Radiology Commons^™

Lymphoma Imaging In Hiv And Non-Hiv Patients: A Retrospective Cross-Sectional Study With Clinical And Pathological Correlation, Poonamjeet Loyal, Edward Chege, Jasmit Shah, Anne Mwirigi, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Background: Patients with Human Immunodeficiency Virus (HIV)have an atypical imaging pattern of lymphoma. There is paucity of literature on differences in tumor volume or burden of disease amongst HIV positive patients compared with HIV negative patients and how this correlates with clinicopathological parameters of aggressiveness and prognosis.

Methods: This was a retrospective cross-sectional study of patients with non-Hodgkin lymphoma which were categorized into HIV positive and HIV negative. The tumor burden, disease sites, international prognostic score and Ki-67 index were recorded. Continuous variables were analyzed using the Kruskal Wallis test and categorical variables with Fisher’s Exact test.

Results …

Not All That Hurts Is Malignant: A Painful Case Of Focal Nodular Hyperplasia, Zamanali Khakhar, Abdullahi Abdigafar Yunis, Dayib Buthul, Khadija Warfa, Soraiya Manji, Rajiv Patel, Sayed Ali Raza Bukhari

Imaging & Diagnostic Radiology, East Africa

Focal nodular hyperplasia (FNH) is a benign hepatic lesion most often detected incidentally during imaging studies. While typically asymptomatic, a small subset of patients may present with abdominal pain or discomfort. Clinically and radiologically, FNH can mimic malignant liver tumors, occasionally resulting in unnecessary invasive procedures. This case report describes a 45-year-old woman with symptomatic FNH who was placed on routine imaging surveillance and managed conservatively. This case underscores the importance of accurately distinguishing this benign condition from hepatic malignancies. It further highlights the diagnostic challenges associated with achieving a definitive diagnosis.

Interobserver Variability In Cardiovascular Fdg Pet/Ct Analysis In Large Vessel Vasculitis, Redemptar Kimeu, Anoop Shah, Samuel Gitau, Gemina Doolub, Jeilan Mohamed

Imaging & Diagnostic Radiology, East Africa

Introduction: PET/CT has a synergistic value for optimal diagnosis, disease activity monitoring, and evaluation of damage progression in large vessel vasculitis. The use of standardized uptake values (SUV) as a measurement of relative tissue uptake facilitates comparisons between patients, and has been suggested as a basis for diagnosis. The SUVmean and SUVmax reproducibility in vascular structures is not widely studied.

Objective: The objective of this study was to evaluate the inter-observer variability of both qualitative visual grading of aortic 18F-FDG uptake and the quantitative aortic mean and maximum SUVs in these patients with mild to moderate covid-19 infection …

Development Of An Online Authentic Radiology Viewing And Reporting Platform To Test The Skills Of Radiology Trainees In Low- And Middle-Income Countries, Hubert Vesselle, Justy Antony Chiramal, Stephen Hawes, Eric Schulze, Tham Nguyen, Rose Ndumia, Sudhir Vinayak

Imaging & Diagnostic Radiology, East Africa

Background: Diagnostic radiology residents in low- and middle-income countries (LMICs) may have to provide significant contributions to the clinical workload before the completion of their residency training. Because of time constraints inherent to the delivery of acute care, some of the most clinically impactful diagnostic radiology errors arise from the use of Computed Tomography (CT) in the management of acutely ill patients. As a result, it is paramount to ensure that radiology trainees reach adequate skill levels prior to assuming independent on-call responsibilities. We partnered with the radiology residency program at the Aga Khan University Hospital in Nairobi (Kenya) to …

Thyroid Cartilage Metastases From Prostate Cancer On 18f Psma Pet Ct: A Case Series, Poonamjeet Loyal, Samuel Gitau, Khalid Makhdomi

Imaging & Diagnostic Radiology, East Africa

Prostate cancer metastases to the thyroid cartilage is an extremely rare phenomenon. We report three cases of advanced prostate carcinoma with metastases to the thyroid cartilage identified on 18F prostate-specific membrane antigen-1007 (PSMA-1007) positron emission tomography (PET)/computed tomography (CT). The pathophysiology and possibility for under-reporting are also discussed. Prostate cancer metastases to the larynx should be considered in the differential diagnosis of thyroid cartilage lesions in patients with advanced prostate cancer and is associated with poor prognosis.

