Radiology Commons^™

Knowledge, Attitude And Preventive Practices For Breast Cancer Among Health Care Professionals At Aga Khan Hospital Karachi, Shiyam Kumar, Ayesha Mallick Imam, Nauman Fazal Manzoor, Nehal Masood

Department of Radiation Oncology

OBJECTIVE: To assess the knowledge and practice of risk factors, symptoms and screening for breast cancer among health care professionals.

METHODS: A cross sectional study was carried out at The Aga Khan University Hospital from January 2008 to March 2008. A total of 336 health care workers including consultants (48), fellows (17), residents (76), medical officers (14), interns (37), nurses (94) and fourth and final year medical students (50) were requested to fill a questionnaire designed to assess the knowledge about the risk factors, signs and symptoms, screening tools, breast self examination (BSE) and treatment.

RESULTS: More than two third …

Department Of Radiology-Annual Executive Summary Report-July 1, 2008 To June 30, 2009, Vijay M. Rao, Md

Department of Radiology Administrative Documents and Reports

87 page Annual Executive Summary Report from Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.

Table of Contents:

Department of Radiology

Chairman, Vice Chairmen 1

Divisions and Directors 1

Committees and Chairmen 1

Radiology Department Faculty Rank 2

Faculty with Secondary Appointments 3

Clinical Divisions 4

Radiology Residents and Fellows 5

Department Organizational Chart 6

Department Administration Chart 7

State of the Department 8

Appendix I: Publications Journal Articles 21

Books and Book Chapters 29

Abstracts 30

Appendix II: Formal Scientific Presentations 40

Appendix III: Honors, Editorial Activities, Service to Regional or National Organizations 61

Appendix IV: Active …

A Real-Time Prostate Cancer Detection Technique Using Needle Insertion Force And Patient-Specific Criteria During Percutaneous Intervention, Kaiguo Yan, T. Podder, L. Li, J. Joseph, D. R. Rubens, E. M. Messing, L. Liao, Y. Yu

Department of Radiation Oncology Faculty Papers

In this article, the authors present a novel real-time cancer detection technique by using needle insertion forces in conjunction with patient-specific criteria during percutaneous interventions. Needle insertion experiments and pathological analysis were performed for developing a computer-aided detection (CAD) model. Backward stepwise regression method was performed to identify the statistically significant patient-specific factors. A baseline force model was then developed using these significant factors. The threshold force model that estimated the lower bound of the cancerous tissue forces was formulated by adding an adjustable classifier to the baseline force model. Trade-off between sensitivity and specificity was obtained by varying the …

Chorioangioma Of The Placenta With Hydrops Foetalis, Gulnaz Shafqat, Farah Iqbal, Farhan Rizvi

Department of Radiology

Chorioangioma, the non trophoblastic tumour, constitutes the commonest benign growth of the placenta. Though benign, 30% rate of maternal or foetal complications are associated with large masses. Sonography including colour Doppler imaging provides the best modality not only for its diagnosis but also the foetal status. A case of large placental chorioangioma has been reported here resulting in dismal foetal outcome diagnosed on antenatal ultrasound.

Old Disease, New Targets--Part-I, Solid Malignancies, Shiyam Kumar, Nehal Masood, Asim Jamal Shaikh

Department of Radiation Oncology

Targeted agents are now an integral part of treatment regimens for some cancers. Trastuzumab is established in treatment of human epidermal receptor 2 (Her2) positive breast cancers, with improvements in both, the disease free and over all survival. Monoclonal antibody (MoAB) against vascular growth factor receptor (VEGF), bevacizumab and cetuximab a MoAB against epidermal growth factor receptor (EGFR) are establishing their role in a many cancers after making their mark in colorectal cancer. Sorafenib and sunitinib have success stories in renal carcinoma. The Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) trial has established sorafenib role in advanced hepatocellular carcinoma, while …

Clinical Characteristics, Management And Outcome Of Major Pulmonary Embolism: An Experience From A Tertiary Care Center In Pakistan, Shahid Javed Husain, Ali Bin Sarwar Zubairi, Kulsoom Fatima, Muhammad Irfan, Muhammad Atif, Muhammad Ammad Saeed

Department of Medicine

Objective: To evaluate the clinical characteristics, risk factors, management and outcome of major pulmonary embolism (PE) in a tertiary care center of Karachi.
Methods: Medical records of all patients who underwent a spiral CT scan of the chest for suspected pulmonary embolism were reviewed between January 2000 and June 2007 at the Aga Khan University Hospital, Karachi. Patients having evidence of major pulmonary embolism on spiral CT scan were selected.
Results: A total of 30 patients (10 males, 20 females) with mean age 52 ± 14.59 years were identified who fulfilled our predefined criteria for major pulmonary embolism. Risk factors …

