Radiology Commons^™

International Consensus Conference Recommendations On Ultrasound Education For Undergraduate Medical Students, Richard A Hoppmann, Jeanette Mladenovic, Lawrence Melniker, Radu Badea, Michael Blaivas, Miguel Montorfano, Alfred Abuhamad, Vicki Noble, Arif Hussain, Gregor Prosen, Tomás Villen, Gabriele Via, Ramon Nogue, Craig Goodmurphy, Marcus Bastos, G Stephen Nace, Giovanni Volpicelli, Richard J Wakefield, Steve Wilson, Anjali Bhagra, Jongyeol Kim, David Bahner, Chris Fox, Ruth Riley, Peter Steinmetz, Bret P Nelson, John Pellerito, Levon N Nazarian, L Britt Wilson, Irene W Y Ma, David Amponsah, Keith R Barron, Renee K Dversdal, Mike Wagner, Anthony J Dean, David Tierney, James W Tsung, Paula Nocera, José Pazeli, Rachel Liu, Susanna Price, Luca Neri, Barbara Piccirillo, Adi Osman, Vaughan Lee, Nitha Naqvi, Tomislav Petrovic, Paul Bornemann, Maxime Valois, Jean-Francoise Lanctot, Robert Haddad, Deepak Govil, Laura A Hurtado, Vi Am Dinh, Robert M Dephilip, Beatrice Hoffmann, Resa E Lewiss, Nayana A Parange, Akira Nishisaki, Stephanie J Doniger, Paul Dallas, Kevin Bergman, J Oscar Barahona, Ximena Wortsman, R Stephen Smith, Craig A Sisson, James Palma, Mike Mallin, Liju Ahmed, Hassan Mustafa

Department of Radiology Faculty Papers

OBJECTIVES: The purpose of this study is to provide expert consensus recommendations to establish a global ultrasound curriculum for undergraduate medical students.

METHODS: 64 multi-disciplinary ultrasound experts from 16 countries, 50 multi-disciplinary ultrasound consultants, and 21 medical students and residents contributed to these recommendations. A modified Delphi consensus method was used that included a systematic literature search, evaluation of the quality of literature by the GRADE system, and the RAND appropriateness method for panel judgment and consensus decisions. The process included four in-person international discussion sessions and two rounds of online voting.

RESULTS: A total of 332 consensus conference statements …

Emerging Applications Of Contrast-Enhanced Ultrasound In Trauma, Brenda Tester, Ji-Bin Liu, John R. Eisenbrey, George Koenig

Department of Radiology Faculty Papers

The use of contrast-enhanced ultrasound (CEUS) has expanded over the past decade to include a variety of diagnostic and therapeutic applications. These include urgent clinical situations that require timely diagnosis and subsequent treatment. With the introduction of microbubble ultrasound contrast agents (UCAs), CEUS provides increased sensitivity and specificity over conventional ultrasound. Within the trauma setting, CEUS benefits include point of care imaging and an ability to monitor perfusion in real-time. Additionally, UCAs are non-nephrotoxic, and can be used when contrast enhanced CT is contraindicated. In this review, we discuss recent advancements of CEUS within trauma settings.

Large Aortic Pseudoaneurysm After Bentall Procedure In A Patient With Marfan's Syndrome., David Saul, Vinay Kandula, Achala Donuru, Christian Pizarro, Mary Patricia Harty

Department of Radiology Faculty Papers

An 11-year-old male with Marfan's syndrome and aortic root dilatation underwent an uneventful Bentall procedure to replace his aortic root and valve. Five months later, surveillance echocardiogram revealed a slowly enlarging pseudoaneurysm arising from the ascending aorta. This finding was subsequently confirmed by computed tomographic angiogram. The patient had successful open surgical repair and paraaortic hematoma evacuation.

