Radiology Commons^™

Retrospective Analysis Of A Washu-Based Knowledge-Based Planning (Kbp) Model For Breast And Chest Wall Planning In Guatemala: Compliance With American Society For Radiation Oncology (Astro) 2026 Guidelines, Milton E Ixquiac Cabrera, Erick O Montenegro, Matthew Schmidt, Baozhou Sun, James A Kavanaugh, Taoran Li, Angel Velarde, Vicky De Falla, Francisco Reynoso

Faculty, Staff and Students Publications

Background/purpose

Breast cancer is among the most prevalent malignancies treated at the Liga Nacional Contra el Cáncer (LNCC) in Guatemala, representing a significant proportion of annual radiotherapy cases. Access to high-quality, standardized treatment planning in resource-constrained settings remains a critical challenge. This study evaluates the dosimetric performance of knowledge-based planning (KBP) models adapted from Washington University (WashU) in St. Louis for breast and chest wall radiotherapy at LNCC, validated against a retrospective 2025 clinical cohort, and benchmarked against the ASTRO 2026 Practical Radiation Oncology guidelines.

Materials and methods

A retrospective analysis of 84 treatment plans (40 left, 44 right) for …

Mri-Based Deep Learning Radiomics Model For Automated Classification Of Disc Degeneration In The Lumbar Spine, Shiv Patil, Om Gandhi, Mert Karabacak, Matthew Carr, Konstantinos Margetis

Student Papers, Posters & Projects

Disc degeneration in the lumbar spine is a major cause of low back pain (LBP). The accurate grading of disc degeneration on magnetic resonance imaging (MRI) is critical for clinical management and patient selection for spine surgery. This study aims to develop and evaluate machine learning (ML) models that combine features from deep learning (DL) and radiomics for the automated prediction of Pfirrmann grade (PG), a measure of disc degeneration, using multi-parametric lumbar spine MRI. Sagittal T1, T2, and T2 SPACE MRIs of 218 patients with LBP were acquired from the SPIDER dataset. For each intervertebral disc and available sequence, …

A Multi-Agent Large Language Model Framework To Automatically Assess Performance Of A Clinical Ai Triage Tool, Adam Flanders, Yifan Peng, Luciano Prevedello, Robyn Ball, Errol Colak, Prahlad Menon, George Shih, Hui-Ming Lin, Paras Lakhani

Department of Radiology Faculty Papers

Radiology reports can be used as a surrogate for performance of clinical AI tools. Radiology reports were analyzed by an ensemble of eight open-source LLM models and a internal version of GPT-4o using a single multi-shot prompt that assessed for presence of ICH. Performance of the open-source models, consensus of models and GPT-4o were compared to human report review. Three ideal consensus LLM ensembles were tested for rating the performance of the triage tool. The capability of each LLM varied. The highest AUC performance was achieved with llama3.3:70b and GPT-4o. Using MCC the ideal combination of LLMs were: Full-9 Ensemble, …

Ghastly Growths And Bone Chilling Cases Pediatric Tumor Diagnosis Demystified, Alexander Aly Restum, Arif Musa

Medical Student Research Symposium

Background:

Pediatric skeletal tumors range from benign to malignant and require multimodal imaging for accurate diagnosis. Recognizing key features enables early detection, guides management, identifies underlying syndromes, and improves outcomes. This presentation provides an educational overview of pediatric tumor evaluation.

Methods:
We conducted a focused review of peer-reviewed literature and representative pediatric imaging studies to outline the radiologic characteristics of common benign and malignant bone tumors in children. Core imaging patterns, diagnostic challenges, and modality-specific advantages were synthesized to create a practical interpretive framework for radiologists.

Results:
The reviewed literature and imaging demonstrated consistent defining features across pediatric bone tumors. …

Imaging Of The Centromedian Thalamic Nucleus Using 3d Fast Gray Matter Acquisition T1 Inversion Recovery Sequence In 3t Mri In Epilepsy, Tunchanok Paprad, Thanyachat Yutthakasaemsan, Supada Prakkamakul

Chulalongkorn Medical Journal

Background:

The centromedian thalamic nucleus (CM) is an emerging deep brain stimulation (DBS) target for neurological disorders, including drug-resistant epilepsy. Traditional DBS localization relies on predefined stereotactic coordinates, which may be imprecise. Novel MRI sequences enhance gray-white matter contrast, potentially allowing direct CM visualization, improving accuracy in DBS planning and targeting.

