Radiology Commons^™

18f-Fdg Pet/Ct Imaging Of Extranodal Rosai-Dorfman Disease With Hepatopancreatic Involvement - A Pictorial And Literature Review., Faiq A. Shaikh Md, Omer Awan Md, Mph, Sohaib A. Mohiuddin Md, Saleem Farooqui, Salman A. Khan, William Mccartney

Department of Radiology & Diagnostic Medical Imaging

We share our experience with serial PET/CT imaging on a patient with extranodal Rosai-Dorfman disease (RDD) with hepatopancreatic involvement. RDD is a benign proliferative disorder of histiocytes mainly involving the lymph nodes. It typically presents with fever and painless cervical lymphadenopathy in young adults and less than half of RDS cases demonstrate extranodal involvement. RDD involvement of the liver and pancreas is extremely rare, and this case highlights the role of PET/CT in its management.

Radiography Clinical Instructors' Perceptions Of The Transition From Technologist To Educator, Christina G. Lee

Electronic Theses and Dissertations

Radiologic technologists who transition into the role of clinical instructor are usually expert practitioners but may lack knowledge of best practices regarding student instruction and evaluation. The purpose of this phenomenological qualitative study was to investigate how CIs experience the transition from practitioner to educator and what knowledge or education of best practices of instruction and evaluation they bring to the position. This study consisted of interviews with radiography CIs from one associate degree radiography program in the southeastern part of the United States. While some CIs felt prepared to transition into the CI role, none of them had previously …

Labrad : Vol 41, Issue 3 - December 2015, Aga Khan University Hospital, Karachi

LABRAD

• Overview on Approach to Inherited Bleeding Disorders
• Diagnostic Approach to Haemoglobinopathies
• Transient Abnormal Myelopoiesis
• Urinary Tract Infections (UTI) in Children
• Role of Histopathology in the Diagnosis of Paediatric Renal Tumours
• Role of Histopathology in the Diagnosis of Paediatric Bone and Soft Tissue Small Round Cell Tumours
• Evaluation of Inborn Errors of Metabolism (IEM) In a Nutshell
• An Update on Blood Lead Levels in Children
• Clinical Utility of Immature Platelet Fraction – An advanced 25 Parameter in Laboratory Hematology
• Meeting Report: “Les Confluences” The Society for the Study 30 of Inborn errors of Metabolism (SSIEM) Annual Symposium 2015 in Lyon, France

Feasibility Of Using Raman-Based Techniques For Breast Cancer Detection, Sara Mollamohammada

Department of Civil and Environmental Engineering: Dissertations, Theses, and Student Research

Breast cancer is one of the common types of cancer among women all over the world. Early diagnosis is an effective way that improve the treatment process and gives the patients a better chance of survival. Many of the patients infected by breast cancer choose breast conservation surgery (BCS). However, some of those will be subjected to mastectomy, and many will have tumor recurrence as there is no precise technique to show the tumor margins. Raman-based methods are powerful techniques with potential to rapidly differentiate normal from tumor tissues and provides a solution to detect tumor margin. This is because …

Voxel-Level Absorbed Dose Calculations With A Deterministic Grid-Based Boltzmann Solver For Nuclear Medicine And The Clinical Value Of Voxel-Level Calculations, Justin Mikell

Dissertations & Theses (Open Access)

Voxel-level absorbed dose (VLAD) is rarely calculated for nuclear medicine (NM) procedures involving unsealed sources or 90Y microspheres (YM). The current standard of practice for absorbed dose calculations in NM utilizes MIRD S-values, which 1) assume a uniform distribution in organs, 2) do not use patient specific geometry, and 3) lack a tumor model. VLADs overcome these limitations. One reason VLADs are not routinely performed is the difficulty in obtaining accurate absorbed doses in a clinically acceptable time. The deterministic grid-based Boltzmann solver (GBBS) was recently applied to radiation oncology where it was reported as fast and accurate for both …

