Radiology Commons^™

Financial Toxicity Tumor Board: A Multi-Disciplinary Team Activity Required In Low And Middle-Income Countries (Lmic), Ahmed Nadeem Abbasi, Sohail Rasool, Laraib Khan

Department of Radiation Oncology

No abstract provided.

Extrusion: A New Method For Rapid Formulation Of High-Yield, Monodisperse Nanobubbles, Claire Counil, Eric Abenojar, Reshani Perera, Agata A. Exner

Faculty Scholarship

Shell-stabilized gas microbubbles (MB) and nanobubbles (NB) are frequently used for biomedical ultrasound imaging and therapeutic applications. While it is widely recognized that monodisperse bubbles can be more effective in these applications, the efficient formulation of uniform bubbles at high concentrations is difficult to achieve. Here, it is demonstrated that a standard mini-extruder setup, commonly used to make vesicles or liposomes, can be used to quickly and efficiently generate monodisperse NBs with high yield. In this highly reproducible technique, the NBs obtained have an average diameter of 0.16 ± 0.05 µm and concentration of 6.2 ± 1.8 × 1010 NBs …

Aspnr Programing: Interesting Pediatric Neuroradiology Case Session (Sa-Cme): Seizures., A Krishnan

Conference Presentation Abstracts

No abstract provided.

The Onus On The Conus: A Neuroimaging Spectrum Of Conus Medullaris Pathologies, A Dearden, J Ghannam, A Wang, A Krishnan

Conference Presentation Abstracts

Purpose The conus medullaris is the tapered, cone-shaped end of the distal thoracic spinal cord, normally terminating near the L1-2 intervertebral disc space. As a junction between the cord and the cauda equina nerve roots, the conus can present with common cord pathologies in atypical presentations, as well as present with unique, complex pathologies found nowhere else in the cord. The conus is optimally evaluated with MRI of the lumbar spine before and after the administration of contrast medium. Accurate diagnosis of lesions within the conus is complicated by the nonspecific nature of increased intramedullary signal on T2-weighted MRI imaging, …

A Rare Case Of Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy, A Dearden, J Doty, A Krishnan, J Fellows

Conference Presentation Abstracts

Purpose This is a 69-year-old male who presented with cognitive decline, hypophonia, dyspraxia, course tremor, myoclonic jerks, and gait dysfunction, all developing over 3-4 weeks. Initial head CT and MRI brain without contrast were negative. EEG demonstrated diffuse slowing. CSF analysis revealed elevated protein and elevated white blood cells (lymphocyte predominant). Given neurological worsening, MRI brain and cervical spine with contrast were performed and unique findings were identified, detailed below. The CSF autoimmune panel returned positive for Glial Fibrillary Acidic Protein (GFAP). The patient was started on steroids with rapid clinical improvement. Materials and Methods MRI brain with contrast 2 …

Benign And Malignant Cervical Lymphadenopathy: A Practical Imaging Approach To The Diagnosis Of Common And Uncommon Conditions, A Dhaliwal, J Sharma, S Noujaim

Conference Presentation Abstracts

Purpose Generally, cervical lymphadenopathy is a benign, self-limited, and reactive process that is frequently encountered, especially in the pediatric population. However, when present in the setting of a neoplastic process, cervical lymphadenopathy is an important prognostic factor that can alter patient management. Determining the etiology of cervical lymphadenopathy is as essential as its detection. Etiologies include infection, granulomatous disease, malignancy, autoimmune disorders, iatrogenic causes, and miscellaneous or unusual conditions. Careful attention to clinical history and laboratory findings and the use of appropriate radiological imaging is crucial to obtaining the correct diagnosis. A variety of cases, including benign and malignant processes, …

Spontaneous Aneurysmal Subdural Hemorrhage: A Rare Entity, M Rizk, A Khan, J Ghannam, M Waheed

Conference Presentation Abstracts

Purpose 36-year-old female who presented to our emergency department for worsening headache and new onset left sided diplopia. Physical exam confirmed a left 3rd nerve palsy. A CT of the head was obtained which showed a subdural hemorrhage which ultimately resulted in coil embolization of a ruptured aneurysm. The patient tolerated the procedure well and was closely followed for vasospasm development with routine transcranial ultrasounds which were negative. Patient remained stable and reported resolution of her headache symptoms on discharge. However, she continued to have a left 3rd nerve palsy. Materials and Methods CT of the head was obtained which …

Neuroimaging Spectrum Of Non-Compressive Non-Neoplastic Myelopathy, J Ghannam, A Dearden, R Joshi, A Wang, K Barry