Objective:

This study evaluates the 3D Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR) MRI sequence for the visualization of the CM in epilepsy patients.

Methods:

This prospective IRB-approved descriptive study included adult epilepsy patients who underwent 3D FGATIR MRI sequence at 3 Tesla. Two neuroradiologists independently assessed CM …

Perceptions Of Radiology Residency Staffing Models Across Years Of Training, Alex Zhang, Alexander Swantek, Adela Pouzar, Sayf Al-Katib

Posters

Case staffing is the primary method by which radiology residencies teach at the workstation. Despite this, the styles and methods for how staffing is performed have not yet been comprehensively described. Understanding these models and evaluating resident perspectives can inform best practices and enhance radiology education.

X-Ray Versus Ct For Femoral Landmark Identification: A Systematic Review And Meta-Analysis, Akash B. Patel, Marzieh Saeedi-Hosseiny, Mohammad Abedin-Nasab

Rowan-Virtua Research Day

Background Accurate femoral bone landmark identification is essential for orthopedic surgical planning, deformity correction, and fracture risk assessment. Radiography offers accessibility and low cost, while CT provides superior spatial resolution and three-dimensional visualization. Despite technological advances, no quantitative synthesis has compared these modalities specifically for femoral landmark identification.

Hypothesis CT provides superior measurement accuracy and interobserver reliability compared to radiography for femoral bone landmark identification.

Methods Following PRISMA 2020 guidelines, Embase, Scopus, and PubMed were searched from 2015-2025. Studies comparing radiography and CT for femoral landmark identification with quantitative outcomes were included. Dual-reviewer screening of 604 records yielded 27 studies …

Impact Of Intracranial Pressure Monitoring On 30-Day Mortality In Severe Traumatic Brain Injury: A Retrospective Cohort Study In Kenya, George Ongas, Idris Chikophe, Jacqueline Mavuti, David Olunya, Mubashir Qureshi, Beverly Cheserem, Edwin Mogere

General Surgery, East Africa

OBJECTIVE The objective of this study was to evaluate 15-year trends in epidemiology, baseline severity, management, and outcomes of severe traumatic brain injury (sTBI) at a Kenyan tertiary center, and to determine the impact of invasive intracranial pressure (ICP) monitoring on 30-day mortality in a low- and middle-income country (LMIC) context.

METHODS A retrospective quasi-experimental cohort analysis of consecutive sTBI admissions (postresuscitation Glasgow Coma Scale [GCS] score ≤ 8, age ≥ 13 years) from January 1, 2010, to December 31, 2024, was conducted. This time period was divided into two eras: era 1 (2010–2014), premonitoring, and era 2 (2015–2024), routine …

A Pain That Wouldn't Sleep: Osteoid Osteoma Masquerading As Lateral Epicondylitis, Madelyn Bagley, Luca Halalau, Aimee Espinosa, Terrence Metz

Conference Presentation Abstracts

Osteoid osteoma is a benign osteogenic tumor that accounts for approximately 10% of all benign bone tumors and predominantly affects adolescents and young adults. It classically presents with nocturnal pain that responds dramatically to nonsteroidal anti-inflammatory drugs, a feature attributed to increased prostaglandin production within the nidus. The femur and tibia are most commonly involved, whereas upper extremity lesions are relatively uncommon. A 19-year-old male presented with nearly two years of chronic, progressive left lateral elbow pain and left wrist weakness. The pain was nocturnal, radiated along the left arm, and was markedly relieved by nonsteroidal antiinflammatory drugs. He was …

Technical Development, Optimization, And Clinical Implementation Of Quantitative Magnetic Resonance Imaging Methods For Radiation Oncology, Lucas Mccullum

Dissertations and Theses (Open Access)

Magnetic resonance imaging (MRI) has gradually grown more important in the field of radiation oncology. This paradigm shift has grown from initial experiments with MRI of cancerous lesions in the early 1970s, to the integration of MRI images for radiation therapy treatment planning (i.e., MRI-Simulation) in the early 1980s, to the combined MRI linear accelerator (MR-Linac) becoming commercially available in 2018 which can simultaneously image a tumor and treat it with radiation. However, due to its novelty in radiation oncology, its full potential for the integration of quantitative MRI-based biomarkers has yet to be fully realized.

