Radiology Commons^™

Development Of A Ct Metal Artifact Management Algorithm For Proton Therapy Planning (Ampp) For Head And Neck Cancer Patients, Daniela Branco

Dissertations and Theses (Open Access)

Purpose: Dental amalgams (high Z materials) are common sources of artifacts in Head and Neck (HN) images. Commercial artifact reduction techniques have been offered, but many are impractical, produce inaccurate CT images or are not clinically available, thus not widely implemented. The goal of this work is to use CT gantry tilts to develop and evaluate a stereoscopic HN metal artifact management algorithm and investigate its improvement in proton treatment planning.

Methods: The in-house CT metal artifact management method for proton planning (AMPP) uses two angled CT scans to generate a single image set with no metal artifacts posterior …

Investigating The Metabolic Progression Of Glioblastoma With Hyperpolarized Magnetic Resonance, Travis Salzillo

Dissertations and Theses (Open Access)

Rapid diagnosis and therapeutic monitoring of aggressive diseases such as glioblastoma (GBM) can improve patient survival by providing physicians the time to optimally deliver treatment. This includes early in development, while the tumor is still manageable, or following initial therapy, when alternative treatments should be considered. The main goal of this project was to determine whether metabolic imaging with hyperpolarized magnetic resonance spectroscopy (MRS) could detect changes in tumor progression more rapidly than conventional anatomic magnetic resonance imaging (MRI) in patient-derived GBM murine models. To comprehensively capture the dynamic nature of cancer metabolism, in vivo pyruvate-to-lactate conversion with hyperpolarized MRI, …

Diagnostic Value Of Mean Elasticity Index As A Quantitative Shear Wave Elastography Parameter For Prediction Of Malignancy In Small Suspicious Solid Thyroid Nodules, Saba Sohail, Sameera Kaliq Uz Zaman

Department of Radiology

Objective: To determine the diagnostic accuracy of mean elasticity index (Emean) on quantitative shear wave elastography (SWE) in detection of malignancy in small solid suspected malignant thyroid nodules on ultrasound, taking histopathology as the gold standard.
Study design: Analytical study.
Place and duration of study: Department of Radiology, Dow Medical College, Dow University of Health Sciences (DUHS) and Dr. Ruth K. M. Pfau Civil Hospital, Karachi from September 2017 to March 2018.
Methodology: Adult patients of either gender with suspected malignant thyroid nodules (solid, ≤10 mm) were subjected to SWE examination. All patients underwent thyroid surgery later. Histopathological findings were …

Discrimination Of Benign From Malignant Breast Lesions In Dense Breasts With Model-Based Analysis Of Regions-Of-Interest Using Directional Diffusion-Weighted Images., Alan I Penn, Milica Medved, Vandana Dialani, Etta D Pisano, Elodia B Cole, David Brousseau, Gregory S Karczmar, Guimin Gao, Barry D Reich, Hiroyuki Abe

Articles, Abstracts, and Reports

BACKGROUND: There is an increasing interest in non-contrast-enhanced magnetic resonance imaging (MRI) for detecting and evaluating breast lesions. We present a methodology utilizing lesion core and periphery region of interest (ROI) features derived from directional diffusion-weighted imaging (DWI) data to evaluate performance in discriminating benign from malignant lesions in dense breasts.

METHODS: We accrued 55 dense-breast cases with 69 lesions (31 benign; 38 cancer) at a single institution in a prospective study; cases with ROIs exceeding 7.50 cm

RESULTS: The region-growing algorithm for 3D lesion model generation improved inter-observer variability over hand drawn ROIs (DSC: 0.66 vs 0.56 (p < 0.001) with substantial agreement (DSC > 0.8) …

Tumor Boards During Covid-19 Pandemic, Ahmed Nadeem Abbasi

Department of Radiation Oncology

No abstract provided.

