A Case Of Solitary Kidney With Duplex Collecting Systems And Renal Vascular Variants In An Adult Male Cadaver, 2020 University of Massachusetts Medical School
A Case Of Solitary Kidney With Duplex Collecting Systems And Renal Vascular Variants In An Adult Male Cadaver, Mehdi S. Salimy, Gabrielle A. Luiselli, Megan Yuen, Rose C. Healy, S. G. Shah, Eustathia Lela Giannaris, Manas Das, Alexandra E. Wink
Open Access Publications by UMMS Authors
We describe a unique solitary kidney with duplex collecting system and vascular variation observed in an 86-year-old White male formaldehyde- and phenol-fixed cadaver during routine academic dissection. The left renal fossa was empty with an intact adrenal gland, and the right renal fossa contained a fused renal mass with apparent polarity between the superior and inferior regions and two renal pelves converging into a single ureter. There were three right renal arteries supplying the renal mass; the superior and middle arteries were noted to be postcaval and the inferior artery was precaval. There were also two right renal veins draining ...
Lc-Ms Based Stability-Indicating Method For Studying The Degradation Of Lonidamine Under Physical And Chemical Stress Conditions, 2020 Thomas Jefferson University
Lc-Ms Based Stability-Indicating Method For Studying The Degradation Of Lonidamine Under Physical And Chemical Stress Conditions, Ankit K. Rochani, Margaret A. Wheatley, Brian Oeffinger, John R. Eisenbrey, Gagan Kaushal
College of Pharmacy Faculty Papers
Background and purpose: Lonidamine is a hexokinase II inhibitor, works as an anticancer molecule, and is extensively explored in clinical trials. Limited information prevails about the stability-indicating methods which could determine the forced degradation of lonidamine under stressed conditions. Hence, we report the use of a rapid, sensitive, reproducible, and highly accurate liquid chromatography and mass spectrometry method to analyze lonidamine degradation. Experimental approach: The Xbridge BEH shield reverse phase C18 column (2.5 μm, 4.6 × 75 mm) using isocratic 50:50 water: acetonitrile with 0.1% formic acid can detect lonidamine with help of mass spectrometer in tandem ...
Development Of A Ct Metal Artifact Management Algorithm For Proton Therapy Planning (Ampp) For Head And Neck Cancer Patients, 2020 The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences
Development Of A Ct Metal Artifact Management Algorithm For Proton Therapy Planning (Ampp) For Head And Neck Cancer Patients, Daniela Branco
The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)
Purpose: Dental amalgams (high Z materials) are common sources of artifacts in Head and Neck (HN) images. Commercial artifact reduction techniques have been offered, but many are impractical, produce inaccurate CT images or are not clinically available, thus not widely implemented. The goal of this work is to use CT gantry tilts to develop and evaluate a stereoscopic HN metal artifact management algorithm and investigate its improvement in proton treatment planning.
Methods: The in-house CT metal artifact management method for proton planning (AMPP) uses two angled CT scans to generate a single image set with no metal artifacts posterior to ...
