Radiology Commons^™

Assessment Of Dobhoff Tube Malposition On Radiographs Using Deep Learning, Kevin George, Paras Lakhani, Md

Phase 1

Introduction: Dobhoff tubes (DHT) are narrow-bore flexible devices that deliver enteral nutrition for critically ill patients. Tracheobronchial insertion of DHTs presents a significant risk for pulmonary complications. Thus, DHT insertion requires radiologist confirmation of correct placement with chest x-ray (CXR), increasing clinical delays. To address this, we demonstrate the novel application of Deep Convolutional Neural Networks (DCNNs) to automatically and accurately identify DHTs in CXRs in real time.

Methods: 141 de-identified HIPAA compliant frontal view chest radiographs containing DHTs in various positions were obtained. The DHTs were first manually segmented and verified by a board certified radiologist. Images were split …

3d Convolutional Neural Networks For The Diagnosis Of 6 Unique Pathologies On Head Ct, Travis Clarke, Paras Lakhani, Md

Phase 1

Introduction: Head CT scans are a standard first-line tool used by physicians in the diagnosis of neurological pathologies. Recently, the development of deep learning models such as convolutional neural networks (CNNs) has allowed the rapid identification of bleeds and other pathologies on CT scans. This study aims to show that by training 3D CNNs with a larger, curated dataset, a more comprehensive list of potential diagnoses can be included in the detailed model.

Methods: A retrospective study was performed using a dataset of 66,000 head CT studies from the Thomas Jefferson University health system. Studies were acquired using a natural …

Potential Impacts Of Artificial Intelligence On Spine Imaging Interpretation And Diagnosis, David Howard Durrant

Walden Dissertations and Doctoral Studies

Spine and related disorders represent one of the most common causes of pain and disability in the United States. Imaging represents an important diagnostic procedure in spine care. Imaging studies contain actionable data and insights undetectable through routine visual analysis. Convergent advances in imaging, artificial intelligence (AI), and radiomic methods has revealed the potential of multiscale in vivo interrogation to improve the assessment and monitoring of pathology. AI offers various types of decision support through the analysis of structured and unstructured data. The primary purpose of this qualitative exploratory case study was to identify the potential impacts of AI solutions …

Automated Assessment Of Cardiothoracic Ratios On Chest Radiographs Using Deep Learning, Varun Danda, Paras Lakhani, Md

Phase 1

Introduction: The cardiothoracic ratio (CTR) is a quantitative measure of cardiac size that can measured from chest radiography (CXR). Although radiologists using digital workstations possess the ability to calculate CTR, clinical demands prevent calculation for every case. In this study, the efficacy of a deep convolutional neural network (dCNN) to assess CTR was evaluated.

Methods: 611 HIPAA-compliant de-identified CXRs were obtained from [institution blinded] and public databases. Using ImageJ, a board-certified radiologist (reader #1) and a medical student (reader #2), measured the CTR by marking four pixels on all CXRs: the right- and left-most chest wall, the right- and left-most …

Early Acid/Base And Electrolyte Changes In Permanent Middle Cerebral Artery Occlusion: Aged Male And Female Rats, Sarah R. Martha, Lisa A. Collier, Stephanie M. Davis, Sarah J. Goodwin, David Powell, Doug Lukins, Justin F. Fraser, Keith R. Pennypacker

Neurosurgery Faculty Publications

BACKGROUND: Early changes in acid/base and electrolyte concentrations could provide insights into the development of neuropathology at the onset of stroke. We evaluated associations between acid/base and electrolyte concentrations, and outcomes in permanent middle cerebral artery occlusion (pMCAO) model.

METHODS: 18-month-old male and female Sprague-Dawley rats underwent pMCAO. Pre-, post- (7 min after occlusion), and at 72 hr of pMCAO venous blood samples provided pH, carbon dioxide, oxygen, glucose, hematocrit, hemoglobin, and electrolyte values of ionized calcium, potassium, and sodium. Multiple linear regression determined predictors of infarct and edema volumes from these values, Kaplan-Meier curve analyzed morality between males and …

Effect Of Contrast-Enhanced Echocardiograms On The Prognosis Of Infective Endocarditis, D. Arias, E. Halpern, F. Forsberg, J. R. Eisenbrey

Phase 1

Objective - Infective endocarditis (IE) is an infectious disease of the cardiac valves where bacteria colonize the valves; typically, via the formation of vegetations. Recent research has shown that the microbubbles in a contrast-enhanced ultrasound (CEUS) examination can move and dislodge bacterial vegetations in vitro. This study investigated whether CEUS resulted in faster resolution of IE in vivo by dislodging the vegetations.