Surgical And Oncological Implications Of Aberrant Arterial Anatomy In Patients Undergoing Pancreatoduodenectomy, Muhammad Rizwan Khan, Saleema Begum, Dawar Burhan Khan, K. M. Inam Pal

Section of General Surgery

Whipple's pancreatoduodenectomy is a complex surgical procedure and any aberrant arterial anatomy may have serious surgical implications. The objective of our study was to analyse the frequency of aberrant hepatic artery and compare the outcomes in patients with normal anatomy. Clinical data and computed tomography scans of 45 consecutive patients who underwent Whipple's procedure from 2007 to 2016 were reviewed. Group 'A' included patients with aberrant hepatic artery while group 'B' with normal anatomy. Aberrant hepatic artery was present in 11 (24%) patients and type V was the most common variant (n=5, 45%). Morbidity rate in group A was 82% …

Osteoblastoma In The Occipital Bone: A Case Report Of A Rare Tumor In The Calvarium, Lukas M. Trunz, Scott H. Faro, Richard J. Gorniak

Department of Radiology Faculty Papers

Osteoblastomas infrequently occur in the calvarium, displaying a preference for temporal and frontal bones when it does. We present an unusual case of a large, expansile osteoblastoma in the occipital bone of a 23-year-old man who presented with a nontender lump at the back of his head. Initial computed tomography scan showed a large occipital bone mass, and after additional imaging, a gross total resection was performed. Histopathological examination revealed an osteoblastoma. Although these tumors are benign, overlapping imaging characteristics of lesions affecting the calvarium often present a diagnostic dilemma. This case emphasizes the importance of imaging in the management …

Adjuvant Therapy In Adrenocortical Carcinoma: Reflections And Future Directions, Sara Bedrose, Marilyne Daher, Lina Altameemi, Mouhammed Amir Habra

Faculty, Staff and Students Publications

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with high risk of recurrence despite macroscopically complete surgical resection. The main predictors of ACC recurrence include advanced disease stage, incomplete surgical resection, cortisol production, certain genetic alterations, and high proliferation rate (Ki-67 proliferation index). Mitotane has been the mainstay adjuvant therapy of ACC. However, the use of mitotane is based on retrospective and occasionally conflicting evidence. As mitotane levels can take a few months before reaching therapeutic levels, there is an emerging practice of combining platinum-based chemotherapy with mitotane in the adjuvant setting. Retrospective data indicate that radiotherapy is an …

Lung Metastasis Postradioembolization Of Hepatocellular Carcinoma With Tumor In Vein, Harit Kapoor, Sreeja Sanampudi, Joseph W. Owen, Driss Raissi

Radiology Faculty Publications

Transarterial radioembolization (TARE) is one of the few treatment options available for infiltrative hepatocellular carcinoma with tumor in vein. This is backed by the published data showing marginally favorable toxicity profile compared with other locoregional and systemic therapies. Although lung shunt fraction studies are performed to prevent radiation injury to the lungs, TARE-induced embolization/metastasis to the lungs has not been reported before. We report an intriguing case of new lung metastases within 1 month after TARE for infiltrative hepatocellular carcinoma with a tumor in the vein, with only a slightly elevated but acceptable lung shunt fraction. This report brings to …

Hepatocellular Carcinoma Treated With Microwave Ablation Prior To Liver Transplantation, Nicole Wagner, Amanda Smolock, Michael Markovitz, Varun Danda, Christopher Neely, Warren Maley, Jesse Civan, Colette Shaw

Phase 1

Introduction: Ablation is a minimally invasive procedure that limits local liver tumor progression and prolongs patients’ transplantation eligibility. Microwave ablation (MWA) utilizes higher temperatures than the standard of care, radiofrequency ablation (RFA), which increases efficiency. Meta-analyses compared MWA with RFA for the treatment of HCC and showed similar efficacy and safety between these modalities. However, limited pathologic data exists determining whether explanted tumors remained viable after MWA.

