Medicine and Health Sciences Commons^™

Applications Of Deep Learning With Detecting Intracranial Aneurysms On Ct Angiograms: A Literature Review, Christian Fang, Emily Wang

Rowan-Virtua Research Day

INTRODUCTION

Deep learning is a method of artificial intelligence involving progressively layered neural networks to extrapolate patterns from data to provide predictions. Moreover, given the arduous nature required for examining CT scans for intracranial aneurysms, discovering ways to expedite this process is beneficial. The use of deep learning to evaluate CT angiograms for intracranial aneurysms has been sparsely studied. This literature review aims to determine the accuracy and reliability of deep learning to analyze CT angiograms in patients suspected to have intracranial aneurysms.

METHODS

A qualitative review of literature using PubMed, SCOPUS, and EMBASE was conducted. Inclusion criteria comprised articles …

Unveiling The Potential: The Role Of Ai-Enhanced Ecg In Cardiovascular Disease Detection, Alisha Vincent

Rowan-Virtua Research Day

Background: The Electrocardiogram (ECG) is a widely utilized, non-invasive, cost-effective cardiac test. Its integration with Artificial Intelligence (AI) has empowered it to become a potent screening tool and a predictor for various cardiovascular diseases, especially in asymptomatic individuals. Objective: This review investigates the utility of AI-powered ECG in early detection of cardiac conditions, focusing on conditions such as low ejection fraction (LEF), atrial fibrillation (AF), aortic valve stenosis (AVS), and cardiac amyloidosis (CA). Methods: A literature review spanning 2018 to 2024 was conducted, analyzing 10 articles - 3 on AF, 3 on AVS, 3 on LEF, and …

Ultrasound Versus Radiography For Evaluating Surgical Necrotizing Enterocolitis, Sayed H. Aftab, Santiago Martinez-Correa, Minh-Huy Huynh, Wondwossen T. Lerebo, Jorge Delgado, Rebecca Denis, Misun Hwang

Rowan-Virtua Research Day

Purpose:

Necrotizing enterocolitis (NEC) is an abdominal inflammatory condition that is common in premature neonates. Although abdominal radiograph (AR) remains the imaging standard for NEC, it may miss up to 50% of early signs of NEC and has been described to have a sensitivity as low as 15.4% for detecting pneumoperitoneum. Abdominal ultrasound (US) is portable, non-invasive, and allows real-time bowel integrity, movement, and perfusion assessment. We aim to evaluate the concordance between US and AR in detecting NEC features and the diagnostic performance of both modalities in detecting pneumoperitoneum.

Methods and materials:

We conducted an IRB-approved retrospective, cross-sectional, single-center …

Using Fmri To Assess Effectiveness Of Olanzapine Treatment For Schizophrenia, William Kyle Copenhaver, David F. Lo, Hanna Rothenberg, Eeshan Khurana, Valerie Rome, Uzayr Wasif, Don D. Shamilov

Rowan-Virtua Research Day

Schizophrenia is a complex mental illness with neurobiological underpinnings and misconceptions about violence. Schizophrenia is associated with high levels of creativity and structural traits like fewer D2 receptors. Patients face reduced life expectancy due to cardiovascular diseases and cope through smoking and sedentariness. Treatment involves pharmacological antipsychotics like olanzapine and nonpharmacological approaches. Olanzapine works by antagonizing D2 receptors but has side effects like weight gain and diabetes risk. fMRI is used to study treatment mechanisms and predict response, but research on olanzapine's brain network effects is limited.

Uti With A New Renal Mass: Chicken Or The Egg?, Grant Nugent, Adam Sigal, Courtney Cassella

Tower Health Research Day

No abstract provided.