Methods - This IRB approved retrospective study reviewed 36 patients who were diagnosed with IE via echocardiography. Data was sourced from patients within the Jefferson University Hospital’s Cardiology EMR system by searching for contrast and vegetation from …

An Assessment Of Pet Dose Reduction With Penalized Likelihood Image Reconstruction Using A Computationally Efficient Model Observer, Howard C. Gifford, C. Ross Schmidtlein, Andrzej Krol, Yuesheng Xu

Mathematics & Statistics Faculty Publications

Developing PET reconstruction algorithms with improved low-count capabilities may provide a timely and cost- effective means of reducing radiation dose in promising clinical applications such as immuno-PET that require long-lived radiotracers. For many PET clinics, the reconstruction protocol consists of postsmoothed ordered-sets expectation-maximization (OSEM) reconstruction, but penalized likelihood methods based on total-variation (TV) regularization could substantially reduce dose. We performed a task-based comparison of postsmoothed OSEM and higher-order TV (HOTV) reconstructions using simulated images of a contrast-detail phantom. An anthropomorphic visual-search model observer read the images in a location-known receiver operating characteristic (ROC) format. Acquisition counts, target uptake, and target …

Discordance Between Breast Imaging And Histopathology Findings After Ultrasound Guided Core Needle Biopsy, Margaret Mutinda Mwania

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Breast cancer is the most prevalent cancer among women worldwide with an estimated global incidence of 11.6%. According to the GLOBOCAN factsheet, in 2018 breast cancer incidence in Kenya was 40.3 per 100,000. Early detection and diagnosis of breast cancer has been shown to reduce mortality and increase years of life gained. Breast lesion diagnosis is heavily based on imaging and pathology and typically findings are reported independent of one another. Correlation of imaging findings and pathology after biopsy is found to be of critical importance in detecting possible sampling error, concordance versus discordance, recommend appropriate management and thus …

Challenges In Medical Journalism: Reflections From The Year Past, Saba Sohail

Department of Radiology

No abstract provided.

Prior Mammographic Screening: What Is Its Effect On The Clinical Stage In Newly Diagnosed Breast Cancer Patients At Akuhn., Jillo Bika

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Breast cancer is now the leading cancer amongst women in Kenya according to GLOBOCAN 2018. It is also a leading cause of cancer deaths in Kenya, after esophageal and cervical cancer. Mammography is the gold standard in the screening of breast cancer. For screening to be effective, however, it has to be offered to the right patients at the appropriate time and intervals. Up until February of 2019, there were no local guidelines to guide the screening of breast cancer in Kenya. The objective of this study is to assess if prior mammographic screening had an effect on the …

Development And Dosimetric Verification Of 3d Customized Bolus In Radiotherapy, Nichakan Chatchumnan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Bolus is a tissue equivalent material that is commonly used to reduce the skin-sparing effect in radiotherapy. The commercial flat bolus cannot form perfect contact with the irregular surface of the patient's skin, resulting in an air gap, especially in irregular surface shape. The purpose of this study was to evaluate the feasibility of two types of silicone rubber bolus, RA-00AB, and RA-05AB that were made as to the fabricated flat and 3D customized bolus using 3D printing technology. The 1 cm thick boluses were made from two types of silicone rubber solutions. The point dose and planar dose differences …

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, …

What Is The Effect Of Iodine Contrast Agents On The Subharmonic Signal Generated From Ultrasound Contrast Agents?, Neal Kalantri, Cara Esposito, Jaydev Dave

Phase 1

Subharmonic-aided pressure estimation (SHAPE) is a technique utilizing subharmonic signals from microbubble-based ultrasound contrast agents (UCA’s) to noninvasively record pressures. Cardiac applications of SHAPE have been demonstrated in canines where low errors (0.19-2.5mmHg) were observed in canine ventricle pressures between the SHAPE technique and pressure catheter measurements. Validation of SHAPE involves simultaneous measurements by a pressure catheter (iodine contrast is used to guide catheter placement) and by SHAPE using UCAs. The goal of this experiment is to determine if mixing Visipaque (iodine contrast, GE Healthcare, Oslo, Norway) and UCAs effects the subharmonic signal.

