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Articles 1321 - 1350 of 2330

Full-Text Articles in Medical Specialties

Adaptation Of A Standardized Handoff System For A Radiology Residency Program, Riti Kanesa-Thasan, Md, Liya Gendler, Md, Megan Margiotta, Md, Kristin Lohr, Md, Grant Turner, Md, Rebecca C. Jaffe, Md, Christopher G. Roth, Md, Suzanne Long, Md Jun 2018

Adaptation Of A Standardized Handoff System For A Radiology Residency Program, Riti Kanesa-Thasan, Md, Liya Gendler, Md, Megan Margiotta, Md, Kristin Lohr, Md, Grant Turner, Md, Rebecca C. Jaffe, Md, Christopher G. Roth, Md, Suzanne Long, Md

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

Background/Objectives:

  • The Joint Commission has linked communication failure as a root cause for a majority of sentinel events.
  • The “I-PASS” system is a hand-off mnemonic that has been shown to decrease medical errors, prevent adverse events, and improve communication.
  • Multiple Jefferson residency programs have adopted I-PASS training over the last year to standardize sign-outs between treatment teams and departments.
  • Radiology residents also participate in hand-offs with other departments, especially in cases of adverse patient reactions that occur within radiology (ie: allergic reaction, seizure, contrast extravasation). In addition, radiology residents also participate in hand offs between daytime and overnight teams, including …


A Bibliometric Analysis Of The Top 100 Cited Articles On Hepatic Magnetic Resonance Imaging., Waqas Ullah, Hafez Mohammad A. Abdullah, Ejaz Ahmad, Mamoon Ur Rashid, Muhammad Bashir, Asad Ur Rahman, Asrar Ahmad, Abu Hurairah Jun 2018

A Bibliometric Analysis Of The Top 100 Cited Articles On Hepatic Magnetic Resonance Imaging., Waqas Ullah, Hafez Mohammad A. Abdullah, Ejaz Ahmad, Mamoon Ur Rashid, Muhammad Bashir, Asad Ur Rahman, Asrar Ahmad, Abu Hurairah

Abington Jefferson Health Papers

The purpose of this study is to guide the readers to the impact of the articles published on hepatic magnetic resonance imaging (MRI). We searched Scopus using 10 different search terms for hepatic MRI. The selected studies were thoroughly reviewed by two independent authors and any disagreement was sorted out by mutual consensus. The list of articles and journals was downloaded into an excel spreadsheet. Only the top 100 cited articles were selected by mutual consensus among all the authors. These articles were further read in the full-text form and were further categorized into subgroups. Three authors independently reviewed the …


Successful Embolization Of A Enterocutaneous Fistula Tract With Onyx 34 Following Low Anterior Resection For Rectal Cancer., Hamza Rahimi, Anthony C Venbrux, Vincent Obias Jun 2018

Successful Embolization Of A Enterocutaneous Fistula Tract With Onyx 34 Following Low Anterior Resection For Rectal Cancer., Hamza Rahimi, Anthony C Venbrux, Vincent Obias

Radiology Faculty Publications

Enterocutaneous fistulas (ECFs) can be one of the complications found after surgical intervention for rectal cancer. Interventional modalities consisting of surgical, endoscopic, and radiological methods are often implemented to treat postoperative symptomatic complications. We present the case of 61-year-old Caucasian man who presented to us with a recent diagnosis of rectal cancer that had invaded the levators as well as anteriorly into the prostate, and who underwent low anterior resection with a diverting loop ileostomy. The patient was found to have a persistent presacral abscess due to an ECF tract. This case highlights the off-label use of ethylene-vinyl alcohol copolymer …


Ultrasound-Guided Introital Drainage Of Pyometrocolpos, I Kim, Ranjith Vellody, Hans G. Pohl, Karun Sharma, Kabir Yadav Jun 2018

Ultrasound-Guided Introital Drainage Of Pyometrocolpos, I Kim, Ranjith Vellody, Hans G. Pohl, Karun Sharma, Kabir Yadav

