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Singh S, Dehghani Firouzabadi F, Chaurasia A, Homayounieh F, Ball MW, Huda F, Turkbey EB, Linehan WM, Malayeri AA. CT-derived radiomics predict the growth rate of renal tumours in von Hippel-Lindau syndrome. Clin Radiol 2024:S0009-9260(24)00080-1. [PMID: 38383255 DOI: 10.1016/j.crad.2024.01.029] [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] [Received: 06/22/2023] [Revised: 12/26/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024]
Abstract
AIM To predict renal tumour growth patterns in von Hippel-Lindau syndrome by utilising radiomic features to assist in developing personalised surveillance plans leading to better patient outcomes. MATERIALS AND METHODS The study evaluated 78 renal tumours in 55 patients with histopathologically-confirmed clear cell renal cell carcinomas (ccRCCs), which were segmented and radiomics were extracted. Volumetric doubling time (VDT) classified the tumours into fast-growing (VDT <365 days) or slow-growing (VDT ≥365 days). Volumetric and diametric growth analyses were compared between the groups. Multiple logistic regression and random forest classifiers were used to select the best features and models based on their correlation and predictability of VDT. RESULTS Fifty-five patients (mean age 42.2 ± 12.2 years, 27 men) with a mean time difference of 3.8 ± 2 years between the baseline and preoperative scans were studied. Twenty-five tumours were fast-growing (low VDT, i.e., <365 days), and 53 tumours were slow-growing (high VDT, i.e., ≥365 days). The median volumetric and diametric growth rates were 1.71 cm3/year and 0.31 cm/year. The best feature using univariate analysis was wavelet-HLL_glcm_ldmn (area under the receiver operating characteristic [ROC] curve [AUC] of 0.80, p<0.0001), and with the random forest classifier, it was log-sigma-0-5-mm-3D_glszm_ZonePercentage (AUC: 79). The AUC of the ROC curves using multiple logistic regression was 0.74, and with the random forest classifier was 0.73. CONCLUSION Radiomic features correlated with VDT and were able to predict the growth pattern of renal tumours in patients with VHL syndrome.
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Affiliation(s)
- S Singh
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - F Dehghani Firouzabadi
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - A Chaurasia
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - F Homayounieh
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - M W Ball
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - F Huda
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - E B Turkbey
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - W M Linehan
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - A A Malayeri
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
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Nikpanah M, Dehghani Firouzabadi F, Farhadi F, Mirmomen SM, Ahlman MA, Huda F, Millo C, Saboury B, Paschall AK, Gahl WA, Estrada-Veras JI, Turkbey E, Jones EC, O'Brien K, Malayeri AA. Skeletal involvement in Erdheim-Chester disease: Multimodality imaging features and association with the BRAF V600E mutation. Clin Imaging 2024; 106:110067. [PMID: 38128404 DOI: 10.1016/j.clinimag.2023.110067] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/01/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The aim of this study was to characterize the distribution of skeletal involvement in Erdheim-Chester disease (ECD) by using radiography, computed tomography (CT), 18F-FDG positron emission tomography/computed tomography (PET/CT), and bone scans, as well as looking for associations with the BRAFV600E mutation. MATERIAL AND METHODS Prospective study of 50 consecutive patients with biopsy-confirmed ECD who had radiographs, CT, 18F-FDG PET/CT, and Tc-99m MDP bone scans. At least two experienced radiologists with expertise in the relevant imaging studies analyzed the images. Summary statistics were expressed as the frequency with percentages for categorical data. Fisher's exact test, as well as odds ratios (OR) with 95 % confidence intervals (CI), were used to link imaging findings to BRAFV600E mutation. The probability for co-occurrence of bone involvement at different locations was calculated and graphed as a heat map. RESULTS All 50 cases revealed skeletal involvement at different regions of the skeleton. The BRAFV600E mutation, which was found in 24 patients, was correlated with femoral and tibial involvement on 18F-FDG PET/CT and bone scan. The appearance of changes on the femoral, tibial, fibular, and humeral involvement showed correlation with each other based on heat maps of skeletal involvement on CT. CONCLUSION This study reports the distribution of skeletal involvement in a cohort of patients with ECD. CT is able to detect the majority of ECD skeletal involvement. Considering the complementary nature of information from different modalities, imaging of ECD skeletal involvement is optimized by using a multi-modality strategy.