The study was performed in an in …

Dynamic Prostatic And Laser-Ablated Lesion Volume Change After Transperineal Laser Ablation In Canine: Preliminary Observation And Its Clinical Significance., Rui-Qing Liu, Ji-Bin Liu, Shao-Bo Duan, Si-Guo Cheng, Zhi-Yang Chang, Hui-Cun Cao, Guang-Shao Cao, Ya-Qiong Li, Na Li, Lian-Zhong Zhang

Department of Radiology Faculty Papers

AIM: The purpose of this study is to observe the volume change of prostate and laser-ablated lesions in the canine and to explore the mechanism and clinical significance through histopathology.

MATERIALS AND METHODS: Transperineal laser ablation (TPLA) was performed under the guidance of transrectal ultrasound (TRUS) in eight canines. Two canines were sacrificed 1 day and 1 week after TPLA, respectively. The remaining six canines were sacrificed after finishing transrectal contrast-enhanced ultrasound (TR-CEUS) at three phases.

RESULTS: The prostatic volumes immediately following TPLA and 1 week later were larger than before TPLA (20.1 ± 3.9 vs 17.1 ± 3.8 ml; …

The Labeling Of 99mtc-Psma-Hbed-Cc For Prostate Cancer Imaging, Benchamat Phromphao

Chulalongkorn University Theses and Dissertations (Chula ETD)

Prostate cancer (PCa) is the second most common cancer and the fifth leading cause of death worldwide in 2018 (1). Initially, PCa diagnosis is based on Prostate Specific Antigen (PSA) blood test, which is low sensitivity and low specificity, and sonography guided needle biopsy, which is invasive. Therefore, molecular imaging recently enrolls as an important technique in PCa diagnosis using some small molecules which are well developed to bind to overexpressed Prostate Specific Membrane Antigen (PSMA). The small molecules, for example PSMA-HBED-CC, PSMA I&T, can be chelated with Ga-68 for diagnostic purpose using positron emission tomography (PET) scan. Even though …

Surface And Build-Up Region Dose Measurement In Head And Neck Region Using Radio - Photoluminescent Glass Dosimeter, Sonam Choki

Chulalongkorn University Theses and Dissertations (Chula ETD)

The use of commercially available radio-photoluminescent glass dosimeter (RPLGD) for radiation measurement has increased in recent years. It has been shown to have superior dosimetric characteristics as compared to other dosimeters. The purpose of this research is to evaluate the suitability of the GD-302M glass dosimeter for surface and build-up region dose measurement in head and neck region. The glass dosimeter was analyzed for its dosimetric properties in photon beam. Then, the study was performed for surface and build-up region dose comparison between EBT3 film and RPLGD in solid water phantom at 0, 2, 3, 5, 10 and 15mm depths …

Determination Of Field Output Correction Factors Of Radiophoto Luminescent Glass Dosimeter In 6 Mv Small Photon Beams, Sumalee Yabsantia

Chulalongkorn University Theses and Dissertations (Chula ETD)

The objective of this study was to determine the field output correction factors of radiophotoluminescent glass dosimeter (RPLGD) for 6 MV photon beams by using Monte Carlo (MC) simulation. The ratios of absorbed dose of water and RPLGD were calculated using egs_chamber code for 6 MV, 90-cm SSD, 10-cm depth, and field size range from 0.5 × 0.5 to 10 × 10 cm2. Then the field output correction factors of RPLGD in perpendicular and parallel orientations were determined. Also, the volume averaging correction factors were discovered for supporting our results. Moreover, the comparison of measurement field output factors of RPLGD …