Effective Communication Of Critical Radiology Results: The Implementation Of Panic Alert Mechanism, Mumtaz Malik, Sidrah Nausheen

Department of Radiology

Objective: To establish an effective channel of timely communication of life-threatening emergencies to primary physicians by radiology team.Methods: The observational study was conducted at Aga Khan Hospital for Women and Children, Kharadar, Karachi. Data was collected from the log book from July 2012 to June 2013.Amultidisciplinary "Panic Alert" protocol was formulated and implemented in the Radiology unit. All radiological examinations were screened as soon as possible and panic alerts [provisional findings] were communicated to their primary care taker/relevant nursing staff, attendants within 30 minutes from the time of completion of examination. Complete log was maintained. Data was analysed on SPSS …

A Comparative Analysis Of Data Collection Systems Used In Radiography Educational Programs And The Role Mobile Electronic Devices Play, Robin S. Garner

Electronic Theses and Dissertations

Each radiography program has a system to collect important data from didactic and clinical settings in order to accurately assess the progress and success of students, provide the needed student intervention, and provide accreditation agencies with appropriate documentation that demonstrates student success in reaching program learning outcomes. The purpose of this research study was to determine the method of data collection and documentation used by radiography programs to evaluate student progress and to examine if MEDs play a role in evaluating and documenting student skills at the point of care.

The majority of radiography programs in this study were using …

Calibration And Optimization Of 3d Digital Breast Tomosynthesis Guided Near Infrared Spectral Tomography, Kelly E. Michaelsen, Venkataramanan Krishnaswamy, Linxi Shi, Srinivasan Vedantham, Steven Poplack, Andrew Karellas, Brian Pogue, Keith Paulsen

Dartmouth Scholarship

Calibration of a three-dimensional multimodal digital breast tomosynthesis (DBT) x-ray and non-fiber based near infrared spectral tomography (NIRST) system is challenging but essential for clinical studies. Phantom imaging results yielded linear contrast recovery of total hemoglobin (HbT) concentration for cylindrical inclusions of 15 mm, 10 mm and 7 mm with a 3.5% decrease in the HbT estimate for each 1 cm increase in inclusion depth. A clinical exam of a patient's breast containing both benign and malignant lesions was successfully imaged, with greater HbT was found in the malignancy relative to the benign abnormality and fibroglandular regions (11 μM vs. …

Pediatric Neuroradiology Pre-Call Primer, Trevor Morrison, Gilbert Vezina, Nadja Kadom

E-Learning Modules

Pediatric neuroimaging can provide a challenge to radiology residents during call due to the fact that it is infrequently encountered in many institutions. The goal of this teaching tool is to provide radiology residents with background knowledge in pediatric brain anatomy and pathology in preparation for taking call. There is one teaching tool and one assessment tool with answers, all three of which are in PowerPoint format. Emergency neuroradiology topics discussed in this module are sutures, skull fractures, bleeds, sulci and mass effect, cisterns, and herniations. After implementing this teaching tool at our institution with all incoming residents and fellows, …

A Prospective Analysis Of Factors Associated With Decreased Physical Activity In Patients With Cirrhosis Undergoing Transplant Evaluation, Anna Christina Dela Cruz, Valery Vilchez, Sooyeon Kim, Benjamin Barnes, Abhishek Ravinuthala, Anthony Zanni, Roberto Galuppo, Achuthan Sourianarayanane, Trushar Patel, Erin Colleen Maynard, Malay B. Shah, Michael F. Daily, Timothy L. Uhl, Karyn A. Esser, Roberto Gedaly

Internal Medicine Faculty Publications

BACKGROUND: Physical activity has been associated with improved recovery time after transplantation. Handgrip strength has been related to post-transplant outcomes.

AIM: To evaluate predictors of physical activity and grip strength in cirrhotic patients undergoing liver transplant evaluation.

METHODS: Single center, prospective analysis.