Radiology Faculty Publications

Pyometrocolpos can be caused by congenital malformations such as distal vaginal atresia and imperforate hymen. Patients usually present with obstructive urinary tract infections, acute kidney injury, or sepsis. Percutaneous drainage of the infected fluid can help treat the patient; however, recurrence is of concern. In this case report, we present a case of a child with recurrent pyometrocolpos due to distal vaginal atresia despite initial percutaneous drainage. To our knowledge, this is the first report of ultrasound-guided introital drainage of pyometrocolpos with relief of symptoms obviating the need for repeat drainage or immediate surgery. © 2017


Unicameral Bone Cysts: Current Concepts, Shahryar Noordin, Salim Allana, Masood Umer, Mujahid Jamil, Kiran Hilal, Nasir Ud Din Jun 2018

Unicameral Bone Cysts: Current Concepts, Shahryar Noordin, Salim Allana, Masood Umer, Mujahid Jamil, Kiran Hilal, Nasir Ud Din

Section of Orthopaedic Surgery

Unicameral bone cysts (UBC) or simple/solitary bone cysts are benign fluid filled cavities that enlarge over time, resulting in thinning of the bone. Usually these cysts are reported in the metaphyseal areas of long bones with open physes. 85% of UBCs occur almost exclusively in children and adolescents. UBCs are more aggressive in the first decade of life and correspondingly the recurrence rate for these patients is four times that for adolescents. The proximal humerus and femur account for almost 90% of these cases. UBCs are classified as active when they are within 1 cm of the physis and latent …


Metachronous Renal Ewing Sarcoma/Primitive Neuroectodermal Tumour In A Survivor Of Burkitt Lymphoma, Kumail Khandwala, Kiran Hilal, Zehra Fadoo, Khurram Minhas Jun 2018

Metachronous Renal Ewing Sarcoma/Primitive Neuroectodermal Tumour In A Survivor Of Burkitt Lymphoma, Kumail Khandwala, Kiran Hilal, Zehra Fadoo, Khurram Minhas

Department of Radiology

We present a case of a 14-year-old girl who was diagnosed with Burkitt lymphoma in 2014. She was managed with chemotherapy and remained in remission for 3 years. On her surveillance imaging in 2017, a left-sided renal neoplastic mass was incidentally discovered. She underwent nephrectomy and pathology of the resected specimen revealed small cell tumour of the kidney with features favouring renal Ewing sarcoma/primitive neuroectodermal tumour. Molecular genetic analysis by fluorescence in situ hybridisation was performed which showed translocation of 22q12, thereby confirming the diagnosis. This is a rare secondary malignancy and an unusual association. This case highlights the importance …


Defining The Radioresponse Of Mossy Cells, Devon Ivy Jun 2018

Defining The Radioresponse Of Mossy Cells, Devon Ivy

Electronic Theses, Projects, and Dissertations

Clinical radiotherapy is used to treat a variety of brain tumors within the central nervous system. While effective, it can result in progressive and debilitating cognitive impairment that can diminish quality of life. These impairments have been linked to hippocampal dysfunction and corresponding deficits in spatial learning and memory. Mossy cells are a major population of excitatory neurons located within the dentate hilus and highly involved in hippocampal circuitry. They play critical roles in spatial navigation, neurogenesis, memory, and are particularly vulnerable to a variety of neurotoxic insults. However, their sensitivity to ionizing radiation has yet to be investigated in …


Determining The Level Of Agreement For Atherosclerotic Cardiovascular Disease Risk Stratification Between Coronary Artery Calcium Score And Traditional Cardiovascular Risk Models., Menge Kuria May 2018

Determining The Level Of Agreement For Atherosclerotic Cardiovascular Disease Risk Stratification Between Coronary Artery Calcium Score And Traditional Cardiovascular Risk Models., Menge Kuria