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Affiliation(s)
- Moozhan Nikpanah
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fatemeh Dehghani Firouzabadi
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Faraz Farhadi
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - S Mojdeh Mirmomen
- Department of Radiology, UC San Diego School of Medicine, San Diego, CA, USA
| | - Mark A Ahlman
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Fahimul Huda
- Department of Radiology, University of Louisville School of Medicine, KY, USA
| | - Corina Millo
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Babak Saboury
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Anna K Paschall
- Duke University Health System, School of Medicine, Durham, NC, USA
| | - William A Gahl
- National Human Genome Research Institute, Medical Genetics Branch, Office of the Clinical Director, National Institutes of Health, Bethesda, MD, USA
| | - Juvianee I Estrada-Veras
- National Human Genome Research Institute, Medical Genetics Branch, Office of the Clinical Director, National Institutes of Health, Bethesda, MD, USA
| | - Evrim Turkbey
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth C Jones
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Kevin O'Brien
- National Human Genome Research Institute, Medical Genetics Branch, Office of the Clinical Director, National Institutes of Health, Bethesda, MD, USA.
| | - Ashkan A Malayeri
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
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Huda F, Abdelmonem A, Dehghani Firouzabadi F, Srinivas Dola VN, Sheikhy A, Taheri MR. The role of arachnoid granulations in idiopathic intracranial hypertension. Neuroradiol J 2023; 36:651-656. [PMID: 37102274 PMCID: PMC10649532 DOI: 10.1177/19714009231173109] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
OBJECTIVES Idiopathic intracranial hypertension (IIH) is a disease defined by elevated intracranial pressure (ICP) without an established etiology. Arachnoid granulations (AG) are conduits for CSF resorption from the subarachnoid space to the venous system. AG have been implicated to play a central role in maintaining CSF homeostasis. We tested the hypothesis that patients with fewer visible AG on MRI are more likely to present with IIH. METHODS In this institutional review board (Institutional Review Board)-approved retrospective chart review study, 65 patients with a clinical diagnosis of idiopathic intracranial hypertension were compared to 144 control patients who met inclusion/exclusion criteria. Patients' signs and symptoms pertaining to IIH were obtained through the electronic medical record Brain MR images were reviewed for the number and distribution of AGs indenting the dural venous sinuses. The presence of imaging and clinical findings associated with long standing increased ICP was noted. Propensity score method (with inverse probability weighting technique) was used to compare case and control groups. RESULTS In the control group, the number of AG indenting the dural venous sinuses on MRI (NAG) was lower in women compared to men when matched for age (20-45 yo) and BMI (>30 kg/m2). The NAG was lower in 20-45 yo females in the IIH group as compared to the 20-45 yo females in the control group. This statistically significant difference persists when controlled for BMI. In contrast, the NAG in >45 yo females in the IIH group trended higher compared to the >45 yo females in the control group. CONCLUSION Our results suggest that alterations in arachnoid granulations could play a role in the development of IIH.
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Affiliation(s)
- Fahimul Huda
- Department of Radiology, The George Washington University Hospital, Washington, DC, USA
| | - Ahmed Abdelmonem
- Department of Radiology, The George Washington University Hospital, Washington, DC, USA
| | | | | | - Ali Sheikhy
- Tehran University of Medical Sciences Non-Communicable Disease Research Center, Tehran, Iran
| | - M Reza Taheri
- Department of Radiology, The George Washington University Hospital, Washington, DC, USA
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Hsu LY, Ali Z, Bagheri H, Huda F, Redd BA, Jones EC. Comparison of CT and Dixon MR Abdominal Adipose Tissue Quantification Using a Unified Computer-Assisted Software Framework. Tomography 2023; 9:1041-1051. [PMID: 37218945 DOI: 10.3390/tomography9030085] [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: 04/15/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023] Open
Abstract
PURPOSE Reliable and objective measures of abdominal fat distribution across imaging modalities are essential for various clinical and research scenarios, such as assessing cardiometabolic disease risk due to obesity. We aimed to compare quantitative measures of subcutaneous (SAT) and visceral (VAT) adipose tissues in the abdomen between computed tomography (CT) and Dixon-based magnetic resonance (MR) images using a unified computer-assisted software framework. MATERIALS AND METHODS This study included 21 subjects who underwent abdominal CT and Dixon MR imaging on the same day. For each subject, two matched axial CT and fat-only MR images at the L2-L3 and the L4-L5 intervertebral levels were selected for fat quantification. For each image, an outer and an inner abdominal wall regions as well as SAT and VAT pixel masks were automatically generated by our software. The computer-generated results were then inspected and corrected by an expert reader. RESULTS There were excellent agreements for both abdominal wall segmentation and adipose tissue quantification between matched CT and MR images. Pearson coefficients were 0.97 for both outer and inner region segmentation, 0.99 for SAT, and 0.97 for VAT quantification. Bland-Altman analyses indicated minimum biases in all comparisons. CONCLUSION We showed that abdominal adipose tissue can be reliably quantified from both CT and Dixon MR images using a unified computer-assisted software framework. This flexible framework has a simple-to-use workflow to measure SAT and VAT from both modalities to support various clinical research applications.