Is There Any Benefit To Adding Corticosteroids To Radiofrequency Ablation Treatments: A Systemic Review., Lee James, Petar Jen, Nikolas Jen, Stefan Jen

Research Day

Introduction: Radiofrequency ablation (RFA) is a procedure done for chronic pain which uses thermal energy to nociceptive pathways with the goal of disrupting pain signaling. The thermal energy leads to nervous tissue disruption using radiofrequency currents through an electrode placed near the target area. RFA has been shown to have an increase in pain reduction as well as an increase in functional ability when compared to corticosteroid injections (CSI), another common treatment for both acute and chronic pain. Many clinicians have logically combined RFA and CI together to achieve a synergistic effect. This study aims to look at the current …

Degree Of Uncertainty In Reporting Imaging Findings For Necrotizing Enterocolitis: A Secondary Analysis From A Pilot Randomized Diagnostic Trial, Disa Rathore, Kira Bourrett, Sherwin S. Chan, Erin Opfer, Alain Cuna

Research Days

Background: Uncertainty in reporting of imaging findings for necrotizing enterocolitis (NEC) can be challenging for clinicians and result in ambiguity, miscommunication, and potential diagnostic errors. The degree to which uncertainty complicates diagnostic imaging for NEC has not been characterized.

Objective: To determine the degree of uncertainty in diagnostic imaging for NEC.

Methods: We conducted a retrospective study using data from a previously completed pilot diagnostic randomized clinical trial (RCT). The study population comprised of preterm infants with suspected NEC who were randomized to either standard imaging with abdominal radiographs (AXR) alone or experimental imaging with AXR + add-on bowel ultrasound …

A Radiologic Analysis: Relationships Of The Thoracic Spine To Aid Palpation Of The Thoracic Transverse Processes, Christopher Baker, Darshan Patel, Michael B. Roberts, Kristie Petree, Randall L. Mcgill

Research Day

Introduction: In the field of osteopathic manipulative medicine, palpation is an important skill used by physicians to localize structures to diagnose and treat patients with somatic dysfunction throughout the musculoskeletal system. Specifically, in the thoracic spine, physicians can use the more superficial spinous process of each vertebra to assist in locating the deeper, more challenging to palpate, transverse process of the vertebra. Historically, the “rule of threes”, proposed by Mitchell et al in 1979, describing the relationships between spinous processes and transverse processes of the thoracic spine has been taught in osteopathic medical schools. However, another model was more recently …

Dislodged Endovascular Heat-Induced Thrombus Resulting In Pulmonary Embolus Following Post-Operative Ultrasound Compression, Danielle Park, Aghilas Belkadi, Luke Perry, Michael Kachmar, Holly Graves

Rowan-Virtua Research Day

Introduction: Venous insufficiency and consequent varicose veins are common problems faced by many patients. Fortunately, there are many treatment options available including a minimally invasive method known as radiofrequency ablation (RFA). RFA is not without complications; amongst those are endovascular heat induced thrombosis (EHIT). This rare complication is typically managed conservatively; however, in rare occasions, the thrombus can detach and embolize causing further issues for patients.

Case Description: A 48-year-old male underwent an uneventful RFA procedure for a CEAP 4a venous insufficiency. On the post-operative ultrasound venous duplex evaluation, the patient was found to have EHIT type 2 in the …

Case Report: Use Of Bedside Handheld Ultrasound To Diagnose Finger Dislocation, Frank Wheeler, Philip Carhart, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Here we present the case of a 37-year-old male with a finger injury in which finger dislocation was suspected clinically. A bedside pocket ultrasound was performed using a water submersion technique, which identified a posterior dislocated right 2nd digit at the PIP joint. This finding was confirmed with an x-ray. This case report demonstrates that ultrasonography can be utilized to correctly identify finger dislocation. Although larger studies need to be performed to validate the accuracy of this imaging technique, the implications may improve care of the patient. It would also be particularly beneficial for this technique to be applied to …

