Medical Specialties Commons^™

Intrapulmonary Teratoma: A Rare Presentation Of Bronchiectasis, Beren Chandler, Garret Duron, Jason Mcclune, Lindsey Goldberg

South Atlantic Division GME Research Day 2022

No abstract provided.

The Use Of Nuclear Medicine In Detecting And Treating Mental Health Diseases, Jena Simmons, Gina Capitano, Walter Kierzkowski

Medical Imaging Senior Posters

Mental health disorders affect over 792 million people around the world, and a leading cause for disability. Mental health disorders include a plethora of conditions that affect mood, thinking and behavior, including but not limited to, depression, dementia, anxiety, autism, and schizophrenia. The most common method of diagnosis is a psychological evaluation, which can lack accuracy if performed as the only method of diagnosis. Nuclear Medicine helps aid in diagnosis of these disorders in conjunction with psychological testing. Brain scans can help determine if there is a pathogenic cause for the symptoms. Brain scans are done utilizing Positron Emission Tomography …

When Should Screening Mammograms Begin?, Michaela Cragle, Lynn Blazaskie

Medical Imaging Senior Posters

When Should Screening Mammograms Begin?

Michaela Cragle

Lynn Blazaskie M.S., R.T. (R) (ARRT)

Abstract

Screening mammograms are imaging exams performed yearly to evaluate breast tissue. As women age, changes in breast tissue can be normal or can be an early sign of cancer. The age women should begin screening mammograms is not clear. According to literature it has created much controversy over the years. Most women begin the screening process at the age of 40, and even earlier depending on family history. Research groups from multiple institutions followed and evaluated women who received yearly mammograms. Most women were divided into …

Ultrasound And Mri Findings Of Meningococcal Meningitis Complicated By Subdural Empyema Formation In A 2-Month Old, Nicholas Fuerstenau, Adam Golembioski, Neal Hall, Dhruv Patel

South Atlantic Division GME Research Day 2022

No abstract provided.

Atrial Esophageal Fistula: A Case Report And Review, David Kupshik, Neal Hall, Chris Burns, Brittany Matthews

South Atlantic Division GME Research Day 2022

No abstract provided.

Petrous Internal Carotid Artery Aneurysm: A Rare Vascular Abnormality, Neal Hall, David Kupshik, Nicholas Fuerstenau, Peter Britt

South Atlantic Division GME Research Day 2022

No abstract provided.

Congenital Lobar Emphysema: A Rare Cause Of Mortality In Premature Infants, Brantley Grimball, Allison Thompson

South Atlantic Division GME Research Day 2022

No abstract provided.

Phase And Dark Field Radiography And Ct With Mesh-Based Structured Illumination And Polycapillary Optics, Uttam Pyakurel

Legacy Theses & Dissertations (2009 - 2024)

Imaging can be performed with a variety of techniques. For example, gamma radiation is used in nuclear medicine and radiation therapy A challenge in using gamma rays is the risk of high radiation exposure, which requires extensive custom shielding. The transmission of gamma rays through 3D printed shielding was measured to evaluate the required thickness of the shielding.Conventional radiography depends on x-ray attenuation. Another imaging technique, X-ray phase imaging, is known to improve the contrast of images relative to conventional imaging for low density materials. Phase differences imparted by soft tissue are roughly 1000 times larger than attenuation differences. Further, …

System Measurements For X-Ray Phase And Diffraction Imaging, Erik Wolfgang Tripi

Legacy Theses & Dissertations (2009 - 2024)

In medical imaging, X rays are used to look inside the body to find fractures in bones, abnormal masses, cavities in teeth, and so on. What makes X rays so good at looking at these types of structures is the X ray’s penetration power. When imaging soft tissue to search for tumors, X-ray images tend to have difficulty performing well. The reason for this is that the background structures, such as fat or fibro glandular tissue have similar absorption coefficients as the tumor. Mammography tends to have a high false positive rate and can miss tumors entirely as well. There …

Development Of End-To-End Test Phantom For Stereotactic Radiosurgery Using Alanine Dosimeter, Aungsumalin Intang

Chulalongkorn University Theses and Dissertations (Chula ETD)