Diffusion Weighted Image (Dwi) Findings In Methanol Intoxication, Humera Ahsan, Muhammad Akbar, Aamir Hameed

Department of Radiology

Methanol is a toxic substance with extremely devastating effects upon exposure. The case described suffered from such kind of poisoning. MRI brain demonstrated necrosis bilaterally in the Putamen areas which is a classic hallmark finding. Additional Diffusion weighted imaging showed abnormal signal bilaterally in the putamen areas along with Diffusion positive bilateral lesions (possibly infarctions) in both the frontal and occipital lobes that were not evident on MRI with or without contrast.

Labrad : Vol 34, Issue 2 - May 2009, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Acute Leukemia Immunophenotyping with Pakistani Perspective
• PAX5: Immunohistochemistry Marker for B cell Lymphoproliferative Disorders
• Understanding the Water Deprivation Test
• Gonadotropins Releasing Hormone (GnRH) Stimulation Test
• Haematology Quiz
• Red Cell Mass Study
• Semen Analysis: An Invaluable Tool for Infertility Work-up
• Foetal Anomaly Scan
• Diagnosis of Helicobacter Pylori Infection
• Hepatitis C Virus (HCV) Genotyping
• Answer to Haematology Quiz

Using Thermoluminescent Dosimeters To Measure The Dose From High And Low Energy X-Ray Sources, Wesley Leon Boyd

UNLV Theses, Dissertations, Professional Papers, and Capstones

This work focused on using thermoluminescent dosimeters (TLDs) to measure the doses from two x-ray sources, a CT scanner and a linear accelerator (linac). In addition ion chambers were used to determine the isodose contours from the operation of the linac. 1mm x 1mm x 1mm TLD-100 microcubes were placed in a Lawrence Livermore National Laboratory (LLNL) torso phantom and irradiated using a Toshiba Aquilion One 320-Slice CT Scanner. Different thicknesses of shielding composed of antimony and bismuth powder suspended in an ethylene copolymer were used to shield the phantom and the dose reduction was measured. The dose reduction ranged …

Us And Mr Imaging Features Of Benign Cystic Mesothelioma Of The Liver: A Diagnostic Dilemma, Sachit K. Verma, Donald G. Mitchell, Oksana H. Baltarowich, Diane Bergin, Raphael Rubin

Department of Radiology Faculty Papers

Cystic mesotheliomas are benign neoplasms, often seen in the parietal and visceral peritoneum, omentum and pelvic organs, and are exceedingly rare in the liver. It is however important to be familiar with the radiological findings of this tumour because the signal-intensity and enhancement pattern of this tumor are unusual and not typical for any of the more frequently seen mass lesions. In our patient, characteristic imaging findings on dynamic contrast-enhanced MRI and histopathological confirmation with appropriate immunohistochemical markers facilitated a correct diagnosis. We herein describe the clinical, imaging and histopathological features, pathogenesis, differential diagnosis and treatment of benign cystic mesothelioma …

To Evaluate The Role Of Sonography As An Adjunct To Mammography In Women With Dense Breasts, Imrana Masroor, Mohammad Nadeem Ahmed, Sajida Pasha

Department of Radiology

OBJECTIVE: To assess the role of sonography as an adjunct to mammography in women with dense breast tissue by determining yield and validity of sonography using histopathology/follow-up mammography as gold standard.

METHODS: It was a descriptive analytical study conducted at the Radiology Department of Aga Khan University Hospital, from September 2005 to April 2007. A total of 76, mammographically dense breasts were evaluated with ultrasound. Of these 32 had palpable lumps on mammography, and were excluded from the study. A total of 44 patients had either symptoms of vague nodularity, nipple discharge, mastalgia or had no symptoms and the mammograms …

Evaluation Of Suspected Renal Colic Patients With Unenhanced Low-Dose Multi-Detector Computed Tomography, N. Twahirwa, J. Rees

Imaging & Diagnostic Radiology, East Africa

Objectives: To determine the proportion of correctly diagnosed ureteric calculi and alternate diagnoses using unenhanced low dose multidetector CT KUB.

Design: Descriptive – prospective study.

Setting: Aga Khan University Hospital, Nairobi between November 2006 and October 2007.

Subjects: One hundred and four patients underwent low dose multi-detector computed tomography (MDCT) KUB.