Dual X-Ray Absorptiometry Has Limited Utility In Detecting Bone Pathology In Children With Hypophosphatasia: A Pooled Post Hoc Analysis Of Asfotase Alfa Clinical Trial Data., 2020 Children's Mercy Hospital
Dual X-Ray Absorptiometry Has Limited Utility In Detecting Bone Pathology In Children With Hypophosphatasia: A Pooled Post Hoc Analysis Of Asfotase Alfa Clinical Trial Data., Jill H. Simmons, Eric T. Rush, Anna Petryk, Shanggen Zhou, Gabriel Á. Martos-Moreno
Manuscripts, Articles, Book Chapters and Other Papers
Asfotase alfa is an enzyme replacement therapy approved for treatment of patients with pediatric-onset hypophosphatasia (HPP), a rare, inherited, systemic disease causing impaired skeletal mineralization, short stature, and reduced physical function in children. The role of dual X-ray absorptiometry (DXA) in the assessment of children with HPP has been insufficiently explored. This post hoc analysis included pooled DXA data from 2 open-label, multicenter studies in 19 children with HPP. The study population was aged ≥5 to <18 years and had received asfotase alfa for ≤6.6 years at enrollment (male: 79%; median age at enrollment: 10.4 y [range: 5.9-16.7]; treatment duration: 6.3 y [range: 0.1-6.6]. Baseline height Z-scores indicated short stature (median [min, max]: -1.26 [-6.6, 0]); mean [SD]: -2.30 [1.97]), thus requiring height adjustment of DXA Z-scores. At Baseline, few patients had height-adjusted bone mineral density (BMDht) Z-scores of -2 or less for whole body (n = 3) or lumbar spine (n = 5). In treated patients, mean whole body and lumbar spine BMDhtZ-scores did not change over time, but whole body and lumbar spine height- adjusted bone mineral content (BMCht) Z-scores increased significantly from Baseline to Last Assessment (P ≤ 0.0056). Improvements in Radiographic Global Impression of Change (RGI-C) scale scores correlated significantly with increases in whole body and lumbar spine BMChtZ-scores (P < 0.05) but not BMDhtZ-Scores. Improvements in Rickets Severity Score (RSS) correlated significantly with increases in lumbar spine BMDhtZ-scores and whole body BMCht Z-scores (P < 0.05). No significant correlations were observed between any DXA and bone histomorphometry measure. These findings suggest that DXA BMD Z-scores, which are commonly used in clinical practice, have limited utility in assessing deficient bone mineralization in patients with HPP. Although BMChtZ-scores increased significantly over time with asfotase alfa therapy, the lack of significant changes in more than one DXA parameter suggests that this tool may not be useful in everyday clinical practice. Furthermore, the use of BMC as an independent metric is not typical or recommended by guidelines. Complementary measures, such as skeletal radiographs supplemented with age-appropriate functional assessments, should be considered.
A Neurovascular High-Frequency Optical Coherence Tomography System Enables In Situ Cerebrovascular Volumetric Microscopy, 2020 University of Massachusetts Medical School
A Neurovascular High-Frequency Optical Coherence Tomography System Enables In Situ Cerebrovascular Volumetric Microscopy, Giovanni J. Ughi, Miklos G. Marosfoi, Robert M. King, Jildaz Caroff, Lindsy M. Peterson, Benjamin H. Duncan, Erin T. Langan, Amanda J. Collins, Anita M. Leporati, Serge Rousselle, Demetrius K. Lopes, Matthew J. Gounis, Ajit S. Puri
Intravascular imaging has emerged as a valuable tool for the treatment of coronary and peripheral artery disease; however, no solution is available for safe and reliable use in the tortuous vascular anatomy of the brain. Endovascular treatment of stroke is delivered under image guidance with insufficient resolution to adequately assess underlying arterial pathology and therapeutic devices. High-resolution imaging, enabling surgeons to visualize cerebral arteries' microstructure and micron-level features of neurovascular devices, would have a profound impact in the research, diagnosis, and treatment of cerebrovascular diseases. Here, we present a neurovascular high-frequency optical coherence tomography (HF-OCT) system, including an imaging console ...
Radiology Education And The Quality Of Care: Radiation Dose, 2020 Winston-Salem State University
Radiology Education And The Quality Of Care: Radiation Dose, Melissa R. B. Foster
Journal of Global Radiology
The purpose of this quantitative, quasi-experimental study was to analyze whether the education of radiology personnel mandated by the American Registry of Radiologic Technologists (ARRT) affects the quality of care delivered to radiology patients. One area of radiology quality of care was focused on the findings presented in this study: radiation dosage. Three groups of study participants were used. The participants were chosen and divided into groups based on their radiology background, non-radiology medical background, or lack of medical background. All study participants were required to complete an assessment asking participants what radiation dosage and shields they would use for ...
A Case Series On Uterine Arteriovenous Malformations: A Life-Threatening Emergency In Young Women, 2020 Aga Khan University
A Case Series On Uterine Arteriovenous Malformations: A Life-Threatening Emergency In Young Women, Rabia Hammad, Sidrah Nausheen, Mumtaz Malik
Department of Obstetrics & Gynaecology
Uterine arteriovenous malformation (AVM) is a rare condition, with few cases reported in the literature. Despite being rare, it is a potentially life-threatening condition in women of child-bearing age. It should be considered in the differential diagnosis of prolonged or irregular vaginal bleeding, which, otherwise, can lead to critical complications ending up in severe morbidity and mortality. This case series describes four cases of young Asian women aged between 33 and 38 years who presented with irregular vaginal bleeding. Trans-abdominal ultrasound of the pelvis showed increased vascularity with multi-directional blood flow in the uterus. Magnetic resonance imaging (MRI) confirmed an ...
