Radiology Commons^™

A Framework For Digital Energy Modulation And Translation In Projectional X-Ray Imaging, Richard R. Wargo

Theses and Dissertations

In projectional X-ray imaging, acquisition energy fundamentally influences subject contrast, image noise, and radiation dose. While dual-energy techniques exploit spectral differences to optimize contrast and enable material separation, acquiring multiple images of the same anatomy often requires additional exposures and increased system complexity.

This dissertation presents a framework for digital energy modulation (DEM), in which computational models are trained to translate projection images between energy domains without requiring additional X-ray acquisitions. DEM is conceived as a generalizable strategy for controlled contrast modulation in projection imaging, with potential applications in image optimization, radiation therapy alignment, and dual-energy applications.

The framework was …

Associations Between Contralesional Neuroplasticity And Motor Impairment Through Deep Learning-Derived Mri Regional Brain Age In Chronic Stroke (Enigma): A Multicohort, Retrospective, Observational Study, Gilsoon Park, Mahir Khan, Justin Andrushko, Nerisa Banaj, Michael Borich, Lara Boyd, Amy Brodtmann, Truman Brown, Cathrin Buetefisch, Adriana Conforto, Steven Cramer, Michael Dimyan, Martin Domin, Miranda Donnelly, Natalia Egorova-Brumley, Elsa Ermer, Wuwei Feng, Fatemeh Geranmayeh, Colleen Hanlon, Brenton Hordacre, Neda Jahanshad, Steven Kautz, Mohamed Salah Khlif, Jingchun Liu, Martin Lotze, Bradley Macintosh, Feroze Mohamed, Jan Nordvik, Fabrizio Piras, Kate Revill, Andrew Robertson, Christian Schranz, Nicolas Schweighofer, Na Jin Seo, Surjo Soekadar, Shraddha Srivastava, Bethany Tavenner, Gregory Thielman, Sophia Thomopoulos, Daniela Vecchio, Emilio Werden, Lars Westlye, Carolee Winstein, George Wittenberg, Jennifer Ferris, Chunshui Yu, Paul Thompson, Sook-Lei Liew, Hosung Kim

Department of Radiology Faculty Papers

BACKGROUND: Stroke leads to complex chronic structural and functional brain changes that specifically affect motor outcomes. The brain predicted age difference (PAD) has emerged as a sensitive biomarker of both sensorimotor and cognitive function after stroke. Our previous study showed a higher global brain PAD associated with poorer motor function after stroke. However, the association between local stroke lesion load, regional brain age, and motor impairment is unclear. This study aimed to investigate the associations between focal lesion damage, regional brain PAD in both hemispheres, and motor outcomes in chronic stroke, and to identify key predictors of motor impairment.

METHODS: …

Ulcer Osteoma: The Role Of Mri In Differentiating Reactive Proliferative Periostitis From Osteomyelitis, Reza Ayoubi, Mathew Dixon

South Atlantic Division GME Research Days 2026

No abstract provided.

Cholecystocolonic Fistula: Ct Diagnosis And Confirmation On Hida Scan, Adam Webb, John T. Belflower, Brian Helmly

South Atlantic Division GME Research Days 2026

No abstract provided.

Primary Renal Lymphoma: A Rare Cause For Acute Renal Failure, Anish Sutaria, Phillip Bloodworth, Anjali Patel

South Atlantic Division GME Research Days 2026

No abstract provided.

Fill The Void - An Introductory Guide For Learning Medical Imaging, Reid Faith, Peter Gahan, Adam Trusty, Aleksandr Zyskin, Chukwuka Ukekwe, Denise Nchinda, Amanda K. Burbage, Alberto E. Musto

EVMS School of Health Professions Faculty Publications

No standardized, comprehensive approach for radiological image interpretation exists among medical schools in the United States of America. In order to rectify this, we outline a model aimed to help improve how medical imaging can be taught in medical schools. The VOID (Visualization, Orientation/Observation, Identification, Description) guide is a proposed universal, stepwise approach to medical image identification, interpretation, and communication. This structured guideline is aimed at building a foundation for students in early medical education. The VOID was applied to CT (Computed Tomography), MRI (Magnetic Resonance Imaging), and x-ray modalities as integrated sessions for medical students during human anatomy laboratory. …

Ct-Based Imaging In Acute Ischemic Stroke: Evolution, Evidence And Emerging Frontiers, Syed Roohan Aamir, Anjana Ganesh, Harshita Cherukuri, Jerome A. Jeevarajan

School of Medicine Publications

Background: The emergent treatment of acute ischemic stroke (AIS) has developed over the past four decades, and neuroimaging has always been a cornerstone of triage and decision-making prior to thrombolysis and thrombectomy interventions. Despite advances in these reperfusion therapies, AIS remains a leading cause of death and disability around the world. This review brings together the historical development of computed tomography (CT) stroke imaging and the current wave of artificial intelligence (AI) applications in a single narrative, with particular attention to non-contrast CT-based patient selection and its relevance to resource-limited settings.