Removal Of Permanent Ivc Filter, Sarah Aleman, Hector Ferral

Medical Student Research Poster Symposium

A 53-year-old woman with history of Crohn’s disease was referred to interventional radiology for inferior vena cava (IVC) filter removal with the diagnosis of a fractured IVC filter. At the time of evaluation, in early 2022, the patient reported back pain. No imaging was available when the patient was first seen. The IVC filter was originally placed in 2011. The indication for filter placement was the presence of deep vein thrombosis (DVT) shortly after small bowel resection. At the time, anticoagulation was contraindicated. Upon spectral CT imaging, several legs of the IVC filter were found to be protruding outside the …

Pulmonary Pseudoaneurysm Due To Penetrating Thoracic Trauma, Michael Mcmahon, Andrew Ea, Hector Ferral

Medical Student Research Poster Symposium

Background: Pulmonary artery pseudoaneurysm (PAP) is a rare but potentially lethal condition. Acquired PAPs are most commonly caused by iatrogenic trauma and infectious disease. Infectious causes include bacterial endocarditis, tuberculosis, mucormycosis, and pyogenic infection. Traumatic PAPs can be caused iatrogenically by pulmonary artery catheterization. Very few cases have been described of patients developing PAP as a complication of a gunshot wound to the chest. Radiologic findings of PAP include hilar enlargement or a new focal lung mass on chest radiograph. CT angiography shows saccular or fusiform areas of dilatation with homogenous contrast filling which occurs simultaneously with the pulmonary artery. …

Osteomyelitis Of The Clivus Secondary To Mucormycosis: A Rare Case Study, Davin Evanson, Ramiz Ahmad, Michael Romeo Do

Tower Health Research Day

No abstract provided.

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 …

Diagnostic Imaging Read By Ai-Assisted Technology Within The Emergency Department, Joshua Leland

Capstone Showcase

Introduction: The emergency department (ED) has had an appreciable increase in volume over the past two decades with more individuals utilizing the ED now than a decade ago which has placed a strain on healthcare resources. Specifically adding to the rising costs in healthcare are diagnostics including chest x-rays. To combat this, institutions across the nation are developing deep-learning and artificial intelligence (AI) programs to assist in reading these diagnostics. Therefore, this systematic review analyzes the use of AI programs by clinicians in the ED to read diagnostic imaging compared to those who do not use these algorithms.

Methods: This …

The Relevance Of More Training Data On Accuracy Of Model Prediction On Chest X-Ray, Ardenne S. Martin, Carl F. Sabottke, Bradley M. Spieler

Medical Student Research Poster Symposium

Background: Artificial Intelligence (AI) has the potential to augment radiologist workflow and decrease strain on radiologists. Development of deep neural networks, artificial neural networks with neurons, synapses, weights, and functions, can be used to train AI models, serving as a response to this need. Publicly available databases like MIMIC-CXR and ChestX-ray8 offer hundreds of thousands of chest x-rays (CXR) used to train neural network models to detect and localize devices or disease. These publicly available databases make training AI models on large datasets possible. Once models are aptly trained, however, challenges include implementation into hospital Picture Archiving and Communication Systems …

Effects Of Breast Cancer Screening Guidelines: A Retrospective Analysis Ofbreast Cancer Patients Under Age 50 In A University Academic Center, Kaylee Woodard, Jane Ball, Brooke Morrell

Medical Student Research Poster Symposium

In 2009, the U.S. Preventative Services Task Force (USPSTF) released updated breast cancer screening guidelines recommending against routine screening mammography in women aged 40-49. The task forceconcluded that the decision to start regular, biennial screening mammography before age 50 years should be an individual one considering patient context, including the patient's values regarding specific benefits and potential harms. In January 2016, the USPSTF reinforced these guidelines in their Final Recommendation Statement grading screening mammography prior to age 50 as a Grade C, stating there is at least moderate certainty that the net benefit is small. Despite the USPSTF’s findings, it …

Infection Imaging, Techniques And Trends: A Radiology Research Alliance (Rra) Taskforce Report, Claire Bise, Prabhakar Rajiah

