current study was to decrease the turnaround time (TAT) of PICC CXRs. TAT was defined as the time from completion of the study to finalization of the report by the interpreting radiologist.

Reducing Double Chest Ct And Unnecesary Radiation: A Quality Improvement Project, Stephan S. Leung, Md, Mansi R. Parekh, Md, Achala Donuru, Md, Paras C. Lakhani, Md, Christopher G. Roth, Md, Baskaran Sundaram, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objectives

To analyze the variables resulting in double chest CTs being ordered and performed, with the aim to reduce the amount of ordered double chest CTs at Thomas Jefferson University Hospital.

Sternoclavicular Joint Arthropathy Mimicking Radiculopathy In A Patient With Concurrent C4-5 Disc Herniation, Prateek Agarwal, Ab, Nitin Agarwal, Md, David Hansberry, Md, Phd, Neil Majmundar, Md, Ira M. Goldstein, Md

Department of Radiology Faculty Papers

Background

Patients with sternoclavicular joint arthropathy, which can result from septic arthritis, often present with localized sternoclavicular pain as well as shoulder pain. Such pain may be similar to the presenting symptoms of cervical intervertebral disc herniation.

Clinical presentation

A 47-year-old female presented with 1 month of significant pain in the neck as well as right anterior chest and deltoid. The patient was found to have reduced strength in the right deltoid muscle on physical examination. MRI revealed a C4-C5 herniated nucleus pulposus. The patient underwent successful C4-C5 anterior cervical discectomy, but subsequently developed painful swelling in the region of …

First Africa Non-Communicable Disease Research Conference 2017: Sharing Evidence And Identifying Research Priorities, Kenneth Juma, Pamela A. Juma, Shukri F. Mohamed, Jared Owuor, Ann Wanyoike, David Mulabi, George Odinya, Maureen Njeru, Gerald Yonga

Imaging & Diagnostic Radiology, East Africa

Non-communicable diseases (NCDs) prevalence is rising fastest in lower income settings, and with more devastating outcomes compared to High Income Countries (HICs). While evidence is consistent on the growing health and economic consequences of NCDs in sub-Saharan Africa (SSA), specific efforts aimed at addressing NCD prevention and control remain less than optimum and country level progress of implementing evidence backed cost-effective NCD prevention approaches such as tobacco taxation and restrictions on marketing of unhealthy food and drinks is slow. Similarly, increasing interest to employ multi-sectoral approaches (MSA) in NCD prevention and policy is impeded by scarce knowledge on the mechanisms …

A Neonate With Upper Gi Bleeding, Suneeta Khemani, Huma Ghulam Qadir, Mumtaz Malik, Faiqa Hassan

Department of Paediatrics and Child Health

Bleeding in the newborn is often a serious problem because of cardiovascular effects associated with a loss of blood and/or the damaging effects of bleeding on neonatal tissues, especially the brain. Gastric polyps are described as abnormal lesions that originate in the gastric epithelium or submucosa and protrude into the stomach lumen. Clinical presentation of gastric polyps in children varies widely, from incidental endoscopic finding to massive gastrointestinal bleeding. However, acute gastrointestinal bleeding in association with hyperplastic gastric polyps has been reported very rarely. We report a case of unusual upper gastrointestinal bleeding in newborn baby on 2nd day of …

Scintillation Event Localization In Novel Hemi-Ellipsoid Detector For Spect, Hanif R. Soysal

LSU Master's Theses

A high sensitivity Cardiac SPECT system using hemi-ellipsoid crystals with pinhole collimation was previously proposed by Dey et al. To investigate detector resolution for this design, the scintillation light spread on a monolithic hemi-ellipsoidal CsI crystal was simulated using Geant4 Monte Carlo. The expected distribution of scintillation light on the outer surface of the crystal from photoelectric absorption events was obtained from the simulations for selected points inside the crystal. Two sets of simulations were performed. For the first set, a look-up table (LUT) of 12 points was created and each point mapped to its expected light distribution—four points at …

Diagnostic Value Of Two Dimensional Shear Wave Elastography Combined With Texture Analysis In Early Liver Fibrosis., Zhao-Cheng Jian, Jin-Feng Long, Yu-Jiang Liu, Xiang-Dong Hu, Ji-Bin Liu, Xian-Quan Shi, Wei-Sheng Li, Lin-Xue Qian

Department of Radiology Faculty Papers

BACKGROUND: Staging diagnosis of liver fibrosis is a prerequisite for timely diagnosis and therapy in patients with chronic hepatitis B. In recent years, ultrasound elastography has become an important method for clinical noninvasive assessment of liver fibrosis stage, but its diagnostic value for early liver fibrosis still needs to be further improved. In this study, the texture analysis was carried out on the basis of two dimensional shear wave elastography (2D-SWE), and the feasibility of 2D-SWE plus texture analysis in the diagnosis of early liver fibrosis was discussed.

