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Jain P, Khorrami M, Gupta A, Rajiah P, Bera K, Vaidya P, Fu P, Dowlati A, Madabhushi A. MA13.02 Novel Non-Invasive Radiomic Signatures Extracted from Radiographic Images can Predict Response to Systemic Treatment in Small Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.264] [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: 11/16/2022]
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Abstract
Computed tomography (CT) has become an important modality in the evaluation of coronary artery disease (CAD). The tremendous technological advances in CT in the last two decades has made it possible to obtain high quality images of coronary arteries with high spatial and temporal resolutions. Multiple trials have confirmed the accuracy of CT compared to invasive catheter angiography. CT is also able to evaluate beyond the lumen in characterizing and quantifying atherosclerotic plaques, including evaluation of high risk features. Although CTA has low specificity in identification of lesion-specific ischemia, functional techniques are now possible such as CT myocardial perfusion and CT-fractional flow reserve (FFR) which evaluate the hemodynamic significance of stenosis and help with revascularization strategies. Multi-energy CT provides additional information beyond what is possible with a conventional CT and is useful in variety of clinical applications, including myocardial perfusion imaging, lesion characterization and low contrast studies. Large trials have confirmed the ability of CT to predict major adverse cardiovascular events and recent trials have even demonstrated improved clinical outcomes by using CT for the evaluation of CAD. CT is also useful in structural heart disease and 3 D printing is now increasingly used for surgical/interventional planning. Machine learning is evolving rapidly and is likely to impact diagnosis and management.
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Affiliation(s)
- P Rajiah
- From the Department of Radiology, Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Texas, USA
| | - S Abbara
- From the Department of Radiology, Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Texas, USA
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den Harder AM, Willemink MJ, de Jong PA, Schilham AMR, Rajiah P, Takx RAP, Leiner T. New horizons in cardiac CT. Clin Radiol 2016; 71:758-67. [PMID: 26932775 DOI: 10.1016/j.crad.2016.01.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/23/2015] [Accepted: 01/21/2016] [Indexed: 12/13/2022]
Abstract
Until recently, cardiovascular computed tomography angiography (CCTA) was associated with considerable radiation doses. The introduction of tube current modulation and automatic tube potential selection as well as high-pitch prospective ECG-triggering and iterative reconstruction offer the ability to decrease dose with approximately one order of magnitude, often to sub-millisievert dose levels. In parallel, advancements in computational technology have enabled the measurement of fractional flow reserve (FFR) from CCTA data (FFRCT). This technique shows potential to replace invasively measured FFR to select patients in need of coronary intervention. Furthermore, developments in scanner hardware have led to the introduction of dual-energy and photon-counting CT, which offer the possibility of material decomposition imaging. Dual-energy CT reduces beam hardening, which enables CCTA in patients with a high calcium burden and more robust myocardial CT perfusion imaging. Future-generation CT systems will be capable of counting individual X-ray photons. Photon-counting CT is promising and may result in a substantial further radiation dose reduction, vastly increased spatial resolution, and the introduction of a whole new class of contrast agents.
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Affiliation(s)
- A M den Harder
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508GA Utrecht, The Netherlands.
| | - M J Willemink
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508GA Utrecht, The Netherlands
| | - P A de Jong
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508GA Utrecht, The Netherlands
| | - A M R Schilham
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508GA Utrecht, The Netherlands
| | - P Rajiah
- Cardiothoracic Imaging Division, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, USA
| | - R A P Takx
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508GA Utrecht, The Netherlands
| | - T Leiner
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508GA Utrecht, The Netherlands
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Etesami M, Ashwath R, Kanne J, Gilkeson RC, Rajiah P. Computed tomography in the evaluation of vascular rings and slings. Insights Imaging 2014; 5:507-21. [PMID: 25008430 PMCID: PMC4141344 DOI: 10.1007/s13244-014-0343-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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] [Received: 03/07/2014] [Revised: 06/07/2014] [Accepted: 06/10/2014] [Indexed: 11/26/2022] Open
Abstract
Vascular rings are congenital abnormalities of the aortic arch-derived vascular and ligamentous structures, which encircle the trachea and oesophagus to varying degrees, resulting in respiratory or feeding difficulties in children. A sling is an abnormality of the pulmonary arterial system resulting in airway compression. Although several imaging examinations are available for the evaluation of these anomalies, computed tomography (CT) has become the preferred test because of rapid acquisitions, making it feasible to perform the study without sedation or general anaesthesia. Furthermore, CT provides excellent spatial and temporal resolution, a wide field of view, multiplanar reconstruction capabilities and simultaneous evaluation of the airway. In this review, the current role and technique of CT in the evaluation of vascular rings are discussed. A brief discussion of the embryology of the aorta and branch vessels is followed by discussion and illustration of common and some uncommon vascular rings along with critical information required by surgeons. Teaching Points • Computed tomography is valuable in the evaluation of vascular rings.• Due to variable clinical and imaging presentations, diagnosis of vascular rings is often challenging.• Laterality of the arch is critical in surgical management.