RESULTS: A hundred patients were evaluated (54% male, mean age 53 ± 9). Common etiologies of liver disease were non-alcoholic hepatitis (27%), hepatitis C (22%), and alcoholic liver disease (21%). Mean MELD score was 13.5. Forty one percent had a history of smoking. Ninety-three patients completed the International Physical Activity Questionnaire. The median total physical activity score of …

Frequency And Severity Of Acute Toxicity Of Pelvic Radiotherapy For Gynecological Cancer, Asim Hafiz, Ahmed Nadeem Abbasi, Nasir Ali, Khurshid Ahmed Khan, Bilal Mazhar Qureshi

Department of Radiation Oncology

Objective: To determine the frequency and severity of acute toxicity of pelvic radiotherapy for gynecological cancer.STUDY Design: A case series.PLACE AND DURATION OF STUDY: Department of Oncology, The Aga Khan University Hospital, Karachi, from March 2011 to June 2012.METHODOLOGY: A total of 99 patients with histologically proven uterine and cervical cancer, receiving radiation therapy, were enrolled into the study after informed consent on justification of inclusion and exclusion criteria. Patients were evaluated for the frequency and severity of pelvic radiotherapys side effects according to toxicity criteria based on RTOG/EORTC and CTC version 2 criteria at the start, during and at …

Plant-Derived Sac Domain Of Par-4 (Prostate Apoptosis Response 4) Exhibits Growth Inhibitory Effects In Prostate Cancer Cells, Shayan Sarkar, Sumeet Jain, Vineeta Rai, Dipak K. Sahoo, Sumita Raha, Sujit Suklabaidya, Shantibhusan Senapati, Vivek M. Rangnekar, Indu B. Maiti, Nrisingha Dey

Radiation Medicine Faculty Publications

The gene Par-4 (Prostate Apoptosis Response 4) was originally identified in prostate cancer cells undergoing apoptosis and its product Par-4 showed cancer specific pro-apoptotic activity. Particularly, the SAC domain of Par-4 (SAC-Par-4) selectively kills cancer cells leaving normal cells unaffected. The therapeutic significance of bioactive SAC-Par-4 is enormous in cancer biology; however, its large scale production is still a matter of concern. Here we report the production of SAC-Par-4-GFP fusion protein coupled to translational enhancer sequence (5′ AMV) and apoplast signal peptide (aTP) in transgenic Nicotiana tabacum cv. Samsun NN plants under the control of a unique recombinant promoter M24. …

Early Results Of Prostate Cancer Radiation Therapy: An Analysis With Emphasis On Research Strategies To Improve Treatment Delivery And Outcomes., Kosj Yamoah, Kwamena Beecham, Sarah E Hegarty, Terry Hyslop, Timothy Showalter, Joel Yarney

Sarah E Hegarty

ABSTRACT: BACKGROUND: There is scant data regarding disease presentation and treatment response among black men living in Africa. In this study we evaluate disease presentation and early clinical outcomes among Ghanaian men with prostate cancer treated with external beam radiotherapy (EBRT). METHODS: A total of 379 men with prostate cancer were referred to the National Center for Radiotherapy, Ghana from 2003 to 2009. Data were collected regarding patient-and tumor-related factors such as age, prostate specific antigen (PSA), Gleason score (GS), clinical stage (T), and use of androgen deprivation therapy (ADT). For patients who received EBRT, freedom from biochemical failure (FFbF) …

Radiation Therapy After Radical Prostatectomy For Prostate Cancer: Evaluation Of Complications And Influence Of Radiation Timing On Outcomes In A Large, Population-Based Cohort., Sarah E Hegarty, Terry Hyslop, Adam Dicker Md, Phd, Timothy Showalter Md

Sarah E Hegarty

PURPOSE: To evaluate the influence of timing of salvage and adjuvant radiation therapy on outcomes after prostatectomy for prostate cancer.

METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare linked database, we identified prostate cancer patients diagnosed during 1995-2007 who had one or more adverse pathological features after prostatectomy. The final cohort of 6,137 eligible patients included men who received prostatectomy alone (n = 4,509) or with adjuvant (n = 894) or salvage (n = 734) radiation therapy. Primary outcomes were genitourinary, gastrointestinal, and erectile dysfunction events and survival after treatment(s).

RESULTS: Radiation therapy after prostatectomy was associated with higher rates …

A Phase 3 Trial Of 2 Years Of Androgen Suppression And Radiation Therapy With Or Without Adjuvant Chemotherapy For High-Risk Prostate Cancer: Final Results Of Radiation Therapy Oncology Group Phase 3 Randomized Trial Nrg Oncology Rtog 9902., Seth A. Rosenthal, Daniel Hunt, A. Oliver Sartor, Kenneth J. Pienta, Leonard G. Gomella, David Grignon, Raghu Rajan, Kevin J. Kerlin, Christopher U. Jones, Michael Dobelbower, William U Shipley, Kenneth Zeitzer, Daniel A. Hamstra, Viroon Donavanik, Marvin Rotman, Alan C. Hartford, Jeffrey Michalski, Michael Seider, Harold Kim, Deborah A. Kuban, Jennifer Moughan, Howard Sandler

Department of Urology Faculty Papers

PURPOSE: Long-term (LT) androgen suppression (AS) with radiation therapy (RT) is a standard treatment of high-risk, localized prostate cancer (PCa). Radiation Therapy Oncology Group 9902 was a randomized trial testing the hypothesis that adjuvant combination chemotherapy (CT) with paclitaxel, estramustine, and oral etoposide plus LT AS plus RT would improve overall survival (OS).

METHODS AND MATERIALS: Patients with high-risk PCa (prostate-specific antigen 20-100 ng/mL and Gleason score [GS] ≥ 7 or clinical stage ≥ T2 and GS ≥ 8) were randomized to RT and AS (AS + RT) alone or with adjuvant CT (AS + RT + CT). CT was …

Accreditation Of Healthcare Facilities: A Friend Or Foe?, Maseeh Uz Zaman, Nosheen Fatima

Department of Radiology

No abstract provided.

Fostering The Development Of Emotional Intelligence Among Health Science Students: Empowering Students To Impact Institutional Culture, Julia Ward, Phd, Rn, Mary Hanson-Zalot, Msn, Rn, Aocn, Collleen Dempsey, Ms, Rt(R)

College of Nursing Posters

Objectives:

Identify challenges of navigating institutional culture for students interacting in a variety of clinical settings

Discuss the importance of integrating concepts of emotional intelligence throughout curricular plans of study

Consider contemporary research findings in the health science literature regarding emotional intelligence among students.

A Single Baseline Ultrasound Assessment Of Fibroid Presence And Size Is Strongly Predictive Of Future Uterine Procedure: 8-Year Follow-Up Of Randomly Sampled Premenopausal Women Aged 35-49 Years., Donna D. Baird, T M Saldana, D L Shore, Michael C. Hill, J M Schectman

Radiology Faculty Publications

STUDY QUESTION: How well can a single baseline ultrasound assessment of fibroid burden (presence or absence of fibroids and size of largest, if present) predict future probability of having a major uterine procedure?

SUMMARY ANSWER: During an 8-year follow-up period, the risk of having a major uterine procedure was 2% for those without fibroids and increased with fibroid size for those with fibroids, reaching 47% for those with fibroids ≥4 cm in diameter at baseline.

