Radiology Commons^™

Advances In Molecular Imaging Of Vegfrs: Innovations In Imaging And Therapeutics, Hanieh Karimi, Sarah Lee, Wenqi Xu, Sigrid A. Langhans, David K. Johnson, Erik Stauff, Heidi H. Kecskemethy, Lauren W. Averill, Xuyi Yue

Department of Radiology Faculty Papers

Vascular endothelial growth factor receptors (VEGFRs) are key regulators of angiogenesis, lymphangiogenesis, and vascular permeability, playing essential roles in both physiological and pathological processes. The VEGFR family, including VEGFR-1, VEGFR-2, and VEGFR-3, interacts with structurally related VEGF ligands (VEGFA, VEGFB, VEGFC, VEGFD, and placental growth factor [PlGF]), activating downstream signaling pathways that mediate critical cellular processes, including proliferation, migration, and survival. Dysregulation of VEGFR signaling has been implicated in numerous diseases, such as cancer, cardiovascular conditions, and inflammatory disorders. Targeting VEGFRs with radiopharmaceuticals, such as radiolabeled peptides, antibodies, and specific tracers like 64Cu-bevacizumab and 89Zr-ramucirumab, has emerged as a powerful …

Reduction In Opioid Requirements Following Changes To Regional Anesthesia For Patients Undergoing Total Knee Arthroplasty, Jeffrey Mauras, Michael Mcmahon, Jaudé Petrie, Ryan Roubion, Amy Bronstone, Claudia Leonardi, Vinod Dasa

School of Medicine Faculty Publications

Background: Newer analgesic techniques to reduce opioid use and pain after total knee arthroplasty (TKA) include preoperative cryoneurolysis, adductor canal block (ACB), and local anesthetic infiltration between the popliteal artery and capsule of the knee (iPACK) block. The purpose of this study was to evaluate whether changing the regional analgesic from ropivacaine to liposomal bupivacaine would provide superior pain relief and reduce opioid requirements at 2 and 12 weeks following TKA. Methods: We conducted a retrospective medical records review of 140 consecutive patients who underwent primary TKA at a single site and received ACB with ropivacaine (multimodal-ropivacaine [MM-R] group, n …

Integrating Radiogenomics And Machine Learning In Musculoskeletal Oncology Care, Rahul Kumar, Kyle Sporn, Akshay Khanna, Phani Paladugu, Chirag Gowda, Alex Ngo, Ram Jagadeesan, Nasif Zaman, Alireza Tavakkoli

Department of Medicine Faculty Papers

Musculoskeletal tumors present a diagnostic challenge due to their rarity, histological diversity, and overlapping imaging features. Accurate characterization is essential for effective treatment planning and prognosis, yet current diagnostic workflows rely heavily on invasive biopsy and subjective radiologic interpretation. This review explores the evolving role of radiogenomics and machine learning in improving diagnostic accuracy for bone and soft tissue tumors. We examine integrating quantitative imaging features from MRI, CT, and PET with genomic and transcriptomic data to enable non-invasive tumor profiling. AI-powered platforms employing convolutional neural networks (CNNs) and radiomic texture analysis show promising results in tumor grading, subtype differentiation …

How Far Does It Go? An Analysis On The Extent Of Spinal Cord Injury In Post-Traumatic Patients, Sravani Mannuru, Sarvani Uppati, Kelsey Baker

Research Colloquium

Background: Spinal cord injury causes debilitating functional loss in post-trauma patients. Previous studies have showed that an area of edema (tissue damage and swelling) occurs at the level of spinal damage and may be related to the amount of functional loss in the patient and their associated recovery potential. We hypothesized that the extent of the injury is greater than previously studied and may better explain functional loss and recovery potential.

