Radiology Commons^™

Diagnosis Of Coronary Stenosis With Ct Angiography Comparison Of Automated Computer Diagnosis With Expert Readings., Ethan J Halpern, David J Halpern

Department of Radiology Faculty Papers

RATIONALE AND OBJECTIVES: To compare computer-generated interpretation of coronary computed tomography angiography (cCTA) by commercially available COR Analyzer software with expert human interpretation.

MATERIALS AND METHODS: This retrospective Health Insurance Portability and Accountability Act‑compliant study was approved by the institutional review board. Among 225 consecutive cCTA examinations, 207 were of adequate quality for automated evaluation. COR Analyzer interpretation was compared to human expert interpretation for detection of stenosis defined as ≥50% vessel diameter reduction in the left main, left anterior descending (LAD), circumflex (LCX), right coronary artery (RCA), or a branch vessel (diagonal, ramus, obtuse marginal, or posterior descending artery). …

Phase I Study Of 'Dose-Dense' Pemetrexed Plus Carboplatin/Radiotherapy For Locally Advanced Non-Small Cell Lung Carcinoma., Xinglei Shen, Albert Denittis, Maria Werner-Wasik, Rita Axelrod, Paul Gilman, Thomas Meyer, Joseph Treat, Walter J Curran, Mitchell Machtay

Department of Radiation Oncology Faculty Papers

BACKGROUND: This phase I study investigates the feasibility of carboplatin plus dose-dense (q2-week) pemetrexed given concurrently with radiotherapy (XRT) for locally advanced and oligometastatic non-small cell lung cancer (NSCLC).

METHODS: Eligible patients had Stage III or IV (oligometastatic) NSCLC. Patients received XRT to 63 Gy in standard fractionation. Patients received concurrent carboplatin (AUC = 6) during weeks 1 and 5 of XRT, and pemetrexed during weeks 1, 3, 5, and 7 of XRT. The starting dose level (level 1) of pemetrexed was 300 mg/m2. Following the finding of dose limiting toxicity (DLT) in dose level 1, an amended dose level …

Chemotherapy-Induced Cognitive Impairment Is Associated With Decreases In Cell Proliferation And Histone Modifications, Teresita L. Briones, Julie Woods

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

In this study, we examined the effects of cyclophosphamide, methothrexate, and 5-Fluorouracil (CMF) drug combination on various aspects of learning and memory. We also examined the effects of CMF on cell proliferation and chromatin remodeling as possible underlying mechanisms to explain chemotherapy-associated cognitive dysfunction. Twenty-four adult female Wistar rats were included in the study and had minimitter implantation for continuous activity monitoring two weeks before the chemotherapy regimen was started. Once baseline activity data were collected, rats were randomly assigned to receive either CMF or saline injections given intraperitoneally. Treatments were given once a week for a total …

International Conference On Advances In Radiation Oncology (Icaro): Outcomes Of An Iaea Meeting, Eeva K. Salminen, Krystyna Kiel, Geoffrey S. Ibbott, Michael C. Joiner, Eduardo Rosenblatt, Eduardo Zubizarreta, Jan Wondergem, Ahmed Meghzifene

Wayne State University Associated BioMed Central Scholarship

Abstract

The IAEA held the International Conference on Advances in Radiation Oncology (ICARO) in Vienna on 27-29 April 2009. The Conference dealt with the issues and requirements posed by the transition from conventional radiotherapy to advanced modern technologies, including staffing, training, treatment planning and delivery, quality assurance (QA) and the optimal use of available resources. The current role of advanced technologies (defined as 3-dimensional and/or image guided treatment with photons or particles) in current clinical practice and future scenarios were discussed.

ICARO was organized by the IAEA at the request of the Member States and co-sponsored and supported by other …

Combination Of Dasatinib And Curcumin Eliminates Chemo-Resistant Colon Cancer Cells, Jyoti Nautiyal, Shailender S. Kanwar, Yingjie Yu, Adhip Pn Majumdar

Wayne State University Associated BioMed Central Scholarship

Abstract

Metastatic colorectal cancer remains a serious health concern with poor patient survival. Although 5-Fluorouracil (5-FU) or 5-FU plus oxaliplatin (FOLFOX) is the standard therapy for colorectal cancer, it has met with limited success. Recurrence of the tumor after chemotherapy could partly be explained by the enrichment of the chemo-resistant sub-population of cancer stem cells (CSCs) that possess the ability for self-renewal and differentiation into different lineages in the tumor. Therefore development of therapeutic strategies that target CSCs for successful treatment of this malignancy is warranted. The current investigation was undertaken to examine the effectiveness of the combination therapy of …

Accuracy Of Computed Tomography In Diagnosing Malignancy In Solitary Pulmonary Lesions, Imaad-Ur-Rehman, Wasim Memon, Yousuf Husen, Waseem Akhtar, Raafay Sophie, Muhammad Akbar Baig

Department of Radiology

OBJECTIVE: To evaluate accuracy of Computed Tomography (CT) for diagnosing malignancy in solitary pulmonary lesions (SPLs).

