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 …

Chemoradiation After Chemotherapy For Metastatic Cervical Cancer Can Provide Chemo-Free Time, Spoorthi Kamepalli, Ashley Chavana, Michelle Ludwig, Madeline Flanagan, Shelly Sharma, Tracilyn Hall, Anthony Costales, Jan Sunde, Claire Hoppenot

Faculty, Staff and Students Publications

Introduction: Stage IVB cervical cancer is treated with a life-prolonging and palliative intent with systemic chemotherapy and immunotherapy. The purpose of this study was to evaluate the number of these patients who had an adequate response to chemotherapy to be eligible for consolidative radiosensitizing chemotherapy and radiation (chemoradiation) and subsequent outcomes.

Materials and methods: This is a retrospective review of metastatic cervical cancer patients treated with chemotherapy and evaluated for treatment with consolidative pelvic chemoradiation at a single safety-net hospital system from 2016 to 2024. Demographic data and clinical information were collected from electronic medical records. Stata was used for …

Gender-Specific Behavior Reductions In Spontaneous Locomotive And Rearing In A Rat Model Of Paclitaxel-Induced Peripheral Neuropathy: A Pilot Study, Serena Jiyeon Kim, Kevin Cao, Patrick M Dougherty, Kathleen E Mcdonough, Saba Javed

Faculty, Staff and Students Publications

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) from agents like paclitaxel causes sensory loss and functional impairment, with limited treatment options. To better model patient-relevant outcomes, we used open field video tracking in rodents to assess gait, anxiety, and exploratory behavior. This approach provides a more comprehensive assessment of CIPN-related deficits beyond pain responses.

Methods and materials: Adult male and female Sprague Dawley rats were given paclitaxel (Taxol; 24 mg/kg cumulative dose) or a vehicle over 8 days. Their distance traveled, time spent in the center and outer zones of the OF test, and rearing behaviors were recorded using a PhenoTyper 4500 …

Phase I Study Of Niraparib With Radiotherapy For Treatment Of Metastatic And Locally Advanced Invasive Carcinoma Of The Cervix (Nivix), Piyush Pathak, Eunji Jo, Susan Hilsenbeck, Matthew L Anderson, Alfredo Echeverria, Shelly Sharma, Jan Sunde, Tracilyn Hall, Anthony Costales, Claire Hoppenot, Michelle Ludwig

Faculty, Staff and Students Publications

Introduction: This Phase I study evaluated the safety and tolerability of concurrent niraparib, an oral poly(ADP-ribose) polymerase (PARP) 1/2 inhibitor, with definitive radiotherapy in women with locally advanced or platinum-sensitive metastatic cervical cancer. Dose escalation followed a Bayesian Optimal Interval (BOIN) design with a target dose-limiting toxicity (DLT) rate of 30%.

Methods: Women ≥18 years with FIGO stage IIIC2 (bulky nodes >1 cm) or stage IV cervical cancer demonstrating response to platinum-based induction chemotherapy were eligible. Niraparib 100 mg was administered daily concurrent with pelvic radiotherapy (45-57.5 Gy via IMRT with nodal boosts) and brachytherapy, continuing 28 days post-radiation. Per …

Phase 1 Trial Of Withania Somnifera Leaf Extract (Rh324) In Advanced Non-Small Cell Lung Cancer Including [18f]Fdg Pet/Ct As A Short-Term Metabolic Biomarker To Assess Efficacy: A Novel Model For Assessment Of Complimentary Therapies In Early Phase Human Clinical Trials, Jin Uk Heo, Santosh Rao, Herbert B Newton, Afshin Dowlati, Raymond F Muzic, Arash Kardan

Faculty, Staff and Students Publications

Background: Withania somnifera (WS), commonly known as ashwagandha, has been used in the traditional medical system of India. It has shown significant activity against numerous solid tumor varieties in pre-clinical in vitro and in vivo studies. This study focuses on RH324 (ReHeva Biosciences, Columbus, OH), a pharmaceutical-grade formulation derived from WS, which has received FDA allowance for clinical development as a botanical drug in the treatment of cancer.