Methods: This narrative review draws on peer-reviewed literature identified …

Sex Differences In Freezing Behavior And Extinction Learning Among Wistar Rats Exposed To Social Isolation And 15cgy Gcrsim Space Radiation Both Alone And In Combination, Zachary N. M. Luyo, Riley S. Heerbrandt, Alea F. Boden, Frederique E. E. Keumeni, Richard A. Britten, Laurie L. Wellman, Larry D. Sanford

Department of Biomedical and Translational Sciences Faculty Publications

Long-term space missions traveling beyond the Earth’s magnetosphere will expose astronauts to prolonged periods of social isolation (SI) and exposure to space radiation (SR). Throughout these missions, astronauts will have to cope with these stressors and adapt to their environment to carry out mission objectives. It is known that SI and SR can impact mission performance and overall health. Additionally, behavioral stress responses can differ between sexes. However, the independent and interactive effects of SI and SR on fear behavior and extinction learning between sexes is unknown. This study compared freezing behavior and stress-induced hyperthermia (SIH) in female and male …

Dynamic Modeling Of The Earth's Trapped Proton Environment, Xiaojing Xu, Steve R. Blattnig, Francis F. Badavi, Martha S. Clowdsley, Edward J. Semones

Physics Faculty Publications

Context: Reliable prediction of space radiation exposure is critical for safeguarding spacecraft systems and ensuring astronaut health during missions. Accurate radiation risk assessment for space mission requires advanced models of the Earth’s trapped proton environment. These models must reflect temporal variations driven by geomagnetic field evolution and solar cycle modulation. Existing static models, such as AP8 and IRENE-AP9, are not designed to fully capture these evolving conditions. Aims: This paper presents a dynamic modeling method for the prediction of trapped proton fluxes, which incorporate time-dependent variations due to geomagnetic field evolution and solar cycle fluctuations. Methods: The …

Real-Space Imaging Of The Electron-Pair Density Hole In Molecular Auger-Meitner Decay, Mats Simmermacher, Nathan Goff, Andres Moreno Carrascosa, Elke Fasshauer, Thomas Northey, Lingyu Ma, Haiwang Yong, Brian Stankus, Asami Odate, Xuan Xu, Wenping Du, Kyle Acheson, Joseph C. Cooper, Daniel Ratner, Mengning Liang, Ruaridh Forbes, Michael P. Minitti, Adam Kirrander, Peter M. Weber

Physics Faculty Publications

Electrons in matter can rearrange extremely quickly under external perturbations, underpinning subsequent structural and chemical transformations. Coulomb interactions between neighbouring electrons often shape this response, giving rise to correlated motion and strongly affecting the distribution of electrons in the system. Here we show that non-resonant hard X-ray scattering can directly access changes in the radial electron-pair density during the rapid rearrangement of core and valence electrons. We do this by studying sulfur hexafluoride molecules undergoing Auger–Meitner decay. We exploit a second-order interaction between the X-ray photons and the molecules to trigger and probe the decay dynamics with a single pulse, …

A Pouch Of Trouble For The Pancreas: Unmasking A Case Of Lemmel Syndrome, Aravindharaj Tamilselvan, Sabari Ramesh

Manipal Journal of Medical Sciences

Lemmel syndrome is a rare cause of biliary and pancreatic obstruction arising from periampullary duodenal diverticula. We report a 72-year-old woman presenting with acute pancreatitis, biliary dilation, and a periampullary diverticulum causing distal CBD compression. Multimodality imaging, including CT and MRCP, established the diagnosis. Although ERCP was advised, the patient declined and improved with conservative management. Early recognition of this uncommon entity is essential to prevent recurrent pancreatobiliary complications.

Beyond The Ordinary: A Case Report On A Giant Choledochal Cyst, Isha Saxena, Naresh Kumar J, Pareekshith Raghupal, Santosh Rai, Jayateertha Joshi

Manipal Journal of Medical Sciences

Choledochal cysts are rare congenital abnormalities of the biliary tract (1), with an incidence of 1:1000 births in the Asian population, with a female predominance. They usually appear within the first decade of life, presenting with symptoms like abdominal pain, jaundice, and a palpable abdominal mass. Todani et al. (2) classified them into five types. Common diagnostic techniques include ultrasound, CT, MRCP and ERCP. This case report presents a 14-year-old female with a giant type 1 choledochal cyst, successfully managed with cholecystectomy and Roux-en-Y jejunostomy.