Results: Ninety (47 males and 43 females with age range of 17 - 79 years, mean 40 years) were included in the statistical analysis while 14 were excluded. Eighteen out of ninety (20%) were classified as definitely having ureteric calculi on the composite reference. Among the 18, 17 were …

Dosimetric Evaluation Of Heterogeneity Corrections For Rtog 0236: Stereotactic Body Radiotherapy Of Inoperable Stage I-Ii Non-Small-Cell Lung Cancer., Ying Xiao, Lech Papiez, Rebecca Paulus, Robert Timmerman, William L. Straube, Walter R. Bosch, Jeff Michalski, James M. Galvin

Department of Radiation Oncology Faculty Papers

PURPOSE: Using a retrospective analysis of treatment plans submitted from multiple institutions accruing patients to the Radiation Therapy Oncology Group (RTOG) 0236 non-small-cell stereotactic body radiotherapy protocol, the present study determined the dose prescription and critical structure constraints for future stereotactic body radiotherapy lung protocols that mandate density-corrected dose calculations.

METHOD AND MATERIALS: A subset of 20 patients from four institutions participating in the RTOG 0236 protocol and using superposition/convolution algorithms were compared. The RTOG 0236 protocol required a prescription dose of 60 Gy delivered in three fractions to cover 95% of the planning target volume. Additional requirements were specified …

Recent Trends In Soft-Tissue Infection Imaging., Nicholas Petruzzi, Md, Nylla Shanthly, Mbbs, Drm, Mathew L. Thakur, Phd

Department of Radiation Oncology Faculty Papers

This article discusses the current techniques and future directions of infection imaging with particular attention to respiratory, central nervous system, abdominal, and postoperative infections. The agents currently in use localize to areas of infection and inflammation. An infection-specific imaging agent would greatly improve the utility of scintigraphy in imaging occult infections. The superior spatial resolution of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) and its lack of reliance on a functional immune system, gives this agent certain advantages over the other radiopharmaceuticals. In respiratory tract infection imaging, an important advancement would be the ability to quantitatively delineate lung inflammation, allowing one to …

Instituting An Undergraduate Core Clerkship In Radiology: Initial Experiences In Pakistan, Naila Nadeem, Abdul Mueed Zafar, Muhammad Nadeem Ahmad

Department of Radiology

Utilization of radiology as an educational resource carries great potential. Accreditation bodies, physicians and medical students deem it important for a well rounded medical curriculum. Unfortunately this resource is yet to be developed and implemented to an optimal extent. We share the experiences from the first radiology core clerkship in Pakistan at the undergraduate level. An overview of clerkship objectives and structure is followed by discussion on lessons learnt during the initial three years of institution. Development of assessable objectives, integration of radiology with other specialties, and supervised andragogical learning tailored for undergraduate students are emphasized.

Facilitated Monocyte-Macrophage Uptake And Tissue Distribution Of Superparmagnetic Iron-Oxide Nanoparticles., Arnaud Beduneau, Zhiya Ma, Cassi B. Grotepas, Alexander Kabanov, Barrett E. Rabinow, Nan Gong, R. Lee Mosley, Huanyu Dou, Michael D. Boska, Howard Gendelman

Journal Articles: Radiology

BACKGROUND: We posit that the same mononuclear phagocytes (MP) that serve as target cells and vehicles for a host of microbial infections can be used to improve diagnostics and drug delivery. We also theorize that physical and biological processes such as particle shape, size, coating and opsonization that affect MP clearance of debris and microbes can be harnessed to facilitate uptake of nanoparticles (NP) and tissue delivery.

METHODS: Monocytes and monocyte-derived macrophages (MDM) were used as vehicles of superparamagnetic iron oxide (SPIO) NP and immunoglobulin (IgG) or albumin coated SPIO for studies of uptake and distribution. IgG coated SPIO was …

Doptaus - A Simple Criterion For Improving Sonographic Diagnosis Of Acute Appendicitis, Saba Sohail, Kausar Jehan Siddiqui

Department of Radiology

Objective: To determine the efficacy of 'Detection Of Pin-point Tenderness on the Appendix on abdominal UltraSound' (DOPTAUS) for improving sonographic diagnosis by junior and senior ultrasound operators.
Methods: An analytical study was done at the Radiology Department, Dow University of Health Sciences and Civil Hospital Karachi from March 2005 to December 2006. Adult patients of either gender with clinically suspected acute appendicitis referred to the department during regular working hours and later operated in the same hospital were included. Each patient was scanned by a junior and a senior ultrasound operator using the conventional criteria first and later focused ultrasound …

Factors Influencing Early Detection Of Breast Cancer In African American Women, Tamrah Joy Parker

Nursing Theses and Capstone Projects

Background. African American women are more likely to have breast cancer diagnosed at a later stage than Caucasian women and with a five year death rate 1.5 times greater than Caucasian women. Mammography screening detects breast cancer in its early stages and can reduce mortality.

