Radiology Commons^™

Leptomeningeal Carcinomatosis In A Young Patient With Colorectal Cancer: A Case Report, Zamanali Khakhar, Soraiya Manji, Rajiv Patel, Karishma Sharma, Sheila Waa, Sayed Karar

Internal Medicine, East Africa

Leptomeningeal carcinomatosis (LMC) is a rare and fatal complication associated with various solid tumors and hematological malignancies. It presents significant diagnostic challenges due to its nonspecific symptoms and complex clinical course. This case report details the presentation, diagnosis, and implications of LMC in a 33-year-old male with a history of colorectal cancer (CRC) and hemicolectomy. The patient presented with nonspecific symptoms of headache and dizziness. Cerebrospinal fluid cytology revealed the presence of malignant cells, leading to the diagnosis of LMC secondary to CRC. The elusive and multifaceted nature of this condition highlights the necessity for increased clinical awareness and extensive …

Development Of An Online Authentic Radiology Viewing And Reporting Platform To Test The Skills Of Radiology Trainees In Low- And Middle-Income Countries, Hubert Vesselle, Justy Antony Chiramal, Stephen Hawes, Eric Schulze, Tham Nguyen, Rose Ndumia, Sudhir Vinayak

Imaging & Diagnostic Radiology, East Africa

Background: Diagnostic radiology residents in low- and middle-income countries (LMICs) may have to provide significant contributions to the clinical workload before the completion of their residency training. Because of time constraints inherent to the delivery of acute care, some of the most clinically impactful diagnostic radiology errors arise from the use of Computed Tomography (CT) in the management of acutely ill patients. As a result, it is paramount to ensure that radiology trainees reach adequate skill levels prior to assuming independent on-call responsibilities. We partnered with the radiology residency program at the Aga Khan University Hospital in Nairobi (Kenya) to …

Proton Therapy Toxicity Outcomes For Localized Prostate Cancer: Long-Term Results At A Comprehensive Cancer Center, Alan J Sosa, Michael K Rooney, Howard D Thames, Jeremiah W Sanders, David M Swanson, Seungtaek L Choi, Quynh-Nhu Nguyen, Henry Mok, Deborah A Kuban, X Ron Zhu, Shalin Shah, Lauren L Mayo, Karen E Hoffman, Chad Tang, Sean E Mcguire, Narayan Sahoo, Xiaodong Zhang, Andrew K Lee, Thomas J Pugh, Usama Mahmood, John W Davis, Brian F Chapin, Paul Corn, Reena Kudchadker, Noveen Ausat, Steven J Frank

Faculty, Staff and Student Publications

BACKGROUND: Proton therapy (PT) has unique biologic properties with excellent clinical outcomes for the management of localized prostate cancer. Here, we aim to characterize the toxicity of PT for patients with localized prostate cancer and propose mitigation strategies using a large institutional database.

METHODS: We reviewed medical records of 2772 patients with localized prostate cancer treated with definitive PT between May 2006 through January 2020. Disease risk was stratified according to National Comprehensive Cancer Network guidelines as low [LR, n = 640]; favorable-intermediate [F-IR, n = 849]; unfavorable-intermediate [U-IR, n = 851]; high [HR, n = 315]; or very high …

Transvenous Tissue Sampling In The Diagnosis Of Intravascular Neoplasm., Christopher J Neely, Christopher M Huff, Andrew C Gordon, Raghu Kolluri, Kush R Desai

Heart and Vascular Articles

No abstract provided.

Against: Adoption Of New Technologies In Radiation Oncology Must Be Evidence-Based, Xuanfeng Ding

Conference Presentation Abstracts

No abstract provided.

Quantitative Evaluation Of Gantry Rotation Perturbation Effects On Spot-Scanning Arc Therapy (Sparc), Peilin Liu, Lewei Zhao, Gang Liu, Xiaoda Cong, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To quantitatively assess the impact of random gantry rotation perturbations on spot-scanning arc (SPArc) therapy.

Methods:

To simulate random gantry rotation perturbations, the initial gantry angle of SPArc treatment plans was modified using an in-house script. Four cases from different disease sites include brain, lung, liver and prostate were selected to evaluate. Original SPArc plans (SPArc_org) were developed through iterative processes, including control point re-sampling, redistribution of control points & energy layers, energy layer filtration, and re-sampling. Considering potential limitations, rotation perturbations of 1mm and 2mm were applied to al SPArc_org plans to generate perturbed SPArc …

Exploit The Potential Clinical Benefit Of Using Proton Arc Therapy For Esophageal Cancer, Peilin Liu, Xiaoda Cong, Raymond Dalfsen, Martin Soukup, James E. Dolan, Shupeng Chen, Craig Stevens, Rohan Deroniyagala, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

No abstract provided.

