Radiology Commons^™

Interobserver Reliability Of The Renal Nephrometry Scoring System: Experience From A Developing Nation, Kumail Khandwala, Dawar Khan, Zainab Hussain, Nida Sajjad, Muhammad Ismail Alvi

Department of Radiology

Introduction: The RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior, location relative to polar lines) nephrometry score (RENAL-NS) has been described as a structured and quantifiable method to describe a renal tumor’s relevant anatomic features as they relate to the complexity of the lesion. We aim to evaluate a tumor’s RENAL-NS and to assess the reproducibility of the score among different observers.
Methods: This retrospective study included 49 patients diagnosed with renal cell carcinoma (RCC) who had complete computed tomography (CT) data, RENAL-NS, and histopathology results. All patients underwent renal surgery/intervention at …

The Correlation Between Stone Nephrolithometry Score And Hemoglobin Drop In Patients Undergoing Percutaneous Nephrolithotomy, Mohammad Shoaib, Muhibullah Bangash, Basit Salam, Hammad Ather

Section of Urology

Objective: In this study, we aimed to determine the correlation between the STONE score [(S)ize of the stone, (T)opography or location, degree of (O)bstruction of the urinary system, (N)umber of stones, and (E)valuation of Hounsfield units] and postoperative hemoglobin drop in patients undergoing percutaneous nephrolithotomy (PCNL).
Methods: This was a prospective observational study and all adult patients aged 18-65 years undergoing unilateral, single-tract PCNL using 26 Ch. Amplatz sheath for renal calculi were included. The five variables of the STONE nephrolithometry score were calculated prior to the procedure. The stone-free rates were assessed on imaging at four weeks and complications …

Malignant Phyllodes Tumor With Extensive Lipomatous Differentiation., Jeffrey Landy, Priya Johal, Alexander Sevrukov, Ida Teberian, Jason Shames, Christopher Sebastiano, Theresa Kaufman

Department of Radiology Faculty Papers

Phyllodes tumors are uncommon neoplasms of the breast. Lipomatous differentiation of malignant phyllodes tumor is a rare stromal alteration of this fibroepithelial tumor, demonstrated as a fat-containing mass on imaging. We present the case of a 46-year-old woman who was diagnosed with a malignant phyllodes tumor of the breast that demonstrated extensive lipomatous differentiation.

Incorporation Of A Machine Learning Algorithm With Object Detection Within The Thyroid Imaging Reporting And Data System Improves The Diagnosis Of Genetic Risk., Shuo Wang, Jiajun Xu, Aylin Tahmasebi, Kelly Daniels, Ji-Bin Liu, Joseph Curry, Elizabeth Cottrill, Andrej Lyshchik, John R Eisenbrey

Department of Radiology Faculty Papers

Background: The role of next generation sequencing (NGS) for identifying high risk mutations in thyroid nodules following fine needle aspiration (FNA) biopsy continues to grow. However, ultrasound diagnosis even using the American College of Radiology's Thyroid Imaging Reporting and Data System (TI-RADS) has limited ability to stratify genetic risk. The purpose of this study was to incorporate an artificial intelligence (AI) algorithm of thyroid ultrasound with object detection within the TI-RADS scoring system to improve prediction of genetic risk in these nodules.

Methods: Two hundred fifty-two nodules from 249 patients that underwent ultrasound imaging and ultrasound-guided FNA with NGS with …

Variability Of Breast Density Assessment And The Need For Additional Imaging: A Comparison Between Computed Mammography And Digital Mammography, Shaista Afzal Saeed, Imrana Masroor, Hina Iqbal, Saira Naz Sufian, Muhammad Awais

Department of Radiology

Objective: To determine the variability of breast density assessment and the need for additional imaging using computed radiography (CR) mammography versus digital radiography (DR) mammography.
Study design: Cohort study.
Place and duration of study: Department of Radiology, The Aga Khan University Hospital, Karachi from March to June 2018.
Methodology: Patients who underwent screening CR mammography, followed by DR mammography a year later, were selected. Only disease-free individuals were included in the study. Evaluation of breast density was done subjectively, using the breast imaging reporting and data system (BI-RADS) by two independent experienced radiologists. Statistical analysis was performed using the Wilcox …

Scalp Myiasis In An Ulcerated Abscess In A 7-Year Old Child, Abdullah Khan, Faheem Ullah Khan, Jawad Ahmad, Hameed Ullah, Wiqar Ahmad

Department of Radiology

No abstract provided.

Postoperative Retroperitoneal Hematoma: A Case Of Saw Palmetto And The Importance Of Primary Care Intervention, Seetha Venkateswaran, Ricardo Declet-Bauzo, Michael Shodeinde, Patricia Gilford

HCA Healthcare Journal of Medicine

Introduction: A middle-aged male with a history of bilateral inguinal hernia repair was admitted for acute abdominal pain. The patient reported that he took prescribed hydrocodone and a saw palmetto supplement prior to surgery. He denied any recent trauma after the procedure, and he was unable to schedule a follow-up appointment with the surgeon or the primary care physician.