Objective. To examine factors influencing early detection of breast cancer for African American women.

Methods. A convenience sample of 39 African American women 50 years of age and older was selected from two local Baptist churches in eastern North Carolina. Eligibility criteria included ability to read and write in English with no prior or present …

Cerebral Fungal Infection With Mycotic Aneurysm Of Basilar Artery And Subarachnoid Haemorrhage, H. Ahsan, F. Ajmal, M. F. Saleem, A. B. Sonawala

Department of Radiology

A 28-year-old Pakistani man was admitted with unresolved severe headaches for the past four weeks. Magnetic resonance (MR) imaging and MR angiography showed an enhancing mass in the sphenoid sinus, bilateral cerebellar infarcts and aneurysmal dilatation of the basilar artery. The differential diagnosis included fungal infection versus neoplastic lesion. The scrappings taken through the endoscope from the sphenoid sinus were initially negative for fungal infection. However, the second biopsy, done after putting him on antifungal, itraconazole 200 mg twice daily, revealed the presence of a fungal infection (aspergillosis). MR imaging revealed extension of the fungal infection from the sphenoid sinus …

Autoimmune Pancreatitis: Disease Evolution, Staging, Response Assessment, And Ct Features That Predict Response To Corticosteroid Therapy, Dushyant V. Sahani, Nisha I. Sainani, Vikram Deshpande, Mehrine S. Shaikh, Dmitry L. Frinkelberg, Carlos Fernandez-Del Castillo

Department of Radiology

Purpose:To evaluate the evolution of morphologic features of autoimmune pancreatitis (AIP) at computed tomography (CT) and to identify imaging features that can predict AIP response to corticosteroid therapy (CST). Materials and

Methods:

This HIPAA-compliant retrospective study had institutional review board approval. From among a cohort of 63 Patients with AIP, 15 Patients (12 men, three women, mean age, 64.7 years, age range, 30-84 years) who underwent sequential CT examinations before treatment were included to assess the evolution of disease by reviewing pancreatic, peripancreatic, and ductal changes. Of these Patients, 13 received CST and underwent posttreatment CT, these CT studies …

Labrad : Vol 34, Issue 1 - January 2009, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• N-Telopeptide of Type I Collagen (NTx): A Biochemical Tool for Assessing Bone Turnover
• Automated Blood Grouping
• Leukocyte Alkaline Phosphatase (LAP Score)
• Pathology Quiz
• Synovial Fluid Analysis in Important Joint Diseases
• Intraductal Papillary Mucinous Tumor (IPMT) of the Pancreas: A Diagnostic Challenge
• Hepatitis Delta Virus (HDV)
• Answers to Pathology Quiz
• Thyroid Autoimmune Diseases and Thyroid Peroxidase (TPO) Antibody
• Therapeutic Monitoring of Tacrolimus
• Meeting Report: 32 Annual Conference of Pakistan Association of Pathologists
• AKU Clinical Laboratory Continuing Medical Education (CME) Seminar in Bahawalpur

Optimizing Computer-Aided Colonic Polyp Detection For Ct Colonography By Evolving The Pareto Front, Jiang Li, Adam Huang, Jack Tao, Jiamin Liu, Robert L. Van Uitert, Nicholas Petrick, Ronald Summers

Electrical & Computer Engineering Faculty Publications

A multiobjective genetic algorithm is designed to optimize a computer-aided detection (CAD) system for identifying colonic polyps. Colonic polyps appear as elliptical protrusions on the inner surface of the colon. Curvature-based features for colonic polyp detection have proved to be successful in several CT colonography (CTC) CAD systems. Our CTC CAD program uses a sequential classifier to form initial polyp detections on the colon surface. The classifier utilizes a set of thresholds on curvature-based features to cluster suspicious colon surface regions into polyp candidates. The thresholds were previously chosen experimentally by using feature histograms. The chosen thresholds were effective for …

An Audit Of Editorial Processing At Jcpsp: Issues And Compliance, Saba Sohail

Department of Radiology

No abstract provided.