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Affiliation(s)
- Li-Yueh Hsu
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10, Room 1C370, 10 Center Drive, Bethesda, MA 20892, USA
| | - Zara Ali
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10, Room 1C370, 10 Center Drive, Bethesda, MA 20892, USA
| | - Hadi Bagheri
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10, Room 1C370, 10 Center Drive, Bethesda, MA 20892, USA
| | - Fahimul Huda
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10, Room 1C370, 10 Center Drive, Bethesda, MA 20892, USA
| | - Bernadette A Redd
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10, Room 1C370, 10 Center Drive, Bethesda, MA 20892, USA
| | - Elizabeth C Jones
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10, Room 1C370, 10 Center Drive, Bethesda, MA 20892, USA
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Chaurasia A, Gopal N, Dehghani Firouzabadi F, Yazdian Anari P, Wakim P, Ball MW, Jones EC, Turkbey B, Huda F, Linehan WM, Turkbey EB, Malayeri AA. Role of ultra-high b-value DWI in the imaging of hereditary leiomyomatosis and renal cell carcinoma (HLRCC). Abdom Radiol (NY) 2023; 48:340-349. [PMID: 36207629 PMCID: PMC10681094 DOI: 10.1007/s00261-022-03689-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome is associated with an aggressive form of renal cell carcinoma with high risk of metastasis, even in small primary tumors with unequivocal imaging findings. In this study, we compare the performance of ultra-high b-value diffusion-weighted imaging (DWI) sequence (b = 2000 s/mm2) to standard DWI (b = 800 s/mm2) sequence in identifying malignant lesions in patients with HLRCC. METHODS Twenty-eight patients (n = 18 HLRCC patients with 22 lesions, n = 10 controls) were independently evaluated by three abdominal radiologists with different levels of experience using four combinations of MRI sequences in two separate sessions (session 1: DWI with b-800, session 2: DWI with b-2000). T1 precontrast, T2-weighted (T2WI), and apparent diffusion coefficient (ADC) sequences were similar in both sessions. Each identified lesion was subjectively assessed using a six-point cancer likelihood score based on individual sequences and overall impression. RESULTS The ability to distinguish benign versus malignant renal lesions improved with the use of b-2000 for more experienced radiologists (Reader 1 AUC: Session 1-0.649 and Session 2-0.938, p = 0.017; Reader 2 AUC: Session 1-0.781 and Session 2-0.921, p = 0.157); whereas no improvement was observed for the less experienced reader (AUC: Session 1-0.541 and Session 2-0.607, p = 0.699). CONCLUSION The inclusion of ultra-high b-value DWI sequence improved the ability of classification of renal lesions in patients with HLRCC for experienced radiologists. Consideration should be given toward incorporation of DWI with b-2000 s/mm2 into existing renal MRI protocols.
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Affiliation(s)
- Aditi Chaurasia
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Nikhil Gopal
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Fatemeh Dehghani Firouzabadi
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Pouria Yazdian Anari
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Paul Wakim
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Mark W Ball
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth C Jones
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Baris Turkbey
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Fahimul Huda
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - W Marston Linehan
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Evrim B Turkbey
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Ashkan A Malayeri
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA.
