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Keshavarz P, Bagherieh S, Nabipoorashrafi SA, Chalian H, Rahsepar AA, Kim GHJ, Hassani C, Raman SS, Bedayat A. ChatGPT in radiology: A systematic review of performance, pitfalls, and future perspectives. Diagn Interv Imaging 2024:S2211-5684(24)00105-0. [PMID: 38679540 DOI: 10.1016/j.diii.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/11/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE The purpose of this study was to systematically review the reported performances of ChatGPT, identify potential limitations, and explore future directions for its integration, optimization, and ethical considerations in radiology applications. MATERIALS AND METHODS After a comprehensive review of PubMed, Web of Science, Embase, and Google Scholar databases, a cohort of published studies was identified up to January 1, 2024, utilizing ChatGPT for clinical radiology applications. RESULTS Out of 861 studies derived, 44 studies evaluated the performance of ChatGPT; among these, 37 (37/44; 84.1%) demonstrated high performance, and seven (7/44; 15.9%) indicated it had a lower performance in providing information on diagnosis and clinical decision support (6/44; 13.6%) and patient communication and educational content (1/44; 2.3%). Twenty-four (24/44; 54.5%) studies reported the proportion of ChatGPT's performance. Among these, 19 (19/24; 79.2%) studies recorded a median accuracy of 70.5%, and in five (5/24; 20.8%) studies, there was a median agreement of 83.6% between ChatGPT outcomes and reference standards [radiologists' decision or guidelines], generally confirming ChatGPT's high accuracy in these studies. Eleven studies compared two recent ChatGPT versions, and in ten (10/11; 90.9%), ChatGPTv4 outperformed v3.5, showing notable enhancements in addressing higher-order thinking questions, better comprehension of radiology terms, and improved accuracy in describing images. Risks and concerns about using ChatGPT included biased responses, limited originality, and the potential for inaccurate information leading to misinformation, hallucinations, improper citations and fake references, cybersecurity vulnerabilities, and patient privacy risks. CONCLUSION Although ChatGPT's effectiveness has been shown in 84.1% of radiology studies, there are still multiple pitfalls and limitations to address. It is too soon to confirm its complete proficiency and accuracy, and more extensive multicenter studies utilizing diverse datasets and pre-training techniques are required to verify ChatGPT's role in radiology.
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Affiliation(s)
- Pedram Keshavarz
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA; School of Science and Technology, The University of Georgia, Tbilisi 0171, Georgia
| | - Sara Bagherieh
- Independent Clinical Radiology Researcher, Los Angeles, CA 90024, USA
| | | | - Hamid Chalian
- Department of Radiology, Cardiothoracic Imaging, University of Washington, Seattle, WA 98195, USA
| | - Amir Ali Rahsepar
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Grace Hyun J Kim
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA; Department of Radiological Sciences, Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Cameron Hassani
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Steven S Raman
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Arash Bedayat
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
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Gao C, Ming Z, Nguyen KL, Pang J, Bedayat A, Dale BM, Zhong X, Finn JP. Ferumoxytol-Enhanced Cardiac Cine MRI Reconstruction Using a Variable-Splitting Spatiotemporal Network. J Magn Reson Imaging 2024. [PMID: 38436994 DOI: 10.1002/jmri.29295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Balanced steady-state free precession (bSSFP) imaging is commonly used in cardiac cine MRI but prone to image artifacts. Ferumoxytol-enhanced (FE) gradient echo (GRE) has been proposed as an alternative. Utilizing the abundance of bSSFP images to develop a computationally efficient network that is applicable to FE GRE cine would benefit future network development. PURPOSE To develop a variable-splitting spatiotemporal network (VSNet) for image reconstruction, trained on bSSFP cine images and applicable to FE GRE cine images. STUDY TYPE Retrospective and prospective. SUBJECTS 41 patients (26 female, 53 ± 19 y/o) for network training, 31 patients (19 female, 49 ± 17 y/o) and 5 healthy subjects (5 female, 30 ± 7 y/o) for testing. FIELD STRENGTH/SEQUENCE 1.5T and 3T, bSSFP and GRE. ASSESSMENT VSNet was compared to VSNet with total variation loss, compressed sensing and low rank methods for 14× accelerated data. The GRAPPA×2/×3 images served as the reference. Peak signal-to-noise-ratio (PSNR), structural similarity index (SSIM), left ventricular (LV) and right ventricular (RV) end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) were measured. Qualitative image ranking and scoring were independently performed by three readers. Latent scores were calculated based on scores of each method relative to the reference. STATISTICS Linear mixed-effects regression, Tukey method, Fleiss' Kappa, Bland-Altman analysis, and Bayesian categorical cumulative probit model. A P-value <0.05 was considered statistically significant. RESULTS VSNet achieved significantly higher PSNR (32.7 ± 0.2), SSIM (0.880 ± 0.004), rank (2.14 ± 0.06), and latent scores (-1.72 ± 0.22) compared to other methods (rank >2.90, latent score < -2.63). Fleiss' Kappa was 0.52 for scoring and 0.61 for ranking. VSNet showed no significantly different LV and RV ESV (P = 0.938) and EF (P = 0.143) measurements, but statistically significant different (2.62 mL) EDV measurements compared to the reference. CONCLUSION VSNet produced the highest image quality and the most accurate functional measurements for FE GRE cine images among the tested 14× accelerated reconstruction methods. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Chang Gao
- Department of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Zhengyang Ming
- Department of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Kim-Lien Nguyen
- Department of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
- Division of Cardiology, University of California Los Angeles and VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Jianing Pang
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - Arash Bedayat
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Brian M Dale
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Cary, North Carliona, USA
| | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - J Paul Finn
- Department of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