A Rare Case Of Biliary Atresia With Biliary Ascites On A (Hepatobiliary Iminodiacetic Acid) Hida Scan, Poonamjeet Loyal, Khalid Makhdomi, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Biliary atresia is one of the most challenging conditions in pediatric surgery even when it is the only finding. Here we present a rare case of biliary atresia complicated with biliary ascites due to ductal perforation identified on a hepatobiliary iminodiacetic acid (HIDA) scan.

Entrance Surface Air Kerma To Patients During Digital Radiographic Examinations In Tanzania, Atumaini Makoba, Ahmed Jusabani, Wilbroad Muhogora, Abdallah Kileo, Musa Ndukeki, Huruma Mammba, Hilda Makungu, Haika Maro, Erick Onoka, Miguta Ngulimi

Imaging & Diagnostic Radiology, East Africa

The aim of this study was to determine the entrance surface air kerma (ESAK) in adult patients during digital radiography and to evaluate the optimisation potential in five common X-ray examinations in Tanzania. Based on a sample of 240–610 patients, ESAK was estimated using X-ray tube output measurements, patient information and backscatter factors. The results show that the mean ESAK values were higher or comparable to data from the literature. The diagnostic reference values of ESAK for digital radiography were 0.31 mGy (chest PA), 4 mGy (lumbar spine AP), 5.4 mGy (lumbar spine LAT), 3.8 mGy (abdomen AP) and 2.4 …

Endovascular Management Of A Congenital Hepatic Arterioportal Malformation In A Low Resource Setting, Poonamjeet Loyal, Ravjit Sagoo

Imaging & Diagnostic Radiology, East Africa

Background: Arterioportal malformations, a rare type of vascular malformation, have significant associated morbid- ity and mortality. Management requires a carefully thought out approach by a multidisciplinary team. Low resource settings have an added challenge of limited treatment options and consumables.

Case presentation: We report a case of a 14-month-old male with failure to thrive due to a congenital hepatic arte- rioportal fistula. He was successfully treated via an endovascular approach with metallic coil embolization.

Conclusion: Hepatoportal fistula, a rare hepatic vascular malformation, has limited treatment options which can further be restricted by overall patient wellness. Minimally invasive …

The Association Of Age At Menarche And Adult Height With Mammographic Density In The International Consortium Of Mammographic Density, Sarah V. Ward, Anya Burton, Rulla M. Tamimi, Ana Pereira, Maria Luisa Garmendia, Marina Pollan, Norman Boyd, Isabel Dos-Santos-Silva, Sudhir Vinayak, Rose Ndumia

Imaging & Diagnostic Radiology, East Africa

Background: Early age at menarche and tall stature are associated with increased breast cancer risk. We examined whether these associations were also positively associated with mammographic density, a strong marker of breast cancer risk.

Methods: Participants were 10,681 breast‐cancer‐free women from 22 countries in the International Consortium of Mammographic Density, each with centrally assessed mammographic density and a common set of epidemio‐ logic data. Study periods for the 27 studies ranged from 1987 to 2014. Multi‐level linear regression models estimated changes in square‐root per cent density (√PD) and dense area (√DA) associated with age at menarche and adult …

A Curriculum Model For Multidisciplinary Training Of Midwife Sonographers In A Low Resource Setting, Sudhir Vinayak, Marleen Temmerman, Geert Villeirs, Sharon M. Brownie

Imaging & Diagnostic Radiology, East Africa

In many low-resource settings, less than 5% of pregnant women can access ultrasound during pregnancy. Thus, gestational age is often difficult to determine, multiple pregnancies are diagnosed late and foetal and pregnancy-related anomalies can go undetected. A pilot solution was designed beyond the traditional approach of increasing numbers of qualified radiologists, gynaecologists and sonographers. An innovative Human Resource for Health (HRH) task sharing, and maternal child health (MCH) workforce training and capacity building initiative was designed, involving development and testing of a curriculum to train midwife sonographers via a teleradiology innovation platform and a partnership between specialist radiologists, sonographers and …

Effect Of Lowering Tube Potential And Increase Iodine Concentration Of Contrast Medium On Radiation Dose And Image Quality In Computed Tomography Pulmonary Angiography Procedure: A Phantom Study, Justin E. Ngaile, Peter K. Msaki, Evarist M. Kahuluda, Furaha M. Chuma, Jerome M. Mwimanzi, Ahmed Jusabani