WHAT IS KNOWN ALREADY: Uterine fibroids are a leading indication for hysterectomy. However, when fibroids are found, there are few available data to help clinicians …

Role Of Cerebrovascular Abnormality In Neurodegenerative Disease And Subcortical Ischemic Disease: Ct Perfusion And Pet Imaging, Jun Yang

Electronic Thesis and Dissertation Repository

Clinical studies indicate that about 30% ~ 50% of patients have cognitive impairment after the first or recurrent stroke. Ischemic injury, particularly subcortical lesions, caused by stroke has been demonstrated to further exacerbate cognitive impairment of Alzheimer’s disease (AD) and vascular dementia. However, the mechanisms whereby cerebrovascular abnormalities contribute to neurodegeneration at early stage of disease and eventually to cognitive decline remain unclear. CT perfusion and positron emission tomography (PET) were used to investigate early mechanisms in a rat comorbid model of cerebral ischemia (CI) and β-amyloid (Aβ, a pathological hallmark of AD) toxicity, and in patients with small subcortical …

The Specificity And Sensitivity Of Ultrasonography In The Diagnosis Of Acute Right Lower Quadrant Pain In Women Of Child Bearing Age, Shumaila Arooj, Arfanul Haq, Zafar Amin

Department of Radiology

Abstract

OBJECTIVE:

To assess the sensitivity and specificity of ultrasonography in differentiating causes of acute right lower quadrant pain in women of child-bearing age by taking surgical outcome as the gold standard.

METHODS:

The descriptive analytical study was conducted at PNS Shifa Hospital, Karachi, from July to December 2008, and comprised female patients of child-bearing age who presented with acute right lower quadrant pain and underwent surgery after ultrasonography. SPSS 10 was used for statistical analysis.

RESULTS:

Of the 75 patients, 54(72%) patients were symptomatically and sonographically positive to have either acutely inflamed non-compressible appendix or focal fluid collection in …

A Novel Compact Microwave Radiometric Sensor To Noninvasively Track Deep Tissue Thermal Profiles, Paolo F. Maccarini, Ankur Shah, Sharmila Y. Palani, Donald V. Pearce, Madhurima Vardhan, Paul R. Stauffer, Dario B. Rodrigues, Sara Salahi, Tiago R. Oliveira, Doug Reudink, Brent W. Snow

Department of Radiation Oncology Faculty Papers

Drawing from space technology to measure star temperature, we developed a noninvasive sensor to passively track thermal profiles in tissues well below the skin (>5cm). Ultra-low noise amplifiers combined with ultralow-loss switches in the 1- 2GHz band produce a high sensitivity multiband microwave radiometer. Due to the complex multilayer anatomy of human head, multiple sensing bands are needed to reconstruct the temperature of deep brain tissue. This is achieved by using a digitally controlled filter bank. To study its accuracy, the sensor was calibrated and tested in a multilayer phantom model of the human head with differential scalp and …

Teleradiology As A Foundation For An Enterprise-Wide Health Care Delivery System, John David N. Dionisio, Ricky K. Taira, Usha Sinha, David B. Johnson, Benjamin Y. Dai, Gregory H. Tashima, Stephen Blythe, Richard Johnson, Hooshang Kangarloo

John David N. Dionisio

An effective, integrated telemedicine system has been developed that allows (a) teleconsultation between local primary health care providers (primary care physicians and general radiologists) and remote imaging subspecialists and (b) active patient participation related to his or her medical condition and patient education. The initial stage of system development was a traditional teleradiology consultation service between general radiologists and specialists; this established system was expanded to include primary care physicians and patients. The system was developed by using a well-defined process model, resulting in three integrated modules: a patient module, a primary health care provider module, and a specialist module. …

The Next Step, Benjamin Y. Dai, Lynn Thompson, John David N. Dionisio, Hooshang Kangarloo, Ricky K. Taira

John David N. Dionisio

In traditional radiology practice, reports are typically dictated and then transcribed.? While the free-text reports represent the semantic knowledge interpreted and conveyed by a physician, the information can be hard to access. The advantages of representing medical data in a structured format using standard terminology are clearly recognized. These include the ability to implement a standardized electronic medical record, automatically invoke medical guidelines when appropriate, and conduct outcomes research. Standard structured reports facilitate intelligent indexing, searching, and retrieval of documents from clinical databases. Recent attempts have been made in the industry to enable structured data entry using preformatted templates, but …