Conference Presentation Abstracts

Purpose Non-compressive, non-neoplastic spinal cord lesions represent a broad range of disease processes and entities. Most commonly, spinal cord lesions demonstrate T2 signal abnormality on magnetic resonance imaging, a relatively nonspecific finding requiring a variety of differentiating factors to build an accurate differential diagnosis (1). Additionally, many disease entities have significant overlapping features on MRI, rendering it difficult to separate diagnoses and guide management (2). The combination of signal characteristics on MRI, timing of clinical presentation, degree of cord expansion, and contrast enhancement patterns can provide improved differentiation between disease entities. The purpose of this exhibit is to educate the …

Vertebral Artery Pathology: A Review Of Diagnosis And Angiographic Intervention, R Joshi, A Abbas, J Wilseck

Conference Presentation Abstracts

Purpose The vertebral arteries are a critical component of the spinal and posterior intracranial circulation. Their associated pathologies are wide ranging including traumatic and congenital causes. Given the profound impact on patient management and outcomes, a careful evaluation of the vertebral artery with a firm understanding of normal anatomy is required to properly rule out pathology. This educational exhibit will provide an overview of the normal anatomy of the vertebral arteries and a case-based review of a large spectrum of their pathologies, including traumatic, spontaneous, iatrogenic, and congenital. Utilization of various imaging modalities including, CTA, MRA, angiography, and ultrasound will …

Neuroimaging Spectrum Of Compressive Non-Neoplastic Myelopathy, A Dearden, J Ghannam, A Wang, A Krishnan

Conference Presentation Abstracts

Purpose Compressive non-neoplastic spinal cord lesions represent a broad spectrum of neurologic disease processes contributing to back pain and neuropathy, including traumatic, inflammatory/infectious, degenerative, and metastatic etiologies. Compressive cord lesions are optimally evaluated with high-field strength magnet MRI with and without contrast. Differential diagnoses for cord lesions are inherently broad due to the nonspecific nature of increased intramedullary signal on T2-weighted images seen with many cord pathologies. However, differentiating features such as degree of cord expansion, enhancement characteristics, and extramedullary findings can provide additional information to refine the differential diagnosis. In this exhibit, we present representative cases of compressive non-neoplastic …

Sex Differences In The Association Between Cardiovascular Diseases And Dementia Subtypes: A Prospective Analysis Of 464,616 Uk Biobank Participants, Caiyun Dong, Chunmiao Zhou, Chunying Fu, Wenting Hao, Akihiko Ozaki, Nipun Shrestha, Salim S. Virani, Shiva Raj Mishra, Dongshan Zhu

Office of the Provost

Background: Whether the association of cardiovascular diseases (CVDs) with dementia differs by sex remains unclear, and the role of socioeconomic, lifestyle, genetic, and medical factors in their association is unknown.
Methods: We used data from the UK Biobank, a population-based cohort study of 502,649 individuals. We used Cox proportional hazards models to estimate sex-specific hazard ratios (HRs) and 95% confidence intervals (CI), and women-to-men ratio of HRs (RHR) for the association between CVD (coronary heart diseases (CHD), stroke, and heart failure) and incident dementia (all-cause dementia, Alzheimer's Disease (AD), and vascular dementia (VD)). The moderator roles of socioeconomic (education, income), …

Atypical Presentation Of Ankylosing Spondylitis, Chandni Patel, Milvin Shroff, Maleeha Memon, Shideh Doroudi, Christine Leroy

Rowan-Virtua Research Day

Radiographic axial spondyloarthritis axSpA ) or typical ankylosing spondyloarthritis (AS) is a classification of axial spondyloarthritis with the classic radiographic features of sacroiliitis. Axial spondyloarthritis is a disabling spondyloarthropathy of the spine that presents with chronic back pain usually before the age of 45. It may be associated with extraspinal features including dactylitis , synovitis, and enthesitis in addition to other nonarticular signs. Chronic back pain is one of the most common presenting symptoms for AS , but frequently there is a 5-7 year delay between the onset of symptoms and diagnosis of the disease . A standard AP plain …

Comparing Radiological Characteristics Of Neck Pain In Younger Versus Older Patients: A Retrospective Analysis, Jnana Aditya Challa, Abdul Majid Khan, Varna Taranikanti

Posters

INTRODUCTION
Neck pain commonly occurs during the fifth or sixth decade of life due to degenerative changes in the spine. With increased usage of digital technology from a very young age we hypothesized an earlier age of onset of these degenerative changes. There have been no recent epidemiologic studies that investigated difference in radiological changes seen in older versus younger patients presenting with neck pain. Hence, this study is undertaken to analyze the variability in radiological changes seen in the cervical vertebrae between older (>50) versus younger (≤50) patients presenting with the chief complaint of neck pain.

Irreversible Electroporation For Recurrent Pelvic Metastases: Case Series And Literature Review, Duncan A. Stevens, Jeffrey H. Savin, Brett J. Friedman, Michael A. Savin

Posters

INTRODUCTION
Irreversible electroporation (IRE) is a nonthermal ablative technique that has potential safety advantages over thermal ablation in the treatment of tumors near critical structures. It creates an electrical field which forms permanent nanopores in the membranes of cells and triggers apoptosis. This case series reviews three patients with pelvic metastases from colorectal cancer treated with IRE.