Alanine dosimeters are generally used in high-dose dosimetry, while accurate and precise dose delivery verification procedures are important in stereotactic radiosurgery (SRS). Hence, an end-to-end test is required. In addition, no end-to-end SRS test employing an alanine dosimeter has been established in Thailand. The objective of this study was to determine the dose accuracy of SRS VMAT plans in end-to-end test phantom using alanine dosimeter. The electron paramagnetic resonance (EPR) parameters were optimized in the 1-2000 cGy dose range. Following that, suitable parameters were used to investigate the alanine characteristics and estimate the uncertainty in radiation therapy dose range. The …

Strategies For Improving Customer Retention For Medical Imaging Devices, Guillermo Sander

Walden Dissertations and Doctoral Studies

Some sales managers of medical imaging devices lack strategies to improve long-term customer retention. Increasing retention can save these sales managers up to 50% of their customer acquisition costs. Grounded in the service profit chain theory, the purpose of this qualitative multiple case study was to explore strategies sales managers of medical imaging devices use to improve long-term customer retention. The participants comprised seven sales managers of medical imaging devices from three companies who successfully achieved long-term customer retention. Data were collected using semistructured interviews and public documents. Thematic analysis was used to analyze the data. Three themes emerged: value-added …

Radiomic Texture Feature Descriptor To Distinguish Recurrent Brain Tumor From Radiation Necrosis Using Multimodal Mri, M. S. Sadique, A. Temtam, E. Lappinen, K. M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Despite multimodal aggressive treatment with chemo-radiation-therapy, and surgical resection, Glioblastoma Multiforme (GBM) may recur which is known as recurrent brain tumor (rBT), There are several instances where benign and malignant pathologies might appear very similar on radiographic imaging. One such illustration is radiation necrosis (RN) (a moderately benign impact of radiation treatment) which are visually almost indistinguishable from rBT on structural magnetic resonance imaging (MRI). There is hence a need for identification of reliable non-invasive quantitative measurements on routinely acquired brain MRI scans: pre-contrast T1-weighted (T1), post-contrast T1-weighted (T1Gd), T2-weighted (T2), and T2 Fluid Attenuated Inversion Recovery (FLAIR) that can …

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 Potential Of Biology-Guided Radiation Therapy In Thoracic Cancer: A Preliminary Treatment Planning Study, Steven N Seyedin, Rostem Bassalow, Osama R Mawlawi, Lehendrick M Turner, Roshal R Patel, Samuel R Mazin, Oluwaseyi M Oderinde, Yevgen Voronenko, Cody A Wages, Peter D Olcott, Joe Y Chang, Peter A Balter, James W Welsh

Faculty, Staff and Student Publications

PURPOSE: We investigated the feasibility of biology-guided radiotherapy (BgRT), a technique that utilizes real-time positron emission imaging to minimize tumor motion uncertainties, to spare nearby organs at risk.

METHODS: Volumetric modulated arc therapy (VMAT), intensity-modulated proton (IMPT) therapy, and BgRT plans were created for a paratracheal node recurrence (case 1; 60 Gy in 10 fractions) and a primary peripheral left upper lobe adenocarcinoma (case 2; 50 Gy in four fractions).

RESULTS: For case 1, BgRT produced lower bronchus V40 values compared to VMAT and IMPT. For case 2, total lung V20 was lower in the BgRT case compared to VMAT …

The Prevalence And Spectrum Of Reported Incidental Adrenal Abnormalities In Abdominal Computed Tomography Of Cancer Patients: The Experience Of A Comprehensive Cancer Center, Aiham Qdaisat, Sara Bedrose, Obadah Ezzeldin, Ahmed W Moawad, Sai-Ching J Yeung, Khaled M Elsayes, Mouhammed Amir Habra

Faculty, Staff and Students Publications

BACKGROUND: The increasing use of computed tomography (CT) has identified many patients with incidental adrenal lesions. Further evaluation of these lesions is often dependent on the language used in the radiology report. Compared to the general population, patients with cancer have a higher risk for adrenal abnormalities, yet data on the prevalence and type of incidental adrenal lesions reported on radiologic reports in cancer patients is limited. In this study, we aimed to determine the prevalence and nature of adrenal abnormalities as an incidental finding reported on radiology reports of cancer patients evaluated for reasons other than suspected adrenal pathology. …

Comparison Of Radiation Dose And Image Quality Between Fast Kvp Switching Dual-Energy Ct And Routine Single-Energy Ct For Whole Abdomen At King Chulalongkorn Memorial Hospital, Chanthawan Khemkhangboon