Development Of A Dual Drug-Loaded, Surfactant-Stabilized Contrast Agent Containing Oxygen, Raj Patel, Quezia Lacerda, Brian E Oeffinger, John R. Eisenbrey, Ankit K. Rochani, Gagan Kaushal, Corinne Wessner, Margaret A Wheatley

Department of Radiology Faculty Papers

Co-delivery of cancer therapeutics improves efficacy and encourages synergy, but delivery faces challenges, including multidrug resistance and spatiotemporal distribution of therapeutics. To address these, we added paclitaxel to previously developed acoustically labile, oxygen-core, surfactant-stabilized microbubbles encapsulating lonidamine, with the aim of developing an agent containing both a therapeutic gas and two drugs acting in combination. Upon comparison of unloaded, single-loaded, and dual-loaded microbubbles, size (~1.7 µm) and yield (~2 × 109 microbubbles/mL) (~1.7) were not statistically different, nor were acoustic properties (maximum in vitro enhancements roughly 18 dB, in vitro enhancements roughly 18 dB). Both drugs encapsulated above required doses …

Alpha-Fetoprotein (Afp) And Afp-L3 Is Most Useful In Detection Of Recurrence Of Hepatocellular Carcinoma In Patients After Tumor Ablation And With Low Afp Level, Madison Force, Grace Park, Divya Chalikonda, Christopher G. Roth, Micah Cohen, Dina Halegoua-De Marzio, Hie-Won Hann

Department of Medicine Faculty Papers

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and is a leading cause of mortality worldwide. While there are many risk factors for HCC including alcohol, obesity, and diabetes, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection still account for the majority of HCC worldwide. Globally, HBV is the leading risk factor for HCC. Patients with chronic hepatitis B (CHB) and advanced liver disease are at high risk for HCC. Screening for HCC is done routinely with ultrasound with or without alpha-fetoprotein (AFP) at six-month intervals. The combination of ultrasound and AFP has been …

Making Waves: How Ultrasound-Targeted Drug Delivery Is Changing Pharmaceutical Approaches., Lauren J Delaney, Selin Isguven, John R Eisenbrey, Noreen J Hickok, Flemming Forsberg

Department of Radiology Faculty Papers

Administration of drugs through oral and intravenous routes is a mainstay of modern medicine, but this approach suffers from limitations associated with off-target side effects and narrow therapeutic windows. It is often apparent that a controlled delivery of drugs, either localized to a specific site or during a specific time, can increase efficacy and bypass problems with systemic toxicity and insufficient local availability. To overcome some of these issues, local delivery systems have been devised, but most are still restricted in terms of elution kinetics, duration, and temporal control. Ultrasound-targeted drug delivery offers a powerful approach to increase delivery, therapeutic …

Idiopathic Midaortic Syndrome, David Saul, Rahul Nikam, Vinay Kandula, Achala Donuru

Department of Radiology Faculty Papers

Midaortic syndrome (MAS) is characterized by narrowing of the descending aorta between the distal aortic arch and the aortic bifurcation. We present the case of a 4-year-old male presenting with a murmur and diagnosed with MAS. He was treated with a thoracoabdominal bypass graft.

Cloud-Based Ultrasound System: Feasibility And Potential, Ji-Bin Liu

Department of Radiology Faculty Papers

No abstract provided.

Dna-Pkcs: A Targetable Protumorigenic Protein Kinase., Emanuela Dylgjeri, Karen E Knudsen

Department of Cancer Biology Faculty Papers

DNA-dependent protein kinase catalytic subunit (DNA-PKcs) is a pleiotropic protein kinase that plays critical roles in cellular processes fundamental to cancer. DNA-PKcs expression and activity are frequently deregulated in multiple hematologic and solid tumors and have been tightly linked to poor outcome. Given the potentially influential role of DNA-PKcs in cancer development and progression, therapeutic targeting of this kinase is being tested in preclinical and clinical settings. This review summarizes the latest advances in the field, providing a comprehensive discussion of DNA-PKcs functions in cancer and an update on the clinical assessment of DNA-PK inhibitors in cancer therapy.

Cerebral Blood Flow And Brain Functional Connectivity Changes In Older Adults Participating In A Mindfulness-Based Stress Reduction Program, Aleeze Sattar Moss, Diane K. Reibel, Nancy Wintering, Faezeh Vedaei, Hannah Porter, Mohsen Khosravi, Justin Heholt, M. Alizadeh, Feroze Mohamed, Andrew B. Newberg

Department of Radiology Faculty Papers

There is a growing interest in the potential beneficial effects of mindfulness meditation training in protecting against age-related physical, emotional, and cognitive decline. The current prospective, single-center, single-arm study investigated if functional magnetic resonance imaging-based changes in cerebral blood flow and brain functional connectivity could be observed in 11 elderly adults (mean age 79) after participation in a Mindfulness-Based Stress Reduction (MBSR) program. The results showed significantly (p < 0.05) altered cerebral blood flow and functional connectivity in the cingulate gyrus, limbic structures, and subregions of the temporal and frontal lobes, similar to findings of other meditation-related studies in younger populations. Furthermore, these changes were also associated with significant improvements in depression symptoms. This study suggests that the MBSR program can potentially modify cerebral blood flow and connectivity in this population.