Methods: Our database was reviewed retrospectively for patients with HCC who underwent MWA prior to liver transplantation between 2013 and 2019. Patient demographics, etiology of disease, tumor size, procedure details, bilirubin, MELD, …

Chloroquine Induction Par-4 And Treatment Of Cancer, Vivek M. Rangnekar

Radiation Medicine Faculty Patents

Described herein are methods for treating cancer in a subject in need thereof by administering chloroquine, or a salt or prodrug thereof, optionally with another agent that promotes Par-4 production to induce prostate apoptosis response-4 (Par-4) production by host cells, particularly non-cancerous host cells, to promote apoptosis in cancer cells, including androgen insensitive prostate cancer cells.

Value Of Elastography In Differentiating Benign From Malignant Breast Lesions Keeping Histopathology As Gold Standard, Faryal Farooq, Syed Mubarak, Shaista Shaukat, Noman Khan, Kahkashan Jafar, Tariq Mahmood, Muhammad Arif Saeed

Department of Radiology

Background: Breast cancer is the most common cancer in females, both in developed and developing countries. Pakistan has the highest breast cancer incidence rate in Asia. Guidelines recommend screening for detecting breast cancer with mammography and ultrasonography (US). Shear-wave elastography (SWE) is a newer technique that can aid additional characterization of breast lesions.
Objective: The aim of this study was to determine the diagnostic accuracy of breast ultrasound elastography in differentiating benign from malignant breast lesions using histology diagnosis as the gold standard.
Materials and methods: The study was conducted at the Abbasi Shaheed Hospital and Jinnah Post Graduate Medical …

Retrospective Evaluation Of Weight Loss In Maine Medical Center Cancer Institute (Mmcci) Patients Receiving Radiation Treatment For Head And Neck Cancer, Julian Johnson, David Debartolo-Stone, Jessica Moore, Ruth Hanselman, Stephen Tyzik, Suneela Nayak, Amy Sparks

Operations Transformation

Treatment for head and neck cancer often results in weight loss as a side effect. One option to mitigate this weight loss is placement of a percutaneous endoscopic gastrostomy (PEG) tube placement. Radiation oncologists at a academic tertiary medical center discuss the option of PEG placement during patient consultation.

A retrospective evaluation of weight loss in patients receiving radiation was conducted over a two-year period. The goal of this data collection was to create a standard for oncology consultations regarding PEG tube placement.

Baseline metrics and a root cause analysis drove subsequent data collection steps. After analyzing the raw data, …

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

Radiation Medicine Faculty Publications

Purpose: In prostate focal therapy, it is important to accurately localize malignant lesions in order to increase biological effect of the tumor region while achieving a reduction in dose to noncancerous tissue. In this work, we proposed a transfer learning–based deep learning approach, for classification of prostate lesions in multiparametric magnetic resonance imaging images. Methods: Magnetic resonance imaging images were preprocessed to remove bias artifact and normalize the data. Two state-of-the-art deep convolutional neural network models, InceptionV3 and VGG-16, were pretrained on ImageNet data set and retuned on the multiparametric magnetic resonance imaging data set. As lesion appearances differ by …

Framework For Algorithmically Optimizing Longitudinal Health Outcomes: Examples In Cancer Radiotherapy And Occupational Radiation Protection, Lydia Joyce Wilson

LSU Doctoral Dissertations

Background: Advancements in the treatment of non-infectious disease have enabled survival rates to steadily increase in recent decades (e.g., diabetes, heart disease, and cancer). Epidemiological studies have revealed that the treatments for these diseases can have life-threatening and/or life–altering effects. Thus, realizing the full beneficial potential of advanced treatments necessitates new tools to algorithmically consider all major components of the health outcome, including benefit and detriment. The goal of this dissertation was to develop a framework for improving projected health outcomes following planned radiation exposures in consideration of all beneficial and detrimental, early and late, and fatal and non-fatal …