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Kaliaev A, Chavez W, Soto J, Huda F, Xie H, Nguyen M, Shamdasani V, Anderson S. Quantitative Ultrasound Assessment of Hepatic Steatosis. J Clin Exp Hepatol 2022; 12:1091-1101. [PMID: 35814521 PMCID: PMC9257875 DOI: 10.1016/j.jceh.2022.01.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS Non-alcoholic fatty liver disease (NAFLD) is widespread chronic disease of the live in humans with the prevalence of 30% of the United States population.1,2 The goal of the study is to validate the performance of quantitative ultrasound algorithms in the assessment of hepatic steatosis in patients with suspected NAFLD. METHODS This prospective study enrolled a total of 31 patients with clinical suspicion of NAFLD to receive liver fat measurements by quantitative ultrasound and reference MRI measurements (proton density fat-fraction, PDFF). The following ultrasound (US) parameters based on both raw ultrasound RF (Radio Frequency) data and 2D B-mode images of the liver were analyzed with subsequent correlation with MRI-PDFF: hepatorenal index, acoustic attenuation coefficient, Nakagami coefficient parameter, shear wave viscosity, shear wave dispersion and shear wave elasticity. Ultrasound parameters were also correlated with the presence of hypertension and diabetes. RESULTS The mean (± SD) age and body mass index of the patients were 49.03 (± 12.49) and 30.12 (± 6.15), respectively. Of the aforementioned ultrasound parameters, the hepatorenal index and acoustic attenuation coefficient showed a strong correlation with MRI-PDFF derivations of hepatic steatosis, with r-values of 0.829 and 0.765, respectively. None of the remaining US parameters showed strong correlations with PDFF. Significant differences in Nakagami parameters and acoustic attenuation coefficients were found in those patients with and without hypertension. CONCLUSIONS Hepatorenal index and acoustic attenuation coefficient correlate well with MRI-PDFF-derived measurements of hepatic steatosis. Quantitative ultrasound is a promising tool for the diagnosis and assessment of patients with NAFLD.
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Key Words
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- BMI, body mass index
- DICOM, digital imaging and communications in medicine
- HIPAA, health insurance portability and accountability act
- HRI, hepatorenal index
- Hgb A1C, hemoglobin A1C (glycated hemoglobin)
- IQ, in-phase quadrature
- IR, insulin resistance
- LDL, low-density lipoprotein
- MRI-PDFF, magnetic resonance imaging - proton density fat-fraction
- NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- RF, raw radio frequency
- ROI, regions of interest
- SD, standard deviation
- T2DM, type 2 diabetes mellitus
- US, ultrasound
- liver fat quantification
- non-alcoholic fatty liver disease
- ultrasound
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Affiliation(s)
- Artem Kaliaev
- Boston University Medical Center, Department of Radiology, Boston, MA, USA,Address for correspondence: Artem Kaliaev, Department of Radiology, Boston University Medical Center, 820 Harrison Ave, Boston, MA 02118, USA.
| | - Wilson Chavez
- Boston University Medical Center, Department of Radiology, Boston, MA, USA
| | - Jorge Soto
- Boston University Medical Center, Department of Radiology, Boston, MA, USA
| | - Fahimul Huda
- Boston University Medical Center, Department of Radiology, Boston, MA, USA
| | - Hua Xie
- Ultrasound Imaging and Interventions, Philips Research North America, Cambridge, MA, USA
| | - Man Nguyen
- Ultrasound Imaging and Interventions, Philips Research North America, Cambridge, MA, USA
| | | | - Stephan Anderson
- Boston University Medical Center, Department of Radiology, Boston, MA, USA
