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Jensen CT, Wong VK, Wagner-Bartak NA, Liu X, Padmanabhan Nair Sobha R, Sun J, Likhari GS, Gupta S. Accuracy of liver metastasis detection and characterization: Dual-energy CT versus single-energy CT with deep learning reconstruction. Eur J Radiol 2023; 168:111121. [PMID: 37806195 DOI: 10.1016/j.ejrad.2023.111121] [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: 07/20/2023] [Revised: 09/08/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To assess whether image quality differences between SECT (single-energy CT) and DECT (dual-energy CT 70 keV) with equivalent radiation doses result in altered detection and characterization accuracy of liver metastases when using deep learning image reconstruction (DLIR), and whether DECT spectral curve usage improves accuracy of indeterminate lesion characterization. METHODS In this prospective Health Insurance Portability and Accountability Act-compliant study (March through August 2022), adult men and non-pregnant adult women with biopsy-proven colorectal cancer and liver metastases underwent SECT (120 kVp) and a DECT (70 keV) portovenous abdominal CT scan using DLIR in the same breath-hold (Revolution CT ES; GE Healthcare). Participants were excluded if consent could not be obtained, if there were nonequivalent radiation doses between the two scans, or if the examination was cancelled/rescheduled. Three radiologists independently performed lesion detection and characterization during two separate sessions (SECT DLIRmedium and DECT DLIRhigh) as well as reported lesion confidence and overall image quality. Hounsfield units were measured. Spectral HU curves were provided for any lesions rated as indeterminate. McNemar's test was used to test the marginal homogeneity in terms of diagnostic sensitivity, accuracy and lesion detection. A generalized estimating equation method was used for categorical outcomes. RESULTS 30 participants (mean age, 58 years ± 11, 21 men) were evaluated. Mean CTDIvol was 34 mGy for both scans. 141 lesions (124 metastases, 17 benign) with a mean size of 0.8 cm ± 0.3 cm were identified. High scores for image quality (scores of 4 or 5) were not significantly different between DECT (N = 71 out of 90 total scores from the three readers) and SECT (N = 62) (OR, 2.01; 95% CI:0.89, 4.57; P = 0.093). Equivalent image noise to SECT DLIRmed (HU SD 10 ± 2) was obtained with DECT DLIRhigh (HU SD 10 ± 3) (P = 1). There was no significant difference in lesion detection between DECT and SECT (140/141 lesions) (99.3%; 95% CI:96.1%, 100%).The mean lesion confidence scores by each reader were 4.2 ± 1.3, 3.9 ± 1.0, and 4.8 ± 0.8 for SECT and 4.1 ± 1.4, 4.0 ± 1.0, and 4.7 ± 0.8 for DECT (odds ratio [OR], 0.83; 95% CI: 0.62, 1.11; P = 0.21). Small lesion (≤5mm) characterization accuracy on SECT and DECT was 89.1% (95% CI:76.4%, 96.4%; 41/46) and 84.8% (71.1%, 93.7%; 39/46), respectively (P = 0.41). Use of spectral HU lesion curves resulted in 34 correct changes in characterizations and no mischaracterizations. CONCLUSION DECT required a higher strength of DLIR to obtain equivalent noise compared to SECT DLIR. At equivalent radiation doses and image noise, there was no significant difference in subjective image quality or observer lesion performance between DECT (70 keV) and SECT. However, DECT spectral HU curves of indeterminate lesions improved characterization.
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Affiliation(s)
- Corey T Jensen
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA.