Imaging & Diagnostic Radiology, East Africa

The aim of the study was to examine the effect of lowering tube potential and increase iodine concentration on image quality and radiation dose in computed tomography pulmonary angiography procedure. The pulmonary arteries were simulated by three syringes. The syringes were filled with 1:10 diluted solutions of 300 mg, 350 mg and 370 mg of iodine per millilitre concentration in three water-filled phantoms simulating thin, intermediate and thick patients. The phantoms were scanned at 80 kVp, 110 kVp and 130 kVp and 0.6 second rotation time using a 16 slice computed tomography (CT) scanner. The tube current was either fixed …

Cardiovascular Mechanisms In Covid-19: Methodology Of A Prospective Observational Multimodality Imaging Study (Cosmic-19 Study), Shirjel Alam, Anoop Shah, Kevin Onyinkwa, Edward Nganga, Samuel Gitau, Khalid Makhdomi, Michael Chung, Sudhir Vinayak

Imaging & Diagnostic Radiology, East Africa

Background: 8-28% of patients infected with COVID-19 have evidence of cardiac injury, and this is associated with an adverse prognosis. The cardiovascular mechanisms of injury are poorly understood and speculative. We aim to use multimodality cardiac imaging including cardiac magnetic resonance (CMR) imaging, computed tomography coronary angiography (CTCA) and positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG-PET/CT) to identify the cardiac pathophysiological mechanisms related to COVID-19 infections.

Methods: This is a single-centre exploratory observational study aiming to recruit 50 patients with COVID-19 infection who will undergo cardiac biomarker sampling. Of these, 30 patients will undergo …

Thinking Outside Malaria: A Rare Case Of Disseminated Cysticercosis With Cardiopulmonary Involvement From Urban Tanzania, Frederick R. Lyimo, Ahmed Jusabani, Hilda Makungu, Maria Mtolera, Salim Surani

Imaging & Diagnostic Radiology, East Africa

Dissemination of the cysticerci throughout the body with cardiopulmonary involvement represents a very rare occurrence and an uncommon form of cysticercosis manifestation. We report a rare case of a 48-yearold African male from urban Tanzania who was, at first, referred to our radiology department for a coronary computed tomography angiography (CCTA), but incidentally on further evaluation of the patient revealed a history of recurrent convulsions, loss of consciousness, a single episode of temporary loss of vision and recent skin nodules. The value of a full clinical and radiological evaluation of the patient presenting with adult-onset seizures cannot be overemphasized for …

Myocardial Echinococcosis: Rare Manifestation Of A Common Parasitic Disease In Northern Tanzania, Ahmed Jusabani, Clement F. Kalambo, Mubashir Jusabani, Salim Surani

Imaging & Diagnostic Radiology, East Africa

Hydatid (Echinococcal) disease often involves the liver and lungs but in sporadic cases, it can involve cardiac structures. A 24-year-old male was referred with symptoms of cough and shortness of breath and a provisional diagnosis of metastatic disease of unknown primary to the lung, which was based on a chest X-ray (CXR). Incidentally, on echocardiogram, he was found to have right ventricular (RV) and myocardial multiseptated cysts, which were compatible with cardiac echinococcosis, as the patient had multiple bilateral lung cysts as well. Imaging with ultrasound, computed tomography (CT) scan, and magnetic resonance imaging (MRI) has ameliorated the diagnosis of …

Spectrum Of Imaging Findings In Aidsrelated Diffuse Large B Cell Lymphoma, Edward Nganga, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Lymphoma in HIV-infected patients is AIDS defining. This is the second most common AIDS defining malignancy after Kaposi’s sarcoma. Development of lymphoma in HIV patients is related to immunosuppression and high viral load. Co-infection with other lymphotrophic viruses especially EBV is also strongly associated with development of lymphoma in HIV patients. Despite advances in HAART therapy, incidence of diffuse large B cell lymphoma in HIV-infected patients remains significantly higher than in the general population.

Early diagnosis is challenging due to presence of opportunistic infections and atypical presentation of the lymphoma in this subset of patients. Atypical imaging findings are not …

Urinary Bladder Metastasis From Breast Cancer: A Rare Cause Of Hematuria, Samuel Gitau, Allan Njau, Sitna Mwanzi

Imaging & Diagnostic Radiology, East Africa

Breast cancer is the most common cancer in women globally as well as in Kenya. The most common sites of metastases reported include the bones, liver and lung. Metastasis to the urinary bladder is relatively uncommon with only a few case reports in literature. It can therefore be easily overlooked as a cause of hematuria in these patients. We describe a rare case of a patient with breast cancer who presented with urinary bladder metastasis as a late complication of her illness.