Association Between Gonial Angle And Mandibular Residual Ridge Resorption In Implant-Overdenture Patients, Pl Ranganayakidevi S Palaniappan, Norsiah Yunus, Norliza Ibrahim, Siti Fauzza Ahmad, Anitha Krishnan

Journal of Dentistry Indonesia

Objectives: The gonial angle could be one of the contributing factors for the continuous bone resorption in edentulous persons. This study aimed to examine the association between the gonial angle and RRR in edentulous patients receiving mandibular implant-supported overdenture (ISOD) and to compare different gonial angle measuring techniques. Methods: Twenty-three individuals with opposing mandibular ISOD and maxillary full dentures were recruited. The proportional area index was used to calculate the posterior RRR. Orthopantomographs (OPGs) pre- and four years post-implant insertion were compared. Comparison of the gonial angle measurements was made on 5 patients using four measurement methods: (i) Two different …

Delayed Delivery Of Antibiotics By Ultrasound-Mediated Rupture Of Polylactic Acid Pockets: In Vitro And In Vivo Studies, Selin Isguven Billmyer, Priscilla Machado, Ryan Tomlinson, Lauren J. Delaney, Ji-Bin Liu, Alexander H Harris, Eric Mclaughlin, Noreen J. Hickok, Flemming Forsberg

Department of Radiology Faculty Papers

Surgical site infections are a devastating complication of instrumented orthopaedic surgery, particularly in the spine. Bacterial biofilms, once formed on the implant surfaces, exhibit antibiotic tolerance and immune escape, which lead to treatment challenges. Up to 9% of instrumented spine surgeries result in infection, despite the use of systemic antibiotics and local, powdered antibiotics for prophylaxis. The bacteria that survive the initial prophylaxis may be susceptible to a second, high dose of antibiotic prophylaxis prior to establishing at the site. Hence, we designed a local drug delivery system consisting of polylactic acid (PLA) film pockets that can be noninvasively triggered …

First Mammography Screening Participation And Breast Cancer Incidence And Mortality, Forruk Ahmed, Anna Aleksyeyeva, Oman Balan, Ashley Hassang

Publications and Research

This population-based cohort study evaluated the long-term relationship between initial participation in mammography screening and subsequent breast cancer outcomes among approximately 432,000 women in Stockholm, Sweden. Women were invited to their first screening between 1991 and 2020 at ages 40 or 50 and followed for up to 25 years through national health registries. Overall, 32% did not attend their initial screening. Non-attenders were significantly less likely to participate in later screening rounds and were more likely to be diagnosed with advanced disease, showing 1.5-fold higher odds of stage III and more than 3.5-fold higher odds of stage IV breast cancer …

Blood-Based Clinical Markers For Early Dementia Detection: Insights From Ad-Detect-Cohort, Benard Aliwa, Jasmit Shah, Olivera Nesic Taylor,, Samuel Nguku, Juzar Hooker, Dilraj Sokhi, Sylvia Mbugua, Litha Musili, Rachel Maina, Harrison Kaleli, Levi Muyela, Anne Njoki Gitere, Anne Nyambura, Zul Merali, Karen Blackmon, Chinedu Momoh

Brain and Mind Institute

Background: Over 55 million people worldwide live with dementia, with more than60% residing in low- and middle-income countries. Alzheimer’s disease, the mostcommon form of dementia, accounts for 60–70% of cases. Early and accurate diagnosisremains a global challenge, necessitating novel approaches to mitigate the diseaseburden. Biomarkers hold significant promise in improving diagnostic accuracy andpredicting disease progression. Validated biomarkers for the preclinical stages ofdementia are crucial for advancing diagnosis and therapeutic strategies. We aimedto identify potential clinical markers for early dementia detection and assess theirpredictive accuracy in identifying high-risk individuals.