| | - Vincenzo K Wong
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA
| | - Nicolaus A Wagner-Bartak
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA
| | - Xinming Liu
- Department of Physics, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA
| | - Renjith Padmanabhan Nair Sobha
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA
| | - Jia Sun
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA
| | - Gauruv S Likhari
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA
| | - Shiva Gupta
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4009, USA
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Virarkar M, Jensen C, Klekers A, Wagner-Bartak NA, Devine CE, Lano EA, Sun J, Tharakeswara B, Bhosale P. Clinical importance of second-opinion interpretations of abdominal imaging studies in a cancer hospital and its impact on patient management. Clin Imaging 2022; 86:13-19. [DOI: 10.1016/j.clinimag.2022.03.014] [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] [Received: 12/27/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 11/03/2022]
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Cai ZJ, Salem AE, Wagner-Bartak NA, Elsayes KM, Negm AS, Rezvani M, Menias CO, Shaaban AM. Correction to: Sciatic foramen anatomy and common pathologies: a pictorial review. Abdom Radiol (NY) 2022; 47:2562. [PMID: 35488899 DOI: 10.1007/s00261-022-03537-x] [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: 11/25/2022]
Affiliation(s)
- Zhuoxuan J Cai
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA
| | - Ahmed Ebada Salem
- Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
- Department of Radiodiagnosis and Intervention, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nicolaus A Wagner-Bartak
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA
| | - Khaled M Elsayes
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
| | - Ahmed S Negm
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA
| | - Maryam Rezvani
- Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
| | | | - Akram M Shaaban
- Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
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Jensen CT, Gupta S, Saleh MM, Liu X, Wong VK, Salem U, Qiao W, Samei E, Wagner-Bartak NA. Reduced-Dose Deep Learning Reconstruction for Abdominal CT of Liver Metastases. Radiology 2022; 303:90-98. [PMID: 35014900 PMCID: PMC8962777 DOI: 10.1148/radiol.211838] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/19/2021] [Accepted: 10/28/2021] [Indexed: 12/22/2022]
Abstract
Background Assessment of liver lesions is constrained as CT radiation doses are lowered; evidence suggests deep learning reconstructions mitigate such effects. Purpose To evaluate liver metastases and image quality between reduced-dose deep learning image reconstruction (DLIR) and standard-dose filtered back projection (FBP) contrast-enhanced abdominal CT. Materials and Methods In this prospective Health Insurance Portability and Accountability Act-compliant study (September 2019 through April 2021), participants with biopsy-proven colorectal cancer and liver metastases at baseline CT underwent standard-dose and reduced-dose portal venous abdominal CT in the same breath hold. Three radiologists detected and characterized lesions at standard-dose FBP and reduced-dose DLIR, reported confidence, and scored image quality. Contrast-to-noise ratios for liver metastases were recorded. Summary statistics were reported, and a generalized linear mixed model was used. Results Fifty-one participants (mean age ± standard deviation, 57 years ± 13; 31 men) were evaluated. The mean volume CT dose index was 65.1% lower with reduced-dose CT (12.2 mGy) than with standard-dose CT (34.9 mGy). A total of 161 lesions (127 metastases, 34 benign lesions) with a mean size of 0.7 cm ± 0.3 were identified. Subjective image quality of reduced-dose DLIR was superior to that of standard-dose FBP (P < .001). The mean contrast-to-noise ratio for liver metastases of reduced-dose DLIR (3.9 ± 1.7) was higher than that of standard-dose FBP (3.5 ± 1.4) (P < .001). Differences in detection were identified only for lesions 0.5 cm or smaller: 63 of 65 lesions detected with standard-dose FBP (96.9%; 95% CI: 89.3, 99.6) and 47 lesions with reduced-dose DLIR (72.3%; 95% CI: 59.8, 82.7). Lesion accuracy with standard-dose FBP and reduced-dose DLIR was 80.1% (95% CI: 73.1, 86.0; 129 of 161 lesions) and 67.1% (95% CI: 59.3, 74.3; 108 of 161 lesions), respectively (P = .01). Lower lesion confidence was reported with a reduced dose (P < .001). Conclusion Deep learning image reconstruction (DLIR) improved CT image quality at 65% radiation dose reduction while preserving detection of liver lesions larger than 0.5 cm. Reduced-dose DLIR demonstrated overall inferior characterization of liver lesions and reader confidence. Clinical trial registration no. NCT03151564 © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Corey T. Jensen
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Shiva Gupta
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Mohammed M. Saleh
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Xinming Liu
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Vincenzo K. Wong
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Usama Salem
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Wei Qiao
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Ehsan Samei
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
| | - Nicolaus A. Wagner-Bartak
- From the Departments of Abdominal Imaging (C.T.J., S.G., M.M.S.,
V.K.W., U.S., N.A.W.B.), Physics (X.L.), and Biostatistics (W.Q.), the
University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473,
Houston, TX 77030-4009; and Center for Virtual Imaging Trials, Carl E. Ravin
Advanced Imaging Laboratories, Clinical Imaging Physics Group, Medical Physics
Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and
Electrical and Computer Engineering, Duke University Medical Center, Durham, NC
(E.S.)