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Affiliation(s)
- M. Etesami
- Cardiothoracic Imaging Section, Radiology, University Hospital of Cleveland, Case Western Reserve School of Medicine, Cleveland, OH USA
| | - R. Ashwath
- Department of Pediatric Cardiology, Rainbow Babies and Children’s Hospital, Cleveland, OH USA
| | - J. Kanne
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - R. C. Gilkeson
- Cardiothoracic Imaging Section, Radiology, University Hospital of Cleveland, Case Western Reserve School of Medicine, Cleveland, OH USA
| | - P. Rajiah
- Cardiothoracic Imaging Section, Radiology, University Hospital of Cleveland, Case Western Reserve School of Medicine, Cleveland, OH USA
- Cardiothoracic Imaging Section, Department of Radiology, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106 USA
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Rajiah P, Nazarian J, Vogelius E, Gilkeson RC. CT and MRI of pulmonary valvular abnormalities. Clin Radiol 2014; 69:630-8. [PMID: 24582177 DOI: 10.1016/j.crad.2014.01.019] [Citation(s) in RCA: 10] [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] [Received: 07/23/2013] [Revised: 12/10/2013] [Accepted: 01/20/2014] [Indexed: 10/25/2022]
Abstract
Pulmonary valve disease constitutes a wide spectrum of conditions. Traditionally, echocardiography has been the technique of choice for the evaluation of pulmonary and other valvular disease. However, with advances in technology, computed tomography (CT) and magnetic resonance imaging (MRI) are playing increasingly important roles in the evaluation of these disorders. In this article, we review the normal appearance of the pulmonary valve and then illustrate various variants and pathological entities of the pulmonary valve.
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Affiliation(s)
- P Rajiah
- Department of Cardiothoracic Imaging, University Hospitals of Cleveland Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
| | - J Nazarian
- Department of Cardiothoracic Imaging, University Hospitals of Cleveland Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - E Vogelius
- Department of Cardiothoracic Imaging, University Hospitals of Cleveland Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - R C Gilkeson
- Department of Cardiothoracic Imaging, University Hospitals of Cleveland Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Sinha R, Rajesh A, Rawat S, Rajiah P, Ramachandran I. Infections and infestations of the gastrointestinal tract. Part 1: bacterial, viral and fungal infections. Clin Radiol 2012; 67:484-94. [PMID: 22257535 DOI: 10.1016/j.crad.2011.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 09/23/2011] [Accepted: 10/12/2011] [Indexed: 01/03/2023]
Abstract
The purpose of this article is to review the imaging findings of various infections affecting the gastrointestinal tract. Barium examinations, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography all play an important role in the diagnostic workup of gastrointestinal tract infections. Knowledge of differential diagnosis, sites of involvement, and typical imaging features of different infections can help in accurate diagnosis and guide treatment.
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Affiliation(s)
- R Sinha
- Department of Clinical Radiology, South Warwickshire NHS Foundation Trust, Warwick, UK.
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Sinha R, Rajesh A, Rawat S, Rajiah P, Ramachandran I. Infections and infestations of the gastrointestinal tract. Part 2: parasitic and other infections. Clin Radiol 2011; 67:495-504. [PMID: 22169349 DOI: 10.1016/j.crad.2011.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 09/23/2011] [Accepted: 10/12/2011] [Indexed: 11/24/2022]
Abstract
The purpose of this article is to provide a comprehensive review of the imaging findings of various parasitic infestations and other miscellaneous infections affecting the gastrointestinal tract. Barium examinations play an important role in the diagnostic workup of parasitic intestinal infections. Knowledge of differential diagnosis, sites of involvement, and imaging features of different infections and infestations can help in accurate diagnosis and guide treatment.
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Affiliation(s)
- R Sinha
- Department of Clinical Radiology, South Warwickshire NHS Foundation Trust, Warwick, UK.
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Abstract
The mediastinum is an uncommon location for vascular malformations. We describe an unusual case of a young patient with a large, extensive mediastinal vascular malformation and draining vein to the left atrium who presented with recurrent ischaemic episodes.
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Affiliation(s)
- P Rajiah
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, USA.
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