Medical Specialties Commons^™

Roundtable Discussion: 68-Year-Old Man With Mhspc, Jason M. Hafron

Articles

No abstract provided.

Case Discussion: 66-Year-Old Man With Low-Volume Prostate Cancer, Jason M. Hafron

Articles

An interview with Michigan Institute of Urology's Doctor Jason M. Hafron is presented. He presents a case of a 66-year-old male with low-volume prostate cancer to discuss his possible prognosis and the risk group he should be categorized. He explains his preferred approach to treat the patient like ordering a bone scan, computed tomography (CT) of the chest, abdomen and pelvis, and germline testing. He recommends some treatments for metastatic castration-sensitive prostate cancer (CSPC).

Association Of Isolated Colitis With Nonsteroidal Anti-Inflammatory Drug Usage, Ashbita Pokharel, Wei Li

Conference Presentation Abstracts

Context: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been known to produce various clinical gastrointestinal side effects and histopathologic changes. It has been reported that NSAID usage is associated with isolated colitis in the periappendiceal orifice region. This study aimed to further evaluate the clinicopathologic features of 16 patients with isolated colitis limited to the cecum or periappendiceal orifice region.

Design: A retrospective review was performed on biopsy specimens from 16 patients with histologically proven colitis (focal active colitis with no chronicity) limited to the cecum or periappendiceal orifice. No significant pathologic changes in the terminal ileum or other parts of the …

Acute Pericarditis And Acute Pleuritis/Empyema Following Submandibular Infection In A Covid-19-Postive Patient: An Autopsy Revealing The Danger Space Of The Neck, Jessica Anderson, Seyedalireza Fatemi, Joseph Fullmer, Ping Zhang

Conference Presentation Abstracts

Acute pericarditis and empyema are life-threatening complications of severe odontogenic infections; reports of these findings from an autopsy perspective are rare. We report an autopsy case demonstrating infection from the mandibular molars to the pericardium and pleura in a patient following COVID-19 infection. A 53-year-old woman with history of COVID-19 (and on repeat testing at admission) presented with submandibular abscess that grew Streptococcus anginosus. Despite incision and drainage of the neck abscess and medical treatment, her condition deteriorated, with sudden death a week after admission. An autopsy with histologic analysis was performed. Externally, a surgical incision containing purulent drainage …

A Cost-Conscious Whole Slide Imaging System For Teaching And Teleconsultation In Pathology, Christopher Thorburn, Mustafa Deebajah, Keran Zhao, Zhenhong Qu

Conference Presentation Abstracts

Context: Whole slide imaging (WSI) systems can provide multiple users with concurrent access to slides without the need to be physically present at the same location. However, the cost of an all-in-one WSI system can be prohibitive for programs that do not already use WSI systems at a clinical scale. Here, we delineate a simple, inexpensive WSI system that is easy to implement and meets the need of a resident teaching environment.

Design: A digital camera (Basler acA2500, Mannheim, Germany) is mounted to a brightfield microscope with a 0.63× C-mount and connected to a computer with the manual WSI program …

Varieties Of Renal Diseases Identified In Renal Biopsies Of Patients Infected By Covid-19, Jessica Anderson, Wei Li, Hassan D. Kanaan, Ping Zhang

Conference Presentation Abstracts

Context: COVID-19 has been shown to cause renal pathology by multiple proposed mechanisms. However, studies evaluating renal biopsies for the effects of COVID-19 remain limited. We report our experience in our health system in a variety of renal pathologic diagnoses caused by COVID-19 infection.

Design: We performed detailed analysis of 5 renal biopsies related to COVID-19 infection, of 812 renal biopsies over the previous 22 months (0.6% of all cases).

Results: The first 3 patients were 2 African American men, 34 and 45 years old, and 1 48-year-old white male transplant recipient who developed acute kidney injury and nephrotic range …

Spectrum Of C3 Glomerulopathies: A Single-Center Experience, Mustafa Deebajah, Wei Li, Hassan D. Kanaan, Ping Zhang

Conference Presentation Abstracts

Context: C3GNs represent a rare type of glomerulopathy due to the activation of alternative complement pathway, including C3-dominant glomerulonephritis (C3D-GN) and dense deposit disease (DDD). The goal of this study was to demonstrate a spectrum of C3GNs.

Design: The study searched 3165 renal biopsies to identify C3GNs and their clinical indices over an 8-year period.