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Cai ZJ, Salem AE, Wagner-Bartak NA, Elsayes KM, Negm AS, Rezvani M, Menias CO, Shaaban AM. Sciatic foramen anatomy and common pathologies: a pictorial review. Abdom Radiol (NY) 2022; 47:378-398. [PMID: 34664097 DOI: 10.1007/s00261-021-03265-8] [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: 05/25/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022]
Abstract
This article reviews the relevant anatomy, imaging features on computed tomography, magnetic resonance imaging, and management of common processes involving the sciatic foramen. The anatomy of the sciatic foramen is complex and provides an important conduit between the pelvis, gluteus, and lower extremity. This paper reviewed the anatomy, common pathologies, and imaging features of this region including trauma, infection, nerve entrapment, tumor spread, hernia, and vascular anomaly.
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Affiliation(s)
- Zhuoxuan J Cai
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA
| | - Ahmed Ebada Salem
- Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
- Department of Diagnostic Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Nicolaus A Wagner-Bartak
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA
| | - Khaled M Elsayes
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
| | - Ahmed S Negm
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA
| | - Maryam Rezvani
- Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
| | - Christine O Menias
- Department of Radiodiagnosis and Intervention, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Akram M Shaaban
- Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
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Virarkar M, Morani AC, Bhosale P, Wagner-Bartak NA, Carter BW, Lano E. Peer Learning and Operationalizing During COVID-19 Pandemic and Beyond. Cureus 2021; 13:e16568. [PMID: 34430170 PMCID: PMC8378281 DOI: 10.7759/cureus.16568] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/23/2022] Open
Abstract
The main objective of the article is to describe the changes in managing the peer learning system in the Department of Abdominal Imaging at our institution during the pandemic and its restrictions. The pandemic poses diverse challenges to academic institutions across the country including radiology education and peer learning. The health sector in some areas of the country has been stretched by the number of coronavirus disease 2019 (COVID-19) patients. In March 2020, our institution cancelled all in-person conferences as per guidelines from the Center of Disease Control and Prevention to mitigate the spread of COVID-19 and the conferences were shifted to virtual platforms. Our recent peer learning approach allowed us to practice appropriate social distancing while following the institutional and national guidelines with minimal disruption. Other institutions that are facing similar challenges can adopt or modify our framework of a successful and efficient virtual peer learning process.
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Affiliation(s)
- Mayur Virarkar
- Radiology, The University of Texas Health Science Center at Houston, Houston, USA
| | - Ajaykumar C Morani
- Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Priya Bhosale
- Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - Brett W Carter
- Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Elizabeth Lano
- Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
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Glober G, Gunther J, Fang P, Milgrom S, Korivi BR, Jensen CT, Wagner-Bartak NA, Ahmed S, Lee HJ, Nair R, Steiner R, Parmar S, Iyer S, Westin J, Fayad L, Rodriguez MA, Neelapu S, Nastoupil L, Flowers CR, Dabaja BS, Pinnix CC. Imaging Surveillance of Limited-stage Classic Hodgkin Lymphoma Patients After PET-CT-documented First Remission. Clin Lymphoma Myeloma Leuk 2020; 20:533-541. [PMID: 32291233 PMCID: PMC10071957 DOI: 10.1016/j.clml.2020.02.008] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Early stage Hodgkin lymphoma (ESHL) is highly curable; however, 10% to 15% of patients experience relapse. We examined the utilization of follow-up imaging for patients with ESHL who achieved a metabolic complete response after upfront therapy. MATERIALS AND METHODS The records of adult patients treated at a single institution between 2003 and 2014 were reviewed. Positron emission tomography-computed tomography (PET-CT) and CT scan frequency was quantified during the 2 years following treatment and subsequent visits beyond 2 years. RESULTS The study cohort contained 179 patients. The median age was 31 years; bulky disease was present in 30%. ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) or AVD (doxorubicin, vinblastine, and dacarbazine) was given in 97%; 75% received radiation therapy. At a median follow-up of 6.9 years, the 5-year progression-free and overall survival rates were 93.7% and 98.1%, respectively. Relapse occurred in 5% (n = 9) of patients at a median of 9.1 months (range, 4.6-27.2 months) from therapy. Two patients presented with symptoms prompting imaging in follow-up. Within 2 years after therapy, 376 PET-CT scans and 3325 CT scans were performed, yielding an average of 2.1 PET-CTs and 18.6 CTs per patient. Of the initial 179 patients, 113 had follow-up conducted beyond 2 years post-therapy; an average of 2.7 PET-CTs and 33.2 CTs were performed. In the 2-year post-therapy period, 463 scans were performed per relapse detected. CONCLUSION In this cohort of patients with ESHL who responded completely to frontline therapy, the relapse rate was low. Routine imaging surveillance lacks clinical benefit in this patient population.