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Huda F, LeBedis CA, Qureshi MM, Anderson SW, Gupta A. Acute cholecystitis: diagnostic value of dual-energy CT-derived iodine map and low-keV virtual monoenergetic images. Abdom Radiol (NY) 2021; 46:5125-5133. [PMID: 34223959 DOI: 10.1007/s00261-021-03202-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To compare conventional and dual-energy CT (DECT) for the diagnosis of acute cholecystitis and gangrene. METHODS Fifty-seven consecutive adult patients with abdominal pain who underwent IV contrast-enhanced abdominal DECT on a dual-layer (dlDECT) or rapid-switching (rsDECT) scanner from September, 2018 to April, 2021 with cholecystectomy and pathology-confirmed cholecystitis were retrospectively reviewed, and compared with 57 consecutive adult patients without cholecystitis from the same interval scanned with DECT. Images were reviewed independently by two abdominal radiologists with 12 and 16 years of experience in two sessions 4 weeks apart, blinded to clinical data. Initially, only blended reconstructions (simulating conventional single-energy CT images) were reviewed (CT). Subsequently, CT and DECT reconstructions including low-keV virtual monoenergetic images and iodine maps were reviewed. Gallbladder fossa hyperemia, pericholecystic fluid, subjective presence of gangrene, heterogeneous wall enhancement, sloughed membranes, intramural air, abscess, overall impression of the presence of acute cholecystitis, and intramural iodine density were assessed. RESULTS Gallbladder fossa hyperemia was detected with increased sensitivity on DECT (R1, 61.4%; R2, 75.4%) vs. CT (R1, 22.8%; R2, 15.8%). DECT showed increased sensitivity for gangrene (R1, 24.6%; R2, 38.6%) vs. CT (R1, 5.3%; R2, 14%), heterogeneous wall enhancement (DECT: R1, 33.3%; R2, 63.2% vs. CT: R1, 7%; R2, 31.6%), and cholecystitis (DECT: R1, 86%; R2, 89.5% vs. CT: R1, 77.2%; R2, 70.2%). In addition, DECT was more sensitive for the detection of acute cholecystitis (R1, 86%; R2, 89.5%) vs. CT (R1, 77.2%; R2, 70.2%). Iodine density threshold of 1.2 mg/ml, 0.8 mg/mL, and 0.5 mg/mL showed specificity for gangrenous cholecystitis of 78.26%, 86.96%, and 95.65%, respectively, using the rsDECT platform. CONCLUSION DECT showed improved sensitivity compared to conventional CT for detection of acute cholecystitis. Iodine density measurements may be helpful to diagnose gangrene.
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Costenbader K, Huda F, Shand M, Brown D, Kraus M, Taheri R. Small subdural hemorrhages: Does size of intracranial hemorrhage impact symptoms after discharge? Am J Emerg Med 2021; 47:223-227. [PMID: 33915377 DOI: 10.1016/j.ajem.2021.03.053] [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] [Received: 01/26/2021] [Revised: 03/09/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022] Open
Abstract
INTRO Patients with small intracranial hemorrhage at initial presentation (ICHi) have a relatively uneventful hospital course, as compared with larger ICHi. In this study, we tested the null hypothesis that ICHi does not impact the symptom profile of patients with traumatic brain injury (TBI) after discharge. METHODS In this retrospective study, TBI patients over 18 years of age with a head CT at initial presentation and at least one follow-up visit between 2015 and 2018 were included. Those with vascular risk factors, major psychiatric comorbidities, neurologic disorders, and TBI / CT evidence of ICH within five years were excluded. Patients were stratified based on the presence or absence of ICHi. Symptom profiles were characterized during early (0-3 months post-TBI) and late follow up (4-12 months post-TBI). An adapted 15-question Post-Concussion Symptom Scale and a vestibulo-oculomotor (VOM) exam were assessed by a TBI specialist. We compared the age adjusted clinical symptom profiles between those with and without ICHi. RESULTS 69 patients met inclusion/exclusion criteria. 26 (37.8%) had ICHi and 43 (62.32%) did not have ICH. The severity of measured symptoms or VOM findings were not more severe in those with ICHi. Age-adjusted analyses did not show any effect on these outcomes. CONCLUSION ICHi does not impact the symptom profile of patients with TBI in either short or long term.
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Affiliation(s)
- Kyle Costenbader
- George Washington University, School of Medicine and Health Sciences, United States of America.
| | - Fahimul Huda
- George Washington University, School of Medicine and Health Sciences, United States of America.
| | - Muhammed Shand
- George Washington University, School of Medicine and Health Sciences, United States of America.
| | - Derek Brown
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, United States of America.
| | - Marilyn Kraus
- George Washington University, School of Medicine and Health Sciences, United States of America.
| | - Reza Taheri
- George Washington University, School of Medicine and Health Sciences, United States of America.