Identification Of Chronic Mild Traumatic Brain Injury Using Resting State Functional Mri And Machine Learning Techniques, Faezeh Vedaei, Najmeh Mashhadi, George Zabrecky, Daniel A. Monti, Emily Navarreto, Chloe Hriso, Nancy Wintering, Andrew B. Newberg, Feroze Mohamed

Department of Radiology Faculty Papers

Mild traumatic brain injury (mTBI) is a major public health concern that can result in a broad spectrum of short-term and long-term symptoms. Recently, machine learning (ML) algorithms have been used in neuroscience research for diagnostics and prognostic assessment of brain disorders. The present study aimed to develop an automatic classifier to distinguish patients suffering from chronic mTBI from healthy controls (HCs) utilizing multilevel metrics of resting-state functional magnetic resonance imaging (rs-fMRI). Sixty mTBI patients and forty HCs were enrolled and allocated to training and testing datasets with a ratio of 80:20. Several rs-fMRI metrics including fractional amplitude of low-frequency …

Association Between Exposure To Radioactive Iodine After The Chernobyl Accident And Thyroid Volume In Belarus 10-15 Years Later, Ekaterina Chirikova, Robert J Mcconnell, Patrick O'Kane, Vasilina Yauseyenka, Mark P Little, Victor Minenko, Vladimir Drozdovitch, Ilya Veyalkin, Maureen Hatch, June M Chan, Chiung-Yu Huang, Kiyohiko Mabuchi, Elizabeth K Cahoon, Alexander Rozhko, Lydia B Zablotska

Department of Radiology Faculty Papers

Background: While there is a robust literature on environmental exposure to iodine-131 (131I) in childhood and adolescence and the risk of thyroid cancer and benign nodules, little is known about its effects on thyroid volume.

Methods: To assess the effect of 131I dose to the thyroid on the volume of the thyroid gland, we examined the data from the baseline screening of the Belarusian-American Cohort Study of residents of Belarus who were exposed to the Chernobyl fallout at ages ≤18 years. Thyroid dose estimates were based on individual thyroid activity measurements made shortly after the accident and dosimetric data from …

Resting-State Functional Mri Metrics In Patients With Chronic Mild Traumatic Brain Injury And Their Association With Clinical Cognitive Performance., Faezeh Vedaei, Andrew B. Newberg, Md, Mahdi Alizadeh, Jennifer Muller, Shiva Shahrampour, Devon Middleton, Ms, George Zabrecky, Nancy Wintering, Anthony J. Bazzan Md, Daniel A. Monti, Md, Feroze Mohamed, Phd

Department of Radiology Faculty Papers

Mild traumatic brain injury (mTBI) accounts for more than 80% of people experiencing brain injuries. Symptoms of mTBI include short-term and long-term adverse clinical outcomes. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) was conducted to measure voxel-based indices including fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC) in patients suffering from chronic mTBI; 64 patients with chronic mTBI at least 3 months post injury and 40 healthy controls underwent rs-fMRI scanning. Partial correlation analysis controlling for age and gender was performed within mTBI cohort to explore the association between rs-fMRI metrics and neuropsychological …

Endovascular Approach In The Management Of Idiopathic Myointimal Hyperplasia Of The Inferior Mesenteric Vein, Yash B Shah, Derek Lee, Tamim S Khaddash

Department of Medicine Faculty Papers

Background: Idiopathic myointimal hyperplasia of the mesenteric vein (IMHMV) is a rare, often undiagnosed pathology affecting the colon. Patients typically present with severe abdominal pain and inflammation caused by smooth muscle proliferation of the veins, leading to arterialization, stenosis, and potential occlusion. The etiology remains unclear, but it has been hypothesized that an arteriovenous connection may be associated with the pathology. This is the first reported case indicating such an association. This case additionally highlights the potential utility of endovascular treatment, as endovascular embolization is generally a less invasive alternative to surgical resection in the treatment of such vascular disorders. …

