Radiology Commons^™

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 …

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 …

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.

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 …

Radiological Comparison Of Tumour Burden Of Lymphoma In Hiv Positive And Hiv Negative Patients, Poonamjeet Kaur Loyal

Theses & Dissertations

Introduction: Patients with Human Immunodeficiency Virus (HIV) are known to exhibit atypical pattern of lymphoma on imaging. There is paucity of literature on differences in tumour volume or burden of disease amongst HIV positive patients compared with HIV negative patients and how this correlates with clinicopathological parameters of aggressiveness and effects on prognosis.

Objective: The purpose of this study was to evaluate the tumour burden of non-Hodgkin’s lymphoma in HIV positive patients compared with HIV negative and how this correlates with the clinicopathological parameters of aggressiveness and the overall clinical outcome.

Methods: This was a retrospective analytical cross-sectional study. All …

Patient Reported Experience In A Radiation Oncology Department, Demetra Yannitsos, Petra Grendarova, Abdulla Al-Rashdan, Linda Watson, Wendy Smith, Fiona Lochray, Jackson Wu, Lisa Barbera

Patient Experience Journal

Understanding patient experience is essential to providing high quality, person-centered care. A real-time baseline cross-sectional study was completed to identify gaps in patient experience that can be targeted for quality improvement (QI). This study is part of PROSE (Person-centered Radiation Oncology Service Enhancement), a QI initiative developed to improve patient experience at a tertiary cancer centre Radiation Oncology (RO) Department. Data was collected using the Your Voice Matters (YVM) questionnaire. The YVM captures information on the patient’s last visit, and questions are organized based on dimensions of person-centered care. Recruitment occurred between May and August 2019 in the radiation department. …

Development Of A Dual Drug-Loaded, Surfactant-Stabilized Contrast Agent Containing Oxygen, Raj Patel, Quezia Lacerda, Brian E Oeffinger, John R. Eisenbrey, Ankit K. Rochani, Gagan Kaushal, Corinne Wessner, Margaret A Wheatley

Department of Radiology Faculty Papers

Co-delivery of cancer therapeutics improves efficacy and encourages synergy, but delivery faces challenges, including multidrug resistance and spatiotemporal distribution of therapeutics. To address these, we added paclitaxel to previously developed acoustically labile, oxygen-core, surfactant-stabilized microbubbles encapsulating lonidamine, with the aim of developing an agent containing both a therapeutic gas and two drugs acting in combination. Upon comparison of unloaded, single-loaded, and dual-loaded microbubbles, size (~1.7 µm) and yield (~2 × 109 microbubbles/mL) (~1.7) were not statistically different, nor were acoustic properties (maximum in vitro enhancements roughly 18 dB, in vitro enhancements roughly 18 dB). Both drugs encapsulated above required doses …

The Benign Mimickers Of Carcinoma On Breast Mri, Irmak Durur-Subasi, Adem Karaman, Elif Demirci, Sare Sipal, Mufide Nuran Akcay

Journal of Mind and Medical Sciences

The similarity between benign and malignant pathologies on magnetic resonance imaging (MRI) and a wide-ranging variability of the lesions from benign proliferative changes to invasive breast carcinoma cause a lower and wide-ranging specificity of breast MRI relative to its surpass sensitivity. A wide range of tissue components such as the skin, the adipose tissue, vascular and neural tissues, connective tissues, glandular tissues, ducts, and muscle tissues are found here all together. This pictorial review was aimed at deliberating benign mimickers of breast carcinoma on MRI and trying to call attention to the overlapping and distinctive features.

Alpha-Fetoprotein (Afp) And Afp-L3 Is Most Useful In Detection Of Recurrence Of Hepatocellular Carcinoma In Patients After Tumor Ablation And With Low Afp Level, Madison Force, Grace Park, Divya Chalikonda, Christopher G. Roth, Micah Cohen, Dina Halegoua-De Marzio, Hie-Won Hann

Department of Medicine Faculty Papers

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and is a leading cause of mortality worldwide. While there are many risk factors for HCC including alcohol, obesity, and diabetes, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection still account for the majority of HCC worldwide. Globally, HBV is the leading risk factor for HCC. Patients with chronic hepatitis B (CHB) and advanced liver disease are at high risk for HCC. Screening for HCC is done routinely with ultrasound with or without alpha-fetoprotein (AFP) at six-month intervals. The combination of ultrasound and AFP has been …

Making Waves: How Ultrasound-Targeted Drug Delivery Is Changing Pharmaceutical Approaches., Lauren J Delaney, Selin Isguven, John R Eisenbrey, Noreen J Hickok, Flemming Forsberg

Department of Radiology Faculty Papers

Administration of drugs through oral and intravenous routes is a mainstay of modern medicine, but this approach suffers from limitations associated with off-target side effects and narrow therapeutic windows. It is often apparent that a controlled delivery of drugs, either localized to a specific site or during a specific time, can increase efficacy and bypass problems with systemic toxicity and insufficient local availability. To overcome some of these issues, local delivery systems have been devised, but most are still restricted in terms of elution kinetics, duration, and temporal control. Ultrasound-targeted drug delivery offers a powerful approach to increase delivery, therapeutic …

Mcph1: A Novel Case Report And A Review Of The Literature, Stefano Giuseppe Caraffi, Marzia Pollazzon, Muhammad Farooq, Ambrin Fatima, Lars Allan Larsen, Roberta Zuntini, Manuela Napoli, Livia Garavelli

