Radiology Commons^™

Dramatically Increased Musculoskeletal Ultrasound Utilization From 2000 To 2009, Especially By Podiatrists In Private Offices, Richard E. Sharpe, Levon N. Nazarian, Laurence Parker, Vijay Rao, David C. Levin

Department of Radiology Faculty Papers

PURPOSE: Over the past two decades, musculoskeletal (MSK) ultrasound has emerged as an effective means of diagnosing MSK pathologies. However, some insurance providers have expressed concern about increased MSK ultrasound utilization, possibly facilitated by the low cost and ready availability of ultrasound technology. The purpose of this study was to document trends in MSK ultrasound utilization from 2000 to 2009 within the Medicare population.

METHODS: Source data were obtained from the CMS Physician/Supplier Procedure Summary Master Files from 2000 to 2009, and records were extracted for procedures for extremity nonvascular ultrasound. We analyzed annual volume by provider type using specialties, …

An Institutional Review Of Transarterial Embolization In Haemorrhagic Urological Emergencies, Raza Sayani, Muhammad Azeemuddin, Tanveer Ul Haq, Rana Shoaib Hamid, Basit Salam

Department of Radiology

OBJECTIVE: To review the effectiveness of therapeutic transarterial embolization in controlling phagic urological emergencies irrespective of the cause of emergencies.

METHODS: Thirty-seven vascular angiographies were performed in 32 patients (19 males and 13 females, age range 19-70 years) who were referred with haemorrhagic urological emergencies to Aga Khan University Hospital's angiography suite from July 2005 to June 2010. Embolization was performed with coils, polyvinyl alcohol particles, N-Butyl cyanoacrylate glue and gel foam according to the clinical indication. Data on clinical indication, technique, site and type of bleeding lesions were obtained from a retrospective review of medical records. Success rate, clinical …

Dentigerous Cyst, Aditya Tadinada

SoDM Presentations

Dentigerous Cyst

Dental School Radiology Presentation : Dentigerous Cyst

Author : Tadinada, Aditya

Medical Subject : Dentigerous Cyst, Odontogenic Cysts

Clinical Presentation Description : Radiolucency arising from the CEJ of an unerupted tooth

Location of Abnormality : Posterior Mandible

Radiological Features : Radiolucency arising from the CEJ of an unerupted tooth

DDx Description : Dentigerous cyst, odontogenic keratocyst, ameloblastoma

Type of Image : Panoramic Radiograph

Digital Publisher : UCONN Health Center : Kilham, Jessica

Format : jpg

Date : 2012

In Ovo Serial Skeletal Muscle Diffusion Tractography Of The Developing Chick Embryo Using Dti: Feasibility And Correlation With Histology, Zien Zhou, Zachary Delproposto, Lianming Wu, Jianrong Xu, Jia Hua, Yan Zhou, Yongquan Ye, Zishu Zhang, Jiani Hu, E Mark Haacke

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Magnetic resonance imaging is a noninvasive method of evaluating embryonic development. Diffusion tensor imaging (DTI), based on the directional diffusivity of water molecules, is an established method of evaluating tissue structure. Yet embryonic motion degrades the in vivo acquisition of long-duration DTI. We used a dual-cooling technique to avoid motion artifact and aimed to investigate whether DTI can be used to monitor chick embryonic skeletal muscle development in ovo, and to investigate the correlation between quantitative DTI parameters fractional anisotropy (FA) and fiber length and quantitative histologic parameters fiber area percentage (FiberArea%) and limb length.

Results

From 84 …

Neuroimaging Of Tumefactive Multiple Sclerosis With Atypical Features, Rohit Koppula, Andrew J. Degnan, Mark Ghassibi, Peter Duggan, Robert Jones, Lucien M. Levy

Radiology Faculty Publications

Tumefactive demyelinating lesions or tumefactive multiple sclerosis constitute a unique presentation of demyelinating disease which frequently mimics intracranial neoplasm, infection or other, non-demyelinating intracranial pathology. Consequently, these lesions, which are larger than typical multiple sclerosis plaques and generally characterized by certain magnetic resonance imaging features including edema and incomplete ring enhancement, pose a serious diagnostic challenge that frequently prompts biopsy in initial evaluation. Biopsy can be averted when imaging features for tumefactive multiple sclerosis are seen on MRI. Herein, we present a biopsy-proven case of tumefactive multiple sclerosis with atypical imaging features, evaluated using magnetic resonance and diffusion tensor imaging.

