Radiology Commons^™

A Tv-Bm3d Iterative Algorithm For Vmat-Ct Reconstruction, Chia-Lung Chien, Beibei Guo, Rui Zhang

Faculty, Staff and Students Publications

Volumetric modulated arc therapy-computed tomography (VMAT-CT), which is the CT reconstructed using the portal images collected during VMAT, can potentially be an effective onsite imaging tool. The goal of this study was to propose an iterative reconstruction algorithm that can further improve the image quality of VMAT-CT and reduce the number of failed reconstructions. An iterative algorithm combining total variation (TV) with block-matching and 3D filtering (BM3D) was proposed, addressing the L1-L2 regularization problem using the split Bregman method. We collected portal images from 67 VMAT cases including 50 phantom and 17 real-patient cases. Both Feldkamp-Davis-Kress (FDK) and TV-BM3D iterative …

Radiologic Findings Of A Mediastinal Mass With Pleural Fluid Cytologic Analysis: A Case Report Of Recurrent Mantle-Cell Lymphoma, Mark Cwajna, Zaain Ahmad, Evan Basha, Emily Maggioncalda, Shehbaz Ahmad, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

This case report details a 69-year-old male who presented with a right-sided pleural effusion and a mediastinal mass that was ultimately identified as recurrent mantle-cell lymphoma, occurring over 20 years after his initial diagnosis. Imaging findings discussed include chest radiograph and chest, abdomen and pelvis computed tomography depicting the mass compressing on various neighboring structures.

Radiologic Evaluation And Management Of Metastatic Renal Cell Carcinoma With Tumor Thrombus Extension Into Right Atrium, Zaain Ahmad, Mark Cwajna, Evan Basha, Adithya Bala, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

This case report discusses the radiologic evaluation, histopathology, and management of a 67-year-old female with metastatic renal cell carcinoma (RCC) extending as a tumor thrombus into the right atrium. The patient had newly developed hematuria that was not followed up with the recommended imaging modality. Months later, the patient presented to the emergency department with progressive hematuria in addition to symptoms of dyspnea and significant weight loss. Initial CT imaging revealed a large renal mass with metastasis to the liver and lungs, along with tumor thrombus invading the inferior vena cava and right atrium. Histopathologic evaluation confirmed metastatic RCC and …

Utility Of Incorporating Radiological Findings Of Right Heart Strain In Patients With Acute Pulmonary Embolism For Risk Stratification Of Adverse Outcomes: A Retrospective Analysis, Joshua Amaya, Sameer Allahabadi, Daniel L. Habenicht, John Hunton, Amal M. Khan, Subhash Venigalla, Curran Reddy, Jeremy V. Doan, Grace Wang, Daniel R. Eickenhorst, Shovendra Gautam

HCA Healthcare Journal of Medicine

Background

Right heart (RH) strain in the setting of pulmonary embolisms can significantly increase the risk of mortality. Thus, screening for risk of complications in these patients is crucial. The goal of our study was to assess the strength of specific diagnostic findings of RH strain for predicting adverse outcomes including mortality, hospital length of stay, and the requirement of advanced interventions.

Methods

A single-center, retrospective cohort study of 81 patients diagnosed with acute pulmonary embolism with RH strain on computed tomography pulmonary angiogram (CTPA) from September 12, 2019, to August 30, 2023. Data were collected on patient computed tomography …

A Space-Occupying Lesion Manifesting As Unilateral Optic Disc Edema, Len V. Koh Od, Phd, Anna Wells Od, Lindsay Jansen Od

Optometric Clinical Practice

Background: Primary and secondary orbital diseases can arise from different tissues in the periorbital regions as space-occupying lesion leading to ophthalmic symptoms. Therefore, eye care providers are often the first encounter for these patients.

Case report: A 54-year-old Caucasian male presented as a new patient at the eye clinic with an incidental finding of edema of the left optic disc. After a thorough optometric evaluation, a referral was made to a local ear-nose-throat (ENT) specialist who confirmed a diagnosis of cavernous hemangioma by further neuroimaging. Surgical removal eventuated in resolution of disc edema with restoration of vision.