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Affiliation(s)
- Gordon Glober
- University of Central Florida College of Medicine, Orlando, FL
| | - Jillian Gunther
- Departments of Radiation Oncology, MD Anderson Cancer Center, Houston, TX
| | - Penny Fang
- Departments of Radiation Oncology, MD Anderson Cancer Center, Houston, TX
| | - Sarah Milgrom
- Department of Radiation Oncology, University of Colorado, Denver, CO
| | - Brinda Rao Korivi
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, TX
| | - Corey T Jensen
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, TX
| | | | - Sairah Ahmed
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Hun Ju Lee
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Ranjit Nair
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Raphael Steiner
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Simrit Parmar
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Swaminathan Iyer
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Jason Westin
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Luis Fayad
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - M Alma Rodriguez
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Sattva Neelapu
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | - Loretta Nastoupil
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX
| | | | - Bouthaina S Dabaja
- Departments of Radiation Oncology, MD Anderson Cancer Center, Houston, TX
| | - Chelsea C Pinnix
- Departments of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
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Jensen CT, Wagner-Bartak NA, Vu LN, Liu X, Raval B, Martinez D, Wei W, Cheng Y, Samei E, Gupta S. Detection of Colorectal Hepatic Metastases Is Superior at Standard Radiation Dose CT versus Reduced Dose CT. Radiology 2018; 290:400-409. [PMID: 30480489 PMCID: PMC6357984 DOI: 10.1148/radiol.2018181657] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose To evaluate colorectal cancer hepatic metastasis detection and characterization between reduced radiation dose (RD) and standard dose (SD) contrast material-enhanced CT of the abdomen and to qualitatively compare between filtered back projection (FBP) and iterative reconstruction algorithms. Materials and Methods In this prospective study (from May 2017 through November 2017), 52 adults with biopsy-proven colorectal cancer and suspected hepatic metastases at baseline CT underwent two portal venous phase CT scans: SD and RD in the same breath hold. Three radiologists, blinded to examination details, performed detection and characterization of 2-15-mm lesions on the SD FBP and RD adaptive statistical iterative reconstruction (ASIR)-V 60% series images. Readers assessed overall image quality and lesions between SD FBP and seven different iterative reconstructions. Two nonblinded consensus reviewers established the reference standard using the picture archiving and communication system lesion marks of each reader, multiple comparison examinations, and clinical data. Results RD CT resulted in a mean dose reduction of 54% compared with SD. Of the 260 lesions (233 metastatic, 27 benign), 212 (82%; 95% confidence interval [CI]: 76%, 86%) were detected with RD CT, whereas 252 (97%; 95% CI: 94%, 99%) were detected with SD (P < .001); per-lesion sensitivity was 79% (95% CI: 74%, 84%) and 94% (95% CI: 90%, 96%) (P < .001), respectively. Mean qualitative scores ranked SD images as higher quality than RD series images, and ASIR-V ranked higher than ASIR and Veo 3.0. Conclusion CT evaluation of colorectal liver metastases is compromised with modest radiation dose reduction, and the use of iterative reconstructions could not maintain observer performance. © RSNA, 2018.