Clinical Findings: Diagnosis: The CT angiography of the abdomen/pelvis was indicative of new interval development of a large left retroperitoneal hematoma. Intervention: No emergent intervention was required following the evaluation by the surgery and interventional radiology (IR) departments. Outcome: There was …

Conference Proceedings: Aurora Scientific Day 2020

Journal of Patient-Centered Research and Reviews

Abstracts published in this supplement were among those presented at the 46th annual Aurora Scientific Day research symposium, held virtually on May 20, 2020. The symposium provides a forum for describing research studies conducted by faculty, fellows, residents, and allied health professionals affiliated with Wisconsin-based Aurora Health Care, a part of the Advocate Aurora Health health system, which publishes the Journal of Patient-Centered Research and Reviews.

Characterization Of Indeterminate Breast Lesions On B-Mode Ultrasound Using Automated Machine Learning Models, Shuo Wang, Sihua Niu, Enze Qu, Flemming Forsberg, Annina Wilkes, Alexander Sevrukov, Kibo Nam, Robert F. Mattrey, Haydee Ojeda-Fournier, John R. Eisenbrey

Department of Radiology Faculty Papers

Purpose: While mammography has excellent sensitivity for the detection of breast lesions, its specificity is limited. Adjunct screening with ultrasound may partially alleviate this issue, but also increases false positives, resulting in unnecessary biopsies. This study investigated the use of Google AutoML Vision (Mountain View, CA), a commercially available machine learning service, to both identify and characterize indeterminate breast lesions on ultrasound.

Methods: B-mode images from 253 independent cases of indeterminate breast lesions scheduled for core biopsy were used for model creation and validation. The performances of two sub-models from AutoML Vision, the image classification model and object detection model …

Navigating The Paradox Of Scarcity: The Case For Radiologist-Driven Care., Daniel A Ortiz, Kevin M Cregan, Join Y Luh, Taj M Kattapuram

Articles, Abstracts, and Reports

No abstract provided.

The Many Faces Of Covid-19: Organizing Pneumonia (Op) Pattern Hrct Features, Gaetano Rea

Translational Medicine @ UniSa

Covid-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On 30 January 2020 the World Health Organization (WHO) declared that the outbreak of Covid-19 realizes a public health emergency of international concern. Because of the primary involvement of the respiratory system, chest CT is strongly recommended in suspected Covid-19 cases, for both initial and follow-up. We present the case of a Covid-19 patient, a 57-year-old man, with a typical HRCT course of OP reaction.

Virtual Connectivity During Quarantine: The Role Of Social Media For Radiation Oncology During Covid-19, Miriam A Knoll, Mudit Chowdhary, Adam Dicker, Thomas Eichler

Kimmel Cancer Center Faculty Papers

No abstract provided.

Minimizing Penile Prosthesis Implant Infection: What Can We Learn From Orthopedic Surgery?, Selin Isguven, Paul H. Chung, Priscilla Machado, Lauren J. Delaney, Antonia Chen, Flemming Forsberg, Noreen J. Hickok

Department of Radiology Faculty Papers

The implantation of penile protheses for the surgical treatment of erectile dysfunction has risen in popularity over the past several decades. Considerable advances have been made in surgical protocol and device design, specifically targeting infection prevention. Despite these efforts, device infection remains a critical problem, which causes significant physical and emotional burden to the patient. The aim of this review is to broaden the discussion of best practices by not only examining practices in urology, but additionally delving into the field of orthopedic surgery to identify techniques and approaches that may be applied to penile prothesis surgery.

Integrated Multiparametric Radiomics And Informatics System For Characterizing Breast Tumor Characteristics With The Oncotypedx Gene Assay, Michael A. Jacobs, Christopher B. Umbricht, Vishwa S. Parekh, Riham H. El Khouli, Leslie Cope, Katarzyna J. Macura, Susan Harvey, Antonio C. Wolff

Radiology Faculty Publications

Optimal use of multiparametric magnetic resonance imaging (mpMRI) can identify key MRI parameters and provide unique tissue signatures defining phenotypes of breast cancer. We have developed and implemented a new machine-learning informatic system, termed Informatics Radiomics Integration System (IRIS) that integrates clinical variables, derived from imaging and electronic medical health records (EHR) with multiparametric radiomics (mpRad) for identifying potential risk of local or systemic recurrence in breast cancer patients. We tested the model in patients (n = 80) who had Estrogen Receptor positive disease and underwent OncotypeDX gene testing, radiomic analysis, and breast mpMRI. The IRIS method was trained …

Organic Field-Effect Transistors As Flexible, Tissue-Equivalent Radiation Dosimeters In Medical Applications, Andrew M. Zeidell, Tong Ren, David S. Filston, Hamna F. Iqbal, Emma Holland, J. Daniel Bourland, John E. Anthony, Oana D. Jurchescu