Patient-Specific Organ Dose Calculated By Dose Tracking Software Based On Monte Carlo Simulation In Pediatric Abdominal Ct, Yuparak Innan

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study aimed to determine the patient-specific organ doses using Radimetrics dose tracking software in pediatric abdominal CT at Praram9 Hospital. The organ doses were measured using the anthropomorphic Rando phantom inserted with radiophotoluminescent glass dosimeters (RPLGDs) to verify the organ doses calculated by Radimetrics program. The retrospective data were collected from pediatric abdominal CT 164 studies (78 patients), age range 0-15 years-old), who underwent single phase abdominal CT at Praram9 Hospital. The tube voltages ranged between 80 and 135 kVp were adjusted according to the size and age of patients, and rotation time 0.35-0.5 sec. All patients were acquired …

The Study Of Local Diagnostic Reference Levels At Unit Of Vascular And Interventional Radiology, King Chulalongkorn Memorial Hospital, Kornkamol Prajamchuea

Chulalongkorn University Theses and Dissertations (Chula ETD)

Interventional Radiology (IR) procedures are minimally invasive surgery using angiographic equipment which the patients and staffs may receive high radiation dose. DRLs, based on 75th percentile of the median dose for a sample of standard sized of patients, are an effective tool for optimization of protection in the medical exposure of patients for diagnostic and interventional procedures (ICRP Publication 135, 2017). The objective of this study is to establish the local DRLs distribution of patient radiation dose and related parameters in interventional radiology procedures in standard-sized of Thai patients. Local DRLs of radiation dose and related parameters of patients (45-75kg …

Evaluation Of Patient Doses From 177lu-Psma In Metastases Prostate Cancer Treatment At King Chulalongkorn Memorial Hospital, Kotchakorn Chatachot

Chulalongkorn University Theses and Dissertations (Chula ETD)

177Lu-PSMA I&T has increasingly used for targeted radionuclide therapy of metastatic castration-resistant prostate cancer (mCRPC). Dosimetric calculation, therefore, is critical to achieve the optimal therapeutic activity while sparing side effects to the normal tissues. The purpose of this study was to determine the radiation dosimetry for metastases prostate cancer patients treated by 177Lu-PSMA I&T at King Chulalongkorn Memorial Hospital (KCMH). Whole-body planar images were acquired in eight patients (12 treatment cycles) at immediately, 4 and 24 h after 177Lu-PSMA I&T injection (range 4.36 to 8.58 GBq). Region of interests (ROIs) were manually contoured on the whole-body, liver, spleen, urinary bladder, …

Feasibility Of A Readiness Exam For Predicting Radiography Program Success: A Pilot Study, Tammy L. Webster, Sarah B. Mcbrien, Gregory M. Mehrer, Harlan R. Sayles

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Background: Research investigating predictors of academic success in rigorous health science education is valuable for curricular intervention for identified at-risk students. Various predictors of success have been investigated, but the literature is insufficient when examining anatomy and physiology readiness scores as they correlate to radiography curricular success. This pilot study assessed the correlation between readiness exam scores and programmatic course GPA to determine if the scores could be used as a metric for identifying academic success resources for incoming students. Cohorts of the radiography program at a midwestern health sciences center demonstrated a longitudinal trend of difficulty with anatomy …

Synthesis Of Radioluminescent Caf2:Ln Core, Mesoporous Silica Shell Nanoparticles For Use In X-Ray Based Theranostics, Hayden Winter, Megan J. Neufeld, Lydia Makotamo, Conroy Sun, Andrea M. Goforth

Chemistry Faculty Publications and Presentations

X-ray radiotherapy is a common method of treating cancerous tumors or other malignant lesions. The side effects of this treatment, however, can be deleterious to patient quality of life if critical tissues are affected. To potentially lower the effective doses of radiation and negative side-effects, new classes of nanoparticles are being developed to enhance reactive oxygen species production during irradiation. This report presents the synthesis and radiotherapeutic efficacy evaluation of a new nanoparticle formulation designed for this purpose, composed of a CaF₂ core, mesoporous silica shell, and polyethylene glycol coating. The construct was additionally doped with Tb and Eu …