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Estimating the risk of future cardiovascular (CV) events is an essential step in the management and prevention of cardiovascular diseases. Many cardiovascular risk tools are available such as the Framingham Risk Score (FRS), the American Heart Association/ American College of Cardiology (AHA/ACC) and the International Society of Hypertension and World Health Organization (ISH/WHO) risk charts. Regrettably, none of these tools has yet to be validated based on data from our Kenyan population. This study, therefore, sought to compare the accuracy of FRS and ACC/AHA in a Kenyan population. The risk estimates derived from the CV tools were correlated with …


Prevalence Of Metastatic Disease In Newly Diagnosed Breast Cancer Patients As Seen On Contrast Enhanced Computed Tomography Of The Chest, Abdomen And Pelvis At The Aga Khan University Hospital, Nairobi., Gregory Obala May 2018

Prevalence Of Metastatic Disease In Newly Diagnosed Breast Cancer Patients As Seen On Contrast Enhanced Computed Tomography Of The Chest, Abdomen And Pelvis At The Aga Khan University Hospital, Nairobi., Gregory Obala

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Breast cancer patients have traditionally been screened for occult metastases with abdominal ultrasound, chest radiography and bone scan although the use of modern tests with greateraccuracy such as computed tomography (CT), 2-[fluorine-18] fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) and Magnetic resonance (MR) imaging is on the increase. The use of contrast enhanced CT (CECT) in the staging of patients with newly diagnosed breast cancer has increased greatly in clinical practice in view of it being widely available and relatively cheapwhen compared to other modalities such as MRI and PET imaging. The clinical utility of routine staging CECT is yet …


Collaborative Task-Sharing To Enhance The Point-Of-Care Ultrasound (Pocus) Access Among Expectant Women In Kenya: The Role Of Midwife Sonographers, Sudhir Vinayak, Sharon Brownie May 2018

Collaborative Task-Sharing To Enhance The Point-Of-Care Ultrasound (Pocus) Access Among Expectant Women In Kenya: The Role Of Midwife Sonographers, Sudhir Vinayak, Sharon Brownie

Imaging & Diagnostic Radiology, East Africa

Unrealized maternal and child health goals continue to challenge Kenya where adverse outcomes remain high and diagnostic services are limited. The acute shortage of doctors and radiographers requires alternate human resources for health (HRH) with the ability to identify risk factors in pregnancy through Point-Of-Care Ultrasound (POCUS). A specialist radiologist and ultrasonography team partnered with midwives to adopt interprofessional task sharing and capacity building. Faculty from the Radiology Department of our hospital designed and implemented the project which was carried out at three outreach health service centres. Designing and implementing a training model to skill midwife sonographers with the capacity …


Recurrent Hotspot Mutations In Hras Q61 And Pi3k-Akt Pathway Genes As Drivers Of Breast Adenomyoepitheliomas., Felipe C. Geyer, Anqi Li, Anastasios D. Papanastasiou, Alison Smith, Pier Selenica, Kathleen A. Burke, Marcia Edelweiss, Huei-Chi Wen, Salvatore Piscuoglio, Anne M. Schultheis, Luciano G. Martelotto, Fresia Pareja, Rahul Kumar, Alissa Brandes, Dan Fan, Thais Basili, Arnaud Da Cruz Paula, John R. Lozada, Pedro Blecua, Simone Muenst, Achim A. Jungbluth, Maria P. Foschini, Hannah Y. Wen, Edi Brogi, Juan P. Palazzo, Brian P. Rubin, Charlotte K.Y. Ng, Larry Norton, Zsuzsanna Varga, Ian O. Ellis, Emad A. Rakha, Sarat Chandarlapaty, Britta Weigelt, Jorge S. Reis-Filho May 2018