METHODS: A prospective cross-sectional study was conducted from 20-01-2007 to 30-06-2008 at the Radiology department, Aga Khan University Hospital (AKUH) Karachi. Fifty-three patients with solitary pulmonary lesions (SPLs) seen in prior chest x-rays or chest CT scans were referred to radiology department for CT guided biopsy. CT scan was performed for each patient prior to biopsy and CT evaluation of the SPLs was performed followed by CT guided Biopsy. Histopathological diagnosis of the lesion was taken as the gold standard.

RESULTS: CT was found …

Assessing Doppler-Derived Pressure Gradients And Liver Echogenicity To Predict Liver Disease, Joy D. Guthrie

Walden Dissertations and Doctoral Studies

Liver disease causes an estimated 36,000 deaths in the United States each year. Currently, to detect liver disease, an invasive biopsy is required. Other, less invasive diagnostic alternatives are needed. The purpose of this study was to assess the efficacy of a modified form of sonographic screening, including portal, hepatic, and splenic venous pressure, hepatic venous waveform analysis, portal vein diameter, and echogenicity of liver parenchyma in predicting liver disease. The study was based on conversion of a velocity measurement to a pressure gradient, allowing a fluid comparison between known catheterization venous pressures and sonographic Doppler-derived pressure gradients. This study …

Labrad : Vol 36, Issue 1 - January 2011, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Routine and Special Liver Function Tests
• Management of Coagulopathy Associated with Liver Disease
• Significance of Clinical and Laboratory Scoring System in Diagnosis of Disseminated Intravascular Coagulation in Chronic Liver Disease
• Laboratory Diagnosis of Hydatid Disease
• Laboratory Diagnosis of Amoebiasis
• Improvement of Bacteriological Yield of Liver Abscess by use of Anaerobic Chambers
• Radiofrequency Ablation of Liver Tumours
• HER2 in Breast Cancer: Frequently Asked Questions
• Clinical Laboratory Continuing Medical Education (CME) Seminar
• World Blood Donor Day at Aga Khan University Blood Bank

Diagnosis Of Langerhans Cell Histiocytosis On Fine Needle Aspiration Cytology: A Case Report And Review Of The Cytology Literature, Neeta Kumar, Shahin Sayed, Sudhir Vinayak

Pathology, East Africa

A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical and radiological setting. This can avoid unnecessary biopsy and guide the management especially where access to histopathology is limited. The highly characteristic common and rare cytological features are highlighted with focus on differential diagnoses and causes of pitfalls.

Ultrasonographic Diagnosis Of Placenta Accreta, Shaista Afza, Imrana Masroor, Gulnaz Shafqat

Department of Radiology

Placenta accreta is the abnormal adherence of placenta to myometrium due to defect in decidua basalis. This type of placenta could not remove manually after delivery and lead to severe hemorrhage that may result in emergency cesarean hysterectomy. Prenatal diagnosis of placenta accreta is important because it reduces the fetal and maternal morbidity and mortality as appropriate pre-operative and per operative procedures are possible. Grey scale ultrasonography along with color Doppler imaging proves to be the non invasive, real time, readily available modality with high sensitivity and high positive predictive value.

Concomitant Gastric And Lung Uptake Of Tc-99m Mdp On Bone Scan In A Patient With Diffuse Large B-Cell Non-Hodgkin’S Lymphoma, Maseeh Uz Zaman, Riffat Hussain Riffat Hussain, Zafar Sajjad, Mansoor Naqvi Mansoor Naqvi, Khalil Khan, Gufran Khan, Zohra I Pirani

Department of Radiology

Extra osseous uptake of Tc-99m Methylene Di Phosphonate (MDP) is not an uncommon finding on skeletal scintigraphy. However, concomitant lung and gastric uptake is a rare presentation. We presented a case report of a young male whose bone scan revealed lung and stomach uptake with a cold lesion over T7 vertebra. CT guided biopsy revealed diffuse large B-cell Non-Hodgkin’s lymphoma. Lung and gastric uptake of Tc-99m MDP on bone scan guides the reporting physician about the soft tissue calcinosis due to hypercalcemia associated with either malignant or non-malignant conditions.