Acr Appropriateness Criteria®  Resectable Rectal Cancer, William E. Jones Iii, Charles R. Thomas Jr, Joseph M. Herman, May Abdel-Wahab, Nilofer Azad, William Blackstock, Prajnan Das, Karyn A. Goodman, Theodore S. Hong, Salma K. Jabbour, Andre A. Konski, Albert C. Koong, Miguel Rodriguez-Bigas, William Small Jr, Jennifer Zook, W Suh

Wayne State University Associated BioMed Central Scholarship

Abstract

The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+) benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The …

Managing Soft Tissue Sarcomas In A Developing Country: Are Prognostic Factors Similar To Those Of Developed World?, Irfan Qadir, Masood Umer, Hafiz Muhammad Umer, Nasir Uddin, Farrok Karson, Muhammad Sharoz Rabbani

Section of Orthopaedic Surgery

Background: Managing soft tissue sarcomas (STS) in a developing country with limited financial resources and a poor health referral system is a challenge. Presenting late, these extremity STS are prone to recurrence despite apparently complete resection. This study aimed to explore and compare the impact of clinico-pathological factors on recurrence and survival in Pakistan with the corresponding figures quoted from the developed world.
Methods: An institutional review was performed on all patients with primary STS of the extremities operated on between 1994 and 2008. The prognostic influence of clinical, pathologic, and treatment variables on local recurrence free survival (LRFS), metastasis …

Segmentation Of Corpus Callosum Using Diffusion Tensor Imaging: Validation In Patients With Glioblastoma, Mohammad-Reza Nazem-Zadeh, Sona Saksena, Abbas Babajani-Fermi, Quan Jiang, Hamid Soltanian-Zadeh, Mark Rosenblum, Tom Mikkelsen, Rajan Jain

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

This paper presents a three-dimensional (3D) method for segmenting corpus callosum in normal subjects and brain cancer patients with glioblastoma.

Methods

Nineteen patients with histologically confirmed treatment naïve glioblastoma and eleven normal control subjects underwent DTI on a 3T scanner. Based on the information inherent in diffusion tensors, a similarity measure was proposed and used in the proposed algorithm. In this algorithm, diffusion pattern of corpus callosum was used as prior information. Subsequently, corpus callosum was automatically divided into Witelson subdivisions. We simulated the potential rotation of corpus callosum under tumor pressure and studied the reproducibility of the …

Breast Imaging Reports For Malignant Lesions: Are We Maintaining Recommended Bi-Rads® Lexicon Standards, Imrana Masroor, Muhammad Azeemuddin, Saima Sakhawat, Madiha Hashmi, Saba Sohail, Rashid Ahmed, M Irfan Ul Haq, Javed Mehboob

Department of Radiology

Background: The purpose of this study was to evaluate mammography reports for diagnosed breast cancer cases in major government and private centers in Karachi, Pakistan, with respect to concordance with the Breast Imaging Reports And Data System (BI-RADS®) lexicon.
Methods: A prospective, descriptive, multicenter study was conducted in the radiology sections of the Aga Khan University Hospital, Pakistan Naval Station Shifa Hospital, Advanced Radiology Clinic, Karachi Institute of Radiotherapy and Nuclear Medicine, and Civil Hospital Karachi between May and October 2010 after approval from the ethical review committee of Aga Khan University. Mammograms reported as BI-RADS category 4 and 5 …

Usefulness Of Hook Wire Localization Biopsy Under Imaging Guidance For Nonpalpable Breast Lesions Detected Radiologically, Imrana Masroor, Shaista Afzal, Gulnaz Shafqat, Hasan Rehman

Department of Radiology

Background: The purpose of this study was to evaluate the usefulness of hook wire localization biopsy under imaging guidance for nonpalpable breast lesions detected radiologically.Methods: This was a descriptive study conducted at the Department of Radiology, Aga Khan University Hospital, Karachi. All patients undergoing needle localization biopsy of a nonpalpable breast lesion under mammographic or ultrasound guidance between January 2009 to December 2010 were included in the study. Patients with incomplete medical records were excluded. All patients' mammograms or ultrasound were categorized using BI-RADS() assessment categories. The percentages of benign and malignant lesions were determined by pathological examination of surgically …

Infectious Intracranial Aneurysms: Collaboration For Treatment Success, Erin M. Conahan Rn, Bsn, Cnrn

Patient Care Services / Nursing

No abstract provided.