Medical Student Research Poster Symposium

Infectious diseases are caused by a wide spectrum of organisms and can present in myriad fashion. They are important contributors to morbidity and mortality. While some infections are localized to specific organs, others can cause systemic illness. Identification of source of infection is a very important step in the management of infections but may be occasionally challenging due to non-specific symptoms and signs. Imaging plays an important role in the diagnosis and localization of infection. Several anatomical and functional imaging modalities are available, with the choice of specific imaging modality dependent on the clinical presentation as well as availability of …

Comparing Semi-Automated Segmentation Of Traditional-Resolution And High-Resolution Hyperpolarized 129xe Mri On Covid-19 Survivors, Tingting Wu

Undergraduate Student Research Internships Conference

Hyperpolarized gas MRI using inert gases like Xe is a valuable tool in visualizing lung ventilation in patients, and can be used as a longitudinal monitoring tool for patients with lung diseases. However, use of this method requires segmentation and quantification of parameters such as ventilation defect percentage (VDP), which is often very subjective depending on the observer. This study aimed to determine the accuracy and consistency of VDP calculation using the same MRI scans from COVID-19 patients, but with high resolution and low (traditional) resolution versions. Using a MATLAB script developed previously, it was found that in general, using …

Pediatric Pulmonary Artery Aneurysms Causing Pulmonary Hemorrhage: A Case Of Transcatheter Intervention While On Va Ecmo Support, Igor Areinamo

Research Days

Background: The incidence of pulmonary artery aneurysm (PAA) in children remains unknown. There are few reports of a transcutaneous interventional approach to address this type of pathology. Management of PAAs while on VA ECMO has not been described in pediatrics.

Objectives/Goal:

Methods/Design:

Case: 9-year-old previously healthy male presented with MRSA associated ARDS and sepsis requiring urgent VA ECMO cannulation. Chest CT done on ECMO day 22 showed development of right sided PAAs. Patient had an episode of significant pulmonary hemorrhage. Angiogram demonstrated two fusiform right PAAs, one of which had ruptured and was bleeding into the lung parenchyma. Patient had …

The Application Of Point-Of-Care Ultrasound In Ed Intubations And Airway Access: A Systematic Review, Frank Wheeler, James Espinosa, Alan Lucerna, Jeffrey Gardecki

Rowan-Virtua Research Day

Intubation is an essential procedure performed on a routine basis in the emergency room. Unsuccessful intubations are associated with deleterious outcomes. A systematic review was performed to investigate the accuracy of point of care ultrasound (POCUS) in successful Endotracheal Tube (ET) tube confirmation, utilizing ultrasonography, identification of the cricothyroid membrane utilizing ultrasound, and dynamically during use of ultrasonography in the process of intubation. This review demonstrated high sensitivity and specificity for ultrasound confirmation of ET tube placement, high success rate in ultrasound-guided intubation, and lower than expected accuracy in identifying the cricothyroid membrane. Ultrasonography should be considered for ET tube …

C25: The “Spot Sign”: A Predictor Of Hematoma Expansion, Mckenzie Merritt

Annual Research Symposium

No abstract provided.

Reading Room Assistance Pilot: Improving Radiologist Workflow, Michael Hoy, Md, Christopher G. Roth, Md, Ms-Hqs, Rashmi Balasubramanya, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aims for Improvement

Our aim for improvement was to find ways to decrease distractions and phone calls in the body radiology reading room and to convert unpredictable and “immediate-response distractions” to “managed distractions” that can be addressed without aborting patient care/case interpretation immediately and unnecessarily. The goal was to decrease interruptions which would allow more time to be spent on reading cases, learning, and teaching. One metric that we identified was the number of phone calls to the reading room, which we intend to decrease by 50% within the first quarter. Another metric was the radiology attending and resident attitudes …

Scanning For Qi: Outcomes From A 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 (2020-)

Objective

The aim of this structural quality improvement (QI) project was to improve the educational ultrasound curriculum.