Conclusions: Our data indicate that C3GN cases had a consistent finding of dominant C3 staining, and low serum C3 in most, but exhibited a wide range of clinical and pathologic changes in pediatric to elderly patients. The findings support the previously reported characteristics of C3GN. …

Lysozyme-Induced Nephropathy Secondary To Chronic Myelomonocytic Leukemia, Vasudevan Mahalingam, Jamal Abukhaled, Ping Zhang

Conference Presentation Abstracts

Lysozyme-induced nephropathy is a rare cause of acute kidney injury (AKI) in patients with chronic myelomonocytic leukemia (CMML). We report the case of an 85-year-old man with type II diabetes and hypertension who was being evaluated for an elevated serum creatinine of 2.27 mg/dL. Additional studies showed proteinuria (1 g), predominantly nonalbumin, along with an IgA λ monoclonal protein found on serum electrophoresis. His serum κ:λ ratio, however, was elevated and urinalysis showed free κ monoclonal protein. Further hematopathologic workup revealed CMML, and he also had progression of his AKI, for which a renal biopsy was performed. Light microscopy showed …

Igg4-Related Interstitial Nephritis Ranges From Kidney Mass To Acute Kidney Injury, Mai Elzieny, Wei Li, Hassan D. Kanaan, Ping Zhang

Conference Presentation Abstracts

Context: IgG4-related interstitial nephritis (IRIN) can present as either a renal mass or with acute kidney injury (AKI). The goal of this study was to present our 4 IRIN cases with different clinical scenarios.

Design: Over the past 5 years, we identified 4 cases of IRIN. Each case was evaluated.

Results: Case 1 involved a 60-year-old man with a 3-cm kidney mass. The core biopsy revealed storiform fibrosis and increased IgG4-positive plasma cells (>30 per high-power field), thus diagnosed as IRIN. Case 2 involved a 69-year-old man with medical history of polymyalgia rheumatica and low complements who developed AKI …

Make A Wish: Happy Birthday Bladder Candle, Alexander Geisenhoff, Mit Shah, Megan Schober

Website/Multimedia Contributions

No abstract provided.

Isopsa: Clinical Performance Of A Single Parameter, Structure Based Test For High Grade Prostate Cancer Unaffected By 5-Ari And A-Blocker Medications, Eric Klein, Alan Partin, Yair Lotan, Jack Baniel, Martin Dineen, Jason Hafron, Kannan Manickam, Marc Pliskin, Matthew Wagnet, Ao Zhang

Website/Multimedia Contributions

No abstract provided.

Successful Treatment Of Symptomatic Cystitis Glandularis Presenting As Bladder Mass, With Cox-2 Inhibitor: A Case Report, Bilal Muhammad, Kenneth Peters

Website/Multimedia Contributions

No abstract provided.

Comparison Of Major Adverse Cardiovascular Events Risk With Androgen Deprivation Therapy By Personal History Of Cardiovascular Diseases Using Real World Data, Jason Hafron, Deborah Boldt-Houle, Stuart Atkinson

Website/Multimedia Contributions

No abstract provided.

Status Epilepticus, David Green

Conference Presentation Abstracts

No abstract provided.

Neurologic Complications Of Cancer, David Green

Conference Presentation Abstracts

No abstract provided.

Automating 4dct-Ventilation Imaging Generation Using Ai-Based Advanced Lung Contours, Yingxuan Chen, Sohrab Pahlavan, Paul Jacobs, Farnoush Forghani, Edward Castillo, Richard Castillo, Yevgeniy Vinogradskiy

Conference Presentation Abstracts

Purpose: Functional avoidance radiotherapy uses functional imaging to reduce pulmonary toxicity by designing radiotherapy plans that reduce doses to functional lung. A novel form of lung functional imaging applied for functional avoidance uses 4DCT imaging to calculating 4DCT-based lung ventilation (4DCT-ventilation). The process of generating 4DCT-ventilation images requires advanced lung segmentation (consisting of a standard lung with airway and vasculature removed) which is a manual and time-consuming process. The purpose of this work is to automate 4DCT-ventilation imaging generation using AI-based auto-segmentation techniques for advanced lung contouring.

Methods: 429 patients with 4DCT data from two institutions were used. Three methods …

End-To-End Commissioning & Treatment Plan Quality Assurance For Cranial Single-Isocenter Multi-Target (Simt) Radiosurgery, Cory Knill

Conference Presentation Abstracts

No abstract provided.

Interlaboratory Comparison Of Metabolomics Analyses Of Human And Rodent Blood Using Biocrates Mxp Quant 500 Kit, Nadia Ashrafi, Ali Yilmaz, Stewart F. Graham, Thomas O'Connell, Sumeyya Akyol

Conference Presentation Abstracts

No abstract provided.