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Rahsepar AA, Tavakoli N, Kim GHJ, Hassani C, Abtin F, Bedayat A. How AI Responds to Common Lung Cancer Questions: ChatGPT vs Google Bard. Radiology 2023; 307:e230922. [PMID: 37310252 DOI: 10.1148/radiol.230922] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background The recent release of large language models (LLMs) for public use, such as ChatGPT and Google Bard, has opened up a multitude of potential benefits as well as challenges. Purpose To evaluate and compare the accuracy and consistency of responses generated by publicly available ChatGPT-3.5 and Google Bard to non-expert questions related to lung cancer prevention, screening, and terminology commonly used in radiology reports based on the recommendation of Lung Imaging Reporting and Data System (Lung-RADS) v2022 from American College of Radiology and Fleischner society. Materials and Methods Forty of the exact same questions were created and presented to ChatGPT-3.5 and Google Bard experimental version as well as Bing and Google search engines by three different authors of this paper. Each answer was reviewed by two radiologists for accuracy. Responses were scored as correct, partially correct, incorrect, or unanswered. Consistency was also evaluated among the answers. Here, consistency was defined as the agreement between the three answers provided by ChatGPT-3.5, Google Bard experimental version, Bing, and Google search engines regardless of whether the concept conveyed was correct or incorrect. The accuracy among different tools were evaluated using Stata. Results ChatGPT-3.5 answered 120 questions with 85 (70.8%) correct, 14 (11.7%) partially correct, and 21 (17.5%) incorrect. Google Bard did not answer 23 (19.1%) questions. Among the 97 questions answered by Google Bard, 62 (51.7%) were correct, 11 (9.2%) were partially correct, and 24 (20%) were incorrect. Bing answered 120 questions with 74 (61.7%) correct, 13 (10.8%) partially correct, and 33 (27.5%) incorrect. Google search engine answered 120 questions with 66 (55%) correct, 27 (22.5%) partially correct, and 27 (22.5%) incorrect. The ChatGPT-3.5 is more likely to provide correct or partially answer than Google Bard, approximately by 1.5 folds (OR = 1.55, P = 0.004). ChatGPT-3.5 and Google search engine were more likely to be consistent than Google Bard by approximately 7 and 29 folds (OR = 6.65, P = 0.002 for ChatGPT and OR = 28.83, P = 0.002 for Google search engine, respectively). Conclusion Although ChatGPT-3.5 had a higher accuracy in comparison with the other tools, neither ChatGPT nor Google Bard, Bing and Google search engines answered all questions correctly and with 100% consistency.
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Affiliation(s)
- Amir Ali Rahsepar
- Department of Radiological Sciences, Division of Cardiothoracic Imaging, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Neda Tavakoli
- School of Computational Science and Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Grace Hyun J Kim
- Center for Computer Vision and Imaging Biomarkers, Dept of Radiological Sciences David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Dept of Biostatistics Fielding School of Public at UCLA, Los Angeles, CA, USA
| | - Cameron Hassani
- Department of Radiological Sciences, Division of Cardiothoracic Imaging, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Fereidoun Abtin
- Department of Radiological Sciences, Division of Cardiothoracic Imaging, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Arash Bedayat
- Department of Radiological Sciences, Division of Cardiothoracic Imaging, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Hassani C, Walker CM, Urdaneta F, Prosper AE, Finn JP, Bedayat A, Saremi F. Cardiac Outpouchings: Practical Approach to Normal Variants and Pathologic Conditions at CT and MRI. Radiographics 2023; 43:e220063. [PMID: 37079461 DOI: 10.1148/rg.220063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Numerous entities, both structural and pathologic, can manifest as a contrast material- or blood-filled cardiac outpouching at imaging. These outpouchings often resemble one another and are frequently unfamiliar to imagers and clinicians, creating uncertainty when detected. Furthermore, the diagnostic criteria for conditions such as hernia, aneurysm, pseudoaneurysm, and diverticulum have not been consistently applied in studies and reports cited in the literature describing these outpouchings, adding to the confusion among general and cardiothoracic imagers. Pouches and outpouchings are commonly found incidentally on thoracic and abdominal CT scans obtained for other reasons. Many pouches and outpouchings can be confidently diagnosed or ignored at routine imaging, whereas others may require further evaluation with electrocardiographically gated CT, cardiac MRI, or echocardiography for a more definitive diagnosis. It is easiest to group and diagnose these entities on the basis of their cardiac chamber location or their involvement with the interatrial and interventricular septa. Ancillary features, such as motion, morphology, neck and body size, presence or absence of thrombus, and late gadolinium enhancement characteristics, are important in reaching a correct diagnosis. The aim of this article is to provide a practical guide to pouches and outpouchings of the heart. Each entity is defined according to its cause, imaging characteristics, clinical significance, and relevant associated findings. Mimics of cardiac pouches and outpouchings such as the Bachmann bundle, atrial veins, and thebesian vessels also are briefly discussed. Quiz questions for this article are available in the supplemental material. ©RSNA, 2023.
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Affiliation(s)
- Cameron Hassani
- From the Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1621, Los Angeles, CA 90095 (C.H., F.U., A.B., A.E.P., J.P.F.); Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS (C.M.W.); and Department of Radiology, Keck Hospital of the University of Southern California, Los Angeles, Calif (F.S.)
| | - Christopher M Walker
- From the Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1621, Los Angeles, CA 90095 (C.H., F.U., A.B., A.E.P., J.P.F.); Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS (C.M.W.); and Department of Radiology, Keck Hospital of the University of Southern California, Los Angeles, Calif (F.S.)
| | - Felipe Urdaneta
- From the Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1621, Los Angeles, CA 90095 (C.H., F.U., A.B., A.E.P., J.P.F.); Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS (C.M.W.); and Department of Radiology, Keck Hospital of the University of Southern California, Los Angeles, Calif (F.S.)
| | - Ashley E Prosper
- From the Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1621, Los Angeles, CA 90095 (C.H., F.U., A.B., A.E.P., J.P.F.); Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS (C.M.W.); and Department of Radiology, Keck Hospital of the University of Southern California, Los Angeles, Calif (F.S.)
| | - John P Finn
- From the Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1621, Los Angeles, CA 90095 (C.H., F.U., A.B., A.E.P., J.P.F.); Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS (C.M.W.); and Department of Radiology, Keck Hospital of the University of Southern California, Los Angeles, Calif (F.S.)
| | - Arash Bedayat
- From the Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1621, Los Angeles, CA 90095 (C.H., F.U., A.B., A.E.P., J.P.F.); Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS (C.M.W.); and Department of Radiology, Keck Hospital of the University of Southern California, Los Angeles, Calif (F.S.)
| | - Farhood Saremi
- From the Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1621, Los Angeles, CA 90095 (C.H., F.U., A.B., A.E.P., J.P.F.); Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS (C.M.W.); and Department of Radiology, Keck Hospital of the University of Southern California, Los Angeles, Calif (F.S.)