We created the pilot for an enduring addition to the radiology residency at Jefferson, with plans to include additional ultrasound examinations as the curriculum becomes more robust.

Stakeholders included 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 improved delivery of care.

Improving Primary Prevention Of Coronary Artery Disease In Women Using Breast Arterial Calcifications Seen On Screening Mammography, Rachel Redfield, Md, Sarah Kamel, Md, Rani Rajaram, Md, Kathryn Anderson, Ba, Matthew Metzinger, Mba, Kamini Patel, Bsn, Lydia Liao, Md, Katherine Sherif, Md, Yair Lev, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Study Aims

• To create an interdisciplinary task force focused on identifying women with CVD by reporting presence of BAC on screening mammograms.
• To monitor the clinical impact of reporting BAC.

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.

Deep Learning, Medical Physics And Cargo Cult Science., Miguel Romero Phd, Gilmer Valdes Phd, Timothy Solberg Phd, Yannet Interian Phd

Creative Activity and Research Day - CARD

Deep learning algorithms have become widely popular, with considerable success in fields where datasets have hundreds of thousands or million points. As deep learning is increasingly applied to the fields of medical physics and radiation oncology, a reasonable question follows: are these techniques the best approach, given the unique conditions in our field? In this study, we investigate the dependence of dataset size on the performance of deep learning algorithms compared with more traditional radiomics-based methods.

The Pivotal Role Of Mri In The Diagnosis Of Listeria Rhomboencephalitis, K.R Uprety, M Reza Taheri

GW Research Days 2016 - 2020

Sixty-six year-old female presented to the Emergency Department with history of several days of headache, malaise, chills, and fatigue with accompanying nausea, vomiting, and inability to tolerate oral intake. She had no history of fever and remained afebrile at the time of presentation. Physical exam and immediate lab values were non-contributory; CSF was obtained and sent for analysis. The patient was placed preemptively on acyclovir, as viral meningitis was the admitting diagnosis. MRI of the brain showed abnormal FLAIR signal hyperintensity and enhancement involving the entire cisternal segment of the left trigeminal nerve, which extended dorsally along the nerve fiber …

Breast Lesions Detected Via Molecular Breast Imaging: Physiological Parameters Affecting Interpretation, Jason Ching, Rachel Brem

GW Research Days 2016 - 2020

Rationale and Objectives:

To evaluate correlations between molecular breast imaging (MBI) descriptor characteristics and positive predictive value (PPV) in detecting breast cancer.

Materials and Methods:

A retrospective review was performed on 193 suspicious findings from 153 women (31-81 years) with positive MBI examinations. We assessed associations between: (i) lesion pattern (mass vs. non-mass) and PPV; (ii) lesion pattern and suspected likelihood of cancer (low vs. moderate vs. high); (iii) background parenchymal uptake (BPU) (homogeneous vs. heterogeneous) and PPV; (iv) breast density (dense vs. non-dense) and PPV; (v) BPU and density.

Results:

One hundred ten of 153 patients were diagnosed with …

Enriching The Medical Student Radiology Clerkship: Simulating The Radiologist’S Experience, Liqi Shu, Faraien Bahri, Navid Mostaghni, Ramin Javan

GW Research Days 2016 - 2020

Background

Current radiology training in medical schools is still predominantly limited to passively observing the radiologist at the workstation and through lectures, textbooks and online sources. Evaluation is also mainly limited on still image interpretation or knowledge-based multiple-choice questions. Furthermore, students may have specific interests based on their choice of residency. In order to create a tailored and active learning experience, and to evaluate students’ ability in image interpretation, we utilized an open-source web-based Picture archiving and communication system (PACS) named "Weasis" and integrated a report system.

Method

We establish a new PACS teaching system by utilizing the open-source PACS …