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Affiliation(s)
- Corey T Jensen
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Nicolaus A Wagner-Bartak
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Lan N Vu
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Xinming Liu
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Bharat Raval
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - David Martinez
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Wei Wei
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Yuan Cheng
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Ehsan Samei
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
| | - Shiva Gupta
- From the Departments of Diagnostic Radiology (C.T.J., N.A.W., L.N.V., B.R., D.M., S.G.), Biostatistics (W.W.), and Physics (X.L.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1473, Houston, TX 77030-4009; and Duke University Medical Center, Durham, NC (Y.C., E.S.)
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Telesmanich ME, Jensen CT, Enriquez JL, Wagner-Bartak NA, Liu X, Le O, Wei W, Chandler AG, Tamm EP. Third version of vendor-specific model-based iterativereconstruction (Veo 3.0): evaluation of CT image quality in the abdomen using new noise reduction presets and varied slice optimization. Br J Radiol 2017; 90:20170188. [PMID: 28707531 DOI: 10.1259/bjr.20170188] [Citation(s) in RCA: 7] [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: 11/05/2022] Open
Abstract
OBJECTIVE To qualitatively and quantitatively compare abdominal CT images reconstructed with a newversion of model-based iterative reconstruction (Veo 3.0; GE Healthcare Waukesha, WI) utilizing varied presetsof resolution preference, noise reduction and slice optimization. METHODS This retrospective study was approved by our Institutional Review Board and was Health Insurance Portability and Accountability Act compliant. The raw datafrom 30 consecutive patients who had undergone CT abdomen scanning were used to reconstructfour clinical presets of 3.75mm axial images using Veo 3.0: 5% resolution preference (RP05n), 5%noise reduction (NR05) and 40% noise reduction (NR40) with new 3.75mm "sliceoptimization," as well as one set using RP05 with conventional 0.625mm "slice optimization" (RP05c). The images were reviewed by two independent readers in a blinded, randomized manner using a 5-point Likert scale as well as a 5-point comparative scale. Multiple two-dimensional circular regions of interest were defined for noise and contrast-to-noise ratio measurements. Line profiles were drawn across the 7 lp cm-1 bar pattern of the Catphan 600 phantom for evaluation of spatial resolution. RESULTS The NR05 image set was ranked as the best series in overall image quality (mean difference inrank 0.48, 95% CI [0.081-0.88], p = 0.01) and with specific reference to liver evaluation (meandifference 0.46, 95% CI [0.030-0.89], p = 0.03), when compared with the secondbest series ineach category. RP05n was ranked as the best for bone evaluation. NR40 was ranked assignificantly inferior across all assessed categories. Although the NR05 and RP05c image setshad nearly the same contrast-to-noise ratio and spatial resolution, NR05 was generally preferred. Image noise and spatial resolution increased along a spectrum with RP05n the highest and NR40the lowest. Compared to RP05n, the average noise was 21.01% lower for NR05, 26.88%lower for RP05c and 50.86% lower for NR40. CONCLUSION Veo 3.0 clinical presets allow for selection of image noise and spatial resolution balance; for contrast-enhanced CT evaluation of the abdomen, the 5% noise reduction preset with 3.75 mm slice optimization (NR05) was generally ranked superior qualitatively and, relative to other series, was in the middle of the spectrum with reference to image noise and spatial resolution. Advances in knowledge: To our knowledge, this is the first study of Veo 3.0 noise reduction presets and varied slice optimization. This study provides insight into the behaviour of slice optimization and documents the degree of noise reduction and spatial resolution changes that users can expect across various Veo 3.0 clinical presets. These results provide important parameters to guide preset selection for both clinical and research purposes.