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Jalili MH, Yu T, Hassani C, Prosper AE, Finn JP, Bedayat A. Contrast-enhanced MR Angiography without Gadolinium-based Contrast Material: Clinical Applications Using Ferumoxytol. Radiol Cardiothorac Imaging 2022; 4:e210323. [PMID: 36059381 PMCID: PMC9434982 DOI: 10.1148/ryct.210323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 07/01/2022] [Accepted: 07/15/2022] [Indexed: 04/25/2023]
Abstract
Vascular imaging can be challenging because of the wide variability of contrast dynamics in different vascular territories and potential safety concerns in patients with renal insufficiency or allergies. Off-label diagnostic use of ferumoxytol, a superparamagnetic iron nanoparticle approved for therapy, is a promising alternative to gadolinium-based contrast agents for MR angiography (MRA). Ferumoxytol has exhibited a reassuring safety profile when used within the dose range recommended for diagnostic imaging. Because of its prolonged and stable intravascular residence, ferumoxytol can be used in its steady-state distribution for a wide variety of imaging indications, including some where conventional MRA is unreliable. In this article, authors discuss some of the major vascular applications of ferumoxytol and highlight how it may be used to provide highly diagnostic images and improve the quality, workflow, and reliability of vascular imaging. Keywords: MR Angiography, MRI Contrast Agent, Cardiac, Vascular © RSNA, 2022.
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Shahrouki P, Fishbein MC, Bedayat A. Severe COVID-19 Pneumonia of Single Transplant Lung Sparing Native Fibrotic Lung. Transplantation 2022; 106:e105-e106. [PMID: 34699458 PMCID: PMC8667682 DOI: 10.1097/tp.0000000000003968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 12/04/2022]
Abstract
Supplemental Digital Content is available in the text.
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Affiliation(s)
- Puja Shahrouki
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA
| | - Michael C. Fishbein
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, CA
| | - Arash Bedayat
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA
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Ghodrati V, Rivenson Y, Prosper A, de Haan K, Ali F, Yoshida T, Bedayat A, Nguyen KL, Finn JP, Hu P. Automatic segmentation of peripheral arteries and veins in ferumoxytol-enhanced MR angiography. Magn Reson Med 2021; 87:984-998. [PMID: 34611937 DOI: 10.1002/mrm.29026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 09/03/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE To automate the segmentation of the peripheral arteries and veins in the lower extremities based on ferumoxytol-enhanced MR angiography (FE-MRA). METHODS Our automated pipeline has 2 sequential stages. In the first stage, we used a 3D U-Net with local attention gates, which was trained based on a combination of the Focal Tversky loss with region mutual loss under a deep supervision mechanism to segment the vasculature from the high-resolution FE-MRA datasets. In the second stage, we used time-resolved images to separate the arteries from the veins. Because the ultimate segmentation quality of the arteries and veins relies on the performance of the first stage, we thoroughly evaluated the different aspects of the segmentation network and compared its performance in blood vessel segmentation with currently accepted state-of-the-art networks, including Volumetric-Net, DeepVesselNet-FCN, and Uception. RESULTS We achieved a competitive F1 = 0.8087 and recall = 0.8410 for blood vessel segmentation compared with F1 = (0.7604, 0.7573, 0.7651) and recall = (0.7791, 0.7570, 0.7774) obtained with Volumetric-Net, DeepVesselNet-FCN, and Uception. For the artery and vein separation stage, we achieved F1 = (0.8274/0.7863) in the calf region, which is the most challenging region in peripheral arteries and veins segmentation. CONCLUSION Our pipeline is capable of fully automatic vessel segmentation based on FE-MRA without need for human interaction in <4 min. This method improves upon manual segmentation by radiologists, which routinely takes several hours.
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Affiliation(s)
- Vahid Ghodrati
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
| | - Yair Rivenson
- Electrical and Computer Engineering Department, University of California, Los Angeles, California, USA
| | - Ashley Prosper
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kevin de Haan
- Electrical and Computer Engineering Department, University of California, Los Angeles, California, USA
| | - Fadil Ali
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
| | - Takegawa Yoshida
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Arash Bedayat
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kim-Lien Nguyen
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - J Paul Finn
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Peng Hu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
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Ghodrati V, Bydder M, Bedayat A, Prosper A, Yoshida T, Nguyen KL, Finn JP, Hu P. Temporally aware volumetric generative adversarial network-based MR image reconstruction with simultaneous respiratory motion compensation: Initial feasibility in 3D dynamic cine cardiac MRI. Magn Reson Med 2021; 86:2666-2683. [PMID: 34254363 PMCID: PMC10172149 DOI: 10.1002/mrm.28912] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/02/2021] [Accepted: 06/12/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Develop a novel three-dimensional (3D) generative adversarial network (GAN)-based technique for simultaneous image reconstruction and respiratory motion compensation of 4D MRI. Our goal was to enable high-acceleration factors 10.7X-15.8X, while maintaining robust and diagnostic image quality superior to state-of-the-art self-gating (SG) compressed sensing wavelet (CS-WV) reconstruction at lower acceleration factors 3.5X-7.9X. METHODS Our GAN was trained based on pixel-wise content loss functions, adversarial loss function, and a novel data-driven temporal aware loss function to maintain anatomical accuracy and temporal coherence. Besides image reconstruction, our network also performs respiratory motion compensation for free-breathing scans. A novel progressive growing-based strategy was adapted to make the training process possible for the proposed GAN-based structure. The proposed method was developed and thoroughly evaluated qualitatively and quantitatively based on 3D cardiac cine data from 42 patients. RESULTS Our proposed method achieved significantly better scores in general image quality and image artifacts at 10.7X-15.8X acceleration than the SG CS-WV approach at 3.5X-7.9X acceleration (4.53 ± 0.540 vs. 3.13 ± 0.681 for general image quality, 4.12 ± 0.429 vs. 2.97 ± 0.434 for image artifacts, P < .05 for both). No spurious anatomical structures were observed in our images. The proposed method enabled similar cardiac-function quantification as conventional SG CS-WV. The proposed method achieved faster central processing unit-based image reconstruction (6 s/cardiac phase) than the SG CS-WV (312 s/cardiac phase). CONCLUSION The proposed method showed promising potential for high-resolution (1 mm3 ) free-breathing 4D MR data acquisition with simultaneous respiratory motion compensation and fast reconstruction time.