Integration Of Biomedical Imaging And Translational Approaches For Management Of Head And Neck Cancer, Abdallah Mohamed, Abdallah Mohamed

Dissertations & Theses (Open Access)

The aim of the clinical component of this work was to determine whether the currently available clinical imaging tools can be integrated with radiotherapy (RT) platforms for monitoring and adaptation of radiation dose, prediction of tumor response and disease outcomes, and characterization of patterns of failure and normal tissue toxicity in head and neck cancer (HNC) patients with potentially curable tumors. In Aim 1, we showed that the currently available clinical imaging modalities can be successfully used to adapt RT dose based-on dynamic tumor response, predict oncologic disease outcomes, characterize RT-induced toxicity, and identify the patterns of disease failure. We …

Hepatocellular Carcinoma Image-Guided Intervention: Quantitative Characterization Of Reagents For Thermochemical Ablation, Emily A. Thompson

Dissertations & Theses (Open Access)

Thermochemical ablation (TCA) is a minimally invasive therapy under development for hepatocellular carcinoma, a leading cause of cancer death worldwide. TCA utilizes acid-base chemistry delivered simultaneously to induce local ablation when administered. When delivered via a mixing catheter placed directly into the tumor, acid (e.g., AcOH) and base (e.g., NaOH) react to completion at the catheter tip, producing the acetate salt, water, and releasing heat (Δ>50°C) in sufficient quantities to induce lethal osmotic and thermal stress in tumor cells. However, these two reagents are not distinguishable from tissues with noninvasive imaging modalities, which makes monitoring the delivery of TCA …

Large Aortic Pseudoaneurysm After Bentall Procedure In A Patient With Marfan's Syndrome., David Saul, Vinay Kandula, Achala Donuru, Christian Pizarro, Mary Patricia Harty

Department of Radiology Faculty Papers

An 11-year-old male with Marfan's syndrome and aortic root dilatation underwent an uneventful Bentall procedure to replace his aortic root and valve. Five months later, surveillance echocardiogram revealed a slowly enlarging pseudoaneurysm arising from the ascending aorta. This finding was subsequently confirmed by computed tomographic angiogram. The patient had successful open surgical repair and paraaortic hematoma evacuation.

Association Between Ct Severity Score And Clinical Severity Score Of Covid-19 Pneumonia At Aga Khan University Hospital, Nairobi, Paul Kareithi Nduati

Theses & Dissertations

Background: Imaging with chest computed tomography (CT) has demonstrated a role in stratifying COVID-19 patients into different clinical severity groups thus facilitating appropriate care decisions. In a limited number of settings, the wider applicability and reproducibility of these findings is unclear.

Objectives: To determine the association between chest CT severity score and clinical severity of illness in RT-PCR confirmed SARS-CoV2 patients. To evaluate the relationship of CT chest severity score with short term clinical outcome of patients.

Methods: CT chest of 172 SARS-CoV2 patients who accessed care at Aga Khan University Hospital Nairobi between 14th March and 31st December 2020 …

Diagnostic Accuracy Of Axillary Ultrasound In Predicting Nodal Metastasis Among Patients With Early Breast Cancer At Aga Khan University Hospital, Nairobi, David Mwaniki

Theses & Dissertations

With emerging evidence showing that the incidence of breast cancer in Kenya is increasing, there is renewed emphasis on screening, early detection, and management of breast cancer. Early breast cancer (EBC) has a better prognosis and is potentially curable. Axillary nodal metastasis is an important prognostic indicator in breast cancer. Axillary ultrasound is the best modality for assessing, and managing, the affected nodes. It is a readily available and versatile tool with several sonographic nodal characteristics suggestive of metastatic involvement having been described in previous studies. Axillary ultrasound (AUS) performance in predicting nodal metastasis has yielded variable results which are …

Optimal Fasting Duration To Effectively Suppress Physiological 18f- Fluorodeoxyglucose (Fdg) Myocardial Uptake On A Positron Emission Tomography Scan., Fatima Abdullahi Ali

Theses & Dissertations

Background: Positron emission tomography (PET) with 18F fluorodeoxyglucose (FDG) is used in evaluation of inflammatory disorders, including the heart such as cardiac sarcoidosis and myocarditis. However, the normal uptake of the myocardium is a challenge as it can obscure pathological uptake in these conditions. The primary objective of this study is to determine the optimal fasting duration to suppress physiological myocardial uptake and thereafter establish an imaging protocol.

Methods: Patients who had whole body FDG PET CT examination for oncological evaluation at the Aga Khan University Hospital between January 2019 and December 2020 were retrospectively reviewed. Patients were divided into …