Conclusion: An insidious …

Radiation Dose In Computed Tomography (Ct), Helen Minnick

Medical Imaging Senior Posters

Computed Tomography (CT) is a critical diagnostic tool that delivers rapid, detailed cross-sectional imaging but remains a major contributor to medical radiation exposure. Increasing use of CT has led to concerns about excessive or low-value exams, including repeat scans that do not often change patient management and may increase long-term cancer risk. Evidence shows that only a small percentage of repeat head CTs reveal clinically significant findings, underscoring the importance of justification and reducing unnecessary imaging. Pediatric patients are particularly vulnerable due to increased tissue radiosensitivity and longer lifespans, making dose optimization essential. National initiatives such as Image Gently and …

The Role Of Computed Tomography And Esophageal Ultrasonography In The Preoperative Evaluation Of Esophageal Cancer Resection, Vasile Cosmin Obleaga, Dan Ionuț Gheonea, Ioana Andreea Gheonea, Cecil Sorin Mirea, Emil Moraru, Mihai Călin Ciorbagiu, Ionică Daniel Vîlcea, Tiberiu Ștefăniță Cojan-Țenea

Journal of Mind and Medical Sciences

Objectives. Esophageal cancer is one of the most aggressive types of cancer, with a 5-year relative survival rate of only 18%-20.5%. Survival is highly dependent on accurate positive diagnosis and staging, in which the imaging modalities available have a primary role. The study is focused on the analysis of the preoperative T and M staging strategy and the reliability of computed tomography and endoscopic esophageal ultrasound in predicting resectability. A second objective was to evaluate the influence of preoperative imaging modalities on decreasing the number of unnecessary thoracotomies and laparotomies. Material and Methods. This study was conducted on a lot …

Emergency Department Imaging Utilization Post-Transcatheter Aortic Valve Replacement: Single Institution 7-Year Experience, Andy Mew, Kaustav Bera, Sirui Jiang, Nikhil Ramaiya, Robert Gilkeson

Faculty Scholarship

Purpose: This study aims to highlight presentations, acute findings and imaging phenotypes of patients presenting to the emergency department (ED) within 30 days of a transcatheter aortic valve replacement (TAVR). Methods: A retrospective review of patients diagnosed with aortic valve disease who underwent a TAVR between Jan 2015 and Nov 2021 at a large academic medical center was completed. From an initial 1271 patients, 146 were included based on their presentation to the ED within 30 days post-TAVR procedure. Patient data, including ED presentation details and imaging results, were recorded and de-identified. Results: Of the 146 post-TAVR patients, there were …

Intraprocedural Versus Initial Follow-Up Minimal Ablative Margin Assessment After Colorectal Liver Metastasis Thermal Ablation: Which One Better Predicts Local Outcomes?, Yuan-Mao Lin, Iwan Paolucci, Jessica Albuquerque Marques Silva, Caleb S O'Connor, Bryan M Fellman, Aaron K Jones, Joshua D Kuban, Steven Y Huang, Zeyad A Metwalli, Kristy K Brock, Bruno C Odisio

Faculty, Staff and Student Publications

Objectives: The aim of this study was to investigate the prognostic value of 3-dimensional minimal ablative margin (MAM) quantified by intraprocedural versus initial follow-up computed tomography (CT) in predicting local tumor progression (LTP) after colorectal liver metastasis (CLM) thermal ablation.

Materials and methods: This single-institution, patient-clustered, tumor-based retrospective study included patients undergoing microwave and radiofrequency ablation between 2016 and 2021. Patients without intraprocedural and initial follow-up contrast-enhanced CT, residual tumors, or with follow-up less than 1 year without LTP were excluded. Minimal ablative margin was quantified by a biomechanical deformable image registration method with segmentations of CLMs on intraprocedural preablation …

Treatment And Diagnosis Of Pulmonary Emboli In Ct, Jacob Gardner

Student Research Poster Presentations 2024

This research project elaborates on the diagnosis and treatment of pulmonary emboli, and how computed tomography can provide a quick and accurate diagnosis. Statistics, symptoms, computed tomography pulmonary angiography protocol, and pulmonary emboli radiographic appearance are also discussed to provide information on how a diagnosis is achieved and which treatment is used. Pulmonary emboli are a life-threatening condition that, if untreated, can potentially be fatal. Pulmonary emboli are the third most frequently occurring cause of cardiovascular death behind a stroke and myocardial infarction. Deaths in the United States from pulmonary emboli are approximately 300,000 deaths per year. In addition, 5-10% …