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Affiliation(s)
- Vahid Ghodrati
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
| | - Mark Bydder
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Arash Bedayat
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Ashley Prosper
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Takegawa Yoshida
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kim-Lien Nguyen
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA.,Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - J Paul Finn
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Peng Hu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
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Mathevosian S, Yoshida T, Hassani C, Jalili M, Finn P, Bedayat A. Abstract No. 468 Evaluation of aortic stent endoleaks using ferumoxytol-enhanced magnetic resonance angiography. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Moore JP, Gallotti R, Nguyen H, Su J, Bedayat A, Prosper A, Buch E. CRYO-BALLOON PULMONARY VEIN AND LEFT ATRIAL POSTERIOR WALL ISOLATION FOR THE TREATMENT OF ATRIAL FIBRILLATION. COMPARABLE OUTCOMES FOR ADULT CONGENITAL HEART DISEASE. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01804-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chiang J, Hebroni F, Bedayat A, Pourzand L. Case 286: Sarcoidlike Granulomatosis and Lymphadenopathy-Thoracic Manifestations of Nivolumab Drug Toxicity. Radiology 2021; 298:471-475. [PMID: 33493088 DOI: 10.1148/radiol.2021191247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
History A 70-year-old man had a posterior left thigh lesion confirmed to be biopsy-proven melanoma. The patient underwent wide excision and sentinel node biopsy, which showed absence of residual melanoma. Two years later, the patient noticed a subcentimeter subcutaneous lump in his thigh. Repeat excisional biopsy showed involvement of the surrounding soft tissue, consistent with a satellite lesion. Follow-up combined PET/CT revealed satellite nodules around the primary lesion, enabling confirmation of subcutaneous metastatic disease. The patient was subsequently started on nivolumab, an anti-programmed cell death 1 (PD-1) immune checkpoint inhibitor that blocks PD-1 and is approved as a first-line treatment in patients with advanced metastatic melanoma. On the baseline scan prior to starting nivolumab, there were no CT findings that suggested metastatic disease, nor were there enlarged mediastinal or hilar lymph nodes. Five months after initiation of nivolumab treatment, the first follow-up chest CT scan was performed and showed new findings in the mediastinum and bilateral lungs. The patient remained asymptomatic during the treatment period. Furthermore, the subcutaneous metastatic disease remained stable during the treatment period, and no other site of metastatic disease was noted on follow-up CT scans obtained during the first 5 months of treatment. The patient had no prior history of infectious or occupational exposures. During the nivolumab treatment cycle, his pertinent laboratory values and physical examination findings were unremarkable.
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Affiliation(s)
- Jason Chiang
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
| | - Frank Hebroni
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
| | - Arash Bedayat
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
| | - Lila Pourzand
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
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12
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Nguyen KL, Ghosh RM, Griffin LM, Yoshida T, Bedayat A, Rigsby CK, Fogel MA, Whitehead KK, Hu P, Finn JP. Four-dimensional Multiphase Steady-State MRI with Ferumoxytol Enhancement: Early Multicenter Feasibility in Pediatric Congenital Heart Disease. Radiology 2021; 300:162-173. [PMID: 33876971 DOI: 10.1148/radiol.2021203696] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The value of MRI in pediatric congenital heart disease (CHD) is well recognized; however, the requirement for expert oversight impedes its widespread use. Four-dimensional (4D) multiphase steady-state imaging with contrast enhancement (MUSIC) is a cardiovascular MRI technique that uses ferumoxytol and captures all anatomic features dynamically. Purpose To evaluate multicenter feasibility of 4D MUSIC MRI in pediatric CHD. Materials and Methods In this prospective study, participants with CHD underwent 4D MUSIC MRI at 3.0 T or 1.5 T between 2014 and 2020. From a pool of 460 total studies, an equal number of MRI studies from three sites (n = 60) was chosen for detailed analysis. With use of a five-point scale, the feasibility of 4D MUSIC was scored on the basis of artifacts, image quality, and diagnostic confidence for intracardiac and vascular connections (n = 780). Respiratory motion suppression was assessed by using the signal intensity profile. Bias between 4D MUSIC and two-dimensional (2D) cine imaging was evaluated by using Bland-Altman analysis; 4D MUSIC examination duration was compared with that of the local standard for CHD. Results A total of 206 participants with CHD underwent MRI at 3.0 T, and 254 participants underwent MRI at 1.5 T. Of the 60 MRI examinations chosen for analysis (20 per site; median participant age, 14.4 months [interquartile range, 2.3-49 months]; 33 female participants), 56 (93%) had good or excellent image quality scores across a spectrum of disease complexity (mean score ± standard deviation: 4.3 ± 0.6 for site 1, 4.9 ± 0.3 for site 2, and 4.6 ± 0.7 for site 3; P < .001). Artifact scores were inversely related to image quality (r = -0.88, P < .001) and respiratory motion suppression (P < .001, r = -0.45). Diagnostic confidence was high or definite in 730 of 780 (94%) intracardiac and vascular connections. The correlation between 4D MUSIC and 2D cine ventricular volumes and ejection fraction was high (range of r = 0.72-0.85; P < .001 for all). Compared with local standard MRI, 4D MUSIC reduced the image acquisition time (44 minutes ± 20 vs 12 minutes ± 3, respectively; P < .001). Conclusion Four-dimensional multiphase steady-state imaging with contrast enhancement MRI in pediatric congenital heart disease was feasible in a multicenter setting, shortened the examination time, and simplified the acquisition protocol, independently of disease complexity. Clinical trial registration no. NCT02752191 © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Roest and Lamb in this issue.