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Parenti V, Huda F, Richardson PK, Brown D, Aulakh M, Taheri MR. Lumbar arachnoiditis: Does imaging associate with clinical features? Clin Neurol Neurosurg 2020; 192:105717. [PMID: 32062307 DOI: 10.1016/j.clineuro.2020.105717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/11/2019] [Accepted: 02/02/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Lumbar arachnoiditis is a rare and debilitating neurologic disorder with multiple etiologies and a spectrum of imaging and clinical characteristics. Prior reports have anecdotally claimed that no association exists between findings of arachnoiditis observed on magnetic resonance imaging (MRI) and those assessed clinically. The purpose of this study was to determine if MRI features of lumbar arachnoiditis associate with the clinical findings of the disorder. PATIENTS AND METHODS Twenty eight patients with lumbar arachnoiditis reported on MRI between 2012 and 2018 were retrospectively identified. A variety of MRI and clinical features of lumbar arachnoiditis were cataloged for these patients based on common findings discovered through literature review. Imaging findings included cauda equina nerve root contour and thickening, adhesion location, level of involvement, enhancement, and Delamarter group. Clinical findings included demographics, etiology, symptom dynamics, and signs/symptoms. Fisher's exact tests were used to determine associations between the imaging and clinical features of lumbar arachnoiditis. RESULTS In general, MRI findings did not associate with the clinical features of lumbar arachnoiditis with a few exceptions. Most notably, confounding lumbar pathology was associated with symptom dynamics (p = 0.004) and nerve root contour was associated with motor and sensory symptoms (p = 0.01). The suspected arachnoiditis etiology of the majority of patients was either post-operative or post-infectious in nature. CONCLUSION MRI findings in lumbar arachnoiditis offer limited insight into the clinical presentation of the disorder.
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Affiliation(s)
- Vincent Parenti
- The George Washington University School of Medicine and Health Sciences, 2300 I St. NW, Washington, DC, 20052, USA.
| | - Fahimul Huda
- The George Washington University School of Medicine and Health Sciences, 2300 I St. NW, Washington, DC, 20052, USA; Department of Radiology, The George Washington University Hospital, 900 23rd St. NW, Washington, DC, 20037, USA.
| | - Perry K Richardson
- The George Washington University School of Medicine and Health Sciences, 2300 I St. NW, Washington, DC, 20052, USA; Department of Neurology, The George Washington University Hospital, 2150 Pennsylvania Ave. NW, Washington, DC, 20037, USA.
| | - Derek Brown
- Department of Biostatistics and Data Science, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX, 77030, USA.
| | - Manek Aulakh
- The George Washington University School of Medicine and Health Sciences, 2300 I St. NW, Washington, DC, 20052, USA; Department of Radiology, The George Washington University Hospital, 900 23rd St. NW, Washington, DC, 20037, USA.
| | - M Reza Taheri
- The George Washington University School of Medicine and Health Sciences, 2300 I St. NW, Washington, DC, 20052, USA; Department of Radiology, The George Washington University Hospital, 900 23rd St. NW, Washington, DC, 20037, USA.
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Valand HA, Huda F, Tu RK. Reply. AJNR Am J Neuroradiol 2019; 40:E53. [PMID: 31537523 DOI: 10.3174/ajnr.a6231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- H A Valand
- American University of Integrative Sciences Brampton, Ontario, Canada
| | - F Huda
- American University of Integrative Sciences Brampton, Ontario, Canada
| | - R K Tu
- American University of Integrative Sciences Brampton, Ontario, Canada
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Valand HA, Huda F, Tu RK. Chimeric Antigen Receptor T-Cell Therapy: What the Neuroradiologist Needs to Know. AJNR Am J Neuroradiol 2019; 40:766-768. [PMID: 31048298 DOI: 10.3174/ajnr.a6042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 03/06/2019] [Indexed: 11/07/2022]
Abstract
Chimeric antigen receptor T-cell therapy is an exciting and rapidly emerging "fifth pillar" treatment for hematologic cancers. Unique treatment-related toxicities and cost remain a major hindrance to its widespread application. The commonly faced challenges with this innovative therapy, its neurotoxicity, and manifestation on neuroimaging studies, are reviewed.
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Affiliation(s)
- H A Valand
- From the American University of Integrative Sciences (H.A.V.), Brampton, Ontario, Canada
| | - F Huda
- Department of Radiology (F.H.), George Washington University Hospital, Washington, DC
| | - R K Tu
- Progressive Radiology (R.K.T.), George Washington University, Washington, DC.