Methods: A phase 1 open label dose ranging study of oral RH324 in advanced non-small cell lung cancer (NSCLC) was conducted. The primary endpoint of the study was assessment of short-term safety …

Beyond Drugs And Surgery: Superselective Adrenal Artery Embolization Redefines Primary Aldosteronism Management-A Systematic Review And Meta-Analysis, Kimia Darmiani, Mehrad Zare, Alisa Mohebbi, Mohammad Mirza-Aghazadeh-Attari, Mohammad Ghasemi Rad, Afshin Mohammadi

Faculty, Staff and Students Publications

Background: Primary aldosteronism (PA) is a leading cause of secondary hypertension associated with increased cardiovascular and cerebrovascular risk. Superselective adrenal artery embolization (SAAE) has emerged as a minimally invasive alternative to adrenalectomy and mineralocorticoid receptor antagonists (MRAs). This systematic review and meta-analysis evaluates the efficacy and safety of SAAE in PA management.

Methods: We searched PubMed, Web of Science, Embase, and Cochrane Library through June 2026 for studies enrolling patients with PA treated by SAAE. Outcomes of interest were changes in blood pressure (BP), biochemical markers (serum potassium, aldosterone, renin activity, and aldosterone-to-renin ratio), clinical and biochemical response rates, daily …

Gallbladder Decompression And Hydrodissection As Adjuncts For Ablation Of Pericholecystic Hepatocellular Carcinomas, Taylor Hoffman, Arta Kasaeian, Johnathon Chung, Ashkan Berenji, David Wynne, Mohammad Ghasemi-Rad, David Léon

Faculty, Staff and Students Publications

Microwave ablation is an effective treatment for hepatocellular carcinoma, but tumors adjacent to extrahepatic organs carry a higher risk for thermal injury. Thermoprotective techniques such as hydrodissection and gallbladder decompression can reduce this risk and expand the range of lesions amenable to percutaneous treatment. We present a case of a 68-year-old woman with hepatocellular carcinoma in hepatic segment V, with partial treatment response from prior transarterial chemoembolization. Due to the lesion's proximity to the gallbladder and transverse colon, microwave ablation was performed with concurrent ultrasound- and CT-guided gallbladder decompression and hydrodissection. The ablation was technically successful without post-procedural complications. At …

Brain Death Versus Circulatory Death: How Functional Warm Ischemia And Cold Storage Impact Myocardial Membrane Repair In Human Donor Hearts, Shiyi Li, Rishav Bhattacharya, Abdussalam E Elsenousi, Katherine V Nordick, Adel M Hassan, Syed B Peer, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal

Faculty, Staff and Students Publications

This study compares myocardial injury responses in human donor hearts from donation after brain death (DBD) and donation after circulatory death (DCD), with a focus on myocardial membrane integrity, pyroptosis, and damage. Unlike DCD hearts, which are exposed to varying durations of functional warm ischemic time (fWIT), DBD hearts, which are never subjected to warm ischemia, served as controls. A total of 24 human hearts were procured, consisting of 6 from the DBD group and 18 from the DCD group. All procured hearts were placed in cold normal saline and stored for up to 6 h. Left ventricular biopsies were …

Improving Prostate Cancer Patients’ Experience And Understanding With A Pre-Ct Simulation Checklist In Genitourinary Radiation Oncology, Christopher Le

Doctor of Nursing Practice Final Project Abstract

Improving Prostate Cancer Patients’ Experience and Understanding With a Pre-CT Simulation Checklist in Genitourinary Radiation Oncology

Purpose

The purpose of this quality improvement (QI) project was to implement a Pre-CT Simulation checklist for Prostate cancer patients in the outpatient Radiation Oncology Genitourinary clinic to improve patients’ experience and comprehension on their Simulation Day.