Recurrent Hotspot Mutations In Hras Q61 And Pi3k-Akt Pathway Genes As Drivers Of Breast Adenomyoepitheliomas., Felipe C. Geyer, Anqi Li, Anastasios D. Papanastasiou, Alison Smith, Pier Selenica, Kathleen A. Burke, Marcia Edelweiss, Huei-Chi Wen, Salvatore Piscuoglio, Anne M. Schultheis, Luciano G. Martelotto, Fresia Pareja, Rahul Kumar, Alissa Brandes, Dan Fan, Thais Basili, Arnaud Da Cruz Paula, John R. Lozada, Pedro Blecua, Simone Muenst, Achim A. Jungbluth, Maria P. Foschini, Hannah Y. Wen, Edi Brogi, Juan P. Palazzo, Brian P. Rubin, Charlotte K.Y. Ng, Larry Norton, Zsuzsanna Varga, Ian O. Ellis, Emad A. Rakha, Sarat Chandarlapaty, Britta Weigelt, Jorge S. Reis-Filho

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Adenomyoepithelioma of the breast is a rare tumor characterized by epithelial-myoepithelial differentiation, whose genetic underpinning is largely unknown. Here we show through whole-exome and targeted massively parallel sequencing analysis that whilst estrogen receptor (ER)-positive adenomyoepitheliomas display PIK3CA or AKT1 activating mutations, ER-negative adenomyoepitheliomas harbor highly recurrent codon Q61 HRAS hotspot mutations, which co-occur with PIK3CA or PIK3R1 mutations. In two- and three-dimensional cell culture models, forced expression of HRAS


Rapid Assessment Of Adults With Traumatic Brain Injuries, Pedro Colio May 2018

Rapid Assessment Of Adults With Traumatic Brain Injuries, Pedro Colio

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project was to improve the medical screening process, enhance medical decision-making, and standardized the utilization of an adult traumatic brain injury neuroimaging guideline among advanced practice providers in a rural emergency department. Neuroimaging, specifically computed tomography (CT) scans, help to identify life-threatening intracranial injuries when clinically appropriate. The literature supports the utilization of neuroimaging guidelines, clinical exam, and provider expertise when identifying the need for a head CT scan. Although head CT scans are clinically useful, they increase healthcare costs and pose potential cancer risks from radiation exposure. Eight advanced practice providers (i.e., nurse practitioners, …


Design And Development Of A Phantom For Tomosynthesis With Potential For Automated Analysis Via The Cloud., David Goodenough, Josh Levy, Hildur Olafsdottir, Ingvi Olafsson May 2018

Design And Development Of A Phantom For Tomosynthesis With Potential For Automated Analysis Via The Cloud., David Goodenough, Josh Levy, Hildur Olafsdottir, Ingvi Olafsson

Radiology Faculty Publications

This paper describes Development of a Phantom for Tomosynthesis with Potential for Automated Analysis via the Cloud. Several studies are underway to investigate the effectiveness of Tomosynthesis Mammographic Image Screening, including the large TMIST project as funded by the National Cancer Institute https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/tmist. The development of the phantom described in this paper follows initiatives from the FDA, the AAPM TG245 task group, and European Reference Organization (EUREF) for Quality Assured Breast Screening and Diagnostic Services Committee report noting, that no formal endorsement nor recommendation for use has been sought, or granted by any of these groups. This paper reports on …


Development And Validation Of A 28-Gene Hypoxia-Related Prognostic Signature For Localized Prostate Cancer., Lingjian Yang, Darren Roberts, Mandeep Takhar, Nicholas Erho, Becky A.S. Bibby, Niluja Thiruthaneeswaran, Vinayak Bhandari, Wei-Chen Cheng, Syed Haider, Amy M.B. Mccorry, Darragh Mcart, Suneil Jain, Mohammed Alshalalfa, Ashley Ross, Edward Schaffer, Robert Den, R. Jeffrey Karnes, Eric Klein, Peter J. Hoskin, Stephen J. Freedland, Alastair D. Lamb, David E. Neal, Francesca M. Buffa, Robert G. Bristow, Paul C. Boutros, Elai Davicioni, Ananya Choudhury, Catharine M.L. West May 2018