Integrated Multimedia Timeline Of Medical Images And Data For Thoracic Oncology Patients, Denise R. Aberle, John David N. Dionisio, Michael F. Mcnitt-Gray, Ricky K. Taira, Alfonso F. Cárdenas, Jonathan G. Goldin, Kathleen Brown, Robert A. Figlin, Wesley W. Chu

John David N. Dionisio

A prototype multimedia medical database has been developed to provide image and textual data for thoracic oncology patients undergoing treatment of advanced malignancies. The database integrates image data from the hospital pieture archiving and communication system with textual reports from the radiology information system, alphanumeric data contained in the hospital information system, and other electronic medical data. The database presents information in a timeline format and also contains visualization programs that permit the user to view and annotate radiographic measurements in tabular or graphic form. The database provides an efficient and intuitive display of the changing status of oncology patients. …

Overview Of The Role Of Duplex Ultrasound For Treatment And Surveillance Of Peripheral Arterial Disease, John H. Fish Iii, Peter Klein-Weigel, Gustav Fraedrich

Journal of Patient-Centered Research and Reviews

Imaging strategies for preinterventional planning in symptomatic peripheral artery disease have employed various modalities ranging from duplex ultrasound to noninvasive angiography with computed tomography (CT) or magnetic resonance (MRA). These methods have classically been compared to the gold standard of digital subtraction angiography and are reviewed here in detail through the work of relevant published studies and meta-analyses between 1996 and 2014. In particular, we focus on the diagnostic performance, reproducibility and cost-effectiveness of these aforementioned modalities with respect to mapping the lower extremity arterial tree for planning vascular intervention and surveillance. The data presented suggests comparable sensitivity and specificity …

Vascular Medicine: A ‘Primary’ Specialty, Mark W. Mewissen

Journal of Patient-Centered Research and Reviews

N/A

Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging., Shubhika Srivastava, Beth F. Printz, Tal Geva, Girish S. Shirali, Paul M. Weinberg, Pierre C. Wong, Peter Lang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging. Spctpd/Acc/Aap/Aha., Shubhika Srivastava, Beth F Printz, Tal Geva, Girish S. Shirali, Paul M Weinberg, Pierre C Wong, Peter Lang, Society Of Pediatric Cardiology Training Program Directors, American College Of Cardiology, American Academy Of Pediatrics, American Heart Association

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Optimization Of Chest Wall Hyperthermia Treatment Using A Virtual Human Chest Model, Dario B. Rodrigues, Mark D. Hurwitz, Paolo F. Maccarini, Paul R. Stauffer

Department of Radiation Oncology Faculty Papers

This work explores different coupling configurations (direct contact, air and water coupling) between a single 915 MHz waveguide applicator and human tissue in the setting of chest wall recurrence (CWR) of breast cancer. The objective is to treat chest wall tumours with microwave hyperthermia, while avoiding hot spots in critical areas such as scars and ribs. The best coupling configuration was a customized 24×29 cm water bolus developed by our team. It helps the applicator deliver an effective field size of 268 cm2 at 1 cm depth and a penetration depth of 2-3 cm. Water bolus thickness can be adjusted …

Targeted Ultrasound Of An Indeterminate Breast Lesion On Mammography: When Does It Influence Management?, Saba Sohail, Imrana Masroor, Shaista Afzal

Department of Radiology

Objective: To determine the change over mammographic diagnosis, BI-RADS category and management following targeted ultrasound of an indeterminate lesion seen on mammography and associated factors, if any.
Study design: Descriptive, analytical study.
Place and duration of study: Radiology Department, The Aga Khan University Hospital and Clifton Medical Services, Karachi, from April 2010 to May 2011.
Methodology: Patients referred for targeted breast ultrasound following X-ray mammography were selected regardless of age. Targeted Ultrasound (TUS) was defined as a limited ultrasound of a specific lesion or breast part as indicated by the referring source. Comparison was made between the post mammography and …