Potential Reduction Of Lung Dose Via Vmat With Jaw Tracking In The Treatment Of Single-Isocenter/Two-Lesion Lung Sbrt, Damodar Pokhrel, Lana Sanford, Matthew Halfman, Janelle A. Molloy

Radiation Medicine Faculty Publications

Purpose/objectives: Due to higher radiosensitivity, non‐target normal tissue dose is a major concern in stereotactic body radiation therapy (SBRT) treatment. The aim of this report was to estimate the dosimetric impact, specifically the reduction of normal lung dose in the treatment of single‐isocenter/two‐lesion lung SBRT via volumetric modulated arc therapy with jaw tracking (JT‐VMAT).

Materials/methods: Twelve patients with two peripherally located early‐stage non‐small‐cell‐lung cancer (NSCLC) lung lesions underwent single‐isocenter highly conformal non‐coplanar JT‐VMAT SBRT treatment in our institution. The mean isocenter to tumors distance was 5.6 ± 1.9 (range 4.3–9.5) cm. The mean combined planning target volume (PTV) was 38.7 …

Comparative Effectiveness Of Intensity Modulated Radiation Therapy To 3-Dimensional Conformal Radiation In Locally Advanced Lung Cancer: Pathological And Clinical Outcomes., Sarit Appel, Jair Bar, Alon Ben-Nun, Marina Perelman, Dror Alezra, Damien Urban, Maoz Ben-Ayun, Nir Honig, Efrat Ofek, Tamar Katzman, Amir Onn, Sumit Chatterji, Sergey Dubinski, Lev Tsvang, Shira Felder, Judith Kraitman, Ory Haisraely, Tatiana Rabin Alezra, Sivan Lieberman, Edith M. Marom, Nir Golan, David Simansky, Zvi Symon, Yaacov Richard Lawrence

Department of Radiation Oncology Faculty Papers

OBJECTIVE: Intensity-modulated radiotherapy (IMRT) has better normal-tissue sparing compared with 3-dimensional conformal radiation (3DCRT). We sought to assess the impact of radiation technique on pathological and clinical outcomes in locally advanced non-small cell lung cancer (LANSCLC) treated with a trimodality strategy.

METHODS: Retrospective review of LANSCLC patients treated from August 2012 to August 2018 at Sheba Medical Center, Israel. The trimodality strategy consisted of concomitant chemoradiation to 60 Gray (Gy) followed by completion surgery. The planning target volume (PTV) was defined by co-registered PET/CT. Here we compare the pathological regression, surgical margin status, local control rates (LC), disease free (DFS) …

Initial Results Of A Prospective Study Of Adjuvant Pancreatic Stereotactic Body Radiation Therapy For Close Or Positive Margins, Mark E. Bernard, Philip A. Sutera, Nicholas A. Iarrobino, Kimmen Quan, Steven A. Burton, Nathan Bahary, Melissa Hogg, Amer Zureikat, Dwight E. Heron

Radiation Medicine Faculty Publications

Purpose: Patients with close or positive margins after surgery for pancreatic carcinoma are at a high risk for recurrence. Stereotactic body radiation therapy (SBRT) allows for safe dose escalation with great conformity and short duration of treatment. Herein, we report the initial results of a prospective observational study that evaluated the efficacy and safety of this treatment option.

Methods and Materials: Patients eligible for the study had pathologically proven T1-4N0-1M0 pancreatic adenocarcinoma with a positive margin (≤ 1 mm) or a close margin defined as < 2.5 mm. Patients were treated with either neoadjuvant or adjuvant chemotherapy, if eligible for systemic therapy. All patients received 36 Gy in 3 fractions to the close or positive margin site.