Development And Validation Of A 28-Gene Hypoxia-Related Prognostic Signature For Localized Prostate Cancer., Lingjian Yang, Darren Roberts, Mandeep Takhar, Nicholas Erho, Becky A.S. Bibby, Niluja Thiruthaneeswaran, Vinayak Bhandari, Wei-Chen Cheng, Syed Haider, Amy M.B. Mccorry, Darragh Mcart, Suneil Jain, Mohammed Alshalalfa, Ashley Ross, Edward Schaffer, Robert Den, R. Jeffrey Karnes, Eric Klein, Peter J. Hoskin, Stephen J. Freedland, Alastair D. Lamb, David E. Neal, Francesca M. Buffa, Robert G. Bristow, Paul C. Boutros, Elai Davicioni, Ananya Choudhury, Catharine M.L. West

Department of Radiation Oncology Faculty Papers

BACKGROUND: Hypoxia is associated with a poor prognosis in prostate cancer. This work aimed to derive and validate a hypoxia-related mRNA signature for localized prostate cancer.

METHOD: Hypoxia genes were identified in vitro via RNA-sequencing and combined with in vivo gene co-expression analysis to generate a signature. The signature was independently validated in eleven prostate cancer cohorts and a bladder cancer phase III randomized trial of radiotherapy alone or with carbogen and nicotinamide (CON).

RESULTS: A 28-gene signature was derived. Patients with high signature scores had poorer biochemical recurrence free survivals in six of eight independent cohorts of prostatectomy-treated patients …


Lumbar Artery Pseudoaneurysm Following Renal Biopsy., Basit Salam, Kumail Khandwala May 2018

Lumbar Artery Pseudoaneurysm Following Renal Biopsy., Basit Salam, Kumail Khandwala

Department of Radiology

Lumbar artery pseudoaneurysms have previously been described as rare iatrogenic complications following percutaneous interventional procedures involving the flanks. We describe a case of a 71-year-old man who became unstable and dropped 3 grams of hemoglobin within 24 hours following renal biopsy. A post-biopsy hemorrhage was suspected, and a pseudoaneurysm of his second right lumbar (L2) artery was found on computed tomography angiogram (CTA). Successful coil embolization was performed in the right L2 artery. This case discusses the diagnostic and therapeutic challenges of this unusual complication as well as the anatomical and technical factors involved in the embolization of the lumbar …


Development Of 3d-Printed Patient Specific Bolus For Clinical Use In To Tal Scalp Irradiation, Garrett Baltz May 2018

Development Of 3d-Printed Patient Specific Bolus For Clinical Use In To Tal Scalp Irradiation, Garrett Baltz

Dissertations and Theses (Open Access)

Total scalp irradiation (TSI) is a specialized radiation therapy technique that aims to deliver a uniform dose to the entire scalp. Original electron-based TSI techniques had limited homogeneity due to hot and cold spots created at field junctions due to the multiple matched fields that were required to treat the entire scalp. The transition to photon volumetric-modulated arc therapy based TSI techniques has improved homogeneity, to the point where non-conformal bolus is now a limiting factor. Bolus is required to build-up full dose to the scalp surface in total scalp irradiation. Creating bolus that is conformal to the scalp is …


Routine Antenatal Ultrasound In Low- And Middle-Income Countries: First Look - A Cluster Randomised Trial, Robert L. Goldenberg, Robert O. Nathan, David Swanson, Sarah Saleem, Waseem Mirza, Fabian Esamai, David Muyodi, Ana L. Garces, Lester Figueroa, Elwyn Chomba May 2018

Routine Antenatal Ultrasound In Low- And Middle-Income Countries: First Look - A Cluster Randomised Trial, Robert L. Goldenberg, Robert O. Nathan, David Swanson, Sarah Saleem, Waseem Mirza, Fabian Esamai, David Muyodi, Ana L. Garces, Lester Figueroa, Elwyn Chomba

Community Health Sciences

Objective: Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centers in resource-limited countries.
Design: Cluster randomized trial.
Settings: Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia).
Methods: Clusters were randomized to standard ANC or standard care plus two ultrasounds and referral for complications. The study trained providers in intervention clusters to perform basic obstetric ultrasounds.
Main Outcome Measures: The primary outcome was a composite of maternal mortality, maternal near-miss mortality, stillbirth, and neonatal mortality. …