Therefore, this dissertation will …

Diffuse Marrow And Orbital Fat Signal Abnormality Mimicking Infiltrative Disease: A Case Of "Flip-Flop" On Mri, Mehdy Haidar, Alexander Pietroski, Kamil Abu-Shaban, Anant Krishnan

Conference Presentation Abstracts

Clinical History A 68-year-old male with a history of left tonsillar squamous cell carcinoma treated 5 months ago and reportedly negative recent PET and CT scans of the neck and body with eye pain with possible but uncertain remote history of trauma was sent in for imaging of the orbits. The patient has a feeding tube and was recently hospitalized and discharged for tube obstruction. Imaging Findings Orbital imaging revealed diffuse signal alterations involving the orbital and scalp fat, and marrow, characterized by low signal intensity on T1WI and high signal intensity on T2WI. In particular on the STIR sequence, …

Immune Checkpoint Inhibitor-Associated Perioptic Neuritis, Neud Kiros, Alina Sinha, Anant Krishnan

Conference Presentation Abstracts

Clinical History A 47-year-old male with history of stage IV gastric cancer on nivolumab presented with blurry vision worse at close distances. Binocular horizontal diplopia was found on exam. Fundus exam demonstrated 4+ disc edema and hemorrhage bilaterally. Recent head MRI was negative for leptomeningeal enhancement. MR venogram and MRI orbits with contrast were ordered as well as lumbar puncture. The patient’s next dose of immunotherapy was held. Opening pressure was normal, and MRV showed no evidence of dural sinus thrombosis. MRI of the orbits was positive for perioptic neuritis bilaterally, and the patient was started on a steroid taper …

When The Eagle Strikes The Vein: A Case Of Styloid-Induced Venous Sinus Thrombosis, Neud Kiros, Ahmad Chehab, Abeer Abukamil, Ali Luqman, Kamil Abu-Shaban, Mehdy Haidar, Ay-Ming Wang

Conference Presentation Abstracts

Clinical History 41-year-old male with no prior relevant medical history presented to the emergency department with severe neck pain and occipital headaches radiating bilaterally to the temporal regions. He also reported diplopia and “tunnel vision.” He had presented two weeks earlier with similar symptoms and was advised outpatient follow-up. Initial CT head and cervical spine were unremarkable. Imaging Findings Brain MRI/MRV demonstrated heterogeneous signal and enhancement in the left transverse and sigmoid sinuses and jugular bulb, initially thought to reflect possible motion artifact. However, CT venography was recommended for further assessment. The MRI also showed subtle left posterior occipital subdural …

A Multi-Institutional Epid-Based 3d Dose Reconstruction Model In A Virtual Phantom For Standardized Patient Qa, Benchmarking And Auditing For Stereotactic Radiosurgery, Benjamin Zwan, Emily Searle, Cameron Stanton, Ching-Ling Teng, Seng Boh Lim, Andrew Dipuglia, Richard Popple, Michael Lovelock, Ashley Cullen, Conor K Mcgarry, Victoria Robinson, Sergei Zavgorodni, Baozhou Sun, Xiaodong Zhao, Matthew Schmidt, Juan-Francisco Calvo-Ortega, Gemma Warner, Andrew Cousins, Michael Barnes, Peter Greer

Faculty, Staff and Students Publications

Background and purpose: For single-isocentre multi-target (SIMT) stereotactic radiosurgery (SRS), benchmarking, auditing and inter-institutional standardisation of dose verification remain challenging as they require specialized equipment and expertise. This work aims to develop and validate an electronic portal imaging device (EPID)-based technique to determine 3D dose in a virtual spherical phantom which is applicable across institutions for SIMT SRS dose verification.

Materials and methods: Small-field output factors from 11 international centres were measured in-water for the TrueBeam linear accelerator, including jaw-defined and high-definition multi-leaf collimator (MLC) fields from 0.5 × 0.5 to 20 × 20 cm2 and depths from 1.5-20 cm. …

Bridging Access Gaps In Radiotherapy: Knowledge-Based Planning In A Resource-Constrained Clinical Setting, Milton E Ixquiac Cabrera, Erick O Montenegro, Matthew Schmidt, Baozhou Sun, James A Kavanaugh, Taoran Li, Angel Velarde, Vicky De Falla, Francisco Reynoso

Faculty, Staff and Students Publications

Background/purpose: Radiotherapy access in low- and middle-income countries (LMICs) is severely limited by shortages of trained personnel, high patient volumes, and large waiting times for manual treatment planning. Knowledge-based planning (KBP) has shown promise in high-income settings, yet its feasibility in resource-constrained environments remains underexplored. This study aimed to evaluate the feasibility of adapting a KBP model developed at a high-income institution for clinical use at Liga Nacional Contra el Cáncer (LNCC) in Guatemala for gynecological radiotherapy planning.