The Transition To Peer Learning, C. G. Roth, H. V. Naringrekar, A. E. Flanders

Department of Radiology Posters

Problem Description: Historically, peer review has been compelled by regulatory and legislative mandates, such as the Joint Commission Ongoing Professional Practice Evaluation (OPPE) requirement and the Health Care Quality Improvement Act (HCQIA) enacted by Congress in 1986. [1] However, these external mandates were focused on quality assurance, generally carrying punitive connotations and practically translated into rote compliance without the benefit of learning and improvement. In fact, the lack of quality improvement focus prompted the Institute of Medicine (IOM) to release its 2015 report, “Improving Diagnosis in Health Care,” stating that a “critical type of error in health care—diagnostic error—has received …

Imaging And Treatment Of Posttraumatic Ankle And Hindfoot Osteoarthritis, Tetyana Gorbachova, Yulia V. Melenevsky, L. Daniel Latt, Jennifer S. Weaver, Mihra S. Taljanovic

Department of Radiology Faculty Papers

Posttraumatic osteoarthritis of the ankle and hindfoot is a common and frequently debil-itating disorder. 70% to 90% of ankle osteoarthritis is related to prior trauma that encompasses a spectrum of disorders including fractures and ligamentous injuries that either disrupt the articular surface or result in instability of the joint. In addition to clinical evaluation, imaging plays a sub-stantial role in the treatment planning of posttraumatic ankle and hindfoot osteoarthritis. Imaging evaluation must be tailored to specific clinical scenarios and includes weight bearing radiography that utilizes standard and specialty views, computed tomography which can be performed with a standard or a …

Contrast-Enhanced Ultrasound Of Muscle Perfusion May Indicate Patient Response To Left Ventricular Assist Device Therapy., Lauren J. Delaney, Kathleen Fitzgerald, Maria Stanczak, Priscilla Machado, John W..C. Entwistle, Flemming Forsberg, Gordon R. Reeves

Department of Radiology Faculty Papers

PURPOSE: Left ventricular assist device (LVAD) support is associated with peripheral vascular abnormalities beyond those associated with heart failure (HF). These abnormalities are associated with persistent functional impairments that adversely impact quality of life (QoL). Methods for measuring peripheral vascular function in this population are needed.

METHODS: This pilot study investigated the use of contrast-enhanced ultrasound (CEUS) using standardized protocols to estimate changes in peripheral (quadriceps) muscle perfusion among patients with HF (INTERMACS profile 3) undergoing LVAD implantation (n = 7). Patients were then stratified by those who did ("responders", n = 4) and did not ("nonresponders", n = 3) …

Alterations In Functional Connectivity Measured By Functional Magnetic Resonance Imaging And The Relationship With Heart Rate Variability In Subjects After Performing Orgasmic Meditation: An Exploratory Study, Andrew B. Newberg, Nancy Wintering, Chloe Hriso, Faezeh Vedaei, Marie Stoner, Reneita Ross

Department of Radiology Faculty Papers

Background: We measured changes in resting brain functional connectivity, with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI), associated with a creative meditation practice that is augmented by clitoral stimulation and is designed to not only achieve a spiritual experience but to help individuals manage their most intimate personal relationships. Briefly, the meditative state is attained by both the male and female participants while the male stimulates the woman's clitoris. The goal of this practice, called orgasmic meditation (OM), according to the practitioners is not sexual, but to use the focus on clitoral stimulation to facilitate a meditative …

Diagnostic Accuracy Of Ultrasonography For Rotator Cuff Tears: A Systematic Review And Meta-Analysis, Ali S Farooqi, Alexander Lee, David Novikov, Ann Marie Kelly, Xinning Li, John D Kelly, Robert L Parisien

Department of Medicine Faculty Papers

Background: With recent improvements in transducer strength, image resolution, and operator training, ultrasound (US) provides an excellent alternative imaging modality for the diagnosis of rotator cuff tears.

Purpose: To evaluate the diagnostic accuracy of US for partial- and full-thickness rotator cuff tears and biceps tendon tears, compare diagnostic values with those of magnetic resonance imaging (MRI) using arthroscopy as the reference standard, assess longitudinal improvements in accuracy, and compare diagnostic values from operators with different training backgrounds.

Study Design: Systematic review; Level of evidence, 3.