Establishing The Quality Management Baseline In The Use Of Computed Tomography Machines In Kenya, Geoffrey K. Korir, Jeska S. Wambani, Ian K. Korir, Bernard O. Ochieng

Imaging & Diagnostic Radiology, East Africa

The objective of this study was to assess the level of compliance to quality assurance and image quality standards in computed tomography facilities in Kenyan hospitals. A quality assurance inspection and physical image quality assessment in eighteen representative computed tomography facilities were completed. A quantitative method was developed and used to score the results obtained from the physical image quality measurements using the American Association of Physicists in Medicine (AAPM) water phantom. Inspection was done in order to establish the level of compliance with internationally recognized standards such as those stipulated in the European Guidelines Quality Criteria for Computed Tomography …

Determining Efficacy Of Breast Cancer Therapy By Pet Imaging Of Her2 Mrna, Bishnuhari Paudyal, Kaijun Zhang, Changpo Chen, Neil Mehta, Eric Wickstrom, Brian Gray, Jeffrey Mattis, Koon Pak, Mathew L Thakur

Department of Radiology Faculty Papers

No abstract provided.

Shades Of Grey: An Exploration Of The Student Learning Experience In Diagnostic Radiology Education, Kathleen Linda Linaker

Dissertations

Diagnostic radiology education is a specialty within healthcare education and encompasses education at both the undergraduate and resident level. There is little research regarding what constitutes effective radiology education. The broad purpose of this study was to investigate through the student perspective how chiropractic students learned diagnostic radiology within their curriculum and what contributed to this learning. This interview-based, qualitative research explored the learning experiences of 12 fourth-year chiropractic students at two colleges. Specifically this study investigated a) the learning strategies students believe both worked and didn't work in learning radiology, b) student perceptions of the effectiveness of instructional methods …

Outcome Of Febrile Neutropenic Patients On Granulocyte Colony Stimulating Factor In A Tertiary Care Hospital, Asif Husain Osmani, Tayyaba Zehra Ansari, Nehal Masood, Bilal Ahmed

Department of Radiation Oncology

Introduction: Febrile neutropenia is a relatively frequent event in cancer patients treated with chemotherapy and improvement in absolute neutrophil count (ANC) has been linked directly to improved outcome. Evaluation of granulocyte colony stimulating factors (GCSFs) for treatment has shown reduced incidences of episodes of prolonged neutropenia and protracted hospitalization. To determine absolute neutrophil counts with GCSF in febrile neutropenic cancer patients admitted to a tertiary care centre and to co-relate the improvement in ANC with mortality and hospital discharge.Methods: A prospective cross sectional study was carried at an oncology ward at Aga Khan University hospital from January 2010 to June …

Correlates Of Morbidity And Mortality In Severe Necrotizing Pancreatitis, K. M. Pal, Pashtoon Murtaza Kasi, Mohammad Tayyeb, S. M. Faisal Mosharraf, Zafar Fatmi

Community Health Sciences

Acute severe pancreatitis is associated with a high morbidity and mortality and frequently is accompanied by underlying pancreatic parenchymal necrosis. Patients with pancreatic necrosis must be identified, because the morbidity and mortality rate in this subgroup is much higher. Our objective was to compare the clinical outcomes of these patients based on the degree of pancreatic necrosis. A total of 35 patients were noted to have pancreatic necrosis. These were divided into 2 groups based on extent of necrosis: group A had less than 50% necrosis and group B had more than 50% necrosis. The rate of mortality (5% versus …

Tracking Of In-111-Labeled Human Umbilical Tissue-Derived Cells (Hutc) In A Rat Model Of Cerebral Ischemia Using Spect Imaging, Ali S. Arbab, Christine Thiffault, Bradford Navia, Stephen J. Victor, Klaudyne Hong, Li Zhang, Quan Jiang, Nadimpalli Rs Varma, Asm Iskander, Michael Chopp

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

In order to increase understanding of how infused cells work, it becomes important to track their initial movement, localization, and engraftment efficiency following transplantation. However, the available in vivo cell tracking techniques are suboptimal. The study objective was to determine the biodistribution of intravenously administered Indium-111 (In-111) oxine labeled human umbilical tissue-derived cells (hUTC) in a rat model of transient middle cerebral occlusion (tMCAo) using single photon emission computed tomography (SPECT).