Diffusion Weighted Mr Imaging (Dwi) And Adc Values In Endometrial Carcinoma, Imrana Masroor, Muhammad Zeeshan, Shaista Afzal, Nadeem Ahmad, Gulnaz Shafqat

Department of Radiology

Objective: To determine the sensitivity of MR imaging utilizing diffusion weighted imaging (DWI) in detection of endometrial cancer and to compare the Apparent Diffusion Coefficient (ADC) values of malignant and normal endometrium.

Study Design: Cross-sectional analytical study.

Place and Duration of Study: Radiology Department, Aga Khan University Hospital Karachi, from January 2007 to December 2009. Methodology: Patients were defined as undergoing MRI for suspected endometrial malignancy, and the controls were female subjects who underwent MRI examination for indications other than endometrial malignancy. Studied variables included the signal characteristics of the endometrium and ADC values. The sensitivity of DWI for the …

Chart Rounds In The Digital Age: A Survey Of North American Institutions, M. A. Whiton, A. P. Dicker, E. J. Wuthrick, L. Doyle, A. S. Harrison, Y. R. Lawrence

Department of Radiation Oncology Faculty Papers

Purpose:

Recent reports of medical errors in radiaKon treatment delivery have emphasized the importance of quality assurance (QA) pracKces. Strict guidelines exist for medical physics QA, but not for QA procedures as applied to clinicians. We sought to document how clinical quality assurance (QA) meeKngs or “chart rounds” are performed across academic North American RadiaKon Oncology departments.

Differential Regulation Of P53 Function By The N-Terminal Δnp53 And Δ113p53 Isoforms In Zebrafish Embryos., William R Davidson, Csaba Kari, Qing Ren, Borbala Daroczi, Adam P Dicker, Ulrich Rodeck

Department of Radiation Oncology Faculty Papers

BACKGROUND: The p53 protein family coordinates stress responses of cells and organisms. Alternative promoter usage and/or splicing of p53 mRNA gives rise to at least nine mammalian p53 proteins with distinct N- and C-termini which are differentially expressed in normal and malignant cells. The human N-terminal p53 variants contain either the full-length (FL), or a truncated (ΔN/Δ40) or no transactivation domain (Δ133) altogether. The functional consequences of coexpression of the different p53 isoforms are poorly defined. Here we investigated functional aspects of the zebrafish ΔNp53 ortholog in the context of FLp53 and the zebrafish Δ133p53 ortholog (Δ113p53) coexpressed in the …

Spinal Changes In Patients With Ankylosing Spondylitis On Mri: Case Series, Rohana Naqi, Humera Ahsan, Muhammad Azeemuddin

Department of Radiology

Magnetic Resonance Imaging appearances are described in three cases of Ankylosing Spondylitis (AS). The different appearances of AS on magnetic resonance imaging are described and their significance in relation to the pathology of this condition is discussed. MRI is increasingly used to detect changes in the spine of patients with AS. Spinal changes associated with spondyloarthritis are florid anterior spondylitis (Romanus lesion), florid discitis (Andersson lesion), ankylosis, insufficiency fractures of the ankylosed spine, syndesmophytes, arthritis of the apophyseal and costovertebral joints and enthesitis of the interspinal ligaments.

From Survival To Survivorship: Late Side Effects Become An Issue In High-Grade Glioma., Yaacov R Lawrence, Wenyin Shi, Adam P Dicker

Department of Radiation Oncology Faculty Papers

“For many patients, controlling neurological symptoms, preventing cognitive dysfunction and maintaining functional independence are just as important as prolonging survival.”

Development Of A Macromolecular Prodrug For The Treatment Of Inflammatory Arthritis: Mechanisms Involved In Arthrotropism And Sustained Therapeutic Efficacy., Ling-Dong Quan, P. Edward Purdue, Xin-Ming Liu, Michael D. Boska, Subodh M. Lele, Geoffrey M. Thiele, Ted R. Mikuls, Huanyu Dou, Steven R. Goldring, Dong Wang

Journal Articles: Radiology

INTRODUCTION: The purpose of the present manuscript is to test the hypothesis that arthrotropic localization and synovial cell internalization account for the unique capacity of N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer-dexamethasone conjugate (P-Dex, a macromolecular prodrug of dexamethasone) to induce sustained amelioration of joint inflammation and inhibition of tissue damage in an animal model of inflammatory arthritis.