Role Of Computed Tomography In Traumatic Brain Injuries, Rebekah Spott

Medical Imaging Senior Posters

This project explains the role of computed tomography (CT) in assessing traumatic brain injuries (TBI). The major components of the research include various intracranial traumas, penetrating vs. non-penetrating TBIs, symptoms, grades of injury, and treatment options. CT is essential in diagnosing a TBI because it can quickly produce hundreds of images of the brain and skull in slices. CT allows radiologists, physicians, and surgeons to plan a course of action for the best possible patient recovery outcome. Images can identify various lesions and fractures as well as their severity. A TBI can present itself as penetrating or non-penetrating, ultimately determining …

Diagnostic Utility Of Multidetector Ct Scan In Penetrating Diaphragmatic Injuries: A Systematic Review And Meta-Analysis, Amir Hassankhani, Melika Amoukhteh, Parya Valizadeh, Payam Jannatdoust, Liesl S Eibschutz, Lee A Myers, Ali Gholamrezanezhad

Faculty, Staff and Student Publications

Penetrating diaphragmatic injuries pose diagnostic and management challenges. Computed tomography (CT) scans are valuable for stable patients, but concern exists for missed injuries and complications in nonoperatively managed cases. The objective of this study was to explore the diagnostic utility of multidetector CT scan (MDCT) in identifying diaphragmatic injuries resulting from penetrating trauma. A systematic review and meta-analysis were conducted, following established guidelines, by searching PubMed, Scopus, Web of Science, and Embase databases up to July 6, 2023. Eligible studies reporting MDCT's diagnostic accuracy in detecting penetrating diaphragmatic injuries were included. Relevant data elements were extracted and analyzed using STATA …

Radiologic And Histologic Findings Of Locally Advanced Mucoepidermoid Carcinoma Managed With Total Surgical Excision, Christopher R. Huber, Don Truong, Joseph Hatem, Joel Thompson, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

The present case report provides images from computed tomography and histology of a patient with a salivary gland neoplasm consistent with mucoepidermoid carcinoma.

Improving Dose-Response Correlations For Locally Advanced Nsclc Patients Treated With Imrt Or Pspt, Yulun He

Dissertations and Theses (Open Access)

The standard of care for locally advanced non-small cell lung cancer (NSCLC) is concurrent chemo-radiotherapy. Despite recent advancements in radiation delivery methods, the median survival time of NSCLC patients remains below 28 months. Higher tumor dose has been found to increase survival but also a higher rate of radiation pneumonitis (RP) that affects breathing capability. In fear of such toxicity, less-aggressive treatment plans are often clinically preferred, leading to metastasis and recurrence. Therefore, accurate RP prediction is crucial to ensure tumor coverage to improve treatment outcome. Current models have associated RP with increased dose but with limited accuracy as they …

Detecting A Pulmonary Embolism Using Computed Tomography, Marissa O'Brien

Medical Imaging Senior Posters

Abstract

A pulmonary embolism is a potentially fatal disease in which a blood clot obstructs the pulmonary artery. Pulmonary emboli affect thousands of people every year in the United States. A timely diagnosis is vital to ensure quick and proper treatment and resolution. Signs and symptoms can vary among different patients, but some include shortness of breath, chest pain, syncope, and leg pain. Computed tomography (CT) is the golden standard for diagnosis, specifically a CT pulmonary angiogram, which quickly and accurately visualizes clots in the pulmonary artery using iodinated contrast in the form of a bolus better than any other …

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.

Single Center Retrospective Review Of Post-Laparotomy Ct Abdomen And Pelvis Findings And Trends, Dylan C. Steffey, Emad A. Chishti, Maximo J. Acevedo, Luis F. Acosta, James T. Lee

Radiology Faculty Publications

Purpose: To identify common findings visualized on CT following damage control laparotomy, including post-surgical changes and additional injuries, and to determine change in frequency of post-laparotomy CT at our institution over time.

