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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, Maine Medical Center Radiation Oncology, Ruth Hanselman, Stephen Tyzik, Suneela Nayak, Amy Sparks 2019 Maine Medical Center

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, Maine Medical Center Radiation Oncology, Ruth Hanselman, Stephen Tyzik, Suneela Nayak, Amy Sparks

Operational Excellence

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 ...


Target(R) Intracranial Aneurysm Coiling Prospective Multicenter Registry: Final Analysis Of Peri-Procedural And Long-Term Safety And Efficacy Results, Osama O. Zaidat, Ajit S. Puri 2019 Bon Secours Mercy Health St. Vincent Hospital

Target(R) Intracranial Aneurysm Coiling Prospective Multicenter Registry: Final Analysis Of Peri-Procedural And Long-Term Safety And Efficacy Results, Osama O. Zaidat, Ajit S. Puri

Radiology Publications

Background and Purpose: To describe the final results of the TARGET Registry, a multicenter, real-world study of patients with intracranial aneurysms treated with new generation TARGET Coils. .

Methods: The TARGET Registry is a prospective, single-arm study with independent medical event monitoring and core-lab adjudication. Patients with de novo intracranial aneurysms were embolized with either TARGET-360 degrees or helical coils in 12 US centers. The primary outcome was aneurysm packing density (PD), which was assessed immediately post-procedure. The secondary outcomes were immediate and long-term aneurysm occlusion rate using the Raymond Scale, and independent functional outcome using the modified Rankin Scale (mRS ...


Sarcopenia In Lung Cancer: Could Chest Imaging Help?, Jennifer Baima, Elke Sarah Schipani, Wasih Kamran, John M. Varlotto, Lacey J. McIntosh, Karl Uy, Isabel Emmerick, Mathew J. Most 2019 University of Massachusetts Medical School

Sarcopenia In Lung Cancer: Could Chest Imaging Help?, Jennifer Baima, Elke Sarah Schipani, Wasih Kamran, John M. Varlotto, Lacey J. Mcintosh, Karl Uy, Isabel Emmerick, Mathew J. Most

Orthopedics and Physical Rehabilitation Publications

Introduction: Fifteen to seventy percent of cancer patients demonstrate sarcopenia.1-6,[i],[ii],[iii],[iv],[v],[vi],[vii],[viii],[ix],[x],[xi],[xii],[xiii] Analysis of iliopsoas cross-sectional area, a non-invasive surrogate measure for sarcopenia in patients with cancer has been associated with survival.[xiv],[xv],[xvi],[xvii] The pectoralis muscle may be a more accessible target for measuring sarcopenia in lung cancer patients,[xviii] but it is not known if it this correlates with iliopsoas cross-sectional area. Since measurements vary, it is most accurate to use internal controls. We attempted to examine the cross-sectional area of the two muscles ...


Hepatic Epithelioid Angiomyolipoma Treated With Laparoscopic Resection: Case Report And Review Of The Literature, Chloe H. Williams, Kelli Hickle, Katherine Bakke, Sarah Jamshed, Adel Bozorgzadeh 2019 University of Massachusetts Medical School

Hepatic Epithelioid Angiomyolipoma Treated With Laparoscopic Resection: Case Report And Review Of The Literature, Chloe H. Williams, Kelli Hickle, Katherine Bakke, Sarah Jamshed, Adel Bozorgzadeh

Open Access Articles

Hepatic angiomyolipoma is a rare primary liver tumor, with a radiographic appearance very similar to hepatocellular carcinoma. We present the case of a noncirrhotic patient with a liver tumor suspicious for HCC by imaging features. Liver biopsy demonstrated angiomyolipoma, and the patient successfully underwent a laparoscopic liver resection.


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

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 2019 Norwegian American Hospital

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 ...


Accelerated Knee Osteoarthritis Is Associated With Pre-Radiographic Degeneration Of The Extensor Mechanism And Cruciate Ligaments: Data From The Osteoarthritis Initiative, Julie E. Davis, Matthew S. Harkey, Robert J. Ward, James W. MacKay, Bing Lu, Lori Lyn Price, Charles B. Eaton, Grace H. Lo, Mary F. Barbe, Timothy E. McAlindon, Jeffrey B. Driban 2019 Tufts Medical Center

Accelerated Knee Osteoarthritis Is Associated With Pre-Radiographic Degeneration Of The Extensor Mechanism And Cruciate Ligaments: Data From The Osteoarthritis Initiative, Julie E. Davis, Matthew S. Harkey, Robert J. Ward, James W. Mackay, Bing Lu, Lori Lyn Price, Charles B. Eaton, Grace H. Lo, Mary F. Barbe, Timothy E. Mcalindon, Jeffrey B. Driban

Open Access Articles

BACKGROUND: To determine if adults with incident accelerated knee osteoarthritis (KOA) are more likely to have degenerative knee ligaments or tendons compared to individuals with typical or no KOA.