Methods: The PubMed and Cochrane Library databases were systematically searched for full-text journal articles published …

Contrast-Enhanced Ultrasound Assessment Of Treatment Response In A Patient With Multifocal Hepatocellular Carcinoma Treated With Transarterial Chemo And Radioembolization, Esika Savsani, M. Tantawi, Corinne Wessner, Philip Lee, Andrej Lyshchik, Kevin Anton, Colette Shaw, Ji-Bin Liu, John R. Eisenbrey

Department of Radiology Faculty Papers

Minimally invasive locoregional therapies have become important treatment options for patients with intermediate or late-stage hepatocellular carcinoma (HCC) who are ineligible for surgical resection or liver transplantation. Imaging modalities are essential for procedural guidance and for assessing treatment response thereafter. We report a unique finding of a patient with multifocal HCC treated with transarterial radioembolization (TARE) with yttrium-90 (Y90) and transarterial chemoembolization (TACE). We compared contrast-enhanced ultrasound (CEUS) with contrast-enhanced magnetic resonance imaging (CE-MRI) in the evaluation of treatment response to demonstrate advantages of CEUS imaging technique and its early detection of viable tumor.

Point-Of-Care Ultrasound: New Concepts And Future Trends, Yaoting Wang, Huihui Chai, Ruizhong Ye, Jingzhi Li, Ji-Bin Liu, Chen Lin, Chengzhong Peng

Department of Radiology Faculty Papers

Ultrasound (US) technology, with major advances and new developments, has become an essential and first-line imaging modality for clinical diagnosis and interventional treatment. US imaging has evolved from one-dimensional, twodimensional to three-dimensional display, and from static to real-time imaging, as well as from structural to functional imaging. Based on its portability and advanced digital imaging technique, US was first adopted by emergency medicine in the 1980s and gradually gained popularity among other specialists for clinical diagnosis and interventional treatment. Point-of-Care Ultrasound (POCUS) was then proposed as a new concept and developed for new uses, which greatly extended clinical US applications. …

Comparing Two Methods Of Rectal Diclofenac Administration For Pain Management In Second Trimester Abortion: A Randomized Clinical Trial, Mahboobeh Shirazi, Mehnoosh Torkzaban, Samira Fallah, Marjan Ghaemi

Department of Radiology Faculty Papers

Background & Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion.

Materials & Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was …

Predicting Long-Term Hepatocellular Carcinoma Response To Transarterial Radioembolization Using Contrast-Enhanced Ultrasound: Initial Experiences., Lauren J. Delaney, M. Tantawi, Corinne Wessner, Priscilla Machado, Flemming Forsberg, Andrej Lyshchik, Patrick O'Kane, Ji-Bin Liu, Jesse M. Civan, Alison Tan, Kevin Anton, Colette Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

Conventional cross-sectional imaging done shortly after radioembolization of hepatocellular carcinoma (HCC) does not reliably predict long-term response to treatment. This study evaluated whether quantitative contrast-enhanced ultrasound (CEUS) can predict the long-term response of HCC to yttrium-90 (Y-90) treatment. Fifteen patients underwent CEUS at three time points: immediately following treatment and 1 and 2 wk post-treatment. Response 3-6 mo after treatment was categorized on contrast-enhanced magnetic resonance imaging by two experienced radiologists using the Modified Response Evaluation Criteria in Solid Tumors. CEUS data were analyzed by quantifying tumor perfusion and residual fractional vascularity using time-intensity curves. Patients with stable disease on …

Aortic Fistulas: Pathophysiologic Features, Imaging Findings, And Diagnostic Pitfalls, Aishwarya Gulati, Md, Harit Kapoor, Md, Achala Donuru, Mbbs, Frcr, Kunal Gala, Mbbs, Dnb, Maansi Parekh, Mbbs, Dnb

Department of Radiology Faculty Papers

Fistulas between the aorta and surrounding organs are extremely rare but can be fatal if they are not identified and treated promptly. Most of these fistulas are associated with a history of trauma or vascular intervention. However, spontaneous aortic fistulas (AoFs) can develop in patients with weakened vasculature, which can be due to advanced atherosclerotic disease, collagen-vascular disease, vasculitides, and/or hematogenous infections. The clinical features of AoFs are often nonspecific, with patients presenting with bleeding manifestations, back or abdominal pain, fever, and shock. Confirmation with invasive endoscopy is often impractical in the acute setting. Imaging plays an important role in …

Reversing The Effects Of Androgen-Deprivation Therapy In Men With Metastatic Castration-Resistant Prostate Cancer, Catherine H Marshall, Jessa Tunacao, Varun Danda, Hua-Ling Tsai, John Barber, Rakhee Gawande, Clifford R Weiss, Samuel R Denmeade, Corinne Joshu

Department of Medical Oncology Faculty Papers

OBJECTIVE: To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life.