Methods: Single institution, IRB-Exempt, retrospective review of the University of Kentucky trauma registry from 1/2006 to 2/2019 for all trauma patients undergoing exploratory laparotomy initially and subsequently undergoing CT of the abdomen and pelvis within 24 hours. Operative findings from surgical operation notes and findings reported on post-laparotomy CT were recorded, including vascular and solid organ injuries, operative changes, free intraperitoneal fluid/air, and retroperitoneal findings. Next steps in …

The Prevalence And Spectrum Of Reported Incidental Adrenal Abnormalities In Abdominal Computed Tomography Of Cancer Patients: The Experience Of A Comprehensive Cancer Center, Aiham Qdaisat, Sara Bedrose, Obadah Ezzeldin, Ahmed W Moawad, Sai-Ching J Yeung, Khaled M Elsayes, Mouhammed Amir Habra

Faculty, Staff and Students Publications

BACKGROUND: The increasing use of computed tomography (CT) has identified many patients with incidental adrenal lesions. Further evaluation of these lesions is often dependent on the language used in the radiology report. Compared to the general population, patients with cancer have a higher risk for adrenal abnormalities, yet data on the prevalence and type of incidental adrenal lesions reported on radiologic reports in cancer patients is limited. In this study, we aimed to determine the prevalence and nature of adrenal abnormalities as an incidental finding reported on radiology reports of cancer patients evaluated for reasons other than suspected adrenal pathology. …

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 …

Interobserver Reliability Of The Renal Nephrometry Scoring System: Experience From A Developing Nation, Kumail Khandwala, Dawar Khan, Zainab Hussain, Nida Sajjad, Muhammad Ismail Alvi

Department of Radiology

Introduction: The RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior, location relative to polar lines) nephrometry score (RENAL-NS) has been described as a structured and quantifiable method to describe a renal tumor’s relevant anatomic features as they relate to the complexity of the lesion. We aim to evaluate a tumor’s RENAL-NS and to assess the reproducibility of the score among different observers.
Methods: This retrospective study included 49 patients diagnosed with renal cell carcinoma (RCC) who had complete computed tomography (CT) data, RENAL-NS, and histopathology results. All patients underwent renal surgery/intervention at …

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

Department of Radiology Faculty Papers

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

Spontaneous Uterine Rupture Secondary To Morbidly Adherent Placenta In An Unscarred Uterus, Nida Sajjad, Kumail Khandwala, Wasim Memon, Jehanzeb Shahid, Burhan Zafar

Department of Radiology

We report a case of spontaneous uterine rupture in a primigravida with an unscarred uterus, which was secondary to morbidly adherent placenta proven on surgery and histology. Although rare, uterine rupture should be considered as a differential diagnosis of acute abdominal pain in pregnancies, especially when associated with free fluid, even with the absence of vaginal bleeding. Abnormal placentation is associated with spontaneous antepartum uterine rupture even in early pregnancy. Most cases in the literature have advocated emergency hysterectomy to arrest life-threatening hemorrhage.

Picture Perfect - Pediatric Ct Utilization In Trauma, Laura Strickland, Christa Zino Md

Pediatrics

See attached document.

Multi-Dimensional Extension Of The Alternating Minimization Algorithm In X-Ray Computed Tomography, Jingwei Lu

McKelvey School of Engineering Graduate Student Theses & Dissertations

X-ray computed tomography (CT) is an important and effective tool in medical and industrial

imaging applications. The state-of-the-art methods to reconstruct CT images have had

great development but also face challenges. This dissertation derives novel algorithms to

reduce bias and metal artifacts in a wide variety of imaging modalities and increase performance

in low-dose scenarios.