Methods: We retrospectively analyzed five T2-weighted MRI spinal cord images from post-trauma patients ages 32-67. Patients had a clinically diagnosed spinal cord injury that affected the cervical …

Imaging Hallmarks Of Idiopathic Intracranial Hypertension And Insights Into Pathogenesis, Albalooshy Basimah, Scott Faro, Hsiangkuo Yuan, Kiran Talekar, Prabath Mondel, Enchao Qiu, Joga Chaganti

Department of Radiology Faculty Papers

Idiopathic Intracranial hypertension (IIH), also referred to as pseudotumor cerebri, is a term used to describe increased intracranial pressure in the absence of a known identifiable secondary cause. Despite advancements of neuroimaging techniques, imaging of the pathological underpinnings in the diagnosis of IIH has been limited. Although the causation of IIH has been ascribed to increased Cerebrospinal Fluid production and disordered drainage through the dural sinuses, new evidence shows that the glymphatic system which is an alternate pathway of drainage is likely to play a pivotal role. In this review, we address the pathophysiological underpinnings in the causation of IIH …

Determining Size In An Era When Size Matters: Inter-Radiologist Variability In Lung Cancer Measurement, Katelyn Ward, Gayaneh Nazarian, Ryan Davis, Sayf Al-Katib, Kiran Nandalur, Thomas Watson

Conference Presentation Abstracts

No abstract provided.

Ensuring Timely Interventional Radiology Biopsy Procedures With Standardized Pre-Procedural Protocol And Guidelines, Joy Zhao, Md, Mohsin Arsiwala, Md, Minki Hong, Md, John Scalise, Md, Limi Jamma, Md, Hanna S. Ellingsen, Md

Health Equity and Quality Improvement (HEQI) Summit

Proposal

• Aim
  • To decrease rate of canceled or delayed IR biopsy procedures by 25% by implementing pre-operative order sets for inpatient IR procedures at Jefferson Center City Hospital in the next 6 months 
• Population of Interest
  • Jefferson Center City teaching team patients requiring IR biopsies
• Intervention
  • Implementing pre-operative order sets that include diet restrictions, anticoagulation guidelines, pre-operative labs, and pre-operative blood pressure and glucose goals 
• Quantifiable Outcome Measurement
  • Comparing rates of canceled and/or delayed IR biopsy procedures in the patient group that use the pre-operative order set compared to those who did not use the order set 
• Data Collection Methods …

Determining Size In An Era When Size Matters: How Accurate Are Lung Cancer Measurements On Preoperative Computed Tomography?, Katelyn Ward, Ryan Davis, Gayaneh Nazarian, Sayf Al-Katib, Kiran Nandalur, Antonela Muca, Thomas Watson

Conference Presentation Abstracts

No abstract provided.

Towards The Performance Characterization Of A Robotic Multimodal Diagnostic Imaging System, George Papaioannou, Christos Mitrogiannis, Mark Schweitzer, Nikolaos Michailidis, Maria Pappa, Pegah Khosravi, Apostolos Karantanas, Sean Starling, Christian Ruberg

Publications and Research

Characterizing imaging performance requires a multidisciplinary approach that evaluates various interconnected parameters, including dosage optimization and dynamic accuracy. Radiation dose and dynamic accuracy are challenged by patient motion that results in poor image quality. These challenges are more prevalent in the brain/cardiac pediatric patient imaging, as they relate to excess radiation dose that may be associated with various complications. Scanning vulnerable pediatric patients ought to eliminate anesthesia due to critical risks associated in some cases with intracranial hemorrhages, brain strokes, and congenital heart disease. Some pediatric imaging, however, requires prolonged scanning under anesthesia. It can often be a laborious, suboptimal …

Radiologic And Histologic Findings Of Undifferentiated Sarcoma Treated With Radical Resection, Justina Kasteri, Stefan Johnson, Joseph Hatem, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

Case report of an 89-year-old patient presenting with a nontraumatic painless growing mass on the right thigh. This article presents the diagnostic imaging and histologic microscopic views of the mass following a radical resection. Further discussing the key findings to diagnose undifferentiated sarcomas as well as the clinical management.