Chulalongkorn University Theses and Dissertations (Chula ETD)

Abdominal computed tomography (CT) using a single energy protocol is a common imaging procedure in hospitals. As CT technology has continued to evolve, dual-energy protocols (DECT) have emerged as a new option. A spectral CT scanner with fast kVp switching was installed at King Chulalongkorn Memorial Hospital in 2017, and its clinical utility in emergency patients has not yet been studied. This study aims to compare the radiation dose and image quality between DECT and SECT in abdominal CT for emergency patients. The study retrospectively collected CT data from 130 standard-sized adult patients who underwent contrast-enhanced using the 256-slice MDCT. …

Diagnostic Accuracy Of Computed Tomography In Adults With Suspected Acute Appendicitis At The Emergency Department In A Private Tertiary Hospital In Tanzania, Nyamuryekun'ge Miten, Miten Wr Patel, Ahmed Jusabani, Ali Akbar Zehri, Athar Ali

General Surgery, East Africa

Introduction: The increasing incidence of acute appendicitis in sub-Saharan Africa emphasizes the need for accurate and reliable diagnostic tools. However, the variability in the diagnostic performance of computed tomography for suspected acute appendicitis coupled with comparatively higher negative appendectomy rates in this setting highlight a possible concern regarding the diagnostic accuracy. This study evaluated the diagnostic accuracy of a computed tomography scan for suspected acute appendicitis at the emergency department in Tanzania.

Methods: A retrospective diagnostic accuracy study was conducted from July to October 2020. All patients above 14 years of age who presented at the emergency department with …

Assessment Of Combined Modality Therapy For Non-Small-Cell Lung Carcinoma: A Simulation Study Concerning Concurrent Chemo-Brachytherapy, Hadi Rezaei, Hesameddin Mostaghimi, Ali Reza Mehdizadeh

Electrical & Computer Engineering Faculty Publications

Although surgery is the treatment of choice for early-stage non-small-cell lung carcinoma, almost two-thirds of patients do not have acceptable pulmonary function for extensive surgeries. The alternative approach for this large group of patients is sublobar resection along with low-dose-rate (LDR) brachytherapy (BT). However, patients with resected lungs have a high risk of recurrence and are often treated with platinum-based (Pt-based) chemotherapy (CT). In this study, we aimed to evaluate the absorbed doses of lung and other thoracic organs, considering concurrent chemo-BT with LDR sources in two modalities: conventional vs. unconventional Pt-based CT. We used the MCNPX code for simulations …

Uncertainty Estimation In Classification Of Mgnt Using Radiogenomics For Glioblastoma Patients, W. Farzana, Z. A. Shboul, A. Temtam, K. M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Glioblastoma Multiforme (GBM) is one of the most malignant brain tumors among all high-grade brain cancers. Temozolomide (TMZ) is the first-line chemotherapeutic regimen for glioblastoma patients. The methylation status of the O6-methylguanine-DNA-methyltransferase (MGMT) gene is a prognostic biomarker for tumor sensitivity to TMZ chemotherapy. However, the standardized procedure for assessing the methylation status of MGMT is an invasive surgical biopsy, and accuracy is susceptible to resection sample and heterogeneity of the tumor. Recently, radio-genomics which associates radiological image phenotype with genetic or molecular mutations has shown promise in the non-invasive assessment of radiotherapeutic treatment. This study proposes a machine-learning framework …

The Pathology Fellowship Application Crisis: The Current State And Suggestions For Remediation, Amanda C Herrmann, Cheryl Hanau, Donald Karcher, Douglas C Miller, Alexandra Murtha, Ashley E Sanders, Charles Timmons, Karen L Kaul

Faculty, Staff and Student Publications

Problems within the Pathology fellowship application process in the US have been recognized and reported for years. Recently, members of the Graduate Medical Education Committee (GMEC) of the Association of Pathology Chairs (APC) and collaborators collected survey data from the residents themselves and the fellowship programs, as represented by both the fellowship program directors (members of the Fellowship Directors Ad Hoc Committee, FDAHC) and the program administrators (members of the Graduate Medical Education Administrators Section, GMEAS). These data are presented and discussed, and potential steps to resolve some of the problems around fellowship applications in pathology are presented.