Department of Biological & Biomedical Sciences

Microcephaly primary hereditary (MCPH) is a congenital disease characterized by nonsyndromic reduction in brain size due to impaired neurogenesis, often associated with a variable degree of intellectual disability (ID). The genetic etiology of MCPH is heterogeneous and comprises more than 20 loci, nearly all following a recessive inheritance pattern. The first causative gene identified, MCPH1 or Microcephalin, encodes a centrosomal protein that modulates chromosome condensation and cell cycle progression. It is also involved in DNA damage response and telomere maintenance in the nucleus. Despite numerous studies on MCPH1 function, MCPH1-affected individuals are rare and the available clinical reports are …

Pre And Postnatal Magnetic Resonance Imaging Of Ventriculomegaly, Ryan Kelsch, Megan Moore, Anant Krishnan

Posters

Purpose or Case Report: The purpose of this research was to analyze our institution’s large database of fetal magnetic resonance (MR) for cases of ventriculomegaly in order to understand trends in pre and postnatal MR.
Methods & Materials: In this retrospective study, 316 individual fetal MR exams from the past 10 years at our institution were reviewed. Of those, 86 patients had fetal MRs with findings of either ventriculomegaly or an ordering indication of ventriculomegaly. Our inclusion criteria of a diagnosis of ventriculomegaly (lateral ventricle measured at the trigone on coronal imaging of over 10mm) on fetal MR with a …

Identifying The 'Vulnerable Plaque' In Asymptomatic Carotid Artery Disease Patients, Zia Ur Rehman

Department of Surgery

No abstract provided.

18 Fdg Pet/Ct Imaging In Carcinoma Cesophagus, Maseeh Uz Zaman, Nosheen Fatima

Department of Radiology

No abstract provided.

Virtual Meetings During Covid-19 Pandemic: Is It Time To Say Goodbye To Physical Meetings?, Maseeh Uz Zaman, Nosheen Fatima

Department of Radiology

Abstract are not provided by the author/publisher

Development And Validation Of Standard And Real Patient Gallstone Library Using Fourier Transform Infra-Red Spectroscopy, Lena Jafri, Muhammad Abbas Abid, Humera Asif, Syed Bilal Hashmi, Hafsa Majid, Farooq Ghani, Sibtain Ahmed, Imran Siddiqui, Aysha Habib

Department of Pathology and Laboratory Medicine

Background: Analysis of the constituents of gallstones using various spectroscopic techniques assists in identification of the pathogenesis of gallstones. In the current study, using Fourier Transform Infra-Red (FTIR) Spectroscopy, a Gallstone Standard Library (GSL) and a Gallstone Real Patients' Library (GRPL) were developed and validated for gallstone composition analysis.
Methods: The study was conducted at the Department of Pathology & Laboratory Medicine, Aga Khan University, Pakistan. Pure standards (cholesterol, calcium carbonate, bilirubin and bile salts) and gallstone specimens were analyzed using FTIR Nicolet iS-5 Spectrometer from Thermo Fisher Scientific, USA. Thermo Scientific™ QCheck™ algorithm, embedded within the OMNIC™ software, was …

Efficacy And Safety Of Direct Oral Anticoagulants With And Without Aspirin: A Systematic Review And Meta-Analysis, Talal Almas, Adeena Musheer, Arooba Ejaz, Fahd Niaz Shaikh, Anousheh Awais Paracha, Fizza Raza, Maryam Sarwar Khan, Fahad Masood, Faiza Siddiqui, Muhammad Hasnain Mankani

Medical College Documents

Background: Various anticoagulant therapies are prescribed to patients under physicians' discretion and recently Direct Oral Anticoagulants(DOAC) have been under trials to evaluate their safety and efficacy. In addition to this, the regimen of DOACs and Aspirin is of keen interest as researchers continue to find an optimal regimen to treat blood clots in patients. This study is a systematic review and meta-analysis of randomized controlled trials and observational studies that asses the safety and efficacy of DOAC with and without Aspirin.
Methods: We queried MEDLINE and Cochrane CENTRAL from their inception to April 2021, for published and randomized controlled …

Idiopathic Midaortic Syndrome, David Saul, Rahul Nikam, Vinay Kandula, Achala Donuru

Department of Radiology Faculty Papers

Midaortic syndrome (MAS) is characterized by narrowing of the descending aorta between the distal aortic arch and the aortic bifurcation. We present the case of a 4-year-old male presenting with a murmur and diagnosed with MAS. He was treated with a thoracoabdominal bypass graft.

Practical Needs And Considerations For Refugees And Other Forcibly Displaced Persons With Neurological Disorders: Recommendations Using A Modified Delphi Approach, Shawheen Rezaei, Foksouna Sakadi, Fu-Liong Hiew, Ildefonso Rodriguez-Leyva, Jera Kruja, Mohammad Wasay, Osheik Abuasha Seidi, Saad Abdel-Aziz, Shahriar Nafissi, Farrah Mateen

Section of Neurology

Background: There are >70 million forcibly displaced people worldwide, including refugees, internally displaced persons, and asylum seekers. While the health needs of forcibly displaced people have been characterized in the literature, more still needs to be done globally to translate this knowledge into effective policies and actions, particularly in neurology.
Methods: In 2020, a global network of published experts on neurological disease and refugees was convened. Nine physician experts from nine countries (2 low, 1 lower-middle income, 5 upper-middle, 1 high income) with experience treating displaced people originating from 18 countries participated in three survey and two discussion rounds in …