1
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Gupta RT, Kalisz K, Khatri G, Caserta MP, Catanzano TM, Chang SD, De Leon AD, Gore JL, Nicola R, Prabhakar AM, Savage SJ, Shah KP, Surabhi VR, Taffel MT, Valente JH, Yoo DC, Nikolaidis P. ACR Appropriateness Criteria® Acute Onset Flank Pain-Suspicion of Stone Disease (Urolithiasis). J Am Coll Radiol 2023; 20:S315-S328. [PMID: 38040458 DOI: 10.1016/j.jacr.2023.08.020] [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: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 12/03/2023]
Abstract
Noncontrast CT (NCCT) is the imaging study of choice for initial evaluation of patients with acute onset of flank pain and suspicion of stone disease without known prior stone disease. NCCT can reliably characterize the location and size of an offending ureteral calculus, identify complications, and diagnose alternative etiologies of abdominal pain. Although less sensitive in the detection of stones, ultrasound may have a role in evaluating for signs of obstruction. Radiography potentially has a role, although has been shown to be less sensitive than NCCT. For patients with known disease and recurrent symptoms of urolithiasis, NCCT remains the test of choice for evaluation. In pregnancy, given radiation concerns, ultrasound is recommended as the initial modality of choice with potential role for noncontrast MRI. In scenarios where stone disease suspected and initial NCCT is inconclusive, contrast-enhanced imaging, either with MRI or CT/CT urogram may be appropriate. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
- Rajan T Gupta
- Duke University Medical Center, Durham, North Carolina.
| | - Kevin Kalisz
- Research Author, Duke University Medical Center, Durham, North Carolina
| | - Gaurav Khatri
- Panel Chair, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | | | - Silvia D Chang
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - John L Gore
- University of Washington, Seattle, Washington; American Urological Association
| | - Refky Nicola
- SUNY Upstate Medical University, Syracuse, New York
| | - Anand M Prabhakar
- Massachusetts General Hospital, Boston, Massachusetts; Committee on Emergency Radiology-GSER
| | - Stephen J Savage
- Medical University of South Carolina, Charleston, South Carolina; American Urological Association
| | - Kevin P Shah
- Duke University Medical Center, Durham, North Carolina, Primary care physician
| | | | - Myles T Taffel
- New York University Langone Medical Center, New York, New York
| | - Jonathan H Valente
- Rhode Island Hospital and Hasbro Children's Hospital, Providence, Rhode Island; American College of Emergency Physicians
| | - Don C Yoo
- Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, Rhode Island; Commission on Nuclear Medicine and Molecular Imaging
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2
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Grassi G, Laino ME, Kalra M, Cherchi MV, Nicola R, Mannelli L, Balestrieri A, Suri JS, Sala E, Saba L. Application of multi-spectral CT imaging in Crohn's disease: a systematic review. Acta Radiol 2023; 64:2347-2356. [PMID: 37138467 DOI: 10.1177/02841851231170849] [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: 05/05/2023]
Abstract
BACKGROUND No quantitative computed tomography (CT) biomarker is actually sufficiently accurate to assess Crohn's disease (CD) lesion activity, with adequate precision to guide clinical decisions. PURPOSE To assess the available literature on the use of iodine concentration (IC), from multi-spectral CT acquisition, as a quantitative parameter able to distinguish healthy from affected bowel and assess CD bowel activity and heterogeneity of activity along the involved segments. MATERIAL AND METHODS A literature search was conducted to identify original research studies published up to February 2022. The inclusion criteria were original research papers (>10 human participants), English language publications, focus on dual-energy CT (DECT) of CD with iodine quantification (IQ) as an outcome measure. The exclusion criteria were animal-only studies, languages other than English, review articles, case reports, correspondence, and study populations <10 patients. RESULTS Nine studies were included in this review; all of which showed a strong correlation between IC measurements and CD activity markers, such as CD activity index (CDAI), endoscopy findings and simple endoscopic score for Crohn's disease (SES-CD), and routine CT enterography (CTE) signs and histopathologic score. Statistically significant differences in IC were reported between affected bowel segments and healthy ones (higher P value was P < 0.001), normal segments and those with active inflammation (P < 0.0001) as well as between patients with active disease and those in remission (P < 0.001). CONCLUSION The mean normalized IC at DECTE could be a reliable tool in assisting radiologists in the diagnosis, classification and grading of CD activity.