Radiographic Findings And Association With Clinical Severity And Outcomes In Critically Ill Patients With Covid-19, Wei Wu, Pavan K Bhatraju, Natalie Cobb, Neha A Sathe, Kevin I Duan, Kevin P Seitz, Matthew R Thau, Clifford C Sung, Daniel S Hippe, Gautham Reddy, Sudhakar Pipavath

Faculty, Staff and Student Publications

PURPOSE: To describe evolution and severity of radiographic findings and assess association with disease severity and outcomes in critically ill COVID-19 patients.

MATERIALS AND METHODS: This retrospective study included 62 COVID-19 patients admitted to the intensive care unit (ICU). Clinical data was obtained from electronic medical records. A total of 270 chest radiographs were reviewed and qualitatively scored (CXR score) using a severity scale of 0-30. Radiographic findings were correlated with clinical severity and outcome.

RESULTS: The CXR score increases from a median initial score of 10 at hospital presentation to the median peak CXR score of 18 within a …

Multiagent Chemotherapy And Stereotactic Body Radiation Therapy In Patients With Unresectable Pancreatic Adenocarcinoma: A Prospective Nonrandomized Controlled Trial, Colin S Hill, Lauren Rosati, Hao Wang, Hua-Ling Tsai, Jin He, Amy Hacker-Prietz, Daniel A Laheru, Lei Zheng, Shuchi Sehgal, Vincent Bernard, Dung T Le, Timothy M Pawlik, Matthew J Weiss, Amol K Narang, Joseph M Herman

Faculty, Staff and Student Publications

PURPOSE: In a prospective multicenter study, gemcitabine monotherapy followed by stereotactic body radiation therapy (SBRT) was well tolerated with outcomes comparable to chemoradiation for locally advanced pancreatic cancer (LAPC). Recent trials have reported improved survival with multiagent chemotherapy (MA-CTX) alone. This prospective trial explored whether SBRT could be safely delivered after MA-CTX. Herein, we report the long-term outcomes of adding SBRT after MA-CTX in LAPC patients and evaluate whether genetic profiles of specimens obtained before SBRT influence outcomes.

METHODS AND MATERIALS: This prospective nonrandomized controlled phase 2 trial enrolled 44 LAPC and 4 locally recurrent patients after multidisciplinary evaluation between …

Detecting Primary Progressive Aphasia Atrophy Patterns: A Comparison Of Visual Assessment And Quantitative Neuroimaging Techniques, Stephanie Franczak, Jessica Pommy, Greta Minor, Chandler Zolliecoffer, Manav Bhalla, Mohit Agarwal, Andrew Nencka, Yang Wang, Andrew Klein, Darren O'Neill, Jude Henry, Glass Umfleet

Faculty, Staff and Student Publications

BACKGROUND: There are now clinically available automated MRI analysis software programs that compare brain volumes of patients to a normative sample and provide

OBJECTIVE: To address this gap in the literature, we examined Neuroreader

METHODS: lvPPA or aMCI patients who underwent MRI with Neuroreader

RESULTS: Cohen's Kappa coefficients were significant in 10 of the 28 computations (

CONCLUSION: Overall, our results indicated moderate to low interrater reliability, and raters never agreed that left asymmetry was present. While lower

In Vivo Dosimetry Of 3d Gynecological Brachytherapy Using The Glass Dosimeter: A Phantom Study, Itsaraporn Konlak

Chulalongkorn University Theses and Dissertations (Chula ETD)

Brachytherapy can deliver high doses to the target while sparing healthy tissues due to its steep dose gradient property. However, treatment was only performed according to the dose calculated by a treatment planning system without verification of the dose due to the characteristics. Therefore, the aim of this study was to design the in-house phantom to evaluate the dosimetric differences of gynecological brachytherapy under clinical conditions between calculation by the treatment planning system and measurement by the RPLGDs. An in-house phantom consisting of the glass dosimeter holder and the holder of the applicator was created. This holder was designed to …

Effect Of Inter-Observer Delineation Variability On Radiomics Features In Nasopharyngeal Cancer, Pongpitch Panyura

Chulalongkorn University Theses and Dissertations (Chula ETD)

Nasopharyngeal cancer (NPC) is a type of head and neck cancer that is prevalent in China and Southeast Asia. The standard treatment for NPC is radiation therapy (RT), which requires accurate target volume delineation (TVD) to ensure an effective radiation dose while minimizing damage to surrounding healthy tissues. However, TVD is subject to intra- and inter-observer variability, which can affect the accuracy of RT and lead to unstable results in radiomics analysis. Radiomics is a technique that extracts quantitative data from medical images, but it is currently limited by the manual process of tumor delineation. This study aims to investigate …