Mesenteric Panniculitis With Pedal Edema In A 33-Year-Old Pakistani Man: A Case Report And Literature Review., Abdul M Zafar, Muhamad A Rauf, Tabish Chawla, Gule Khanda

Department of Radiology

Introduction:Mesenteric panniculitis is a rare pathology of unknown etiology characterized by inflammation and fibrosis in the mesentery. Its protean clinical and radiological manifestations make it a diagnostic challenge. There is no established treatment available for its management. The clinical outcome is inconsistent, with the prognosis ranging from complete resolution without any treatment to rapid progression culminating in death. Case Presentation: A 33-year-old Pakistani man presented with vague abdominal pain, an ill-defined epigastric mass and bilateral pedal edema. A detailed review of his history and laboratory investigations did not point to any diagnosis. The Patient underwent an exploratory laparotomy based …

Comparison Of Mandibular Alveolar Bone With Facial Type Using Cbct, Jason M. Loop

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate the relationship between facial type and cortical bone thickness (mm), cortical bone density (rHU) and trabecular bone density (rHU) in the mandibular alveolar bone. Twenty-five consecutive dolichofacial, 25 consecutive mesiofacial, and 25 consecutive brachyfacial patients with T1 lateral cephalograms and CBCT scans were used in this study. A Ricketts analysis was used to compute the VERT index for each patient. All statistical analyses were performed at the significance level of α = 0.05. The one-way ANOVA and LSD post hoc tests indicated there was a statistically significant relationship between facial type and …

Buccal Bone Changes Following Rapid Maxillary Expansion (Rmf), Long-Term Results, Elena S. Iacob

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to use Cone Beam Computed Tomography (CBCT) images to quantitatively evaluate buccal bone changes of maxillary first premolar (P1), second premolar (P2) and first molar (M1) shortly after Rapid Maxillary Expansion (RME) and at the end of orthodontic treatment, as well as to evaluate the variables that may be associated with the short-term and long-term changes. Forty-seven consecutive patients (25 males and 22 females) with a mean age of 14.5years and who required RME as part of their orthodontic treatment and had pre-RME (T1) and post-RME (T2) CBCT images available were used for the …

Torsion Of Fallopian Tube, Fimbrial Cyst, Imrana Masroor, Nadir Khan

Department of Radiology

A case of fallopian tube fimbrial cyst torsion with haemorrhage is presented, occurring in a 37-year-old female who had tubal ligation 6 years back. She presented in emergency with acute abdomen. Initial assessment of ovarian cyst haemorrhage or torsion was made. Ultrasound showed cystic structures in left adnexa and complex cyst in right adnexa with suspicion of torsion. Laparoscopy was performed and bilateral fimbrial cysts in fallopian tubes were identified with torsion on right side, and a left ovarian haemorrhagic cyst, which was subsequently confirmed on histopathology. Although fallopian tube torsion of fimbrial cyst is rare, it should be considered …

Assessment Of Menisci And Ligamentous Injuries Of The Knee On Magnetic Resonance Imaging: Correlation With Arthroscopy, Gul-E Khanda, Waseem Akhtar, Humera Ahsan, Nadeem Ahmad

Department of Radiology

OBJECTIVE: To evaluate the validity of MRI, in the assessment of the meniscal and cruciate ligamenteous injuries of the knee joint and comparison with arthroscopic findings.

METHODS: A one year prospective cross-sectional study from January 2006 to January 2007, was performed on 50 patients (32 males & 18 females) with knee injury presenting at the orthopedic unit of AKUH. The patients were referred to radiology department for MRI evaluation and arthroscopy.

RESULTS: The sensitivity, specificity and accuracy for MRI of the menisci and ligaments were as follows: medial meniscus resulted in 100% sensitivity, 69.27% specificity, 90% PPV, 100% NPV and …

Labrad : Vol 33, Issue 3 - September 2008, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Vitamin D Deficiency: Are We Still Ignoring the Evidence?
• Collection and Transport of Urine for Culture
• Understanding and Interpreting Serum Protein Electrophoresis
• Cystic Fibrosis at a Glance
• What you need to know about Dengue Infection
• CT Colonoscopy: Introduction
• CT Enteroclysis: A New Technique to Evaluate Small Bowel
• CSF-DR: An Important Diagnostic Tool
• G6PD Quantification
• Quality Assurance
• Clinical Laboratory Continuing Medical Education (CME) Seminars
• Meeting Reports

Cephalometric Analysis Using Magnetic Resonance Imaging, Wade A. Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to determine if T1-weighted 3D magnetic resonance images performed at 3.0 Tesla could be used to conduct routine orthodontic cephalometric analysis.

Methods: Three cranial imaging methods were compared using sixteen non-growing subjects (10 male and 6 female) who were not claustrophobic, did not have any metallic restorations on the distal of first molars, had no medical implants and the female subjects were not pregnant. Sagittal cranial images were produced by three methods: (1) a digital lateral cephalometric (LC) radiograph (Orthophos XG Plus, Sirona^TM, Bensheim, Germany), (2) a 12-inch FOV cone beam …