A Case Of Retroperitoneal Fibrosis Secondary To Chronic Periaortitis, Mariam Omar, Naushad Karim, Saeed Samnakay

Imaging & Diagnostic Radiology, East Africa

Retroperitoneal fibrosis is a rare inflammatory disorder causing increased fibrotic deposition in the retroperitoneum, often leading to ureteral obstruction. We present a case report of a 33-year-old male with 2-month history of back pain. Initial imaging showed thickening around the infrarenal aorta. Six months later the patient presented with renal failure; a CT abdomen revealed extensive soft tissue mass around the aorta resulting in ureteral obstruction. Histology results of biopsy of the soft tissue mass revealed retroperitoneal fibrosis. It is important for clinicians to treat periaortitis early as this can prevent progression to retroperitoneal fibrosis which can cause severe secondary …

Bone Scintigraphy Imaging Of Cardiac Amyloidosis, Issa Menge Kuria, Samuel Gitau, Khalid Makhdomi

Imaging & Diagnostic Radiology, East Africa

Transthyretin-related cardiac amyloidosis (ATTR) amyloidosis is an aggressive, rapidly progressive, and fatal disease, for which several promising therapies are in development. This condition is frequently underdiagnosed because of the limited specificity of echocardiography and the traditional requirement for histological diagnosis. It is well known that 99mtechnetium-labeled bone scan radiotracers can localize in the myocardial amyloid deposits, but the use of this imaging modality to differentiate between the two subtypes has only lately been revisited. We report a case of a 76-year-old man with a clinical diagnosis of amyloidosis who underwent a bone scan that had features of ATTR amyloidosis. To …

First Africa Non-Communicable Disease Research Conference 2017: Sharing Evidence And Identifying Research Priorities, Kenneth Juma, Pamela A. Juma, Shukri F. Mohamed, Jared Owuor, Ann Wanyoike, David Mulabi, George Odinya, Maureen Njeru, Gerald Yonga

Imaging & Diagnostic Radiology, East Africa

Non-communicable diseases (NCDs) prevalence is rising fastest in lower income settings, and with more devastating outcomes compared to High Income Countries (HICs). While evidence is consistent on the growing health and economic consequences of NCDs in sub-Saharan Africa (SSA), specific efforts aimed at addressing NCD prevention and control remain less than optimum and country level progress of implementing evidence backed cost-effective NCD prevention approaches such as tobacco taxation and restrictions on marketing of unhealthy food and drinks is slow. Similarly, increasing interest to employ multi-sectoral approaches (MSA) in NCD prevention and policy is impeded by scarce knowledge on the mechanisms …

Effect Of 10-Valent Pneumococcal Conjugate Vaccine On The Incidence Of Radiologically-Confirmed Pneumonia And Clinically-Defined Pneumonia In Kenyan Children: An Interrupted Time-Series Analysis, Micah Silaba, Michael Ooko, Christian Bottomley, Joyce Sande, Rachel Benamore, Kate Park, James Ignas, Kathryn Maitland, Neema Mturi, Anne Makumi

Imaging & Diagnostic Radiology, East Africa

Background: Pneumococcal conjugate vaccines (PCV) are highly protective against invasive pneumococcal disease caused by vaccine serotypes, but the burden of pneumococcal disease in low-income and middle-income countries is dominated by pneumonia, most of which is non-bacteraemic. We examined the effect of 10-valent PCV on the incidence of pneumonia in Kenya.