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Affiliation(s)
- Giovanni Grassi
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Maria Elena Laino
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
- Artificial Intelligence Center, IRCSS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Mannudeep Kalra
- Department of Radiology, Massachusetts General Hospital and the Harvard Medical School, Boston, MA, USA
| | - Maria Valeria Cherchi
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Refky Nicola
- Department of Radiology, Roswell Park Cancer Institute, Jacobs School of Medicine and Biomedical Science, Buffalo, NY, USA
| | | | - Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Jasjit S Suri
- Diagnostic and Monitoring Division, AtheroPoint™, Roseville, CA, USA
- Knowledge Engineering Center, Global Biomedical Technologies, Inc., Roseville, CA, USA
- Department of Electrical and Computer Engineering, Idaho State University, Pocatello, ID, USA (Affl)
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
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3
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Nicola R, Bittencourt LK. PI-RADS 3 lesions: a critical review and discussion of how to improve management. Abdom Radiol (NY) 2023; 48:2401-2405. [PMID: 37160472 DOI: 10.1007/s00261-023-03929-7] [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: 01/19/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 05/11/2023]
Abstract
Since the publication of PI-RADS v1 in 2012, the debate regarding the question of how to manage PI-RADS 3 lesions has been mostly unsolved. However, based on our review of the current literature we discuss possible solutions and improvements to the original classification, factors such as PSAD (Prostate Specific Antigen Density), age, and tumor volume, in the decision of whether to proceed with a biopsy or not.
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Affiliation(s)
- Refky Nicola
- Division of Abdominal Radiology, SUNY-Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA.
| | - Leonardo Kayat Bittencourt
- School of Medicine, Abdominal Imaging, Case Western University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
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4
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Scialpi M, Martorana E, Trippa F, Di Marzo A, Battista Scalera G, Cristina Aisa M, D’Andrea A, Maria Mancioli F, Nicola R, Scialpi P, Di Blasi A. Prostate Imaging for Local Recurrence Reporting and Data System for Biparametric Magnetic Resonance Imaging: A Proposal. Urol Res Pract 2023; 49:233-240. [PMID: 37877824 PMCID: PMC10544277 DOI: 10.5152/tud.2023.22228] [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] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 06/05/2023] [Indexed: 10/26/2023]
Abstract
We investigated a novel dedicated Prostate Imaging for Local Recurrence Reporting and Data System (PI-RRADS) in biochemical recurrence after radiotherapy (RT) and rad- ical prostatectomy (RP) evaluating biparametric magnetic resonance imaging (bpMRI) exams, at 3T MRI of 55 patients. Associating bpMRI and biochemical recurrence data, we calculated bpMRI diagnostic accuracy. Four probability categories, from 1 (very low) to 4 (very high), were distinguished. In 20 patients with radiotherapy, 25% and 75% of lesions were reported as PI-RRADS 3, and 4, respectively. In 35 patients with radi- cal prostatectomy, 7.7% of lesions were included in PI-RRADS 1-2, whereas 40.4% and 51.9% in PI-RRADS 3 and 4 categories, respectively. Excellent agreement and significant correlation between bpMRI and biochemical recurrence were found. BpMRI showed sensitivity, specificity, positive predictive value, negative predictive value, false-posi- tive value, false-negative value, and total diagnostic accuracy of 96.15%, 86.7%, 97.4 %, 81.25%, 13.3%, 3.8% and 94.6%, respectively. BpMRI-based PI-RRADS allows the detection and localization local recurrence in biochemical recurrence after RT and RP contributing in clinical management and treatment.
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Affiliation(s)
- Michele Scialpi
- Department of Medicine and Surgery, Division of Diagnostic Imaging, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | | | - Fabio Trippa
- Radiation Oncology Centre, Ospedale Santa Maria, Terni, Italy
| | | | | | - Maria Cristina Aisa
- Department of Medicine and Surgery, Division of Obstetric and Gynaecology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | | | | | - Refky Nicola
- Department of Radiology, Syracuse, SUNY Upstate Medical, State University of New York Upstate Medical University, USA
| | - Pietro Scialpi
- Division of Urology, Portogruaro Hospital, Venice, Italy
| | - Aldo Di Blasi
- Division of Radiology, Tivoli Hospital, Tivoli, Italy
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Ganeshan D, Khatri G, Ali N, Avery R, Caserta MP, Chang SD, De Leon AD, Gupta RT, Lyshchik A, Michalski J, Nicola R, Pierorazio PM, Purysko AS, Smith AD, Taffel MT, Nikolaidis P. ACR Appropriateness Criteria® Staging of Renal Cell Carcinoma: 2022 Update. J Am Coll Radiol 2023; 20:S246-S264. [PMID: 37236747 DOI: 10.1016/j.jacr.2023.02.008] [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: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 05/28/2023]
Abstract
Renal cell carcinoma is a complex group of highly heterogenous renal tumors demonstrating variable biological behavior. Pretreatment imaging of renal cell carcinoma involves accurate assessment of the primary tumor, presence of nodal, and distant metastases. CT and MRI are the key imaging modalities used in the staging of renal cell carcinoma. Important imaging features that impact treatment include tumor extension into renal sinus and perinephric fat, involvement of pelvicalyceal system, infiltration into adrenal gland, involvement of renal vein and inferior vena cava, as well as the presence of metastatic adenopathy and distant metastases. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
| | - Gaurav Khatri
- Panel Chair, UT Southwestern Medical Center, Dallas, Texas
| | - Norman Ali
- The University of Texas MD Anderson Cancer Center, Houston, Texas, Primary care physician
| | - Ryan Avery
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Commission on Nuclear Medicine and Molecular Imaging