Dosimetric Differences Between Scheduled And Adapted Plans Generated From Ethos Adaptive Radiotherapy For Patients With Prostate Cancer, Sarita Suvira

Chulalongkorn University Theses and Dissertations (Chula ETD)

Prostate is one of the organs that can easily move or change during the treatment fractions. Adaptive radiotherapy can help to reduce the uncertainty of interfraction and decrease the side effects produced from the radiation given to the patients. The objective of this study was to provide evidence of the efficiency of adaptive radiotherapy for prostate cancer patients by investigating the dosimetric differences between the scheduled and adapted plans generated from Ethos. The treatment data of 100 fractions of prostate cancer patients who had previously been treated on Ethos daily adaptive radiotherapy were collected. The treatment data in each fraction …

Accuracy In Classification Of Liver Lesion Ultrasound Using Artificial Intelligence, Sutthirak Tangruangkiat

Chulalongkorn University Theses and Dissertations (Chula ETD)

B-mode ultrasound imaging is the standard method for hepatocellular carcinoma (HCC) screening. If a lesion has a unique appearance, a conventional detector can be applied. However, if the lesion shares its appearance with other lesion, a large training dataset is required, which may be unavailable. Therefore, a two-stage method is proposed. In the first stage, lesions are detected but not differentiated into any particular class. The detected lesions are then classified in the second stage using a conventional convolutional neural network (CNN). The aims of the dissertation are to design an artificial intelligent system model and to investigate the most …

Accuracy Of Small-Field High Energy Photon Using Plastic Scintillation Detector In Heterogenous Media Compared With Model-Based Algorithm Calculation, Thanat Kaewsuksri

Chulalongkorn University Theses and Dissertations (Chula ETD)

Some radiotherapy techniques such as stereotactic body radiotherapy (SBRT) has the challenges in small field dosimetry in heterogenous media. This study aims at evaluating the accuracy of W2 plastic scintillation detector (PSD) compared with the calculation from algorithms for small-field high energy photon in heterogenous media. The characteristics of W2-PSD were studied. The percentage depth dose (PDD) of 6 FFF and 10 FFF with various field sizes ranging from 1x1 to 4x4 cm2 were measured in solid water phantom with low-density inhomogeneities slabs of air (Styrofoam) and lung (cork) and high-density inhomogeneity slab of aluminum. The characteristics of W2 plastic …

Validation Of Independent Software-Based Calculation In Patient-Specific Quality Assurance, Yasmine Joy Labagnoy

Chulalongkorn University Theses and Dissertations (Chula ETD)

The Mobius3D software addresses limitations lacking in measurement-based methods in patient-specific QA. The objective of this study is to validate its dosimetric performance against conventionally used portal dose measurements using gamma analysis and confidence limits. First, a total of 240 patient-specific QA plans for the Varian Halcyon linear accelerator were collected. Then, the EPID was characterized and the Mobius3D software commissioned through plan verification. Then all patient-specific plans underwent QA using the Portal Dosimetry software and the Mobius3D. The EPID exhibited high reproducibility, dose linearity, and stable dose rate, gantry speed, and MLC speed responses. QA data were assessed using …

Comparative Dosimetry Between 2d Planar-Based And Hybrid-Based Method For Personalized 177 Lu-Psma I&T And 177lu-Dotatate Therapy, Wuri Handayani

Chulalongkorn University Theses and Dissertations (Chula ETD)

Targeted radionuclide therapy (TRT) uses unsealed radiation sources that are accumulated in the target tissues to deliver a damaging radiation dose to the cancerous cells, and a part of the radiopharmaceutical will end up in non-targeted tissues. To avoid treatment-related side effects, dosimetry is mandatory for TRT for each treatment cycle. This study aimed to evaluate and compare the feasibility of 2D planar-based dosimetry and hybrid-based dosimetry for 177Lu-PSMA I&T and 177Lu-DOTATATE therapy. Whole-body planar images and SPECT/CT images were acquired from 27 treatment cycles, 18 patients (13 patients for 177Lu-PSMA I&T and 5 patients for 177Lu-DOTATATE treatment) at immediately, …