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Affiliation(s)
- Kim-Lien Nguyen
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Reena M Ghosh
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Lindsay M Griffin
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Takegawa Yoshida
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Arash Bedayat
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Cynthia K Rigsby
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Mark A Fogel
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Kevin K Whitehead
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - Peng Hu
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
| | - J Paul Finn
- From the Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences (K.L.N., T.Y., A.B., P.H., J.P.F.), and Division of Cardiology (K.L.N.), David Geffen School of Medicine at UCLA, 300 Medical Plaza, B119, Los Angeles, CA 90095; VA Greater Los Angeles Healthcare System, Los Angeles, Calif (K.L.N.); Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa (R.M.G., M.A.F., K.K.W.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital, Chicago, Ill (L.M.G., C.K.R.); and Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.M.G., C.K.R.)
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Moore JP, Gallotti R, Su J, Nguyen HL, Bedayat A, Prosper A, Buch E. Pulmonary vein and left atrial posterior wall isolation for the treatment of atrial fibrillation: Comparable outcomes for adults with congenital heart disease. J Cardiovasc Electrophysiol 2021; 32:1868-1876. [PMID: 33821546 DOI: 10.1111/jce.15027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Optimal treatment strategies for ACHD with AF are unknown. This study sought to assess outcomes of pulmonary vein isolation (PVI) ± left atrial (LA), posterior wall isolation (PWI) for adults with congenital heart disease (ACHD), and atrial fibrillation (AF). METHODS A retrospective review of all cryoballoon (CB) PVI ± PWI procedures at a single center over a 3-year period were performed. Clinical characteristics and outcomes for patients with and without ACHD were compared. The primary outcome was the occurrence of atrial tachyarrhythmia at 12-months postablation after a 90-day blanking period. RESULTS Three-hundred and sixteen patients (mean: 63 ± 12 years, [63% male]) underwent CB PVI ± PWI during the study, including 31 (10%) ACHD (simple 35%, moderate 39% complex 26%; nonparoxysmal AF in 52%). ACHD was younger (51 vs. 64 years; p < .001) with a lower CHADS2 DS2 -VASc score (1.2 vs. 2.1; p = .001) but had a greater LA diameter (4.9 vs. 4.0 cm; p < .001) and a number of prior cardioversions (0.9 vs. 0.4; p < .001) versus controls. 12-month freedom from recurrent AF was similar for ACHD and controls (76% vs. 80%; p = .6) and remained nonsignificant in multivariate analysis (hazard ratio: 1.8, 95% confidence interval: 0.7-5.1; p = .22). At 12-months postablation, 75% of ACHD versus 93% of control patients were off antiarrhythmic drug therapy (p = .07). CONCLUSION This study demonstrates younger age and lower conventional stroke risk, yet clinically advanced AF for ACHD relative to controls. CB PVI ± PWI was an effective strategy for the treatment of AF among all forms of ACHD with similar 12-month outcomes as compared to controls.
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Affiliation(s)
- Jeremy P Moore
- Ahmanson/UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine, Los Angeles, California, USA.,UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California, USA
| | - Roberto Gallotti
- Ahmanson/UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine, Los Angeles, California, USA.,UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California, USA
| | - Jonathan Su
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Heajung L Nguyen
- UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California, USA
| | - Arash Bedayat
- Department of Radiological Sciences, Thoracic and Diagnostic Cardiovascular Imaging, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Ashley Prosper
- Department of Radiological Sciences, Thoracic and Diagnostic Cardiovascular Imaging, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Eric Buch
- UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California, USA
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14
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Bedayat A, Jalili MH, Hassani C, Chalian H, Reuhm S, Moriarty J. CT evaluation of unrepaired/incidental congenital cardiovascular diseases in adults. Diagn Interv Imaging 2020; 102:213-224. [PMID: 34102129 DOI: 10.1016/j.diii.2020.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/25/2022]
Abstract
Congenital heart disease (CHD) affects approximately one million people in the USA with the number increasing by 5% each year. Patients are usually both diagnosed and treated in infancy, however many of them may have subclinical CHD that remains undiagnosed until late adulthood. Patients with complex CHD tend to be symptomatic and are diagnosed at a younger age than those with a single defect. CHDs can be divided into three categories, including cardiac, great vessels and coronary artery anomalies. Recent advances in computed tomography (CT) technology with faster acquisition time and improved spatial resolution allow for detailed evaluation of cardiac morphology and function. The concomitant increased utilization of CT has simultaneously led to more sensitive detection and more thorough diagnosis of CHD. Recognition of and understanding the imaging attributes specific to each anomaly is important for radiologists in order to make a correct and definite diagnosis. This article reviews the spectrum of CHDs, which persist into adulthood that may be encountered by radiologists on CT.
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Affiliation(s)
- Arash Bedayat
- Department of Radiological Sciences, Thoracic and Diagnostic Cardiovascular Imaging, David Geffen School of Medicine, 90095 Los Angeles, CA, USA.