METHODS: We identified 3 sex-matched groups among Osteoarthritis Initiative participants who had a knee without radiographic KOA at baseline (Kellgren-Lawrence [KL] < 2): 1) accelerated KOA: at least 1 knee had KL grade > /= 3 in < /=48 months, 2) typical KOA: at least 1 knee increased in radiographic scoring within 48 months, 3) no KOA: both knees had the same KL grade at baseline and 48 months. We evaluated knee magnetic resonance images up to 2 years before and after a visit when the accelerated or typical KOA criteria were met (index visit). Radiologists reported degenerative signal changes for cruciate and collateral ligaments, and extensor mechanism and proximal gastrocnemius tendons. We used generalized linear mixed models with 2 independent variables: group and time.

RESULTS: Starting at least 2 years before onset, adults with accelerated KOA were twice as likely to have degenerative cruciate ligaments than no KOA (odds ratio = 2.10, 95% CI = 1.18, 3.74). A weaker association (not statistically significant) was detected for adults with accelerated versus typical ...


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 2019 Capital Medical University

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 ± 520 ...


A Transfer Learning Approach For Malignant Prostate Lesion Detection On Multiparametric Mri, Quan Chen, Shiliang Hu, Peiran Long, Fang Lu, Yujie Shi, Yunpeng Li 2019 University of Kentucky

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 ...


Solutions To Reduce Unnecessary Imaging., David C. Levin, Vijay M. Rao 2019 Thomas Jefferson University

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

Department of Radiology Faculty Papers

No abstract provided.


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 2019 Thomas Jefferson University

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.


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 2019 Thomas Jefferson University

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.


Scanning For Qi: Resident And Sonographer Driven Improvement Of Radiology Resident Ultrasound Technique, Brian Blumhof, MD, Corinne Wessner, BS, RDMS, RVT, Kristen McClure, MD 2019 Thomas Jefferson University

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 from ...


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 2019 Thomas Jefferson University

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.


Benign Breast Cyst In A Young Male, Nima Azimi, Azniv Azar, Ashraf Khan, Carolynn M. DeBenedectis 2019 University of Massachusetts Medical School

Benign Breast Cyst In A Young Male, Nima Azimi, Azniv Azar, Ashraf Khan, Carolynn M. Debenedectis

Radiology Publications

Simple benign breast cysts are commonly diagnosed in female breasts and may present as palpable masses. However, they are extremely uncommon in the male breast and are rarely reported in the literature. Here, we report a case of a simple benign cyst of the breast in a relatively healthy 37-year-old man. The patient initially presented with a palpable 2-3 mm tender left breast lump. Further evaluation with mammography and ultrasound revealed a mass most consistent with a simple benign cyst. However, considering the rarity of breast cysts in males, the lesion was biopsied to rule out malignancy. Pathology results from ...


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 2019 University of Pennsylvania

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 ...


Scintillation Event Localization In Novel Hemi-Ellipsoid Detector For Spect, Hanif R. Soysal 2019 Louisiana State University and Agricultural and Mechanical College

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 ...


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 2019 Capital Medical University; Affiliated Hospital of Weifang Medical University

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 ...


Early Pre-Radiographic Structural Pathology Precedes The Onset Of Accelerated Knee Osteoarthritis, Matthew S. Harkey, Julie E. Davis, Bing Lu, Lori Lyn Price, Robert J. Ward, James W. MacKay, Charles B. Eaton, Grace H. Lo, Mary F. Barbe, Ming Zhang, Jincheng Pang, Alina C. Stout, Timothy E. McAlindon, Jeffrey B. Driban 2019 University of Massachusetts Medical School

Early Pre-Radiographic Structural Pathology Precedes The Onset Of Accelerated Knee Osteoarthritis, Matthew S. Harkey, Julie E. Davis, Bing Lu, Lori Lyn Price, Robert J. Ward, James W. Mackay, Charles B. Eaton, Grace H. Lo, Mary F. Barbe, Ming Zhang, Jincheng Pang, Alina C. Stout, Timothy E. Mcalindon, Jeffrey B. Driban

Open Access Articles

BACKGROUND: Accelerated knee osteoarthritis (AKOA) is characterized by more pain, impaired physical function, and greater likelihood to receive a joint replacement compared to individuals who develop the typical gradual onset of disease. Prognostic tools are needed to determine which structural pathologies precede the development of AKOA compared to individuals without AKOA. Therefore, the purpose of this manuscript was to determine which pre-radiographic structural features precede the development of AKOA.

METHODS: The sample comprised participants in the Osteoarthritis Initiative (OAI) who had at least one radiographically normal knee at baseline (Kellgren-Lawrence [KL] grade < 1). Participants were classified into 2 groups based on radiographic progression from baseline to 48 months: AKOA (KL grade change from < 1 to > 3) and No AKOA. The index visit was ...


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 2019 Thomas Jefferson University

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 ...


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