Can Contrast Enhanced Ultrasound Differentiate Intrahepatic Cholangiocarcinoma From Hepatocellular Carcinoma?, 2020 West China Hospital of Sichuan University
Can Contrast Enhanced Ultrasound Differentiate Intrahepatic Cholangiocarcinoma From Hepatocellular Carcinoma?, Jia-Yan Huang, Jia-Wu Li, Wen-Wu Ling, Tao Li, Yan Luo, Ji-Bin Liu, Qiang Lu
Department of Radiology Faculty Papers
BACKGROUND: Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) differ in treatment and prognosis, warranting an effective differential diagnosis between them. The LR-M category in the contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) was set up for lesions that are malignant but not specific to HCC. However, a substantial number of HCC cases in this category elevated the diagnostic challenge.
AIM: To investigate the possibility and efficacy of differentiating ICC from HCC classified in the LR-M category according to the CEUS LI-RADS.
METHODS: Patients with complete CEUS records together with pathologically confirmed ICC and LR-M HCC (HCC classified ...
The Impact Of Temporal Resolution On Clinical Decision-Making For Individuals With Dysphagia, 2020 University of New Mexico
The Impact Of Temporal Resolution On Clinical Decision-Making For Individuals With Dysphagia, Shauna Corinne Murray
Speech and Hearing Sciences ETDs
INTRODUCTION: Dysphagia, or a disordered swallow, affects up to 1 in 25 individuals in the United States. The gold standard for assessing dysphagia is the videofluoroscopic evaluation of swallowing (VFES). This allows the clinician to observe the swallow anatomy in motion via an X-ray movie, which historically was recorded at 30 frames per second. In recent years VFES have been performed at less frames per second due to radiation concern. This project investigates the effect of using lower temporal resolutions on assessment of video-fluoroscopic swallow studies.
METHODS: In this investigation, 30 swallow studies, all acquired at 30 frames per second ...
Trapped Embolic Protection Device: A Salvage Technique, 2020 University of Massachusetts Medical School
Trapped Embolic Protection Device: A Salvage Technique, Anna L. Kuhn, Ajit S. Puri, Katyucia De Macedo Rodrigues, Francesco Massari, Jasmeet Singh
After carotid artery stenting, retrieval of the embolic protection device can sometimes be difficult due to incomplete stent expansion, stent fracture, vasospasm, and vessel tortuosity. In this technical report, we describe a novel rescue technique used in a patient with diffuse calcific atherosclerosis of the left common and proximal left internal carotid arteries who underwent left internal carotid artery stenting with cerebral protection and in whom, due to an under-expanded proximal carotid stent strut in relation to a densely calcified plaque, we were initially unable to advance the retrieval device.
Evolving Role Of Radiology In Covid-19 Pandemic: A Review, 2020 University of Massachusetts Medical School
Evolving Role Of Radiology In Covid-19 Pandemic: A Review, Sarwat Hussain
COVID-19 Publications by UMMS Authors
Background: This worldwide outbreak has disrupted a steady world of healthcare. Until now, diagnostic radiology and laboratory tests had been reasonably accurate in confirmed disease.
Methods: The review article used data bases, published literature, radiological guidelines issued from societies related to COVID-19 and large number of research journals to find out the latest evidence for the evolving role of radiology in COVID-19 pandemic.
Results: Computed Tomography scanning of the lungs demonstrated ground glass grounded opacities (34%) alone or in combination with consolidations (41%). In the first 5 days following exposure the false-negative rate of the RT-PCR testing is as much ...