| | - Mohammad H Jalili
- Department of Radiological Sciences, Thoracic and Diagnostic Cardiovascular Imaging, David Geffen School of Medicine, 90095 Los Angeles, CA, USA
| | - Cameron Hassani
- Department of Radiological Sciences, Thoracic and Diagnostic Cardiovascular Imaging, David Geffen School of Medicine, 90095 Los Angeles, CA, USA
| | - Hamid Chalian
- Department of Radiology, Duke University Medical Center, 27710 Durham, NC, USA
| | - Stefan Reuhm
- Department of Radiological Sciences, Thoracic and Diagnostic Cardiovascular Imaging, David Geffen School of Medicine, 90095 Los Angeles, CA, USA
| | - John Moriarty
- Department of Radiological Sciences, Thoracic and Diagnostic Cardiovascular Imaging, David Geffen School of Medicine, 90095 Los Angeles, CA, USA
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15
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Chiang J, Hebroni F, Bedayat A, Pourzand L. Case 286. Radiology 2020; 297:237-238. [PMID: 32956029 DOI: 10.1148/radiol.2020191246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
History A 70-year-old man had a posterior left thigh lesion confirmed to be biopsy-proven melanoma. The patient underwent wide excision and sentinel node biopsy, which showed absence of residual melanoma. Two years later, the patient noticed a subcentimeter subcutaneous lump in his thigh. Repeat excisional biopsy showed involvement of the surrounding soft tissue, consistent with a satellite lesion. Follow-up combined PET/CT revealed satellite nodules around the primary lesion, enabling confirmation of subcutaneous metastatic disease. The patient was subsequently started on nivolumab, an anti-programmed cell death 1 (PD-1) immune checkpoint inhibitor that blocks PD-1 and is approved as a first-line treatment in patients with advanced metastatic melanoma. On the baseline scan prior to starting nivolumab, there were no CT findings that suggested metastatic disease, nor were there enlarged mediastinal or hilar lymph nodes. Five months after initiation of nivolumab treatment, the first follow-up chest CT scan was performed and showed new findings in the mediastinum (Fig 1) and bilateral lungs (Figs 2, 3). The patient remained asymptomatic during the treatment period. Furthermore, the subcutaneous metastatic disease remained stable during the treatment period, and no other site of metastatic disease was noted on follow-up CT scans obtained during the first 5 months of treatment. The patient had no prior history of infectious or occupational exposures. During the nivolumab treatment cycle, his pertinent laboratory values and physical examination findings were unremarkable.
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Affiliation(s)
- Jason Chiang
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
| | - Frank Hebroni
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
| | - Arash Bedayat
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
| | - Lila Pourzand
- From the Department of Radiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095
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16
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Bedayat A, Hassani C, Prosper AE, Chalian H, Khoshpouri P, Ruehm SG. Recent Innovations in Renal Vascular Imaging. Radiol Clin North Am 2020; 58:781-796. [DOI: 10.1016/j.rcl.2020.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Ansari-Gilani K, Chalian H, Rassouli N, Bedayat A, Kalisz K. Chronic airspace disease: Review of the causes and key computed tomography findings. World J Radiol 2020; 12:29-47. [PMID: 32368328 PMCID: PMC7191307 DOI: 10.4329/wjr.v12.i4.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/09/2019] [Accepted: 01/28/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic airspace diseases are commonly encountered by chest, body or general radiologists in everyday practice. Even though there is significant overlap in the imaging findings of different causes of chronic airspace disease, some key clinical, laboratory and imaging findings can be used to guide the radiologist to the correct diagnosis. The goal of this article is to review and compare these features.
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Affiliation(s)
- Kianoush Ansari-Gilani
- Department of Radiology, University Hospitals, Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Hamid Chalian
- Department of Radiology, Duke University Medical Center, Durham, NC 27705, United States
| | - Negin Rassouli
- Department of Radiology, University Hospitals, Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Arash Bedayat
- Department of Radiological Sciences, University of California-Los Angeles, Los Angeles, CA 90095, United States
| | - Kevin Kalisz
- Department of Radiology, Northwestern University, Chicago, IL 60611, United States
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18
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Bedayat A, Yang E, Ghandili S, Galera P, Chalian H, Ansari-Gilani K, Guo HH. Tracheobronchial Tumors: Radiologic-Pathologic Correlation of Tumors and Mimics. Curr Probl Diagn Radiol 2019; 49:275-284. [PMID: 31076268 PMCID: PMC7115773 DOI: 10.1067/j.cpradiol.2019.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/19/2019] [Accepted: 04/02/2019] [Indexed: 12/26/2022]
Abstract
Tracheobronchial masses encompass a broad spectrum of entities, ranging from benign and malignant neoplasms to infectious and inflammatory processes. This article reviews the cross-sectional findings of tracheal tumors and tumor-like entities, correlates imaging findings with histologic pathology, and discusses pearls and pitfalls in accurately diagnosing and classifying tracheal tumors and mimics.
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Affiliation(s)
- Arash Bedayat
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA.
| | - Eric Yang
- Department of Pathology, Stanford University Medical center, Stanford, CA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Saeed Ghandili
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Pallavi Galera
- Department of Pathology, University of Massachusetts Medical School, Worcester, MA, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Hamid Chalian
- Department of Radiology, Duke University, Durham, NC, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Kianoush Ansari-Gilani
- Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Heiwei Henry Guo
- Department of Radiology, Duke University, Durham, NC, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
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Bedayat A, Chen BY, Hayim M, Zheng L, Gagne SM, Mcintosh LJ, Deng AC, Lo HS. A Private Investigation: Radiologic-Pathologic Correlation of Testicular Tumors. Curr Probl Diagn Radiol 2017; 46:242-256. [DOI: 10.1067/j.cpradiol.2016.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 05/17/2016] [Indexed: 01/08/2023]
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20
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Affiliation(s)
- Arash Bedayat
- Department of Radiology; University of Massachusetts Medical School; Worcester Massachusetts
| | - Marjan Mirzabeigi
- Department of Pathology; University of Massachusetts Medical School; Worcester Massachusetts
| | - Hongbo Yu
- Department of Pathology; University of Massachusetts Medical School; Worcester Massachusetts
| | - Rebecca Hultman
- Department of Radiology; University of Massachusetts Medical School; Worcester Massachusetts
| | - Sue MacMaster
- Department of Radiology; University of Massachusetts Medical School; Worcester Massachusetts
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21
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Yu S, Kumamaru KK, George E, Dunne RM, Bedayat A, Neykov M, Hunsaker AR, Dill KE, Cai T, Rybicki FJ. Classification of CT pulmonary angiography reports by presence, chronicity, and location of pulmonary embolism with natural language processing. J Biomed Inform 2014; 52:386-93. [PMID: 25117751 DOI: 10.1016/j.jbi.2014.08.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/01/2014] [Accepted: 08/01/2014] [Indexed: 11/17/2022]
Abstract
In this paper we describe an efficient tool based on natural language processing for classifying the detail state of pulmonary embolism (PE) recorded in CT pulmonary angiography reports. The classification tasks include: PE present vs. absent, acute PE vs. others, central PE vs. others, and subsegmental PE vs. others. Statistical learning algorithms were trained with features extracted using the NLP tool and gold standard labels obtained via chart review from two radiologists. The areas under the receiver operating characteristic curves (AUC) for the four tasks were 0.998, 0.945, 0.987, and 0.986, respectively. We compared our classifiers with bag-of-words Naive Bayes classifiers, a standard text mining technology, which gave AUC 0.942, 0.765, 0.766, and 0.712, respectively.