Pivotal Trial Of Mri-Guided Transurethral Ultrasound Ablation In Men With Localized Prostate Cancer: Three-Year Follow-Up, Steven S. Raman, Sandeep Arora, Katarzyna J. Macura, Aytekin Oto, Jurgen Fütterer, Robert Staruch, Temel Tirkes, David Bonekamp, Masoom Haider, Derek W. Cool, Kiran Nandalur

Conference Presentation Abstracts

Purpose: MRI-guided transurethral ultrasound ablation (TULSA) of prostate tissue is a novel directional ultrasound heating under real-time MRI thermometry feedback control. We report 3-year outcomes from the pivotal TULSA-PRO Ablation Clinical Trial. Materials and Methods: With IRB approval and HIPAA compliance, 115 men with organ-confined prostate cancer (≤T2b, PSA ≤15 ng/ml, Grade Group [GG] 1-2) across 13 centers underwent whole-gland ablation sparing the urethra, bladder neck, and urinary sphincter. Primary endpoints were safety and PSA reduction at 1 year. Secondary endpoints: prostate volume reduction, mpMRI, and 10 core biopsy at 1 year; quality of life, PSA, and salvage to 3 …

Clinical Trial Innovations In A Post-Covid World, Francisco A. Ponce, Ludy Chen Shih, Michael Staudt

Conference Presentation Abstracts

No abstract provided.

Trust-Ii: A Global Phase Ii Study For Taletrectinib In Ros1 Fusion-Positive Lung Cancer And Other Solid Tumors, Misako Nagasaka, Shunichi Sugawara, Chang-Min Choi, Tatsuro Okamoto, Noriko Yangitani, Kaname Nosaki, Toshiaki Takahashi, Yutaka Fujiwara, John Khoury, Jorge J. Nieva

Conference Presentation Abstracts

Background: Taletrectinib (AB-106/DS-6051b) is a next-generation, brain-penetrant, ROS1/ NTRK tyrosine kinase inhibitor (TKI) and has shown clinically meaningful effect and safety profile in ROS1+ Non-Small Cell Lung Cancer (NSCLC) patients in phase 1 studies (Fujiwara et al, Oncotarget 2018; 9(34): 23729-23737; Ou et al, JTO Clin Res Rep. 2020 Oct 21;2(1):100108). Taletrectinib has also demonstrated activity against ROS1 G2032R resistance mutation and CNS metastases in the ongoing phase 2 TRUST study (NCT04395677) in China. Also, taletrectinib has shown preliminary efficacy against NTRK positive solid tumors in an ongoing phase 2 study (NCT04617054). Methods: TRUST-II study (NCT04919811) is a phase 2, …

An Evolutionary Algorithm Of The Spot Sparsity Optimization In Proton Arc Therapy, Lewei Zhao, Gang Liu, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: Spot-scanning Proton Arc (SPArc) plan normally contains thousands of spot numbers in which is the delivery time is proportional to the number of spots. It is critical to find an optimal SPArc with a fast delivery speed while maintaining a good plan quality. Thus, we developed a novel evolutionary algorithm to directly search the optimal spot sparsity solution in the balance of plan quality and beam delivery time (BDT). Methods: The planning platform included a plan quality objective, a selector and a generator. A selector was designed to filter or add the spot according to the expected spot number, …

Clinical Experience Of Exactrac To Guide Six Degree Of Freedom Fiducial Marker Based Patient Positioning For Hypo-Prostate Fractionation, R Sandhu, C Knill, B Loughery, L Lin, Z Seymour

Conference Presentation Abstracts

Purpose: ExacTrac is clinically used for inter- and intra- fraction shift corrections for hypofractionated prostate patients by registering to implanted fiducial markers. ExacTrac corrections for thirty-three prostate patients were collated and analyzed. Methods: ExacTrac shifts were exported for prostate patients (140 total fractions) who were treated with two 180° partial arcs with beam-on time less than 60seconds/arc. Prior to each treatment fraction, a cone beam computed tomography (CBCT) image was acquired to verify bladder and rectal filling against simulation. Following CBCT, ExacTrac was used for initial prostate localization and shifts were applied using a 6 degree-of-freedom (6D) couch. Following initial …

Detection Of Enterotoxin Gene Cluster In Staphylococcus Epidermidis Recovered From Neonatal Liver Abscess, Bishara J. Freij, Barbara E. Robinson-Dunn, Patrick M. Schlievert

Posters

• Neonatal pyogenic liver abscesses are rare • Potential routes of hepatic infection include: portal vein, biliary ducts, hepatic artery during sepsis, or direct spread from infected contiguous structures • Risk factors may include bloodstream infection, abdominal surgery, umbilical vein catheterization, total parenteral nutrition, necrotizing enterocolitis, and/or immune deficiencies • More common in premature infants at present • Variety of etiologic agents for neonatal liver abscess: Staphylococcus aureus (methicillin-susceptible and resistant), coagulase-negative staphylococci (CONS), streptococci, Escherichia coli, Klebsiella, Pseudomonas, Enterobacter, Serratia, and Candida • Umbilical stump and catheter exit site hub often colonized with CONS • CONS colonize nearly all …

Vampirism For The Microbiologist, Joudeh B. Freij, Bishara J. Freij

Posters

Vampirism has been a means to explain the cause of communicable diseases throughout the centuries.