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Affiliation(s)
- Morgan E Telesmanich
- 1 Department of Diagnostic Radiology, Baylor College of Medicine , Houston , USA
| | - Corey T Jensen
- 2 Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center , Houston , USA
| | - Jose L Enriquez
- 1 Department of Diagnostic Radiology, Baylor College of Medicine , Houston , USA
| | - Nicolaus A Wagner-Bartak
- 2 Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center , Houston , USA
| | - Xinming Liu
- 3 Department of Imaging Physics, The University of Texas MD Anderson Cancer Center , Houston , USA
| | - Ott Le
- 2 Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center , Houston , USA
| | - Wei Wei
- 4 Department of Biostatistics, The University of Texas MD Anderson Cancer Center , Houston , USA
| | - Adam G Chandler
- 3 Department of Imaging Physics, The University of Texas MD Anderson Cancer Center , Houston , USA.,5 Department of Molecular Imaging and Computed Tomography Research, GE Healthcare , Waukesha , USA
| | - Eric P Tamm
- 2 Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center , Houston , USA
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Michelle M A, Jensen CT, Habra MA, Menias CO, Shaaban AM, Wagner-Bartak NA, Roman-Colon AM, Elsayes KM. Adrenal cortical hyperplasia: diagnostic workup, subtypes, imaging features and mimics. Br J Radiol 2017; 90:20170330. [PMID: 28707538 DOI: 10.1259/bjr.20170330] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Adrenal cortical hyperplasia manifests radiologically as a non-malignant growth, or enlargement, of the adrenal glands, specifically the cortex, although the cortex cannot be definitively identified by conventional imaging. Controlled by the pituitary gland, the adrenal cortex drives critical processes, such as the production of cortisol, mineralocorticoid and sex hormones. Any disruption in the multiple enzymes and hormones involved in these pathways may cause serious or life-threatening symptoms, often associated with anatomical changes in the adrenal glands. Diagnosis and treatment of adrenal cortical hyperplasia requires a thorough clinical evaluation. As imaging has become more robust so has its role in the diagnosis and treatment of adrenal conditions. CT has been the primary modality for adrenal imaging owing to reproducibility, temporal and spatial resolution and broad access. MRI serves a complimentary role in adrenal imaging and can be used to further evaluate indeterminate CT findings or serve as an adjunct tool without the use of ionizing radiation. Ultrasound and fluoroscopy (genitography) are most commonly used in children and foetuses to evaluate congenital adrenal hyperplasia. This article will discuss the clinical presentation, laboratory workup and imaging features of adrenal cortical hyperplasia, both congenital and acquired.
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Affiliation(s)
- Agrons Michelle M
- 1 Department of Diagnostic Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Corey T Jensen
- 2 Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mouhammed Amir Habra
- 3 Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Akram M Shaaban
- 5 Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
| | | | - Alicia M Roman-Colon
- 1 Department of Diagnostic Radiology, Baylor College of Medicine, Houston, TX, USA.,6 Department of Radiology, Texas Children's Hospital, Houston, TX, USA
| | - Khaled M Elsayes
- 1 Department of Diagnostic Radiology, Baylor College of Medicine, Houston, TX, USA
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Yedururi S, Kang HC, Wei W, Wagner-Bartak NA, Marcal LP, Stafford RJ, Willis BJ, Szklaruk J. Free-breathing radial volumetric interpolated breath-hold examination vs breath-hold cartesian volumetric interpolated breath-hold examination magnetic resonance imaging of the liver at 1.5T. World J Radiol 2016; 8:707-715. [PMID: 27551341 PMCID: PMC4965355 DOI: 10.4329/wjr.v8.i7.707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/05/2016] [Accepted: 04/18/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare breath-hold cartesian volumetric interpolated breath-hold examination (cVIBE) and free-breathing radial VIBE (rVIBE) and determine whether rVIBE could replace cVIBE in routine liver magnetic resonance imaging (MRI).
METHODS: In this prospective study, 15 consecutive patients scheduled for routine MRI of the abdomen underwent pre- and post-contrast breath-hold cVIBE imaging (19 s acquisition time) and free-breathing rVIBE imaging (111 s acquisition time) on a 1.5T Siemens scanner. Three radiologists with 2, 4, and 8 years post-fellowship experience in abdominal imaging evaluated all images. The radiologists were blinded to the sequence types, which were presented in a random order for each patient. For each sequence, the radiologists scored the cVIBE and rVIBE images for liver edge sharpness, hepatic vessel clarity, presence of artifacts, lesion conspicuity, fat saturation, and overall image quality using a five-point scale.