AIM: To assess the diagnostic value of 2D-SWE combined with textural analysis …

Monitoring Progression Of Ductal Carcinoma In Situ Using Photoacoustics And Contrast-Enhanced Ultrasound., Ryan Margolis, Corinne Wessner, Maria Stanczak, Ji-Bin Liu, Jingzhi Li, Kibo Nam, Flemming Forsberg, John R. Eisenbrey

Department of Radiology Faculty Papers

Breast cancer is the leading form of cancer in women, accounting for approximately 41,400 deaths in 2018. While a variety of risk factors have been identified, physical exercise has been linked to reducing both the risk and aggressiveness of breast cancer. Within breast cancer, ductal carcinoma in situ (DCIS) is a common finding. However, less than 25% of DCIS tumors actually progress into invasive breast cancer, resulting in overtreatment. This overtreatment is due to a lack of predictive precursors to assess aggressiveness and development of DCIS. We hypothesize that tissue oxygenation and perfusion measured by photoacoustic and contrast-enhanced ultrasound imaging, …

Radiologic Technology Advanced Placement, Stacy Gosselin

Instructional Design Capstones Collection

The radiologic technology field is rapidly changing. Its technologists and students need to be prepared for these alterations. All students and technologists must pass the national board exam administered by the American registry of Radiologic Technologist. This exam assesses the participant in patient care, image acquisition, radiation safety and imaging procedures. The performance problem identified is the increased amount of radiologic technologists and radiologic technology students either failing the registry due to being unprepared, or due to insufficient continuing education credits. Many of these technologists have been out of the classroom for 20 years, seemed adapted to their own imaging …

Human Immunodeficiency Virus Theranostics, Christopher J. Woldstad

Theses & Dissertations

RATIONALE: Long-acting slow effective release antiretroviral therapy (LASER ART) was developed to improve patient regimen adherence, prevent new infections, and facilitate drug delivery to human immunodeficiency virus cell and tissue reservoirs. However, maintenance of sustained plasma drug levels, for weeks or months, after a single high-level dosing, could improve regimen adherence but, at the same time, affect systemic toxicities. Of these, the most troubling are those that affect the central nervous system (CNS) In an effort to facilitate LASER ART development, “multimodal imaging theranostic nanoprobes” were created. These allow combined bioimaging, drug pharmacokinetics and tissue biodistribution tests in animal …

Framework For Algorithmically Optimizing Longitudinal Health Outcomes: Examples In Cancer Radiotherapy And Occupational Radiation Protection, Lydia Joyce Wilson

LSU Doctoral Dissertations

Background: Advancements in the treatment of non-infectious disease have enabled survival rates to steadily increase in recent decades (e.g., diabetes, heart disease, and cancer). Epidemiological studies have revealed that the treatments for these diseases can have life-threatening and/or life–altering effects. Thus, realizing the full beneficial potential of advanced treatments necessitates new tools to algorithmically consider all major components of the health outcome, including benefit and detriment. The goal of this dissertation was to develop a framework for improving projected health outcomes following planned radiation exposures in consideration of all beneficial and detrimental, early and late, and fatal and non-fatal …

Case Report: Elbow Plica In A High School Pitcher, Steven Barrientos Do, Sunny Gupta Do, Mitesh Patel Md

Rowan-Virtua Research Day

Elbow pain is a very common joint complaint with a variety of etiologies. Plica are often benign, asymptomatic and have no known function. Elbow plica may cause clinical symptoms in the elbow joint after they become hypertrophied or inflamed from repetitive activities or trauma. Symptomatic elbow plica may strike at any age but it is not a common radiographic finding among the pediatric population. In this case report, we are presenting a case of symptomatic left lateral hypertrophic elbow radiocapitellar plica in a 16 year old baseball thrower.

Potential Reduction Of Lung Dose Via Vmat With Jaw Tracking In The Treatment Of Single-Isocenter/Two-Lesion Lung Sbrt, Damodar Pokhrel, Lana Sanford, Matthew Halfman, Janelle A. Molloy

Radiation Medicine Faculty Publications

Purpose/objectives: Due to higher radiosensitivity, non‐target normal tissue dose is a major concern in stereotactic body radiation therapy (SBRT) treatment. The aim of this report was to estimate the dosimetric impact, specifically the reduction of normal lung dose in the treatment of single‐isocenter/two‐lesion lung SBRT via volumetric modulated arc therapy with jaw tracking (JT‐VMAT).

Materials/methods: Twelve patients with two peripherally located early‐stage non‐small‐cell‐lung cancer (NSCLC) lung lesions underwent single‐isocenter highly conformal non‐coplanar JT‐VMAT SBRT treatment in our institution. The mean isocenter to tumors distance was 5.6 ± 1.9 (range 4.3–9.5) cm. The mean combined planning target volume (PTV) was 38.7 …

Assessment Of Magnetic Resonance Imaging Safety: Allied Health Professional Clinical Competence, Tiffany Houser

Electronic Theses and Dissertations

Magnetic resonance imaging is a major advancement in the diagnostic imaging field. Most patients can tolerate an MRI however, there are some who are unable to complete a lengthy scan while lying completely still without sedatives or anesthesia. Non-MRI healthcare providers are trained to use equipment that is “unsafe” in the MRI suite due to the strong magnetic field. Staff who are not fully knowledgeable and trained in MRI safety measures can endanger staff and patients.

The purpose of this study was to determine the knowledge level of non-MRI healthcare providers regarding safety risks associated with MRI and to determine …

Automation, Regulation, And Collaboration: Threats And Opportunities For Clinical Medical Physics Careers In Diagnostic Imaging And Nuclear Medicine., David W. Jordan, Eric L. Gingold, Ehsan Samei

Department of Radiology Faculty Papers

No abstract provided.