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Affiliation(s)
- Sheng Yu
- Partners HealthCare Personalized Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States.
| | - Kanako K Kumamaru
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States
| | - Elizabeth George
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States
| | - Ruth M Dunne
- Thoracic Imaging, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States
| | - Arash Bedayat
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States; Department of Radiology, University of Massachusetts Medical School, Worcester, MA, United States
| | - Matey Neykov
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, United States
| | - Andetta R Hunsaker
- Thoracic Imaging, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States
| | - Karin E Dill
- Department of Radiology, University of Chicago, Chicago, IL, United States
| | - Tianxi Cai
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, United States
| | - Frank J Rybicki
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States
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22
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Kumamaru KK, Hunsaker AR, Kumamaru H, George E, Bedayat A, Rybicki FJ. Correlation between early direct communication of positive CT pulmonary angiography findings and improved clinical outcomes. Chest 2014; 144:1546-1554. [PMID: 23828207 DOI: 10.1378/chest.13-0308] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Despite a general consensus that rapid communication of critical radiology findings from radiologists to referring physicians is imperative, a possible association with superior patient outcomes has not been confirmed. The objective of this study was to evaluate the correlation between early direct communication of CT image findings by radiologists to referring physicians and better clinical outcomes in patients with acute pulmonary embolism (PE). METHODS This was a retrospective, single-institution, cohort study that included 796 consecutive patients (February 2006 to March 2010) who had acute PE confirmed by CT pulmonary angiography (CTPA) and whose treatment had not been initiated at the time of CTPA acquisition. The time from CTPA to direct communication of the diagnosis was evaluated for its association with time from CTPA to treatment initiation and with 30-day mortality. Cox regression analysis was performed with inverse probability weighting by propensity scores calculated using 20 potential confounding factors. RESULTS In 93.4% of patients whose first treatment was anticoagulation, the referring physicians started treatment after receiving direct notification of the diagnosis from the radiologist. Late communication (> 1.5 h after CTPA; n = 291) was associated with longer time to treatment initiation (adjusted hazard ratio [HR], 0.714; 95% CI, 0.610-0.836; P < .001) and higher all-cause and PE-related 30-day mortality (HR, 1.813; 95% CI, 1.163-2.828; P = .009; and HR, 2.625; 95% CI, 1.362-5.059; P = .004, respectively). CONCLUSIONS Delay (> 1.5 h of CTPA acquisition) in direct communication of acute PE diagnosis from radiologists to referring physicians was significantly correlated with a higher risk of delayed treatment initiation and death within 30 days.
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Affiliation(s)
- Kanako K Kumamaru
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Andetta R Hunsaker
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Hiraku Kumamaru
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Elizabeth George
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Arash Bedayat
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Frank J Rybicki
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA.
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23
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Parast L, Cai B, Bedayat A, Kumamaru KK, George E, Dill KE, Rybicki FJ. Statistical methods for predicting mortality in patients diagnosed with acute pulmonary embolism. Acad Radiol 2012; 19:1465-73. [PMID: 23122566 DOI: 10.1016/j.acra.2012.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 09/17/2012] [Accepted: 09/18/2012] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES Risk stratification in pulmonary embolism (PE) guides patient management. The purpose of this study was to develop and test novel mortality risk prediction models for subjects with acute PE diagnosed using computed tomographic pulmonary angiography in a large cohort with comprehensive clinical data. MATERIALS AND METHODS Retrospective analyses of 1596 consecutive subjects diagnosed with acute PE from a single, large, urban teaching hospital included two modern statistical methods to predict survival in patients with acute PE. Landmark analysis was used for 90-day mortality. Adaptive least absolute shrinkage and selection operator (aLASSO), a penalization method, was used to select variables important for prediction and to estimate model coefficients. Receiver-operating characteristic analysis was used to evaluate the resulting prediction rules. RESULTS Using 30-day all-cause mortality outcome, three of the 16 clinical risk factors (the presence of a known malignancy, coronary artery disease, and increased age) were associated with high risk, while subjects treated with anticoagulation had lower risk. For 90-day landmark mortality, subjects with recent operations had a lower risk for death. Both prediction rules developed using aLASSO performed well compared to standard logistic regression. CONCLUSIONS The aLASSO regression approach combined with landmark analysis provides a novel tool for large patient populations and can be applied for clinical risk stratification among subjects diagnosed with acute PE. After positive results on computed tomographic pulmonary angiography, the presence of a known malignancy, coronary artery disease, and advanced age increase 30-day mortality. Additional risk stratification can be simplified with these methods, and future work will place imaging-based prediction of mortality in perspective with other clinical data.