Perfusion-Guided Sonopermeation Of Neuroblastoma: A Novel Strategy For Monitoring And Predicting Liposomal Doxorubicin Uptake, 2020 University of Texas at Dallas
Perfusion-Guided Sonopermeation Of Neuroblastoma: A Novel Strategy For Monitoring And Predicting Liposomal Doxorubicin Uptake, Aditi Bellary, Arelly Villarreal, Rojin Eslami, Quincy J Undseth, Bianca Lec, Ann M Defnet, Naina Bagrodia, Jessica J Kandel, Mark A Borden, Sumbul Shaikh, Rajiv Chopra, Theodore W Laetsch, Lauren J. Delaney, Colette Shaw, Md, John R. Eisenbrey, Sonia L Hernandez, Shashank R Sirsi
Department of Radiology Faculty Papers
Neuroblastoma (NB) is the most common extracranial solid tumor in infants and children, and imposes significant morbidity and mortality in this population. The aggressive chemoradiotherapy required to treat high-risk NB results in survival of less than 50%, yet is associated with significant long-term adverse effects in survivors. Boosting efficacy and reducing morbidity are therefore key goals of treatment for affected children. We hypothesize that these may be achieved by developing strategies that both focus and limit toxic therapies to the region of the tumor. One such strategy is the use of targeted image-guided drug delivery (IGDD), which is growing in ...
Diagnostic Value Of Mean Elasticity Index As A Quantitative Shear Wave Elastography Parameter For Prediction Of Malignancy In Small Suspicious Solid Thyroid Nodules, Saba Sohail, Sameera Kaliq Uz Zaman
Department of Radiology
Objective: To determine the diagnostic accuracy of mean elasticity index (Emean) on quantitative shear wave elastography (SWE) in detection of malignancy in small solid suspected malignant thyroid nodules on ultrasound, taking histopathology as the gold standard.
Study design: Analytical study.
Place and duration of study: Department of Radiology, Dow Medical College, Dow University of Health Sciences (DUHS) and Dr. Ruth K. M. Pfau Civil Hospital, Karachi from September 2017 to March 2018.
Methodology: Adult patients of either gender with suspected malignant thyroid nodules (solid, ≤10 mm) were subjected to SWE examination. All patients underwent thyroid surgery later. Histopathological findings were ...
Coronary Artery Aneurysm In Kawasaki Disease., 2020 Thomas Jefferson University Hospitals
Coronary Artery Aneurysm In Kawasaki Disease., Achala Donuru, Maansi Parekh, Vinay V R Kandula, Sharon Gould
Department of Radiology Faculty Papers
A 3-year-old male presents to the emergency department with chief complaints of fever and vomiting. He had a positive rapid streptococcus throat test with cervical lymphadenopathy. The patient was started on antibiotics. On examination, there was diffuse erythematous macular rash on the chest. Laboratory tests revealed elevated white cell count and C-reactive protein. Electrocardiogram was notable for prolonged PR interval indicating 1st degree atrioventricular block. Echocardiogram revealed ectasia of the right coronary artery (RCA). A presumptive diagnosis of Kawasaki disease was made and the patient was started on high-dose aspirin and intravenous immunoglobulins. Cardiac computed tomography angiography (CTA) showed ...
Dosimetric Effect When Treating Multiple Lesion Srs Using Vmat With And Without Jaw Tracking, 2020 Grand Valley State University
Dosimetric Effect When Treating Multiple Lesion Srs Using Vmat With And Without Jaw Tracking, Mindy Bui
Culminating Experience Projects
The main purpose of this study was to determine if jaw tracking or non-jaw tracking is the superior technique for patients with multiple brain metastasis that are treated with Volumetric Modulated Radiation Therapy (VMAT) Stereotactic Radiosurgery (SRS). Doses to the organs at risk (OAR) and the target volumes were analyzed using the dose volume histogram (DVH) and dose statistics for each plan. The goal of this study included analyzing the dosimetric effect on the organs at risk and the normal tissue when using jaw tracking versus non jaw tracking. The pros and cons for each technique were identified as well ...