Can Anemia Be A Prognostic Indicator To Scope For Gastroesophageal Junction Adenocarcinoma?, Ryan Tam, Neha Narayanan, Evan Basha, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

Gastroesophageal junction adenocarcinoma is a rapidly progressive disease that has a poor prognosis with a 5-year survival rate of 20%. It commonly presents with major symptoms of dysphagia and weight loss in addition to a long-standing history of reflux. As of now, screening for esophageal adenocarcinoma (EAC) is dependent on identifying risk factors which include a family history of Barrett’s esophagus and esophageal adenocarcinoma or patients with gastroesophageal reflux disease and at least one other risk factory for EAC such as age greater than 50 years, obesity or central adiposity, history of smoking, or male gender. Here, we present a …

Pericardial Effusion Of Uncommon Origin: A Diagnostic Journey, Tannoz Norouzi, Carol Lima, Sayf Al-Katib

Conference Presentation Abstracts

Tuberculous (TB) pericarditis is a rare yet serious form of extrapulmonary tuberculosis, characterized by a diverse clinical presentation and the potential to occur as an isolated extrapulmonary manifestation. In developed countries, tuberculosis is a rare cause of pericarditis, contributing to less than 5% of pericardial effusion cases and an even smaller percentage of constrictive pericarditis cases. This case describes a 27-year-old male from Mali with no significant medical history presenting with progressive fatigue, shortness of breath, and palpitations over one year. Family history revealed sudden cardiac death in his father in his 30s. Physical examination and initial investigations, including echocardiography, …

Efficacy Of Neuromuscular Ultrasound In Diagnosing And Treating A Mammogram-Induced Brachial Plexus Injury-A Case Report, Jaime Dougherty, Tyler Pigott, Altamash E Raja

Rowan-Virtua School of Osteopathic Medicine Departmental Research

A 40-year-old woman presented with chronic left anterior shoulder, upper arm, and axillary pain following a routine mammogram 3 years prior. Despite multiple interventions, her pain persisted significantly affecting her quality of life. Ultrasound examination revealed fascicular edema in the medial brachial cutaneous nerve (MBCN), intercostobrachial cutaneous nerve (ICBN), and a positive sono-Tinel. Ultrasound-guided hydrodissection of these nerves provided complete axillary pain relief and significant improvement in anterior arm pain, sustained for 6 months. This case highlights the diagnostic challenges of cutaneous nerve entrapment syndromes, often overlooked and misdiagnosed, especially without a clear inciting injury. Ultrasound proves superior to electrodiagnostic …

Predicting Coronary Artery Calcium Using Abdominal Aorta And Visceral Artery Calcification, Jared Dixon, Sayf Al-Katib, Kiran Nandalur, Jacob Ghannam, Ali Beydoun, Desiree Clement

Posters

CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes, especially useful in asymptomatic people for planning primary prevention interventions such as statins and aspirin.1 The Multiethnic Study of Atherosclerosis (MESA) demonstrated that a CAC score of 0 represents a less than 5 percent 10-year Atherosclerotic cardiovascular disease (ASCVD) risk. CAC scores 1-299 represent borderline to intermediate risk, and CAC score >300 represents a “high risk” 10 percent or greater 10-year ASCVD risk.2

When used correctly, CAC scoring is a powerful predictor of ASCVD risk and holds the key for many …

Ultrasonographic Appearance Of Suspected Zinner Syndrome, Wen Hao Luo, Jared Garfinkle, Jack Hennen, Robert Martin, Kathleen Deiling

Rowan-Virtua Research Day

Zinner syndrome (ZS) is a rare congenital condition characterized by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. ZS is suspected to be caused by the malformation of the mesonephric duct during embryogenesis. The incomplete migration of the ureteric bud results in ipsilateral renal agenesis and ejaculatory duct obstruction. The remaining gonad develops with inadequate seminal fluid drainage, leading to the formation of seminal vesicle cysts. ZS is often asymptomatic, leading to challenges in diagnosis, particularly in adolescents. Symptoms can include pain, dysuria, pollakisuria, perineal pain, epididymitis, and pain after ejaculation. Imaging plays …

The Importance Of How And When In Measuring Epicardial Adipose Tissue, Brian Fardman, Juan Antonio Requena-Ibáñez, Carlos García Santos-Gallego, Anderly José Rodriguez Cordero, Samantha Sartori, Javier Sanz Sanz, Valentin Fuster, Juan José Badimon