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Affiliation(s)
- Layla Parast
- Department of Biostatistics, Harvard University, Cambridge, MA, USA
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24
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Mehrazma M, Otukesh H, Madani A, Hooman N, Bedayat A, Dianati Maleki N, Ehteshami Afshar A, Hoseini R. Histopathologic and clinical findings of congenital nephrotic syndrome in Iranian children: a study of two centers. Iran J Kidney Dis 2012; 6:426-431. [PMID: 23146979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 06/09/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Congenital nephrotic syndrome (CNS), an uncommon form of kidney disease, presents during the first year of life and is a diagnostic and therapeutic challenge for the pediatricians as well as pediatric nephrologists. Our study is the first study of Iranian children with CNS in two pediatric nephrology centers in Tehran, Iran. MATERIALS AND METHODS We reviewed medical charts of 30 infants diagnosed with CNS from 1990 to 2005. RESULTS There were 15 boys and 15 girls with CNS (mean age, 1.7 months). The presentation of the disease was nephrotic syndrome in 96.6% of the patients. Eighty percent of the patients presented within 3 months of life and 16 in the neonatal period. The Finnish type of CNS was seen in 43.3% and diffuse mesangial sclerosis in 50%. Preterm labor and low birth weight was seen in 20%. A family history of nephrotic syndrome in infancy was noted for 8 children (26.7%). Numerous complications of nephrotic syndrome occurred in 73.3%. Seventy percent of the patients had 27 episodes of infections. Sepsis was seen in 43.3% of the children, of which 61.5% were caused by gram-negative bacteria and 38.6% were caused by Staphylococcus aureus. Thrombotic complications and hypertension developed in 6.6% and 23.3% of the patients, respectively. The mortality rate of patients was 86.6%. CONCLUSIONS Diffuse mesangial sclerosis is an important cause of CNS. The outcome of our patients was poor and most of our patients died before reaching the age of 5 years old.
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Affiliation(s)
- Mitra Mehrazma
- Department of Pathology and Oncopathology Research Center, Ali-Asghar Children Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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25
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Kumamaru KK, Hunsaker AR, Bedayat A, Soga S, Signorelli J, Adams K, Wake N, Lu MT, Rybicki FJ. Subjective assessment of right ventricle enlargement from computed tomography pulmonary angiography images. Int J Cardiovasc Imaging 2011; 28:965-73. [PMID: 21670986 DOI: 10.1007/s10554-011-9903-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 05/27/2011] [Indexed: 11/25/2022]
Abstract
To retrospectively evaluate prognostic accuracy of subjective assessment of right ventricle (RV) enlargement on CT pulmonary angiography (CTPA) images in comparison with objective measures of RV enlargement in patients with acute pulmonary embolism (PE). For 200 consecutive patients with acute PE, two readers blinded to patient outcomes subjectively determined whether the maximum RV diameter was greater than that of the left ventricle (LV) using axial CTPA images. For the objective measurements, RV/LV diameter ratios were calculated using axial images and 4-chamber reformatted images. For all assessments, sensitivities and specificities for predicting PE-related death within 30-days and a composite outcome including PE-related death or the need for intensive therapies were compared. The agreement between two readers was 91.5% (kappa = 0.83) and all other assessments had pair-wise agreement over 75% (kappa = 0.53-0.72). There was no significant difference in sensitivity between the subjective and objective methods for predicting both outcomes. The specificity for subjective RV enlargement (55.4-67.7%) was significantly higher than objective measures (45.8-53.1%), except for the 4-chamber views where, for one reader, the specificity of the subjective evaluation was higher but did not reach statistical significance. Complex measurements of RV/LV diameter ratios may not be needed to maximize the prognostic value from CTPA. The radiologist who interprets the CTPA images should report RV enlargement when the RV diameter subjectively appears larger than the LV.
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Affiliation(s)
- Kanako K Kumamaru
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
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Montazeri F, Bedayat A, Jamali L, Salehian M, Montazeri G. Leech endoparasitism: report of a case and review of the literature. Eur J Pediatr 2009; 168:39-42. [PMID: 18548278 DOI: 10.1007/s00431-008-0706-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Accepted: 02/26/2008] [Indexed: 11/25/2022]
Abstract
We report the case of an 11-year-old boy who presented with fresh blood in his mouth and a history of sore throat during the past 2 weeks that was unresponsive to antibiotic therapy. Inspection of the oral cavity revealed a black circular mass attached to the posterior wall of the oropharynx. This mass was determined to be a live engorged leech. Leech endoparasitism is caused by aquatic leeches that attach themselves to mucus membranes of body cavities after the host has swum in bodies of fresh water or drunk from unsafe water sources. Pharyngeal hirudiniasis may present in different forms depending on the exact location of the parasite in the body and must be included in the list of differential diagnosis for common conditions such as pharyngitis, hemoptysis or anemia in pediatric patients living in endemic areas.
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Affiliation(s)
- Farhad Montazeri
- Digestive Disease Research Center, Shariati Hospital, Medical sciences/Tehran University, 72, Karegar Shomali Avenue, 17th street, 1438837431, Tehran, Iran.
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Montazeri F, Montazeri G, Bedayat A, Sedighi N. A case of concomitant autosomal recessive osteopetrosis and G6PD deficiency. Ann Hematol 2007; 87:333-5. [DOI: 10.1007/s00277-007-0392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2007] [Accepted: 09/17/2007] [Indexed: 11/29/2022]
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Otukesh H, Chalian M, Hoseini R, Chalian H, Hooman N, Bedayat A, Yazdi RS, Sabaghi S, Mahdavi S. Urine macrophage migration inhibitory factor in pediatric systemic lupus erythematosus. Clin Rheumatol 2007; 26:2105-2107. [PMID: 17479310 DOI: 10.1007/s10067-007-0632-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2006] [Revised: 03/29/2007] [Accepted: 04/11/2007] [Indexed: 11/25/2022]
Abstract
We reported a series of ten patients with lupus nephritis (five patients in the relapse phase and five in the remission phase) and measured the macrophage migration inhibitory factor (MIF), an important pro-inflammatory cytokine with probable role in the pathogenesis of many inflammatory diseases, in their urine samples. MIF/creatinine (Cr) ratio directly correlated with disease activity and it does not have any significant difference between inactive disease and normal ones. We found that the urine MIF/Cr ratio not only differentiates active disease from inactive disease and normal ones but also correlates with the activity indices of renal pathology.
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Affiliation(s)
| | | | | | | | | | | | - Reza Salman Yazdi
- Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Saeed Sabaghi
- Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Saeed Mahdavi
- Iran University of Medical Sciences and Health Services, Tehran, Iran
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