The Air Gap Effect Between A Bolus And The Skin Surface For Chest Wall Irradiation, 2020 Grand Valley State University
The Air Gap Effect Between A Bolus And The Skin Surface For Chest Wall Irradiation, Marisa Clark
Culminating Experience Projects
Planning technique and bolus choice are important aspects in planning chest wall irradiation (CWI). Many previous studies have tested various combinations of photon energies, electron energies, bolus types and sizes, air gaps sizes, and treatment methods. This study aims to assess the effect of smaller, clinically relevant air gap sizes on specific chest wall treatments using a variety of common bolus types. Due to the Covid-19 pandemic, no data was able to be collected and was instead fabricated by the researcher. Four different treatment plans were created on a phantom patient using various energies of photons (6MV and 10MV) and ...
The Pulmonary Venous Ridge Length To Stratify Stroke Risk In Atrial Fibrillation, 2020 Thomas Jefferson University
The Pulmonary Venous Ridge Length To Stratify Stroke Risk In Atrial Fibrillation, Varun Singh, Joy Li, Mark Keroles, Daniel Frisch, Behzad B. Pavri, Baskaran Sundaram, Md, Jason Jacobson, Rajiv Kabadi
Department of Radiology Faculty Papers
Purpose of Study: To evaluate the left superior pulmonary venous ridge length (RL) and the left atrial appendage fractal dimension (LAA FD) as predictors of cardioembolic ischemic stroke (CVA) and transient ischemic attack (TIA) in patients with atrial fibrillation (AF).
Materials, Methods and Procedures: A multicenter, retrospective multicenter study was conducted on patients with AF who underwent cardiac CT prior to catheter ablation between 01/01/2010 and 12/31/2015. Patients were grouped by the presence or absence of prior CVA/TIA. Patients with mitral stenosis, prior mechanical aortic valve replacement, ascending aortic arch atheroma, highrisk patent foramen ovale ...
Dosimetric Comparison Of Hypofractionated Prostate Radiation With Simultaneous Integrated Boost And Conventional Fractionation With Sequential Boost, Kristina Sammon
Culminating Experience Projects
Introduction: Hypofractionated treatment delivery regimens are associated with better overall long-term disease control for prostate cancer. For patients with high-risk disease, there may be an indication for treatment of the surrounding pelvic lymph nodes for better over-all disease control. In order to achieve a hypofractionated regimen with treatment to the surrounding pelvic lymph nodes a simultaneous integrated boost technique is employed. There are concerns regarding achievability of target dose coverage and limitation of dose to the surrounding organs at risk with this fractionation.
Methods: This study is a retrospective dosimetric analysis of 7 randomly selected patients with high-risk prostate cancer ...
Diagnostic Radiology In Nigeria: A Country Report, 2020 Department of Radiology, Union Diagnostics and Clinical Services Plc, Yaba, Lagos, Nigeria
Diagnostic Radiology In Nigeria: A Country Report, Bukunmi Michael Idowu, Tolulope Adebayo Okedere
Journal of Global Radiology
Nigeria is located in West Africa. The Nigerian healthcare system is stratified into three tiers corresponding to the three tiers of government: primary (local), secondary (state), and tertiary (federal). In addition to this public health structure, private facilities play a significant role in healthcare delivery. Nigeria has a shortage of healthcare equipment and personnel, with a doctor per 1,000 population ratio of 0.17, which is one of the lowest on the African continent. Despite these challenges, a wide range of medical imaging services is available in the country, through a network of public and private facilities. The public ...
Myocardial Echinococcosis: Rare Manifestation Of A Common Parasitic Disease In Northern Tanzania, 2020 Aga Khan University
Myocardial Echinococcosis: Rare Manifestation Of A Common Parasitic Disease In Northern Tanzania, Ahmed Jusabani, Clement F. Kalambo, Mubashir Jusabani, Salim Surani
Imaging & Diagnostic Radiology, East Africa
Hydatid (Echinococcal) disease often involves the liver and lungs but in sporadic cases, it can involve cardiac structures. A 24-year-old male was referred with symptoms of cough and shortness of breath and a provisional diagnosis of metastatic disease of unknown primary to the lung, which was based on a chest X-ray (CXR). Incidentally, on echocardiogram, he was found to have right ventricular (RV) and myocardial multiseptated cysts, which were compatible with cardiac echinococcosis, as the patient had multiple bilateral lung cysts as well. Imaging with ultrasound, computed tomography (CT) scan, and magnetic resonance imaging (MRI) has ameliorated the diagnosis of ...