Tmsotf Assisted Synthesis Of 2’-Deoxy-2’-[18f] Fluoro-Β-D-Arabinofuranosylcytosine ([18f] Fac), Kishore K. Gangangari, John L. Humm, Steven M. Larson, Naga Vara Kishore Pillarsetty May 2018

Tmsotf Assisted Synthesis Of 2’-Deoxy-2’-[18f] Fluoro-Β-D-Arabinofuranosylcytosine ([18f] Fac), Kishore K. Gangangari, John L. Humm, Steven M. Larson, Naga Vara Kishore Pillarsetty

Publications and Research

[18F]FAC (2’-deoxy-2’-[18F]fluoro-β-D-arabinofuranosylcytosine, 1) is a versatile probe for imaging deoxycytidine kinase (dCK) expression levels in vivo. dCK is responsible for phosphorylation of deoxycytidine (dC, 2) and other nucleoside analogs, plays a key role in immune activation and has demonstrated to be one of the key enzymes in activating nucleoside based drugs including gemcitabine. Reported synthesis of [18F]FAC is high yielding but is quite challenging requiring bromination using HBr and careful drying of excess HBr which is critical for successful synthesis. Here in we report a simplified trimethylsilyl trifluoromethanesulfonate (TMSOTf) assisted synthesis …


Going Beyond The Final Impression With Radiologic Data In The Era Of Clerical Medicine: A Case Report Of Coronary Artery Disease Found Incidentally On Computed Tomography, Andrea M. Lauffer Apr 2018

Going Beyond The Final Impression With Radiologic Data In The Era Of Clerical Medicine: A Case Report Of Coronary Artery Disease Found Incidentally On Computed Tomography, Andrea M. Lauffer

Marshall Journal of Medicine

Introduction:

Given the challenges in modern healthcare, physicians find themselves devoting a great deal of mental and emotional energy into executing the appropriate care for patients as well as performing their daily clerical duties. Many clinicians have resorted to innovative ways to minimize their tasks which often leads to narrowing the focus of a patient’s overall care and the birth of medical errors described in the Swiss cheese effect model.

Case Description:

A 66 year old male established care with a new primary care physician. Previous radiologic data revealed a pulmonary nodule that did not have appropriate follow up imaging. …


Contrast-Enhanced Ultrasound Identifies Early Extrahepatic Collateral Contributing To Residual Hepatocellular Tumor Viability After Transarterial Chemoembolization., Sriharsha Gummadi, Maria Stanczak, Andrej Lyshchik, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey Apr 2018

Contrast-Enhanced Ultrasound Identifies Early Extrahepatic Collateral Contributing To Residual Hepatocellular Tumor Viability After Transarterial Chemoembolization., Sriharsha Gummadi, Maria Stanczak, Andrej Lyshchik, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

The mainstay of treatment for unresectable hepatocellular carcinoma is locoregional therapy including percutaneous ablation and transarterial chemo- and radioembolization. While monitoring for tumor response after transarterial chemoembolization is crucial, current imaging strategies are suboptimal. The standard of care is contrast-enhanced magnetic resonance imaging or computed tomography imaging performed at least 4 to 6 weeks after therapy. We present a case in which contrast-enhanced ultrasound identified a specific extra-hepatic collateral from the gastroduodenal artery supplying residual viable tumor and assisting with directed transarterial management.