Rowan-Virtua Research Day

Epicardial Adipose Tissue (EAT) is drawing increasing attention. As a quantifiable, modifiable, and potentially new cardiovascular therapeutic target, its accurate measurement is particularly relevant. In Cardiac Magnetic Resonance (CMR) different methods can be used to assess EAT burden. We take advantage of CMR-studies of EMPATROPISM trial to assess EAT through three different methods, evaluate the effect of Empagliflozin and look for significant difference in the ability to detect changes in serial measurements. In some settings such as treatment-induced changes or patient follow-up, multi-slice method of EAT evaluation provides higher accuracy to detect significant differences, otherwise unnoticed by single-slice approaches.

Interobserver Variability In Cardiovascular Fdg Pet/Ct Analysis In Large Vessel Vasculitis, Redemptar Kimeu, Anoop Shah, Samuel Gitau, Gemina Doolub, Jeilan Mohamed

Imaging & Diagnostic Radiology, East Africa

Introduction: PET/CT has a synergistic value for optimal diagnosis, disease activity monitoring, and evaluation of damage progression in large vessel vasculitis. The use of standardized uptake values (SUV) as a measurement of relative tissue uptake facilitates comparisons between patients, and has been suggested as a basis for diagnosis. The SUVmean and SUVmax reproducibility in vascular structures is not widely studied.

Objective: The objective of this study was to evaluate the inter-observer variability of both qualitative visual grading of aortic 18F-FDG uptake and the quantitative aortic mean and maximum SUVs in these patients with mild to moderate covid-19 infection …

Ultrasound-Guided Vs. Fluoroscopy Guided Steroid Injection For Lumbar Spine Pain On Functional And Pain Outcomes: A Systematic Review, Yashas Sattur, Akash Patel, Alec Birnbaum, Athena Nomula

Rowan-Virtua Research Day

Fluoroscopy-guided steroid injections are standard for lumbar spine pain but involve radiation. Ultrasound offers a safer, radiation-free alternative. Ultrasound-guided injections are non-inferior in improving pain and function. A systematic review of PubMed, Embase, Cochrane, Scopus, and Web of Science was conducted. Studies in adults comparing ultrasound and fluoroscopy-guided injections reporting VAS, NRS, or ODI were included. Fifteen studies showed both techniques significantly improved pain and function, with no consistent superiority. Ultrasound-guided injections are effective and safe, providing comparable outcomes to fluoroscopy while eliminating radiation exposure.

Prostatic Urethral Length On Mri As A Predictor Of Late Genitourinary Toxicity After Prostate Cancer Radiation, Kyu Kim, Joseph Lee, Allison Hazy, Sayf Al-Katib, Hong Ye, Nathan Kolderman, Abhay Dhaliwal, Daniel Krauss, Thomas Quinn, Kimberly Marvin, Kiran R. Nandalur

Posters

Radiation therapy (RT) is a widely used treatment for prostate cancer.1 While effective, some patients develop late genitourinary (GU) toxicity, which can impact quality of life.2,4 Identifying pre-treatment factors that predict toxicity risk may help improve clinical decision-making. Recent studies suggest that prostatic urethral length (PUL) seen on MRI is associated with an increased risk of late GU toxicity.3 Understanding this relationship could enhance risk stratification before treatment.

The Development Of A Trauma Interventional Radiology Alert Protocol Reduces Time To Vessel Puncture In Cases Of Active Hemorrhage., Aahad Khan, Akhil Gangisetty, Steve Mitchell, Nick Daughtery, Brent Goslin, William B Devoe, John Bach

Trauma and Acute Care Articles

Introduction Trauma continues to be a major cause of death in the United States, with uncontrolled bleeding contributing to a significant portion of trauma-related fatalities. In recent years, the management of hemorrhagic trauma patients has expanded to include interventional radiology (IR). The American College of Surgeons Committee on Trauma recommends that Level 1 and 2 trauma centers ensure IR availability within 60 minutes of the decision to proceed with angiography. Delays in IR intervention are associated with poorer outcomes and increased mortality. To address this, our Level 2 trauma center developed and implemented an institutional protocol involving trauma surgeons, interventional …