Methods: We linked prospective hospital surveillance for clinically-defined WHO severe or very severe pneumonia at Kilifi County Hospital, Kenya, from 2002 to 2015, to population surveillance at Kilifi Health and Demographic Surveillance System, comprising 45000 children younger than 5 years. Chest radiographs were read according to a WHO standard. A …

Comparison Of Quantitative Analysis To Qualitative Analysis For Interpretation Of Lower‑Limb Lymphoscintigraphy, Edward Nganga, Khalid Makhdomi

Imaging & Diagnostic Radiology, East Africa

Qualitative analysis of lymphoscintigrams is subject to wide variability and may miss subtle differences in ilioinguinal uptake between normal and abnormal limbs. This study compared quantitative analysis to qualitative analysis of lower‑limb lymphoscintigraphy in diagnosing lymphedema. Fifty‑two lymphoscintigrams performed using standardized protocol, 99‑metastable technetium nanocolloid intradermal injection at the first interdigital space, were analyzed quantitatively. Fifty‑three normal and 51 abnormal limbs were analyzed. For each limb, a region of interest (ROI) was drawn around the injection site, and ilioinguinal nodes on the 1.5 h static images and the counts in these ROIs were recorded. Percentage ilioinguinal nodes uptake was then …

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

Imaging & Diagnostic Radiology, East Africa

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

Mammographic Density And Ageing: A Collaborative Pooled Analysis Of Cross-Sectional Data From 22 Countries Worldwide, Anya Burton, Gertraud Maskarinec, Beatriz Perez-Gomez, Celine Vachon, Hui Miao, Martín Lajous, Ruy López-Ridaura, Megan Rice, Ana Pereira, Maria Luisa Garmendia, Rulla M. Tamimi, Kimberly Bertrand, Ava Kwong, Giske Ursin, Sudhir Vinayak, Rose Ndumia, Shivaani Mariapun

Imaging & Diagnostic Radiology, East Africa

Background:Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known.

Methods and findings: We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35–85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of …

Thyroid Ultrasound: State Of The Art Part 1 - Thyroid Ultrasound Reporting And Diffuse Thyroid Diseases, Manjiri Dighe, Richard Barr, Jörg Bojunga, Vito Cantisani, Maria Cristina Chammas, David Cosgrove, Xin-Wu Cui, Yi Dong, Franziska Fenner, Maija Radzina, Sudhir Vinayak, Jun-Mei Xu, Christoph F. Dietrich

Imaging & Diagnostic Radiology, East Africa

Accurate differentiation of focal thyroid nodules (FTL) and thyroid abnormalities is pivotal for proper diagnostic and therapeutic work-up. In these two part articles, the role of ultrasound techniques in the characterization of FTL and evaluation of diffuse thyroid diseases is described to expand on the recently published World Federation in Ultrasound and Medicine (WFUMB) thyroid elastography guidelines and review how this guideline fits into a complete thyroid ultrasound exam.

Prostate-Specific Antigen As A Risk Factor For Skeletal Metastasis In Native Ethnic African Men With Prostate Cancer: A Case-Control Study, Mahmood Qureshi, Khalid Makhdomi, William Stones

Imaging & Diagnostic Radiology, East Africa

Prostate cancer is the most common noncutaneous cancer in males. Men of African origin are at a significantly higher risk as reflected in the higher incidence and mortality rates in this racial group. Metastases incidence increases parallel to serum levels of prostate-specific antigen (PSA), contributing significantly to morbidity and mortality. Staging of the disease involves bone scans, which are sensitive in detecting skeletal metastases. Suggestions that these scans may be omitted in some situations in patients with low prostate specific antigen levels have drawn attention to the matter. In this case-control study, using radiology and pathology records, a registry of …

Ultrasound Shear Wave Elastography And Liver Fibrosis: A Prospective Multicenter Study, Joyce Sande, Suleman Verjee, Sudhir Vinayak, Farin Amersi, Munir Ghesani

Imaging & Diagnostic Radiology, East Africa

Aim: To assess the accuracy of shear wave elastography (SWE) alone and in combination with aminotransferase platelet ratio index (APRI) score in the staging of liver fibrosis.

Methods: A multicenter prospective study was conducted to assess the accuracy of SWE (medians) and APRI to predict biopsy results. The analysis focused on distinguishing the different stages of liver disease, namely, F0 from F1-4, F0-1 from F2-4, F0-2 from F3-4 and F0-3 from F4; F0-F1 from F2-F4 being of primary interest. The area under the receiver operating characteristic (AUROC) curve was computed using logistic regression model. The role of age, gender and …

Training Midwives To Perform Basic Obstetric Point-Of-Care Ultrasound In Rural Areas Using A Tablet Platform And Mobile Phone Transmission Technology—A Wfumb Coe Project, Sudhir Vinayak, Joyce Sande, Harvey Nisenbaum, Christian Pállson Nolsøe