Results: From February 2013 to January 2018, 50 patients were enrolled with 49 patients treated …

Survival And Treatment Outcomes Of Metaplastic Breast Carcinoma: Single Tertiary Care Center Experience In Pakistan, Zarka Samoon, Madiha Beg, Romana Idress, Adnan Jabbar

Department of Radiation Oncology

Background: Metaplastic breast carcinoma (MBC) is a rare disease with incidence of less than 1%. MBC present with a larger tumor size, less number of nodes involved, mostly undifferentiated triple negative tumors. We aimed to determine progression-free and overall survival and reported hospital-based incidence of MBC.
Material and Methods: A retrospective closed Cohort study elicited data of 42 patients with MBC from January 2008 to December 2013; followed till August 2016. Kaplan-Meier method was applied to compute overall and progression-free survival analysis. Cox Proportional hazard ratios were computed to assess associations between survival and independent variables.
Results: Hospital-based incidence of …

Li-Rads: A Conceptual And Historical Review From Its Beginning To Its Recent Integration Into Aasld Clinical Practice Guidance, Khaled M. Elsayes, Ania Z. Kielar, Victoria Chernyak, Ali Morshid, Alessandro Furlan, William R. Masch, Robert M. Marks, Aya Kamaya, Richard K. G. Do, Yuko Kono, Kathryn J. Fowler, An Tang, Mustafa R. Bashir, Elizabeth M. Hecht, Kedar Jambhekar, Andrej Lyshchik, Shuchi K. Rodgers, Jay P. Heiken, Marc Kohli, David T. Fetzer, Stephanie R. Wilson, Zahra Kassam, Mishal Mendiratta-Lala, Amit G. Singal, Christopher S. Lim, Irene Cruite, James Lee, Ryan Ash, Donald G. Mitchell, Matthew D. F. Mcinnes

Radiology Faculty Publications

The Liver Imaging Reporting and Data System (LI-RADS^®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in individuals at high risk for hepatocellular carcinoma (HCC). LI-RADS is supported and endorsed by the American College of Radiology (ACR). Upon its initial release in 2011, LI-RADS applied only to liver observations identified at CT or MRI. It has since been refined and expanded over multiple updates to now also address ultrasound-based surveillance, contrast-enhanced ultrasound for HCC diagnosis, and CT/MRI for assessing treatment response after locoregional therapy. The LI-RADS 2018 version was …

Excluding Ptv From Lung Volume May Better Predict Radiation Pneumonitis For Intensity Modulated Radiation Therapy In Lung Cancer Patients, Yinnan Meng, Haihua Yang, Wei Wang, Xingni Tang, Caiping Jiang, Yichao Shen, Wei Luo

Radiation Medicine Faculty Publications

Background: Lung dose-volume histogram (DVH) in radiotherapy could be calculated from multiple normal lung definitions. The lung dosimetric parameters generated from various approaches are significantly different. However, limited evidence shows which definition should be used to more accurately predict radiation pneumonitis (RP). We aimed to compare the RP prediction accuracy of dosimetric parameters from three lung volume methods in lung cancer patients treated with Intensity-Modulated Radiation Therapy (IMRT).

Methods: We retrospectively reviewed 183 consecutive lung cancer patients treated with IMRT from January 2014 to October 2017. The normal lungs were defined by total bilateral lung volume (Total Lung), excluding PTV …

Evaluation Of Plan Quality And Treatment Efficiency For Single-Isocenter/Two-Lesion Lung Stereotactic Body Radiation Therapy, Lana Sanford, Janelle A. Molloy, Sameera S. Kumar, Marcus Randall, Ronald C. Mcgarry, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose/objectives: To evaluate the plan quality and treatment delivery efficiency of single‐isocenter/two‐lesions volumetric modulated arc therapy (VMAT) lung stereotactic body radiation therapy (SBRT).