| | | | - Silvia D Chang
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Rajan T Gupta
- Duke University Medical Center, Durham, North Carolina
| | - Andrej Lyshchik
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Jeff Michalski
- Mallinckrodt Institute of Radiology Washington University School of Medicine, Saint Louis, Missouri; Commission on Radiation Oncology
| | - Refky Nicola
- SUNY Upstate Medical University, Syracuse, New York
| | - Phillip M Pierorazio
- Presbyterian Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania; American Urological Association
| | | | - Andrew D Smith
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Myles T Taffel
- New York University Langone Medical Center, New York, New York
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6
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Nicola R. Will histogram analysis replace mean attenuation threshold in the diagnosis of adrenal lesions? Radiol Bras 2023; 56:V. [PMID: 37168040 PMCID: PMC10165969 DOI: 10.1590/0100-3984.2023.56.2e1] [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: 05/13/2023] Open
Affiliation(s)
- Refky Nicola
- Associate Professor of Radiology, Division of Abdominal Radiology, SUNY Upstate Medical University, Syracuse, NY, USA.
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7
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Olinger K, Maheshwari E, Shenoy-Bhangle AS, Adejolu M, McGettigan M, Mathew H, Lee KS, Nicola R. Mimics of cancer in pregnancy. Abdom Radiol (NY) 2022; 48:1752-1773. [PMID: 36577923 DOI: 10.1007/s00261-022-03783-z] [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] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
Pregnancy is a remarkable time of pronounced growth and development of the fetus. Benign pathologies outside of the uterus, including those containing hormonally responsive tissue which undergo physiologic changes and other incidentally identified lesions, may mimic malignancy on clinical evaluation and imaging. A detailed history and physical exam, ultrasound and non-contrast magnetic resonance imaging features and comparison with prior imaging if available may help to narrow the list of potential differential diagnoses. Follow-up imaging in the postpartum period is often vital to confirm benignity and, in some cases, sampling to confirm the diagnosis is necessary. This review will cover the clinical, pathological and multimodality imaging features of numerous potential mimickers of cancer in the setting of pregnancy organized by organ systems. The goal is to better equip abdominal radiologists to accurately identify benign disease and help guide further imaging or follow-up recommendations to avoid unnecessarily aggressive intervention and improve patient care.
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Affiliation(s)
- Kristen Olinger
- Division of Abdominal Radiology, Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Building, Chapel Hill, NC, 27599, USA.
| | - Ekta Maheshwari
- Division of Abdominal Imaging, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15143, USA
| | - Anuradha S Shenoy-Bhangle
- Division of Abdominal Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02214, USA
| | - Margaret Adejolu
- Department of Radiology, The Royal Marsden Hospital, London, England, UK
| | | | | | - Karen S Lee
- Division of Abdominal Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Refky Nicola
- Division of Abdominal Imaging, Department of Radiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
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8
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Grassi G, Laino ME, Fantini MC, Argiolas GM, Cherchi MV, Nicola R, Gerosa C, Cerrone G, Mannelli L, Balestrieri A, Suri JS, Carriero A, Saba L. Advanced imaging and Crohn’s disease: An overview of clinical application and the added value of artificial intelligence. Eur J Radiol 2022; 157:110551. [DOI: 10.1016/j.ejrad.2022.110551] [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: 06/15/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/03/2022]
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9
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Smith AD, Nikolaidis P, Khatri G, Chong ST, De Leon AD, Ganeshan D, Gore JL, Gupta RT, Kwun R, Lyshchik A, Nicola R, Purysko AS, Savage SJ, Taffel MT, Yoo DC, Delaney EW, Lockhart ME. ACR Appropriateness Criteria® Acute Pyelonephritis: 2022 Update. J Am Coll Radiol 2022; 19:S224-S239. [PMID: 36436954 DOI: 10.1016/j.jacr.2022.09.017] [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: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
Acute pyelonephritis (APN) is a severe urinary tract infection (UTI) that has the potential to cause sepsis, shock, and death. In the majority of patients, uncomplicated APN is diagnosed clinically and is responsive to treatment with appropriate antibiotics. In patients who are high risk or when treatment is delayed, microabscesses may coalesce to form an acute renal abscess. High-risk patients include those with a prior history of pyelonephritis, lack of response to therapy for lower UTI or for APN, diabetes, anatomic or congenital abnormalities of the urinary system, infections by treatment-resistant organisms, nosocomial infection, urolithiasis, renal obstruction, prior renal surgery, advanced age, pregnancy, renal transplant recipients, and immunosuppressed or immunocompromised patients. Pregnant patients and patients with renal transplants on immunosuppression are at an elevated risk of severe complications. Imaging studies are often requested to aid with the diagnosis, identify precipitating factors, and differentiate lower UTI from renal parenchymal involvement, particularly in high-risk individuals. Imaging is usually not appropriate for the first-time presentation of suspected APN in an uncomplicated patient. The primary imaging modalities used in high-risk patients with suspected APN are CT, MRI, and ultrasound, although CT was usually not appropriate for initial imaging in a pregnant patient with no other complications. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer-reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
- Andrew D Smith
- University of Alabama at Birmingham, Birmingham, Alabama.