Imaging & Diagnostic Radiology, East Africa

Point-of-care ultrasound (POCUS) has become a topical subject and can be applied in a variety of ways with differing outcomes. The cost of all diagnostic procedures including obstetric ultrasound examinations is a major factor in the developing world and POCUS is only useful if it can be equated to good outcomes at a lower cost than a routine obstetric examination. The aim of this study was to assess a number of processes including accuracy of images and reports generated by midwives, performance of a tablet-sized ultrasound scanner, training of midwives to complete ultrasounds, teleradiology solution transmissions of images via internet, …

Antenatal Umbilical Coiling Index And Newborn Outcomes: Cohort Study, Josephine Mwikali Ndolo, Sudhir Vinayak, Micah Ominde, William Stones

Imaging & Diagnostic Radiology, East Africa

Objectives: We aimed to test the predictive value of antenatal umbilical coiling index (aUCI) among a prospectively recruited cohort of antenatal women.

Methods: Women with singleton pregnancies were recruited at their second‑trimester scan. Images of the umbilical cord were used to calculate the aUCI. Pregnancy and birth outcomes were recorded and statistical associations between aUCI and small for gestational age (SGA) using international standard birth weight centiles and preterm birth were investigated (n = 430).

Results: aUCI results were consistent with the literature and showed good reproducibility between observers. Abnormal aUCI was not associated with SGA, but there was a …

Mammographic Density Assessed On Paired Raw And Processed Digital Images And On Paired Screen-Film And Digital Images Across Three Mammography Systems, Anya Burton, Graham Byrnes, Jennifer Stone, Rulla M. Tamimi, John Heine, Celine Vachon, Vahit Ozmen, Ana Pereira, Maria Luisa Garmendia, Christopher Scott, John H. Hipwell, Caroline Dickens, Joachim Schüz, Mustafa Erkin Aribal, Kimberly Bertrand, Ava Kwong, Graham G. Giles, John Hopper, Beatriz Pérez Gómez, Marina Pollán, Soo-Hwang Teo, Shivaani Mariapun, Nur Aishah Mohd Taib, Martín Lajous, Ruy Lopez-Riduara, Megan Rice, Isabelle Romieu, Anath Arzee Flugelman, Giske Ursin, Samera Qureshi, Huiyan Ma, Eunjung Lee, Reza Sirous, Mehri Sirous, Jong Won Lee, Jisun Kim, Dorria Salem, Rasha Kamal, Mikael Hartman, Hui Miao, Kee-Seng Chia, Chisato Nagata, Sudhir Vinayak, Rose Ndumia, Carla H. Van Gils, Johanna O. P. Wanders, Beata Peplonska, Agnieszka Bukowska, Steve Allen, Sarah Vinnicombe, Sue Moss, Anna M. Chiarelli, Linda Linton, Gertraud Maskarinec, Martin J. Yaffe, Norman F. Boyd, Isabel Dos-Santos-Silva, Valerie A. Mccormack

Imaging & Diagnostic Radiology, East Africa

Background: Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/ digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types.

Methods: We obtained 1294 pairs of images saved in both raw and processed formats from Hologic and General Electric (GE) direct digital systems and a Fuji computed radiography (CR) system, and 128 screen-film and processed CR-digital pairs from consecutive screening rounds. Four readers performed Cumulus-based MD measurements (n = 3441), with each image pair read …

High Prevalence Of Liver Fibrosis In Patients With Human Immunodeficiency Virus Monoinfection And Human Immunodeficiency Virus Hepatitis-B Co-Infection As Assessed By Shear Wave Elastography: Study At A Teaching Hospital In Kenya, Samuel Gitau, Sudhir Vinayak, Micah Ominde, Rodney Adam, Reena Shah

Imaging & Diagnostic Radiology, East Africa

Objectives:The aim of this study was to determine the prevalence of liver fibrosis in patients with human immunodeficiency virus (HIV) monoinfection versus those with HIV hepatitis-B virus (HBV) co-infection as assessed with shear wave elastography (SWE) in a tertiary sub-Saharan Africa hospital.

Materials and Methods:A total of 105 consecutive patients, 70 with HIV monoinfection and 35 with HIV-HBV co-infection, had liver elastography obtained using SWE to assess for the presence of liver fibrosis the cutoff of which was 5.6 kPa. Assessment of aspartate aminotransferase-to-platelet ratio index (APRI) score (a noninvasive serum biomarker of liver fibrosis) in these patients …