Surgical Treatment Of Multiple Deforming Xanthomas Of The Foot And Ankle With Complete Excision And Rotational Skin Flaps: A Case Report, Qanita Ali, Rachelle Randall, Lawrence M. Fallat

Articles

Xanthomas are cholesterol rich nodular dermal lesions characterized by lipid-laden macrophages that accumulate in skin and tendons.1 These lesions are frequently associated with hyperlipidemia disorders characterized by impaired cholesterol metabolism and accelerated atherosclerotic plaque development.2 Until recently, xanthomas were considered mere cosmetic lesions, however extensive evidence has shown that the presence of xanthomas signify increased cardiovascular risk and reduced average lifespan.3 Treatment centers around lipid lowering agents and rarely are these masses large enough to require surgical resection, thus there is very little literature discussing proper surgical excision.4, 5 We present a rare case of a 65 year old female …

Commissioning And Validation Of A Monte Carlo Algorithm For Spine Stereotactic Radiosurgery, C Knill, R Sandhu, B Loughery, L Lin, R Halford, D Drake, M Snyder

Conference Presentation Abstracts

Purpose: A 6FFF Monte Carlo (MC) dose calculation algorithm was commissioned for spine stereotactic radiosurgery (SRS) planning on the Versa HD. Initial model generation, validation, and ensuing model tuning will be presented. Methods: The model was generated by the manufacturer, Brainlab, using both in-air and in-water commissioning measurements of field sizes between 6mm and 400mm on the Versa HD. Initial model validation was performed by simulating a water tank in the planning system, calculating commissioning fields, and comparing calculations to measured data. Model accuracy was quantified for output factors, PDDs, profile sizes, and profile penumbras. Nine previously treated Spine SRS …

A Novel Technique To Evaluate Skin Toxicity In Breast Cancer Radiotherapy, R Culcasi, M Vlachaki, M Snyder

Conference Presentation Abstracts

Purpose: To evaluate skin toxicity throughout breast radiotherapy by visualizing variations in Eulerian amplified microcirculation and correlating to skin temperature as measured by a thermal camera. Methods: High-resolution monochrome video recordings and thermal images were acquired for four breast cancer patients prior to radiation treatment followed weekly over 3-5 weeks. During these visits, the radiation oncologist assessed the patient’s skin following the CTCAE scoring system. Videos were amplified by a factor of 100 for frequencies near the patient's measured heart rate (as measured by a fingertip pulse oximeter) with a bandwidth of 0.2Hz, based on a technique developed by CSAIL …

Evaluation Of 4pi Arc Positioning For Cranial Vmat Srs In Elements, B Loughery, C Knill, R Sandhu, L Lin, Z Seymour

Conference Presentation Abstracts

Purpose: Brainlab’s Elements Cranial VMAT (CVMAT) v3.0 introduces a 4Pi optimization that includes automated gantry and couch positioning alongside collimator optimization. In contrast, v1.5 uses a fixed collimator angle and predefined templates for gantry and couch angles that are manually modified by the planner. This study evaluates the 4Pi generated plans for clinical acceptability in terms of plan quality and delivery accuracy on a VersaHD. Methods: We chose a recent sample of 9 clinical plans that represent our catalog of target locations, fractionation schemes, and target sizes. Cases were replanned in CVMAT v3.0 using 4Pi optimization. These plans were evaluated …

Does Lung Function Imaging Modality Have A Dosimetric Impact On Functional Avoidance Treatment Planning: Assessment Using Prospective Clinical Trial Data, J Belardo, S Zhang, E Castillo, R Castillo, C Rusthoven, B Jones, M Miften, T Guerrero, I Grills, Y Chen

Conference Presentation Abstracts

Purpose: Functional avoidance radiotherapy proposes to use functional imaging to design treatment plans that reduce doses to functional regions of lung. Prospective data has shown that reducing doses to functional lung results in reduced pulmonary toxicity. Various lung function imaging modalities have been proposed for functional avoidance; however, there have been no studies evaluating whether using different imaging modalities results in dosimetrically different functional avoidance plans. The purpose of this study was to quantify the differences in treatment plans as a function of lung function imaging modality. Methods: 25 lung cancer patients enrolled on a prospective trial underwent nuclear medicine …