METHODS: Rats with adjuvant-induced arthritis (AA) were treated with P-Dex, free dexamethasone, saline or HPMA homopolymer. To define the biodistribution of P-Dex, conjugates with different imaging labels were given to AA rats and analyzed. Isolated joint tissues were evaluated by fluorescence-activated cell sorting (FACS) and immunohistochemical …

Central Nervous System Involvement In Multiple Myeloma, Rohana Naqi, Muhammad Azeemuddin, Humera Ahsan

Department of Radiology

Involvement of the central nervous system by multiple myeloma (MM) is considered to be extremely rare. Magnetic Resonauce Imaging (MRI) is the imaging modality of choice to detect and differentiate myeloma at unusual sites. We present the case of a sixty-year-old man who was a known case of MM. In this case report MRI findings of central nervous system in myeloma lesions are reported. The purpose is to increase the awareness of the clinical presentation, neuroradiological findings and follow-up of multiple myeloma with intracranial growth. There are only a few reported cases found concerning MM with intracranial involvement in the …

Percutaneous Cholecystostomy (Pc) In The Management Of Acute Cholecystitis In High Risk Patients, Shaista Afzal Saeed, Imrana Masroor

Department of Radiology

OBJECTIVE: To determine the role of ultrasound-guided percutaneous cholecystostomy (PC) regarding complications and outcome in the management of acute cholecystitis in patients high risk for surgery and anaesthesia and not responding to conservative management.

STUDY DESIGN: Observational case series.

PLACE AND DURATION OF STUDY: The study was carried out at The Aga Khan University Hospital, Karachi, from January 2003 to December 2007.

METHODOLOGY: The study included patients admitted with acute cholecystitis considered unfit for immediate surgery but not responding to conservative management. Percutaneous cholecystostomy was conducted under ultrasound guidance. The studied variables included patients' demographics, co-morbid, ultrasound findings of biliary …

Facial Type Analysis Comparison Between Mri, Cbct, And Lateral Cephalometrics, Matthew A. Sanders

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Single Cephalometric measurements are comparable between Cone Beam Computed Tomography (CBCT), Magnetic Resonance Imaging (MRl) and Conventional Lateral Cephalometric (LC) imaging methods. This study evaluated the agreement between the three imaging methods in facial type analysis (using a composite of 5 cephalometric measures).

Methods and Materials: Twenty-two subjects participated in this study. Cranial images were generated via three modalities: LC, CBCT and MRl. Cephalometric landmarks were identified on the three images per subject and a facial type analysis performed. An equally weighted facial type calculation composed of 5 cephalometric measurements (facial axis, facial depth, mandibular plane, lower face height, …

Correlating The Slope Of The Vomer With Cephalometric Vectors Of Facial Growth, Ryan Michael Pulfer

Loma Linda University Electronic Theses, Dissertations & Projects

It is important for orthodontists to have a basic understanding of the growth and development of the face. Scott's nasal septal cartilage theory proposes that the cartilage of the nasal septum proliferates along the anterior slope of the vomer bone by interstitial growth, simultaneously pulling and displacing the maxilla downward and forward. It is therefore logical to conclude that the vector of nasomaxillary growth has a geometric correlation with the anterior slope of the vomer bone.

There are no published studies comparing either the anterior or posterior slope of the vomer with any lateral cephalometric landmarks, the vectors of nasomaxillary …

Creating Prediction Models For Obstructive Sleep Apnea Based On Gender, Jeffrey Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Obstructive sleep apnea (OSA) is a common chronic disorder that is characterized by repetitive episodes of airflow cessation or reduction occurring during sleep as a result of partial or complete upper airway obstruction. These recurrent events have a tremendous impact on the cardiovascular system with a multitude of dangerous consequences. Numerous studies have been conducted determining etiological risk factors for OSA including anatomical predictors which have been observed with multiple imaging techniques. Cone beam computed tomography (CBCT) is a low-radiation mode of imaging that can be used to accurately identify anatomical landmarks and measure craniofacial relationships and airway dimensions. …

Microct Study Of Critical-Sized Defects Restored With A New Rhbmp-2 Carrier, Joanne S. Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Regenerating bone in critical-sized maxillofacial osseous defects remains a challenge. The utilization of recombinant human bone morphogenetic protein-2 (rhBMP-2) to form new bone has been shown to be a promising alternative to autogenous bone grafts, and the development of a carrier matrix to effectively deliver the rhBMP-2 has been identified as the critical factor necessary for the successful clinical application of rhBMP-2. The objective of this study was to perform a microCT analysis to examine the density of reconstructed bone using different rhBMP-2 carriers in critical-sized defects.