Highly Reusable Electrochemical Immunosensor For Ultrasensitive Protein Detection, Kavya L Singampalli, Camille Neal-Harris, Cassian Yee, Jamie S Lin, Peter B Lillehoj

Faculty, Staff and Student Publications

The detection and quantification of protein biomarkers in bodily fluids is important for many clinical applications, including disease diagnosis and health monitoring. Current techniques for ultrasensitive protein detection, such as enzyme-linked immunosorbent assay (ELISA) and electrochemical sensing, involve long incubation times (1.5-3 hr) and rely on single-use sensing electrodes which can be costly and generate excessive waste. This work demonstrates a reusable electrochemical immunosensor employing magnetic nanoparticles (MNPs) and dually labeled gold nanoparticles (AuNPs) for ultrasensitive measurements of protein biomarkers. As proof of concept, this platform was used to detect C-X-C motif chemokine ligand 9 (CXCL9), a biomarker associated with …

Clinical And Radiological Identification And Management Of Sapho Syndrome, Obyda Al-Housni, Jessica M. Alonso, Matthew Thornburg, Enny Cancio

HCA Healthcare Journal of Medicine

Introduction

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an autoinflammatory disease whose acronymic name stands for the symptoms commonly seen in the disease. These symptoms typically occur simultaneously, in different combinations, in patients during exacerbations of the disease. SAPHO syndrome is a rare disease, most frequently seen in patients aged 30 to 50. It is estimated to be found in 1 in 10 000 persons in White populations, with an even lower incidence seen in non-White populations.

Case Presentation

A post-menopausal woman with a medical history of SAPHO presented to the emergency department with left foot pain and …

Contrast Enhanced Ultrasound Of Liver Lesions In Patients Treated For Childhood Malignancies., Ayatullah Mostafa, Zachary Abramson, Mina Ghbrial, Som Biswas, Sherwin S. Chan, Himani Darji, Jessica Gartrell, Seth E. Karol, Yimei Li, Daniel A. Mulrooney, Tushar Patni, Tarek M. Zaghloul, M Beth Mccarville

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Patients treated for cancer have a higher incidence of focal liver lesions than the general population and there is often concern for a malignant etiology. This can result in patient, caregiver and physician anxiety and is managed by a "wait and watch" approach, or immediate additional imaging, or biopsy, depending on the degree of clinical concern. Because it is a low-cost, easily accessible, radiation and sedation free modality, we investigated the value of contrast enhanced ultrasound (CEUS) to accurately distinguish benign from malignant liver lesions in patients treated for childhood malignancies.

METHODS: We performed an IRB approved retrospective study …

Recurrent High Grade Serous Endometrial Cancer With Brain Metastases: Immunotherapy Confers Improved Quality Of Life And Survival, Kierany B. Shelvin, Jill Vincent, Shawna Morron, Michael Morin, Aaron Mammoser, Navya Nair

School of Medicine Faculty Publications

No abstract provided.

Interventional Radiology's Exploration Into Artificial Intelligence, Raymond Nguyen

Master's Projects and Capstones

Background: Artificial intelligence (AI) has become more prominent in our daily lives in recent years. This includes various aspects of healthcare. Interventional radiology (IR) is one of these specialties that has taken strides in understanding how AI can be leveraged for patient care. This literature review aims to understand what areas will be most impacted by AI in IR and how it will influence both the patient and interventional radiologist.

Methods: Twenty-six publications from 2019-2024 were selected from PubMed and Scopus. Publications were sourced through a combination of keywords, subject headings (MeSH terms), and citation searching.

Results: This literature review …

Clinical And Radiographic Outcomes After Mechanical Thrombectomy In Medium-Vessel Posterior Cerebral Artery Occlusions: Subgroup Analysis From Star, Eyad Almallouhi, Matthew C Findlay, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Nitin Goyal, Shinichi Yoshimura, Hugo Cuellar, Brian Howard, Ali Alawieh, Ali Alaraj, Mohamad Ezzeldin, Daniele G Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Fazeel Siddiqui, Joshua Osbun, Roberto Crosa, Charles Matouk, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Ergun Daglioglu, Richard Williamson, Pedro Navia, Peter Kan, Reade De Leacy, Shakeel Chowdhry, David J Altschul, Alejandro Spiotta, Ramesh Grandhi

Faculty, Staff and Students Publications

BACKGROUND: Whereas mechanical thrombectomy (MT) has become standard-of-care treatment for patients with salvageable brain tissue after acute stroke caused by large-vessel occlusions, the results of MT in patients with medium-vessel occlusions (MEVOs), particularly in the posterior cerebral artery (PCA), are not well known.

METHODS: Using data from the international Stroke Thrombectomy and Aneurysm Registry (STAR), we assessed presenting characteristics and clinical outcomes for patients who underwent MT for primary occlusions in the P2 PCA segment. As a subanalysis, we compared the PCA MeVO outcomes with STAR's anterior circulation MeVO outcomes, namely middle cerebral artery (MCA) M2 and M3 segments.