RESULTS: Compared to rVIBE, cVIBE yielded significantly (P < 0.001) higher scores for liver edge sharpness (mean score, 3.87 vs 3.37), hepatic-vessel clarity (3.71 vs 3.18), artifacts (3.74 vs 3.06), lesion conspicuity (3.81 vs 3.2), and overall image quality (3.91 vs 3.24). cVIBE and rVIBE did not significantly differ in quality of fat saturation (4.12 vs 4.03, P = 0.17). The inter-observer variability with respect to differences between rVIBE and cVIBE scores was close to zero compared to random error and inter-patient variation. Quality of rVIBE images was rated as acceptable for all parameters.
CONCLUSION: rVIBE cannot replace cVIBE in routine liver MRI. At 1.5T, free-breathing rVIBE yields acceptable, although slightly inferior image quality compared to breath-hold cVIBE.
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Jensen CT, Vicens-Rodriguez RA, Wagner-Bartak NA, Fox PS, Faria SC, Carrion I, Qayyum A, Tamm EP. Multidetector CT detection of peritoneal metastases: evaluation of sensitivity between standard 2.5 mm axial imaging and maximum-intensity-projection (MIP) reconstructions. ACTA ACUST UNITED AC 2016; 40:2167-72. [PMID: 25666971 DOI: 10.1007/s00261-015-0370-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Our purpose was to evaluate the sensitivity of multidetector CT for the detection of peritoneal metastases between standard 2.5 mm axial imaging and maximum-intensity-projection (MIP) reconstructions. MATERIALS AND METHODS The Institutional Review Board approved this retrospective study and waived the need to obtain patient consent. We retrospectively identified 36 patients with pancreatic adenocarcinoma and peritoneal metastatic disease who underwent a pancreatic protocol CT examination of the abdomen and pelvis between January 2012 and January 2014. Three independent radiologists reviewed a randomized combination of standard axial (2.5 mm reconstructed thickness, 2.5 mm interval) and axial MIP reconstructions (6, 3 mm interval) over two sessions. Each reader recorded metastasis location in PACS. Subsequent consensus review by two radiologists determined the final number and size of metastases. RESULTS The reviewers found 328 peritoneal implants in 36 patients. After accounting for the size, location, and number of lesions as well as multiple readers, a generalized estimating equations model showed that the statistical combination of MIP with standard technique significantly increased the odds of correctly identifying a lesion (OR 2.16; 95% CI 1.86-2.51; p value < 0.0001) compared to standard technique alone. MIP reconstruction as a standalone technique was less sensitive compared to standard technique alone (OR 0.81; 95% CI 0.65-0.99; p value = 0.0468). When compared to standard axial imaging, evaluation via MIP reconstructions resulted in the identification of an additional 50 (15%), 45 (14%), and 55 (17%) lesions by Readers 1-3, respectively. CONCLUSION The axial 6 mm MIP series is complimentary in the CT evaluation of peritoneal metastases. MIP reconstruction evaluation identified a significant number of additional lesions, but is not adequate as a standalone technique for peritoneal cavity assessment.
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Affiliation(s)
- Corey T Jensen
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA.
| | - Rafael A Vicens-Rodriguez
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Nicolaus A Wagner-Bartak
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Patricia S Fox
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Silvana C Faria
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Ivan Carrion
- University Hospital Joan XXIII (Tarragona), Avda. Jaume Balmes, XX, X-X, Vilanova i la Geltru Barcelona, 08800, Spain
| | - Aliya Qayyum
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Eric P Tamm
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
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Wagner-Bartak NA, Levine MS, Rubesin SE, Laufer I, Rombeau JL, Lichtenstein GR. Crohn's disease in the ileal pouch after total colectomy for ulcerative colitis: findings on pouch enemas in six patients. AJR Am J Roentgenol 2005; 184:1843-7. [PMID: 15908540 DOI: 10.2214/ajr.184.6.01841843] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study was to describe our experience with six patients who developed Crohn's disease in the ileal pouch or distal ileum after a total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis. CONCLUSION Pouch enemas showed characteristic findings of Crohn's disease, including nodularity, thickened folds, ulceration, cobblestoning, strictures, sinus tracks, and fistulas to the perianal region and vagina. It is important for radiologists to be aware of the findings of Crohn's disease in the ileal pouch and distal ileum on radiographic studies of the pouch after total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis because of the implications for patient management.
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Affiliation(s)
- Nicolaus A Wagner-Bartak
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA
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