The most widely available CT systems still use the single-energy CT (SECT), which is

good at showing the anatomic structure of the patient body. However, in SECT image

reconstruction, energy-related information is lost. In applications like radiation treatment

planning and dose prediction, accurate energy-related information …

Multi-Dimensional Extension Of The Alternating Minimization Algorithm In X-Ray Computed Tomography, Jingwei Lu

McKelvey School of Engineering Graduate Student Theses & Dissertations

X-ray computed tomography (CT) is an important and effective tool in medical and industrial imaging applications. The state-of-the-art methods to reconstruct CT images have had great development but also face challenges. This dissertation derives novel algorithms to reduce bias and metal artifacts in a wide variety of imaging modalities and increase performance in low-dose scenarios. The most widely available CT systems still use the single-energy CT (SECT), which is good at showing the anatomic structure of the patient body. However, in SECT image reconstruction, energy-related information is lost. In applications like radiation treatment planning and dose prediction, accurate energy-related information …

The Characteristics Of Appendicoliths Associated With Acute Appendicitis, Mohammad Shoaib Khan, Mustafa Belal Hafeez Chaudhry, Noman Shahzad, Muhammad S. Khan, Maryam Wajid, Wasim Memon, Abdul Rehman Alvi

Section of General Surgery

Introduction: Differences between appendicoliths associated with appendicitis and those found incidentally have not been studied. The objective of this study was to determine the characteristics of appendicoliths that are associated with acute appendicitis.
Methods: A cross-sectional study of patients with appendicoliths identified on computed tomographic (CT) scan from January 2008 till December 2014 was conducted. Patients were divided into two group: appendicitis and appendicoliths (AA) and incidentally discovered appendicoliths (IA).
Results: Overall, 321 patients were included in the study. Of these, 103 (32%) patients were in the AA group while 218 (68%) patients were in the IA group. Both groups …

The "Lightning Bolt" Sign On Computed Tomography During Percutaneous Renal Mass Cryoablation, Qian Yu, Driss Raissi

Radiology Faculty Publications

Ice‑ball fracture is a rare and often overlooked entity that may lead to intraprocedural hemorrhage after percutaneous cryoablation of renal masses. There is scant literature on ice‑ball fractures associated with percutaneous renal cryoablation. Immediate recognition of the lightning bolt sign during intraprocedural computed tomography can help identify patients who may have developed this complication.

A Variant Of Crossed Pulmonary Arteries In Association With Coarctation Of Aorta, Rabail Raza, Kumail Khandwala, Hafsa Qayyum, Muhammad Anwar Saeed, Anwar Ahmad

Department of Radiology

Crossed or "crisscross" pulmonary arteries (CPA) are a result of an anomalous origin and course of both the pulmonary arteries from the main pulmonary trunk in which the left pulmonary artery (PA) ostium usually lies directly superior and to the right PA ostium after which they cross each other and supply their respective lungs. This condition is usually associated with conotruncal malformations and genetic syndromes. We describe a case report of an infant, suspected to have Down syndrome, who was diagnosed with CPA and coarctation of aorta on computed tomography (CT) angiography. Our case is unusual because in our patient …

Diagnostic Efficiency Of Multidetector Computed Tomography In The Evaluation Of Clinically Equivocal Cases Of Acute Appendicitis With Surgical Correlation, Jawaid Iqbal, Raza Sayani, Misbah Tahir, Syed Mustahsan

Department of Radiology

Acute appendicitis is one of the most frequent causes of lower abdominal pain and requires immediate surgical intervention. The diagnosis often poses a lot of challenge even to experienced surgeon. Those patients with equivocal symptoms may require different imaging modalities like radiography, contrast examination and ultrasound with limited utility. Multidetector computed tomography (MDCT) used in suspected acute appendicitis has, however, resulted in improved diagnostic accuracy and also reduction of negative surgeries. Objective We intend to determine the diagnostic efficiency of MDCT in clinically equivocal cases of acute appendicitis correlating it with surgical/histopathological findings. Materials and methods A group of 116 …

Motion-Induced Artifact Mitigation And Image Enhancement Strategies For Four-Dimensional Fan-Beam And Cone-Beam Computed Tomography, Matthew J. Riblett

Theses and Dissertations

Four dimensional imaging has become part of the standard of care for diagnosing and treating non-small cell lung cancer. In radiotherapy applications 4D fan-beam computed tomography (4D-CT) and 4D cone-beam computed tomography (4D-CBCT) are two advanced imaging modalities that afford clinical practitioners knowledge of the underlying kinematics and structural dynamics of diseased tissues and provide insight into the effects of regular organ motion and the nature of tissue deformation over time. While these imaging techniques can facilitate the use of more targeted radiotherapies, issues surrounding image quality and accuracy currently limit the utility of these images clinically.

The purpose of …