PATIENTS AND METHODS: Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life.

RESULTS: …

Validating Deep Learning Inference During Chest X-Ray Classification For Covid-19 Screening., Robbie Sadre, Baskaran Sundaram, Sharmila Majumdar, Daniela Ushizima

Department of Radiology Faculty Papers

The new coronavirus unleashed a worldwide pandemic in early 2020, and a fatality rate several times that of the flu. As the number of infections soared, and capabilities for testing lagged behind, chest X-ray (CXR) imaging became more relevant in the early diagnosis and treatment planning for patients with suspected or confirmed COVID-19 infection. In a few weeks, proposed new methods for lung screening using deep learning rapidly appeared, while quality assurance discussions lagged behind. This paper proposes a set of protocols to validate deep learning algorithms, including our ROI Hide-and-Seek protocol, which emphasizes or hides key regions of interest …

Primary Leiomyosarcoma Of The Distal Tibia: A Case Report., Sachin Dheer, Pamela Gekas, Faith Schick, Homyar Karanjia, Nicholas Taweel

Department of Radiology Faculty Papers

The authors present an unusual case of a leiomyosarcoma of the distal tibia. Leiomyosarcoma tumors typically originate from smooth muscle tissue. It is rare for it to derive from bone and even rarer to be found in a bone of the lower limb. Given this extreme rarity in addition to nonspecific findings on plain film radiographs and magnetic resonance imaging (MRI), biopsy was needed in this case. It was only through immunochemistry staining that a definitive diagnosis was made. As such, this case is an illustrative example of an aggressive, though rare, primary lesion of the bone which should be …

Gemcitabine-Loaded Microbubble System For Ultrasound Imaging And Therapy., Lauren J. Delaney, John R. Eisenbrey, David Brown, Jonathan R Brody, Masaya Jimbo, Brian E Oeffinger, Maria Stanczak, Flemming Forsberg, Ji-Bin Liu, Margaret A Wheatley

Department of Radiology Faculty Papers

Ultrasound imaging presents many positive attributes, including safety, real-time imaging, universal accessibility, and cost. However, inherent difficulties in discrimination between soft tissues and tumors prompted development of stabilized microbubble contrast agents. This presents the opportunity to develop agents in which drug is entrapped in the microbubble shell. We describe preparation and characterization of theranostic poly(lactide) (PLA) and pegylated PLA (PEG-PLA) shelled microbubbles that entrap gemcitabine, a commonly used drug for pancreatic cancer (PDAC). Entrapping 6 wt% gemcitabine did not significantly affect drug activity, microbubble morphology, or ultrasound contrast activity compared with unmodified microbubbles. In vitro microbubble concentrations yielding ≥ 500nM …

N-Acetyl Cysteine Administration Affects Cerebral Blood Flow As Measured By Arterial Spin Labeling Mri In Patients With Multiple Sclerosis., Shiva Shahrampour, Justin Heholt, Andrew Wang, Faezeh Vedaei, Feroze B. Mohamed, Mahdi Alizadeh, Ze Wang, George Zabrecky, Nancy Wintering, Anthony J. Bazzan, Thomas P. Leist, Daniel A. Monti, Andrew B. Newberg

Department of Radiology Faculty Papers

Background: The purpose of this study was to explore if administration of N-acetyl-cysteine (NAC) in patients with multiple sclerosis (MS) resulted in altered cerebral blood flow (CBF) based on Arterial Spin Labeling (ASL) magnetic resonance imaging (MRI).

Methods: Twenty-three patients with mild to moderate MS, (17 relapsing remitting and 6 primary progressive) were randomized to either NAC plus standard of care (N = 11), or standard of care only (N = 12). The experimental group received NAC intravenously (50 mg/kg) once per week and orally (500mg 2x/day) the other six days. Patients in both groups were evaluated initially and after …

Radiologic Measurements In The Assessment Of Patellar Instability: A Systematic Review And Meta-Analysis., Alex E White, Peters T Otlans, Dylan P. Horan, Daniel Calem, William Emper, Kevin Freedman, Fotios Tjoumakaris, Md

Rothman Institute Papers

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies.

Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability.

Study Design: Systematic review; Level of evidence, 4.

Methods: We performed a systematic review of the literature using the PubMed, SCOPUS, and Cochrane databases. Each database was searched for variations of the …