Methods

Rats received 3 million In-111 labeled hUTC (i.v.) 48 hrs after tMCAo. Following the administration of either hUTC or equivalent dose of In-111-oxine (18.5 MBq), animals …

Using Learned Under-Sampling Pattern For Increasing Speed Of Cardiac Cine Mri Based On Compressive Sensing Principles, Pooria Zamani, Mohammad Kayvanrad, Hamid Soltanian-Zadeh

Wayne State University Associated BioMed Central Scholarship

Abstract

This article presents a compressive sensing approach for reducing data acquisition time in cardiac cine magnetic resonance imaging (MRI). In cardiac cine MRI, several images are acquired throughout the cardiac cycle, each of which is reconstructed from the raw data acquired in the Fourier transform domain, traditionally called k-space. In the proposed approach, a majority, e.g., 62.5%, of the k-space lines (trajectories) are acquired at the odd time points and a minority, e.g., 37.5%, of the k-space lines are acquired at the even time points of the cardiac cycle. Optimal data acquisition at the even time points is learned …

Trends In The Utilization Of Outpatient Advanced Imaging After The Deficit Reduction Act., David C Levin, Vijay M Rao, Laurence Parker

Department of Radiology Faculty Papers

PURPOSE: After the Deficit Reduction Act (DRA) took effect in 2007, there was concern that private office-based imaging facilities would close, that advanced imaging would shift to less convenient hospital-based facilities, and that access to advanced imaging might be restricted. The aim of this study was to see if these developments occurred during the years after the DRA.

METHODS: Using Medicare data, outpatient CT, MRI, and nuclear medicine trends before and after the DRA were studied. Procedure volumes performed in private offices and hospital outpatient departments (HOPDs) were tabulated separately. Volumes were tracked from 2000 to 2006 (before the DRA) …

Left Atrial Volume: Comparison Of 2d And 3d Transthoracic Echocardiography With Ecg-Gated Ct Angiography., Anish R Koka, Stuart D Gould, Alyson N Owen, Ethan J. Halpern

Department of Radiology Faculty Papers

RATIONALE AND OBJECTIVES: Left atrial volume (LAV) measurement by conventional two-dimensional (2D) transthoracic echocardiography (TTE) may be limited by the geometric model, by suboptimal definition of left atrial endocardium, or by chamber foreshortening. Three-dimensional (3D) TTE is posited to eliminate chamber foreshortening, and LAV measurement by 3D TTE should be more reflective of true LAV. The aim of this study was to compare conventional 2D TTE and newer 3D TTE for measurements of LAV to multidetector computed tomographic (MDCT) measurements using automated chamber reconstruction (ACR).

MATERIALS AND METHODS: Twenty-two subjects consented to undergo 2D TTE and 3D TTE immediately prior …

Optical Imaging For Determination Of Apoptosis Medicated Therapeutic Efficacy, Kaijun Zhang, Bishnuhari Paudyal, Neil Mehta, Brian Gray, Koon Y. Pak, Eric Wickstrom, Mathew L Thakur

Department of Radiology Faculty Papers

No abstract provided.

Functional Evaluation Of The Urinary Tract By Duplex Doppler Ultrasonography In Patients With Acute Renal Colic., Raza Sayani, Muhammad Ali, Kashif Shazlee, Rana Shoaib Hamid, Kamran Hamid

Department of Radiology

Purpose: To determine the role of duplex Doppler ultrasonography (DDU) in Patients with acute unilateral renal obstruction. Subjects And Methods:A total of 161 Patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU). The mean intra-arterial resistive index (RI) and the difference of mean resistive index between both kidneys (delta RI) were determined for each person. An RI value of ≥0.70 and a delta RI value of ≥0.06 were taken as the discriminatory threshold for obstruction. IVU results were considered the " reference standard" against which renal DDU findings were compared.

Results: …

Can Computer Assisted Diagnosis (Cad) Be Used As A Screening Tool In The Detection Of Pulmonary Nodules When Using 64-Slice Multidetector Computed Tomography?, Zishan Haider, Muhammad Idris, W. Memon, Nazia Kashif, Sidra Idris, Zafar Sajjad, Saeed Akram

Department of Radiology

Objectives:To evaluate (1) whether or not the addition of computer-assisted diagnosis (CAD) to 64-slice multidetector computed tomography (CT) can be used as a screening tool for detection of pulmonary nodules in routine CT chest examinations and (2) whether or not to advocate the incorporation of CAD as a screening tool into our daily practice. Materials And

Methods:

A retrospective cross-sectional analysis of 109 consecutive Patients who had all undergone routine contrast-enhanced CT chest examinations for indications other than lung cancer at the Radiology Department of Aga Khan University Hospital, Karachi, between November 2010 and January 2011. All examinations were …

Sonographic Fetal Biometry Charts For A Pakistani Cohort., W. Akhtar, A. Ali, M. A. Arain, F. Saeed, S. Siddiqui, A Memon

Department of Radiology

This study aimed to develop growth centiles at different gestational weeks for fetal biparietal diameter, abdominal circumference, femur length and head circumference in a Pakistani cohort. Data were collected at a tertiary referral hospital from pregnant women at gestational ages 13-40 weeks referred for obstetric ultrasound as a part of routine antenatal care. A total of 1599 fetal sonographic biometric measurements were collected after screening for the inclusion criteria. For each measurement, separate regression models were derived to estimate the mean, standard deviation and reference percentiles at each week of gestational age for this cohort. The best fitting model for …