A Review Of Clinical Radioprotection And Chemoprotection For Oral Mucositis., Bryan Oronsky, Sharad Goyal, Michelle M Kim, Pedro Cabrales, Michelle Lybeck, Scott Caroen, Neil Oronsky, Erica Burbano, Corey Carter, Arnold Oronsky Apr 2018

A Review Of Clinical Radioprotection And Chemoprotection For Oral Mucositis., Bryan Oronsky, Sharad Goyal, Michelle M Kim, Pedro Cabrales, Michelle Lybeck, Scott Caroen, Neil Oronsky, Erica Burbano, Corey Carter, Arnold Oronsky

Radiology Faculty Publications

The first tenet of medicine, "primum non nocere" or "first, do no harm", is not always compatible with oncological interventions e.g., chemotherapy, targeted therapy and radiation, since they commonly result in significant toxicities. One of the more frequent and serious treatment-induced toxicities is mucositis and particularly oral mucositis (OM) described as inflammation, atrophy and breakdown of the mucosa or lining of the oral cavity. The sequelae of oral mucositis (OM), which include pain, odynodysphagia, dysgeusia, decreased oral intake and systemic infection, frequently require treatment delays, interruptions and discontinuations that not only negatively impact quality of life but also tumor control …


Procedural Competency Training During Diagnostic Radiology Residency: Time To Go Beyond “See One, Do One, Teach One”!, Driss Raissi, Qiong Han, Michael A. Winkler, Edward J. Escott Apr 2018

Procedural Competency Training During Diagnostic Radiology Residency: Time To Go Beyond “See One, Do One, Teach One”!, Driss Raissi, Qiong Han, Michael A. Winkler, Edward J. Escott

Radiology Faculty Publications

Objectives: Achieving procedural competency during diagnostic radiology residency can impact the radiologist's future independent practice after graduation, especially in a private practice setting. However, standardized procedure competency training within most radiology residency programs is lacking, and overall procedural skills are still mainly acquired by the traditional “see one, do one, teach one” methodology. We report the development of a simple standardized procedural training protocol that can easily be adopted by residency programs currently lacking any form of structured procedural training.

Materials and Methods: An ad hoc resident procedural competency committee was created in our radiology residency program. A procedural certification …


Bezoar: Imaging Findings & Case Study Of A Rare Pathology, Tanya M. Custer, Kim Michael Apr 2018

Bezoar: Imaging Findings & Case Study Of A Rare Pathology, Tanya M. Custer, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

A bezoar is a hard, indigestible mass of material that forms within the alimentary canal, most commonly the stomach.1 Bezoars are classified according to composition. The most common type of bezoar is a phytobezoar composed of indigestible food fibers that occur in fruits & vegetables, including celery, pumpkin, prunes, raisins, & sunflower-seed shells. Other common types of bezoars include trichobezoars, composed of hair, & pharmacobezoars, made of undissolved medications.

A number of risk factors have been associated with bezoar development. Patients who have undergone gastric surgery, such as partial gastrectomy, are at an increased risk of developing a bezoar due …


Renal Granulomatosis Post Intravesical Bacillus Calmette-Guerin Therapy For Non-Muscle-Invasive Bladder Cancer, Karen Tran-Harding, Rashmi T. Nair, Halemane S. Ganesh Apr 2018

Renal Granulomatosis Post Intravesical Bacillus Calmette-Guerin Therapy For Non-Muscle-Invasive Bladder Cancer, Karen Tran-Harding, Rashmi T. Nair, Halemane S. Ganesh

Radiology Faculty Publications

Intravesical Bacillus Calmette–Guerin (BCG) immunotherapy is a proven, effective treatment for intermediate- and high-risk non-muscle-invasive bladder cancer. Minor side effects are common and expected but systemic effects can occur in < 5% of treated patients. We present a rare case of a 49-year-old male that presented with fever and chills after 3 weeks of intravesical BCG therapy post transurethral resection of bladder tumor. New renal lesions were present on contrast-enhanced computed tomography scan which was histologically proven to be necrotizing renal granulomatosis.