Background

The CT simulation is a critical step in treatment planning. Lack of clear, concise, consistent instruction and education preparation prior to simulation day can delay planning and treatment. Currently, there is no standardized checklist to ensure patients are educated and prepared for their CT simulation day. …

Bortezomib And Vorinostat In Combination With Mitoxantrone, Dexamethasone, And Pegasparaginase During Induction And Reinduction For Infants With Acute Lymphoblastic Leukaemia: A Multicentre Single-Arm Phase 1/2 Study, Tanja A. Gruber, Sima Jeha, Rebecca J. Deyell, Victor Lewis, Bill H. Chang, Eric J. Lowe, Jamie Frediani, Catherine Vezina, Bruno Michon, Michael Richards, Erin H. Breese, Thai-Hoa Tran, Norman Lacayo, Christine Bolen, Sunil Desai, Jennifer L. Pauley, Minxuan Huang, Emily Ashcraft, Cheng Cheng, Kirk R. Schultz, Linda Stork, Krysta Schlis, Van T. Huynh, Nathan Gossai, Yoav H. Messinger, Henrique Bittencourt, Terzah M. Horton, Uma Athale, Duncan Stearns, Deborah Schiff, Paul S. Gaynon

Department of Pediatrics Faculty Publications

Background: Acute lymphoblastic leukaemia in infants remains a therapeutic challenge. In preclinical studies we previously identified bortezomib and vorinostat as active agents against KMT2A rearranged (KMT2Ar) leukaemia. The aim of this study was to determine the tolerability of incorporating bortezomib and vorinostat into an acute lymphoblastic leukaemia-chemotherapy backbone for newly diagnosed infants with acute lymphoblastic leukaemia both with and without KMT2Ar.

Methods: In this single-arm phase 1/2 study conducted at 18 hospitals in the USA and Canada, we enrolled patients aged 1 year or younger at the time of diagnosis with newly diagnosed acute lymphoblastic leukaemia or undifferentiated leukaemia (with …

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.

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 …

Administration Of A Novel Reprogramming Formula Improves Cardiac Function And Decreases Cardiac Fibrosis In A Myocardial Infarction Model, Megumi Mathison, Saliha S Pathan, Aliya Lackan, Jianchang Yang, Tamer M A Mohamed, Todd K Rosengart

Faculty, Staff and Students Publications

Background: The reprogramming of fibroblasts into (induced) cardiomyocytes offers a direct myocardial regeneration strategy for improving postinfarction myocardial function. Compared to lower-order species, human cells are relatively resistant to such reprogramming. We previously found that p63-transactivation inhibitory domain (TID; the portion of p63 that physical interacts and interferes with its activation of the epigenetic repressor HDAC1) combined with the cardio-differentiation factors Hand2 and Myocardin (HM) enhanced rat and human cell transdifferentiation. The present study sought to determine the in vivo effects of this reprogramming strategy in a rat myocardial infarction model.

Methods: Adult male and female rats underwent left anterior …

The State Of Educational Research In Cardiothoracic Surgery: A Review Of The Literature, Amirtha Shekar, Victoria Hart, John Treffalls, Travis J Miles, Todd K Rosengart, Marc R Moon, Joseph S Coselli, Lauren M Barron, Shawn S Groth, Shanda H Blackmon, Ravi K Ghanta, Dawn S Hui, Subhasis Chatterjee

Faculty, Staff and Students Publications

Objective: Evolving training paradigms in cardiothoracic surgery (CTS) are changing the educational needs of integrated residents and traditional fellows. Educational research is important for evaluating specialty training. This study assessed CTS education articles to analyze their prevalence, content, and reach.

Methods: In a cross-sectional observational study of education articles published on North American CTS programs from January 2013 through December 2023, articles were identified by querying PubMed, other databases, and journals. Articles that passed an initial abstract review underwent full-text review. Articles were organized by content into 9 categories: curriculum, simulation, trainee assessment, program evaluation, wellness/burnout, diversity/inclusion, mentorship/career, outcomes, and …