Materials/methods: Eight consecutive patients with two peripherally located early stage nonsmall‐cell‐lung cancer (NSCLC) lung lesions underwent single‐isocenter highly conformal noncoplanar VMAT SBRT treatment in our institution. A single‐isocenter was placed between the two lesions. Doses were 54 or 50 Gy in 3 and 5 fractions respectively. Patients were treated every other day. Plans were calculated in Eclipse with AcurosXB algorithm and normalized to at least 95% of the planning target volume (PTV) receiving 100% of the prescribed …

A Custom Radiopaque Thermoresponsive Chemotherapy-Loaded Hydrogel For Intratumoural Injection: An In Vitro And Ex Vivo Assessment Of Imaging Characteristics And Material Properties, Seóna M. Rossi, Timothy E. Murray, John Cassidy, Michael J. Lee, Helena M. Kelly

Articles

Purpose Thermoresponsive hydrogels are gels which have different properties at varying temperatures. The objective of this study was to assess the material characteristics, imaging properties and chemotherapeutic drug release profile of a novel radiopaque thermoresponsive hydrogel in vitro, which is liquid at room temperature but solidifies at body temperature, to determine potential suitability for intratumoural delivery. Materials and Methods An iodinated radiopaque thermoresponsive hydrogel was formulated using iodixanol at a range of concentrations and assessed for sol–gel transition, radiopacity and imaging using CT and US. A lead formulation containing iodixanol at a concentration of 9.22% weight by weight (w/w, g …

Effect Of Differences In Metabolic Activity Of Melanoma Models On Response To Lonidamine Plus Doxorubicin., Kavindra Nath, Jeffrey Roman, David S. Nelson, Lili Guo, Seung-Cheol Lee, Stepan Orlovskiy, Kevin Muriuki, Daniel F. Heitjan, Stephen Pickup, Dennis B. Leeper, Ian A. Blair, Mary E. Putt, Jerry D. Glickson

Department of Radiation Oncology Faculty Papers

Lonidamine (LND), a metabolic modulator, sensitizes DB-1 human melanoma to doxorubicin (DOX) chemotherapy by acidifying and de-energizing the tumor. This report compares the effects of LND on two human melanoma lines, DB-1 and WM983B, which exhibit different metabolic properties. Using liquid chromatography mass spectrometry and Seahorse analysis, we show that DB-1 was more glycolytic than WM983B in vitro. ³¹P magnetic resonance spectroscopy (MRS) indicates that LND (100 mg/kg, i.p.) induces similar selective acidification and de-energization of WM983B xenografts in immunosuppressed mice. Over three hours, intracellular pH (pHi) of WM983B decreased from 6.91 ± 0.03 to 6.59 ± 0.10 (p …

Comprehensive Evaluation Of Treatment And Outcomes Of Low-Grade Diffuse Gliomas, Catherine R. Garcia, Stacey A. Slone, Thomas A. Pittman, William H. St. Clair, Donita D. Lightner, John L. Villano

Markey Cancer Center Faculty Publications

Background

Low-grade gliomas affect younger adults and carry a favorable prognosis. They include a variety of biological features affecting clinical behavior and treatment. Having no guidelines on treatment established, we aim to describe clinical and treatment patterns of low-grade gliomas across the largest cancer database in the United States.

Methods

We analyzed the National Cancer Database from 2004 to 2015, for adult patients with a diagnosis of World Health Organization grade II diffuse glioma.

Results

We analyzed 13,621 cases with median age of 41 years. Over 56% were male, 88.4% were white, 6.1% were black, and 7.6% Hispanic. The most …

Evaluation Of Hybrid Arc And Volumetric-Modulated Arc Therapy Treatment Plans For Fractionated Stereotactic Intracranial Radiotherapy., Jun Li, David To, Vickie Gunn, Wenyin Shi, Yan Yu, Haisong Lui

Department of Radiation Oncology Faculty Papers

PURPOSE: The study was aimed to compare hybrid arc and volumetric-modulated arc therapy treatment plans for fractionated stereotactic radiotherapy of brain tumors.