Material and Methods: Critical-sized defects (approximately 2.5 cm) were created in the …

One Year Survival With Poorly Differentiated Metastatic Pancreatic Carcinoma Following Chemoembolization With Gemcitabine And Cisplatin., Daniel B Brown, Carin F Gonsalves, Charles J Yeo, Agnes K Witkiewicz, Brian I Carr

Department of Radiology Faculty Papers

While hepatic arterial chemoembolization is efficacious for a number of malignancies, there is scant data regarding treatment of pancreatic adenocarcinoma. We report a complete radiographic response at one year from diagnosis of metastatic pancreatic carcinoma. Gemcitabine/cisplatin based chemoembolization may be of potential benefit for patients with liver-dominant metastases from pancreatic carcinoma. Given the typical survival of 6 months or less in this patient group with standard therapies, further research is warranted.

Traumatic Dural Venous Sinus Thrombosis In High-Risk Acute Blunt Head Trauma Patients, W. Akhtar

Department of Radiology

No abstract provided.

Identification Of A Unique Core Domain Of Par-4 Sufficient For Selective Apoptosis Induction In Cancer Cells, Vivek M. Rangnekar

Radiation Medicine Faculty Patents

The present invention relates to Par-4 mutants which cause apoptosis in cancer cells which are sensitive to Par-4 and also induce apoptosis in cancer cells which are resistant to Par-4. The present invention also relates to methods of using the Par-4 mutant to treat certain cancers, as well as to kits, vectors, and polypeptides for same.

High Pressure Liquid Chromatography Studies Of The Reaction Of Platinum Complexes With Peptides, Khaja Muneeruddin

Masters Theses & Specialist Projects

Platinum complexes (cisplatin, carboplatin and oxaliplatin) are effective anticancer agents. However the major drawbacks of platinum chemotherapy are toxic side effects and resistance. The affinity of platinum complexes to sulfur donor ligands of side chains of methionine and cysteine amino acids was assumed to be responsible for toxicity and resistance. Recently, it was found that the reaction of platinum complex with proteins containing sulfur donor ligands could actually favor its anticancer activity. Copper transporter 1 (Ctr 1), a protein involved in the transport of copper into the cell, also helps in the influx of cisplatin by binding to N-terminal domain …

Treatment Of Intracranial Aneurysms Using Detachable Coils; Initial Results At A University Hospital In Pakistan, Rana Shoaib Hamid, Tanveer-Ul-Haq, Ishtiaq Chishti, Muhammad Azeemuddin, Zafar Sajjad, Basit Salam

Department of Radiology

OBJECTIVE: To evaluate the technical success, safety and outcome of endovascular coiling procedure in intracranial aneurysms.

METHODS: From April 2003 to April 2009, 43 patients (23 males and 20 females), age range 11 to 70 years, mean age 46.67 +/- 11.57 years were treated for intracranial aneurysms by detachable coil deployment at Radiology Department of Aga Khan University Hospital. Aneurysm rupture with subarachnoid haemorrhage was the cause of presentation in 39 patients while 4 patients were diagnosed with un-ruptured aneurysms. At time of presentation, grading of subarachnoid haemorrhage was done according to Hunt and Hess grading system. Eleven patients presented …

Cystic Artery Pseudo-Aneurysm: A Complication Of Xanthogranulomatous Cholecystitis, I. Ahmed, U. H. Tanveer, Z. Sajjad, B. Munazza, U. D. Azeem

Department of Radiology

A 54-year-old man presented for radiology with pain and a feeling of fullness in the upper abdomen and an epigastric mass. Ultrasound revealed a large cystic mass with internal echoes, lying posterior and inferior to left lobe of the liver. The gallbladder was thick-walled and contracted, and contained a calculus and echogenic sludge. A cystic structure that produced swirling flow signals on colour Doppler was demonstrated within the gallbladder. The CT scan showed a thickened gallbladder with adjacent inflammation and a 2-cm pseudo-aneurysm in its wall. High-density material was present in the gallbladder lumen, in the extra-hepatic bile ducts and …

Characterization Of Optically Stimulated Luminescent Detectors In Photon & Proton Beams For Use In Anthropomorphic Phantoms, James R. Kerns

Dissertations and Theses (Open Access)

This study investigated characteristics of optically stimulated luminescent detectors (OSLDs) in protons, allowing comparison to thermoluminescent detectors, and to be implemented into the Radiological Physics Center’s (RPC) remote audit quality assurance program for protons, and for remote anthropomorphic phantom irradiations. The OSLDs used were aluminum oxide (Al2O3:C) nanoDots from Landauer, Inc. (Glenwood, Ill.) measuring 10x10x2 mm3. A square, 20(L)x20(W)x0.5(H) cm3 piece of solid water was fabricated with pockets to allow OSLDs and TLDs to be irradiated simultaneously and perpendicular to the beam. Irradiations were performed at 5cm depth in photons, and in the center of a 10 cm SOBP in …