Chemistry Faculty Publications

Radiation therapy is one of the most prevalent procedures for cancer treatment, but the risks of malignancies induced by peripheral beam in healthy tissues surrounding the target is high. Therefore, being able to accurately measure the exposure dose is a critical aspect of patient care. Here a radiation detector based on an organic field‐effect transistor (RAD‐OFET) is introduced, an in vivo dosimeter that can be placed directly on a patient's skin to validate in real time the dose being delivered and ensure that for nearby regions an acceptable level of low dose is being received. This device reduces the errors …

A Sonographer’S Step-By-Step Approach For Preventing Transmission Of Covid-19, Corinne Wessner, Joann Nelson, Sarah Mott, Maria Francesco, Laurence Needleman

Department of Radiology Faculty Papers

The 2019 novel coronavirus, known as COVID-19, has greatly affected the way sonographers care for their patients. Sonography can be a useful imaging tool for surveillance and diagnosis of various conditions associated with COVID-19 patients or patients under investigation (PUIs). Currently, there are limited resources and protocols for preventing the transmission of COVID-19 from ultrasound equipment. Our institution has created a detailed protocol for scanning COVID-19 patients or PUIs to address this important issue.

Localizing An Occult Insulinoma By Selective Calcium Arterial Stimulation Test: First Ever Experience And A New Dimension To Diagnosis In Pakistan, Muhammad Owais Rashid, Sumerah Jabeen, Zareen Kiran,, Khurram Minhas, Muhammad Azeemuddin, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Insulinomas are rare, usually benign, solitary tumours accounting for 60% of islet cell tumours. These tumours can be difficult to localize preoperatively due to their small size. We present a challenging case of a 40 year old male with frequent hypoglycaemic spells and endogenous hypoglycaemia who presented as a diagnostic dilemma. Patient had an occult insulinoma with inconclusive CT Abdomen, MRI Abdomen and Octreotide scan. The final localization of the tumour was made by selective arterial calcium stimulation testing (SCAT), done for the first time in Pakistan at Aga Khan University Hospital. This was followed by successful distal pancreatectomy as …

Ultrasonographic Risk Stratification Of Indeterminate Thyroid Nodules; A Comparison Of An Artificial Intelligence Algorithm With Radiologist Performance, Aylin Tahmasebi, Shuo Wang, Kelly Daniels, Elizabeth Cottrill, Ji-Bin Liu, Jiajun Xu, Andrej Lyshchik, John R. Eisenbrey

Department of Radiology Faculty Papers

Background, Motivation and Objective: Thyroid nodules with indeterminate or suspicious cytology are commonly encountered in clinical practice and their clinical management is controversial. Recently, genetical analysis of thyroid fine needle aspiration (FNAs) was implemented at some institutions to differentiate thyroid nodules as high and low risk based on the presence of certain oncogenes commonly associated with aggressive tumor behavior and poor patient outcomes. Our group recently detailed the performance of a machine-learning model based on ultrasonography images of thyroid nodules for the prediction of high and low risk mutations. This study evaluated the performance of a second-generation machine-learning algorithm incorporating …

Detection Of Left Ventricular Thrombi On Cardiac Magnetic Resonance Viability Studies, Donya Ahmed Alhassan, Khawaja Bilal Waheed, Muhammad Nasim Sharif, Muhammad Zia Ulhassan, Fazal Ghaffar, Khaled Saleh Saleem, Emad Fouad Mahmoud Said, Bayan Mohammed Altalaq, Zechariah Jebakumar Arulanantham, Ahmad Omar Qarmash

Journal of the Saudi Heart Association

Objective: To highlight detection of left ventricular thrombi on cardiac magnetic resonance (CMR) viability studies.

Method: This retrospective observational study was conducted in the Radiology Department at our Hospital in Dhahran, from April 2015-2019. All recently re-perfused (post-percutaneous coronary intervention/ PCI) patients with ST-segment elevation myocardial infarctions (STEMI), having low ejection fractions (

Results: Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (

Conclusion: Left ventricular thrombi can be detected on cardiac viability studies …

Digital Breast Tomosynthesis Versus Additional Diagnostic Mammographic Views For The Evaluation Of Asymmetric Mammographic Densities, Hira Waheed, Imrana Masroor, Shaista Afzal Saeed, Muhammad Ismail Alvi, Syed Jahanzeb

Department of Radiology

Introduction: Many young females present with an advanced stage of breast cancer, which has a negative effect on the prognosis. Digital breast tomosynthesis is a new emerging imaging technique that aids in improving the specificity of mammography with subsequent early detection of breast cancer, especially in women with radiographically dense breasts. Tomosynthesis is subjectively preferred to conventional mammography and may offer superior diagnostic accuracy for the evaluation of breast lesions.
Method: Two breast radiologists retrospectively reviewed asymmetric densities using protocols that were institutional review board-approved in 185 patients aged 18 - 70 years (mean: 48 years) who underwent diagnostic mammography …