METHODS: Treatment plans of 22 patients were studied. Hybrid arc and volumetric-modulated arc therapy plans were generated using Brainlab iPlanDose and Varian Eclipse treatment planning systems, respectively, with 6 MV photon beams on a Varian TrueBeam STx linear accelerator (Palo Alto, CA). Prescription dose was 54 Gy. The fractionation was 1.8 Gy per fraction and 30 fractions in total, or 2 Gy per fraction and 27 fractions in total. Planning target volume ranged from 2.4 to 28.6 cm …

Clinical Audit To Assess Delays In Chemotherapy Administration At Daycare Oncology Center At A Tertiary Care Hospital In Karachi, Pakistan, Arifa Arifa Aziz, Zarka Samoon, Afsheen Feroz, Nadia Ayoub, Safia Awan, Madhia Beg

Department of Radiation Oncology

Aim: There were delays reported by patients in chemotherapy administration in daycare oncology. Therefore, we decided to audit all processes which are involved in chemotherapy administration. The objective was to improve our service by decreasing the time between admission and initiation of chemotherapy and identify the reasons for delays. Materials and Methods: The audit was conducted in three parts. In Review I, audit tool was developed and information documented of 109 patients receiving chemotherapy at daycare center from April 14 to May 13, 2015. Five processes were assessed out of which delay in initial assessment by the nurse was the …

The Pervasive Crisis Of Diminishing Radiation Therapy Access For Vulnerable Populations In The United States—Part 4: Appalachian Patients, Shearwood Mcclelland Iii, Tasneem Kaleem, Mark E. Bernard, Hiba Z. Ahmed, Terence T. Sio, Robert C. Miller

Radiation Medicine Faculty Publications

Purpose: Compared with the rest of the United States, the population of Appalachia has lower education levels, higher rates of poverty, and limited access to health care. The presence of disparities in radiation therapy (RT) access for Appalachian patients with cancer has rarely been examined.

Methods and materials: The National Cancer Institute initiatives toward addressing disparities in treatment access for rural populations were examined. An extensive literature search was undertaken for studies investigating RT access disparities in Appalachian patients, beginning with the most common cancers in these patients (lung, colorectal, and cervical).

Results: Although the literature investigating RT access disparities …

Trans-Lymphatic Contrast-Enhanced Ultrasound In Combination With Blue Dye Injection Is Feasible For Detection And Biopsy Of Sentinel Lymph Nodes In Breast Cancer, Xiangmei Chen, Md, Jieyu Zhong, Md, Zhengming Hu, Md, Wei Wei, Md, Weihua Yin, Md, Ligang Cui, Md, Ji-Bin Liu, Md, Desheng Sun, Md

Department of Radiology Faculty Papers

Objective: The best method for sentinel lymph node biopsy (SLNB) in early-staged breast cancer (EBC) remains controversial. This study aimed to evaluate a novel method by combining trans-lymphatic contrast-enhanced ultrasound (TLCEUS) with blue dye injection as a guidance of SLNB.

Methods: TLCEUS was performed in 88 patients with newly diagnosed EBC. Methylene blue dye was percutaneously injected into enhanced sentinel lymph nodes (SLNs) under ultrasound guidance, followed by standard SLNB and axillary lymph node dissection. Enhancement patterns and the arriving time (AT) of contrast agent within SLNs were evaluated. Histopathological examination of dissected nodes was performed to confirm metastasis.

Results: …

A Glance At Imaging Bladder Cancer., Ebru Salmanoglu, Ethan J. Halpern, Edouard J. Trabulsi, Sung Kim, Mathew L. Thakur

Department of Radiology Faculty Papers

Purpose: Early and accurate diagnosis of Bladder cancer (BCa) will contribute extensively to the management of the disease. The purpose of this review was to briefly describe the conventional imaging methods and other novel imaging modalities used for early detection of BCa and outline their pros and cons.

Methods: Literature search was performed on Pubmed, PMC, and Google scholar for the period of January 2014 to February 2018 and using such words as "bladder cancer, bladder tumor, bladder cancer detection, diagnosis and imaging".

Results: A total of 81 published papers were retrieved and are included in the review. For patients …