Method: We analyzed blood samples from dementia cases (n = 30) and …

Ultra-Low-Field Portable Magnetic Resonance Imaging Feasibility And Safety In Pediatric And Neonatal Extracorporeal Membrane Oxygenation: A Single-Center Year-Long Experience., Jessica S. Wallisch, Asdis Finnsdottir Wagner, John M. Daniel Iv, Allison Taber, Maura Sien, Sarah Foster, Nathan S. Artz, Timothy Zinkus, Hung-Wen Yeh, Jose A. Pineda, Patrick M. Kochanek, Sherwin S. Chan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improving outcomes, extracorporeal membrane oxygenation (ECMO) remains associated with high rates of acute brain injury, impacting survival and outcomes. Clinical imaging modalities, including computed tomography and standard-field magnetic resonance imaging (≥1.5 Tesla), have either limited early detection of ischemic-type injuries or are incompatible with ECMO, causing diagnostic delays. A Food and Drug Administration-cleared ultra-low-field portable magnetic resonance imaging (pMRI; 0.064 Tesla) has shown promise in acute brain injury detection and use with MRI-unsafe equipment, but pediatric ECMO data are limited.

METHODS: This institutional review board-approved, single-center study was conducted at a quaternary children's hospital. Neonatal and pediatric patients …

Cordmilk: Umbilical Cord Milking Versus Early Cord Clamping On Short-And Long-Term Outcomes In Neonates Who Are Non-Vigorous At Birth-Study Protocol Of A Multi-Center, Cluster-Randomized, Crossover-Controlled Trial, S. Yogeshkumar, Sunil S. Vernekar, Sangappa M. Dhaded, Kiran Talekar, Benjamin E Leiby, Rebecca Hartman, Yvonne Vaucher, Nitin Chouthai, Meenakshi Girish, Manish Jain, Shuchi Jain, Seema Parvekar, Vinita Jain, Alka Patankar, Milind Suryawanshi, Manish Tiwari, Manjushri Waikar, Nidhi Nashine, Deepali Ambike, Mahesh Asalkar, Rajesh Kulkarni, Sandhya Haribhaktha, Hemraj Narkhede, Sudha Chaudhari, Milind Kamble, Deepti Shrirame, Balchandra Falke, Seema Mehta, Asha Verma, Sunil Gothwal, Shivaprasad S. Goudar, Richard Derman, Anup Katheria, Zubair H. Aghai

Department of Radiology Faculty Papers

BACKGROUND: Facilitating placental transfusion-the transfer of blood from the placenta to the newborn-via delayed cord clamping (DCC) or umbilical cord milking (UCM) at birth has been shown to improve iron stores in healthy term infants and may positively impact long-term neurodevelopmental outcomes. Infants who are non-vigorous at birth and at risk of developing hypoxic-ischemic encephalopathy (HIE) are particularly likely to benefit from placental transfusion. This process may offer neuroprotection by enhancing cardiopulmonary transition, supporting cardiac preload, improving systemic and cerebral perfusion, delivering stem cells and neurotrophic factors, and preventing iron deficiency. While DCC is not currently recommended for non-vigorous term …

Exploring Generation Z Student Satisfaction In Radiography Programs Within A Southern State: Development And Application Of A Survey Instrument For Leadership Use, Brittany Seruntine Smith

Doctoral Dissertations

This dissertation employed a sequential exploratory mixed-methods design to examine the extent to which Generation Z students in radiography programs within a southern state perceive that their needs and expectations are being fulfilled. Additionally, the study examined how program leaders perceived and plan to utilize the survey and its findings within the cycle of continuous program improvement and accreditation readiness. A Likert-scale survey instrument was constructed by cross-referencing Generation Z’s characteristics, needs, and expectations with JRCERT standards. Items were refined through target population focus groups and validated using Lawshe’s Content Validity Ratio. The validated instrument was then administered to Generation …

Development Of A Longitudinal, Small-Group Pocus Curriculum For Internal Medicine Residents, Shah N. Mahmud Do, Ammar W. Bhatti Do, Ariq Rahman Md, Omar Al Qassab Md, Fraser Mackay Md

The Lahey Journal

Development of a Longitudinal, Small-Group POCUS Curriculum for Internal Medicine Residents

Introduction

Point-of-Care Ultrasound (POCUS) is integral for clinicians to enhance their diagnostic and procedural skills. Unlike Emergency Medicine or Anesthesia training programs, Internal Medicine programs often lack a structured and standardized curriculum. We thus developed a longitudinal and multi-pronged POCUS curriculum aimed at building trainee competency when utilizing ultrasound for diagnostic and procedural work-up.

Methods

The curriculum encompasses the following: basics of ultrasound, ultrasound-guided procedures, thoracic ultrasound/Bed Lung Ultrasound in Emergency (BLUE), and cardiac ultrasound/Focus-Assessed Transthoracic Echocardiography (FATE). These modules were integrated into the residents’ clinic blocks. We utilized …