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Ruswandi Y, Hidayat S, Huda F, Putri T, Qomarilla N, Kurnia D, Satari M, Bashari M. The n-hexane fraction of Myrmecodia pendans suppresses survival and proliferation in colon cancer cells. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx652.014] [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: 11/15/2022] Open
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13
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Khanduri S, Chaudhary M, Sabharwal T, Usmani T, Goyal A, Khanduri S, Bhagat S, Huda F, Yadav S, Katyal G. A Low-Cost, Low-Skill Model for Efficient Breast Cancer Screening in Low Resource Rural Settings of a Developing Country. Cureus 2017; 9:e1571. [PMID: 29057183 PMCID: PMC5642813 DOI: 10.7759/cureus.1571] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective To suggest a low-cost, easily-operable, non-invasive imaging modality for cancer detection in rural settings. Method A total of 212 cases with palpable breast masses aged 18 - 65 years were enrolled and underwent thorough clinical, mammographic, and ultrasonographic (USG) evaluation. Imaging findings were reported using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS®) criteria. The findings were confirmed histopathologically. Data were analyzed using the Chi-square test. Results The malignancy rate was 35.8% (n = 76). On mammography, lesions size, margins, shape, calcification, and distorted arch/skin thickening were significantly associated with malignancy. On USG, the number of nodules, shape, margins, echotexture, posterior wall echo, through transmission changes, distorted arch/skin thickening, microlobulation, duct extension, and height/width ratio were significantly associated with malignancy. Independently, mammography and USG had a sensitivity of 78.1% and 80.3%, respectively, and a specificity of 83.3% and 89.0%, respectively. Using a positive result of either study as the criteria, the sensitivity was 97.4% and the specificity was 80.1%. Conclusion The combined use of mammography and USG provides high sensitivity and specificity, thus showing that a combination of two can be used as a screening tool for use in low resource rural settings.
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Affiliation(s)
| | | | | | - Tarim Usmani
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Aakshit Goyal
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | | | - Saurav Bhagat
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Fahimul Huda
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Santosh Yadav
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Gaurav Katyal
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
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Faggion CM, Liu J, Huda F, Atieh M. Assessment of the quality of reporting in abstracts of systematic reviews with meta-analyses in periodontology and implant dentistry. J Periodontal Res 2013; 49:137-42. [PMID: 23668725 DOI: 10.1111/jre.12092] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Proper scientific reporting is necessary to ensure the correct interpretation of study results by readers. The main objective of this study was to assess the quality of reporting in abstracts of systematic reviews (SRs) with meta-analyses in periodontology and implant dentistry. Differences in reporting of abstracts in Cochrane and paper-based reviews were also assessed. METHODS The PubMed electronic database and the Cochrane database for SRs were searched on November 11, 2012, independently and in duplicate, for SRs with meta-analyses related to interventions in periodontology and implant dentistry. Assessment of the quality of reporting was performed independently and in duplicate, taking into account items related to the effect direction, numerical estimates of effect size, measures of precision, probability and consistency. RESULTS We initially screened 433 papers and included 146 (127 paper-based and 19 Cochrane reviews, respectively). The direction of evidence was reported in two-thirds of the abstracts while strength of evidence and measure of precision (i.e., confidence interval) were reported in less than half the selected abstracts. Measures of consistency such as I(2) statistics were reported in only 5% of the selected sample of abstracts. Cochrane abstracts reported the limitations of evidence and precision better than paper-based ones. Two items ("meta-analysis" in title and abstract, respectively), were nevertheless better reported in paper-based abstracts. CONCLUSION Abstracts of SRs with meta-analyses in periodontology and implant dentistry currently have no uniform standard of reporting, which may hinder readers' understanding of study outcomes.
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Affiliation(s)
- C M Faggion
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Abstract
Reports on research conducted in eight residential and/or nursing homes belonging to six different charity organizations. The organizations ranged in size from local bodies dealing exclusively with care homes to large nationals involved in various other activities. However, staff training is a core issue to all of them, and activity directed towards it has met with varying degrees of success. Aims to highlight those indicators which will minimize failure of the training schedule and to make homes aware of the wider issues which affect training schemes.
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Affiliation(s)
- F Huda
- London Management Centre, University of Westminster, UK
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