RESULTS: …

Assessing The Concomitant Presentation Of Acl And Anterolateral Ligament Injuries, Kiang Huang, Katherine Quesada-Tibbetts, Leela Prakash, Neelesh Prakash

Radiology Student Publications

Anterior cruciate ligament (ACL) injuries severely compromise the quality of life in affected patients, so early detection of concurrent injuries is crucial for quicker rehabilitation and proper surgical treatment. Although injuries to the medial meniscus and medial collateral ligament are frequently linked to damage to the ACL, little is known about other important but underappreciated ligament lesions in individuals with ACL injury. The anterolateral ligament (ALL) is a less well-known lesion that presents tearing injuries in 32%-88% of patients with ACL tears in the same knee, with a higher prevalence in complete ACL tears. Despite their lower occurrence, ALL tears …

Commonly Missed Miscellaneous Ligament Injuries Co-Occurring With Acl Tears On Diagnostic Imaging, Katherine Quesada-Tibbetts, Kian Huang, Mafaz Kattih, Albert Brotgandel, Neelesh Prakash

Radiology Student Publications

Anterior cruciate ligament (ACL) injuries greatly affect patient quality of life, necessitating the early identification of additional injuries for faster recovery and appropriate surgical care. Although injuries to the medial meniscus and medial collateral ligament are commonly linked with ACL injuries, there is less awareness of other significant but less recognized ligament lesions in ACL-deficient patients. These less-common injuries include meniscal ramp lesions and meniscal root tears. Research indicates that concomitant ramp lesions are present in 15%-42% of ACL reconstructions, lateral meniscal root tears in 10%-14%, and medial meniscal root tears in a mere 3%. Despite their lower incidence, meniscal …

The Case For Bisphosphonate Use In Astronauts Flying Long-Duration Missions, Reece Rosenthal, Victor S Schneider, Jeffrey A Jones, Jean D Sibonga

Faculty, Staff and Students Publications

Changes in the structure of bone can occur in space as an adaptive response to microgravity and on Earth due to the adaptive effects to exercise, to the aging of bone cells, or to prolonged disuse. Knowledge of cell-mediated bone remodeling on Earth informs our understanding of bone tissue changes in space and whether these skeletal changes might increase the risk for fractures or premature osteoporosis in astronauts. Comparisons of skeletal health between astronauts and aging humans, however, may be both informative and misleading. Astronauts are screened for a high level of physical fitness and health, are launched with high …

An Interesting Case Of Wunderlich Syndrome And Page Kidney, Megan Worthington, Nicholaus Monsma, Raj Pyne

Advances in Clinical Medical Research and Healthcare Delivery

We present a case of Wunderlich Syndrome and Page Kidney, a rarely reported combination. Wunderlich Syndrome, characterized by spontaneous renal hemorrhage without a history of trauma, is typically associated with Lenk’s triad of flank pain, mass, and hypovolemia. Page Kidney induced hypertension, a rare condition resulting from external renal compression associated with renin-mediated mechanisms. Our case demonstrates the importance in quick recognition and treatment as blood pressure changes can be fast and dramatic. Our case also has the added dimension of renin measurements. After the patients hypertension developed, his initial renin levels were within normal range, but they later showed …

Case Report Of Unilateral Dysphagia In The Context Of A Classical Type Of Eagle Syndrome, Ryan Tam, Stephen D. Howard, Timothy Ehmann, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

A patient presents with unilateral, right-sided dysphagia and generalized facial symptoms following past surgical history of tonsillectomy that is consistent with an underdiagnosis of Eagle Syndrome. The elongation of the styloid process likely impinged on the glossopharyngeal and vagus nerves resulting in symptoms. Given the lack of recognition of the disease, this case report describes the presentation of Eagle Syndrome to encourage physicians to consider this disease as part of a broader differential diagnosis.

Renal Mass Imaging Modalities: Does Body Mass Index (Bmi) Matter?, Young Son, Mark E Quiring, Raeann M Dalton, Brian Thomas, Noah Davidson, Dayna Devincentz, Collin Payne, Sahil H Parikh, Benjamin A Fink, Thomas Mueller, Gordon Brown

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Accurate measurement of renal mass size is crucial in the management of renal cancer. With the burdensome cost of imaging yet its need for management, a better understanding of the variability among patients when determining mass size remains of urgent importance. Current guidelines on optimal imaging are limited, especially with respect to body mass index (BMI). The aim of this study is to discern which modalities accurately measure renal mass size and whether BMI influences such accuracy.

METHODS: A multi-institutional chart review was performed for adult patients undergoing partial or radical nephrectomy between 2018 and 2021, with 236 patients …

Parameter Estimation For Stroke Patients Using Brain Ct Perfusion Imaging With Deep Temporal Convolutional Neural Network, Shake Ibna Abir

Masters Theses & Specialist Projects

Acute ischemic stroke, caused by cerebral artery blockage, is a leading cause of long-term disability and mortality. Effective management relies on accurate, timely assessments from neuroimaging data. Computed tomography perfusion (CTP) imaging is crucial in evaluating stroke patients, offering detailed maps of cerebral perfusion to identify irreversibly damaged tissue and at-risk areas. This detailed assessment is essential for informed therapeutic decisions.

Key perfusion parameters derived from CTP imaging, including cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), and mean transit time (MTT), are crucial for understanding the extent and nature of cerebral ischemia, providing valuable insights …