Materials and methods: A RapidPlan KBP model (Varian-Siemens Healthineers, Palo Alto, CA, USA) originally developed at Washington University in St. Louis using …

From Pages To Practice: Course Design For Integrative And Connected Learning, Prutha Deshpande

UNLV Best Teaching Practices Expo

The poster provides resources for the design of courses to incorporate considerable reading, paired with purposeful activities and reflection questions that deepen understanding of key points of learning, support knowledge transfer, and encourage dialogue and connection.

“Finding From The Field”—An Approach To Encourageexperiential And Epistemological Reflection, Julian Kilker

UNLV Best Teaching Practices Expo

The “Findings from the Field” teaching practice asks students to document and analyze experiences, locations, or artifacts encountered outside the classroom. While traditional field trips emphasize experiential learning by, ideally, linking course concepts to real-world experiences, this “Findings from the Field” approach extends this model through epistemological reflection guided by annotating observations. Students are prompted to consider not only what they observe, but how they know what they know, encouraging metacognition about observation, experience, and empirical research.

Reinforcement Learning Improves Llm Accuracy And Reasoning In Disease Classification From Radiology Reports, Yishu Wei, Yi Lin, Adam Flanders, George Shih, Yifan Peng

Department of Radiology Faculty Papers

Accurate disease classification from radiology reports is essential for many applications. While supervised fine-tuning (SFT) of lightweight LLMs improves accuracy, it can degrade reasoning. We propose a two-stage approach: SFT on disease labels followed by Group Relative Policy Optimization (GRPO) to refine predictions by optimizing accuracy and format without reasoning supervision. Across three radiologist-annotated datasets, SFT outperformed baselines and GRPO further improved classification and enhanced reasoning recall and comprehensiveness.

Optimization Of Pediatric Multidetector Ct Imaging Parameters Using A Machine Learning–Based Monte Carlo Simulation Model, Ali O. Masoud, Adithya Rajnaryanan, Khamis O. Amour, Ahmed M. Jusabani, Justin E Ngaile, Manoj Kumar, Mwingereza John Kumwenda Dr

Tanzania Journal of Science

This study utilized Monte Carlo (MC) simulations to optimize radiation doses in pediatric multidetector computed tomography (MDCT) head scans by analyzing key parameters like tube current (mA), tube voltage (kV), pitch, and slice thickness. The findings indicate that reducing tube current significantly lowers the Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP), effectively minimizing patient radiation exposure. Higher pitch values (0.7–0.9) further reduced radiation by decreasing beam overlap, while using a thinner slice thickness (0.6 mm) improved dose efficiency. A comparison highlighted the effectiveness of optimization: simulated parameters kVp 100, mAs 81, pitch 0.98 yielded a CTDIvol of …

Spatial Computing With The Apple Vision Pro In Minimally Invasive Procedure Simulation: A Randomized Crossover Feasibility Study, Sydney Cooper, Aaron Kyle Jones, Rahul Anil Sheth, Koustav Pal, Bruno Odisio, Mark Blaylock, Shelita Kimble, Justin Bird, David Rice, Daniel Shoenthal, Emil Patel, Vipin Kamath, Sanjay Gupta, Jeffrey Siewerdsen, Joshua Kuban

Advances in Cancer Education and Quality Improvement

Purpose: This study aimed to evaluate the feasibility of wearing the Apple Vision Pro (AVP), a mixed-reality headset that integrates augmented and virtual reality, while performing minimally invasive procedures. While studies have demonstrated that spatial computing technology can improve surgical precision and reduce the risks of surgical complications, to our knowledge, no studies have specifically addressed the impact of the AVP on task performance during simulated image-guided procedures.

Materials and Methods: Thirteen diagnostic and interventional radiology residents performed image-guided central venous catheter placement, thoracentesis, and paracentesis on simulation models. Each participant completed a non-timed practice followed by the procedures once …