Novel Amino Acid Transporter-Targeted Radiotracers For Breast Cancer Imaging, Fanlin Kong

Dissertations and Theses (Open Access)

Breast cancer is the most common malignancy among women in the world. Its 5-year survival rate ranges from 23.4% in patients with stage IV to 98% in stage I disease, highlighting the importance of early detection and diagnosis. ¹⁸F-2-Fluoro-2-deoxy-glucose (¹⁸F-FDG), using positron emission tomography (PET), is the most common functional imaging tool for breast cancer diagnosis currently. Unfortunately, ¹⁸F-FDG-PET has several limitations such as poorly differentiating tumor tissues from inflammatory and normal brain tissues. Therefore, ¹⁸F-labeled amino acid-based radiotracers have been reported as an alternative, which is based on the fact that tumor cells uptake …

Optimizing Heart Dose Reduction For Deep Inspiration Left Breast Radiotherapy, Ronald James Harder

UNLV Theses, Dissertations, Professional Papers, and Capstones

Multiple studies have shown that an increased risk of late injury cardiac abnormalities including congestive heart failure (CHF), ischemia, and coronary artery disease (CAD) can be associated with common left breast radiation therapy (RT) techniques. Many radiation therapy clinics have adopted the Deep Inspiration Breath Hold (DIBH) technique for the treatment of the left breast with external beam therapy based on studies showing a decrease in the dose received by the heart. A common technology used to monitor inhalation during DIBH is the Real-Time Position Management (RPM) system (Varian Medical Systems, Palo Alto, CA). This study analyzes if there is …

Value-Added Services Of Hospital-Based Radiology Groups, Vijay M. Rao, Md

Department of Radiology Faculty Papers

Presentation at 97th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

Summary of presentation.

16 slides.

Diagnosis Of Hepatoma Using Grayscale And Doppler Ultrasound In Patients With Chronic Liver Disease., W. Memon, Zishan Haider, Mirza Amanullah Beg, Muhammad Idris, Tanveer Ul Haq, Sidra Idris

Department of Radiology

Objective:To determine the diagnostic accuracy of liver ultrasound for the detection of hepatoma in chronic liver disease (CLD) Patients by either taking histopathology or serum alpha-fetoprotein levels or a biphasic computed tomography (CT) scan (whichever is available) as the gold standard. Study Design: Cross-sectional. Place And Duration Of Study: Radiology Department, The Aga Khan University Hospital, Karachi, Pakistan, from January 2007 to January 2010.

Methods:

A total of 239 Patients (156 males and 83 females) with clinical suspicion or surveillance of hepatoma in CLD referred to the radiology department for ultrasound evaluation followed by either liver biopsy and histopathology …

Endovascular Approach As Primary Treatment For Traumatic Carotid Cavernous Fistula: Local Experience From Pakistan, Rana Shoaib Hamid, Tanveer Ul Haq, Muhammad Shahzad Shamim, Syed Faraz Kazim, Basit Salam

Department of Radiology

Objective: To evaluate the technical success, complications and outcome of endovascular management of post traumatic carotid cavernous fistula (CCF) in patients presenting at a tertiary care hospital in Karahci.
Methods: Descriptive case series of 26 patients of post traumatic CCF treated by endovascular techniques was carried out at Radiology and Neurosurgery departments of Aga Khan University hospital between January 2010 to March 2010. Medical records and radiology reports were retrospectively reviewed from November 2000 to December 2009. The diagnosis was primarily clinical and was confirmed in all cases by CT or MRI. Endovascular procedures were performed under general anaesthesia through …

Labrad : Vol 37, Issue 2 - September 2011, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Biochemical Bone Profiles Available at Clinical Laboratory of Aga Khan University Hospital
• Ionized Calcium Determination in Clinical Labortory
• Parathyroid Hormone Disorders and Issues of Testing
• Tubular Maximum Reabsorption Rate of Phosphate to Glomerular Filtration Rate (TmP/GFR)
• LABRAD Quiz
• Renal Osteodystrophy: A Disturbed Metabolic Aspect of Renal Failure
• Osteopenia and Osteoporosis in Beta Thalassemia Major
• Role of β2 Microglobulin in Multiple Myeloma
• Update on Microbiological Diagnosis of Bone and Joint Disorders
• Bone Sarcomas: Role of Histopathology in Diagnosis