Evaluation Of Hepatocellular Carcinoma Transarterial Chemoembolization Using Quantitative Analysis Of 2d And 3d Real-Time Contrast Enhanced Ultrasound., Kibo Nam, Maria Stanczak, Andrej Lyshchik, Priscilla Machado, Yuko Kono, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey Apr 2018

Evaluation Of Hepatocellular Carcinoma Transarterial Chemoembolization Using Quantitative Analysis Of 2d And 3d Real-Time Contrast Enhanced Ultrasound., Kibo Nam, Maria Stanczak, Andrej Lyshchik, Priscilla Machado, Yuko Kono, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

Quantitative 2D and 3D contrast-enhanced ultrasound (CEUS) was assessed to evaluate early transarterial chemoembolization (TACE) treatment response. Seventeen patients scheduled for TACE for the treatment of hepatocellular carcinoma participated in the study. 2D and 3D CEUS were performed for each patient at three time points: Prior to TACE, 1-2 weeks post TACE, and 1 month post TACE. Peak-intensities of the tumor and surrounding liver tissue were calculated from 2D and 3D data before and after TACE and used to evaluate tumor treatment response. Residual tumor percentages were calculated from 2D and 3D CEUS acquired 1-2 weeks and 1 month post …


Optimizing Vaccine Immunotherapy For Prostate Cancer, G. Hattier, E. K. Bongiorno, C. Portocarrero, Trevor R. Baybutt, Adam E. Snook, U. Rodeck Apr 2018

Optimizing Vaccine Immunotherapy For Prostate Cancer, G. Hattier, E. K. Bongiorno, C. Portocarrero, Trevor R. Baybutt, Adam E. Snook, U. Rodeck

Sigma Xi Student Research Day

Introduction: Treatment options for metastatic prostate cancer are limited and cures are rare. In other cancers immunotherapy has shown remarkable efficacy in certain patient subsets particularly when combined with other treatment modalities. Our previous work showed that combining radiation and vaccine therapy slows the growth of syngeneic prostate cancer in mice more effectively than single modality treatment arms. Here we tested the hypothesis that addition of immune checkpoint inhibitors targeting the PD1/PD-L1 axis further improves efficacy of the dual radiation/vaccine treatment.

Methods: Mice were injected with tumor cells expressing human prostate specific antigen (TPSA-23). The mice were divided into six …


Stochastic Modeling Of Radiation-Induced Dendritic Damage On In Silico Mouse Hippocampal Neurons, Eliedonna Cacao, Vipan K. Parihar, Charles L. Limoli, Francis A. Cucinotta Apr 2018

Stochastic Modeling Of Radiation-Induced Dendritic Damage On In Silico Mouse Hippocampal Neurons, Eliedonna Cacao, Vipan K. Parihar, Charles L. Limoli, Francis A. Cucinotta

Health Physics and Diagnostic Sciences Faculty Research

Cognitive dysfunction associated with radiotherapy for cancer treatment has been correlated to several factors, one of which is changes to the dendritic morphology of neuronal cells. Alterations in dendritic geometry and branching patterns are often accompanied by deficits that impact learning and memory. The purpose of this study is to develop a novel predictive model of neuronal dendritic damages caused by exposure to low linear energy transfer (LET) radiation, such as X-rays, gamma-rays and high-energy protons. We established in silico representations of mouse hippocampal dentate granule cell layer (GCL) and CA1 pyramidal neurons, which are frequently examined in radiation-induced cognitive …


Compressed Sensing For Few-View Multi-Pinhole Spect With Applications To Preclinical Imaging, Benjamin Michael Rizzo Apr 2018

Compressed Sensing For Few-View Multi-Pinhole Spect With Applications To Preclinical Imaging, Benjamin Michael Rizzo

Dissertations (1934 -)

Single Photon Emission Computed Tomography (SPECT) can be used to identify and quantify changes in molecular and cellular targets involved in disease. A radiopharmaceutical that targets a specific metabolic function is administered to a subject and planar projections are formed by imaging emissions at different view angles around the subject. The reconstruction task is to determine the distribution of radioactivity within the subject from the projections. We present a reconstruction approach that utilizes only a few view angles, resulting in a highly underdetermined system, which could be used for dynamic imaging applications designed to quantify physiologic processes altered with disease. …


The Pivotal Role Of Mri In The Diagnosis Of Listeria Rhomboencephalitis, K.R Uprety, M Reza Taheri Apr 2018

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 Apr 2018

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 …