| | - Paul Nikolaidis
- Vice-Chair, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gaurav Khatri
- UT Southwestern Medical Center, Dallas, Texas; Chief, Division of Body MRI; Interim Chief, Division of Abdominal Imaging; Program Director, Body MRI Fellowship
| | - Suzanne T Chong
- Indiana University, Indianapolis, Indiana; Committee on Emergency Radiology-General, Small, Emergency and/or Rural Practice
| | | | | | - John L Gore
- University of Washington, Seattle, Washington; American Urological Association
| | - Rajan T Gupta
- Duke University Medical Center, Durham, North Carolina
| | - Richard Kwun
- Swedish Medical Center, Issaquah, Washington; American College of Emergency Physicians
| | - Andrej Lyshchik
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Refky Nicola
- Roswell Park Cancer Institute, Jacobs School of Medicine and Biomedical Science, Buffalo, New York
| | - Andrei S Purysko
- Cleveland Clinic, Cleveland, Ohio; ACR Learning Network, Prostate MR Image Quality Improvement Collaborative, Physician Leader
| | - Stephen J Savage
- Medical University of South Carolina, Charleston, South Carolina; American Urological Association; Professor and Vice Chairman of Urology
| | - Myles T Taffel
- New York University Langone Medical Center, New York, New York; Associate Section of Body Imaging
| | - Don C Yoo
- Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, Rhode Island; Commission on Nuclear Medicine and Molecular Imaging
| | - Erin W Delaney
- University of Alabama at Birmingham Medical Center, Birmingham, Alabama; Primary care physician
| | - Mark E Lockhart
- University of Alabama at Birmingham, Birmingham, Alabama; Chair UAB Department Appointments, Promotions, and Tenure Committee
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10
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Nicola R, Pecoraro M, Lucciola S, Dos Reis RB, Narumi Y, Panebianco V, Muglia VF. VI-RADS score system - A primer for urologists. Int Braz J Urol 2022; 48:609-622. [PMID: 35195385 PMCID: PMC9306377 DOI: 10.1590/s1677-5538.ibju.2021.0560] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer (BCa) is one of the most common cancers worldwide and is also considered to be one of the most relapsing and aggressive neoplasms. About 30% of patients will present with muscle invasive disease, which is associated with a higher risk for metastatic disease. The aim of this article is to review the state of art imaging in Radiology, while providing a complete guide to urologists, with case examples, for the rationale of the development of the Vesical Imaging Reporting and Data System (VI-RADS), a scoring system emphasizing a standardized approach to multiparametric Magnetic Resonance Imaging (mpMRI) acquisition, interpretation, and reporting for BCa. Also, we examine relevant external validation studies and the consolidated literature of mpMRI for bladder cancer. In addition, this article discusses some of the potential clinical implications of this scoring system for disease management and follow-up.
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Affiliation(s)
- Refky Nicola
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Martina Pecoraro
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Italy
| | - Sara Lucciola
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Italy
| | - Rodolfo Borges Dos Reis
- Departamento de Cirurgia, Divisão de Urologia - Faculdade de Medicina de Ribeirão Preto - USP, Ribeirão Preto, SP, Brasil
| | | | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Italy
| | - Valdair Francisco Muglia
- Departamento de Imagens Médicas, Oncologia e Hematologia - Divisão de Imagem, Faculdade de Medicina de Ribeirão Preto - USP, Ribeirão Preto, SP, Brasil
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11
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Causa-Andrieu P, Nicola R, Lipsich F, Adri D, Gomez M, Pol M, Wernicke A, Saraniti G, Chacon CRB. Characterization of Ovarian Granulosa Cell Tumors using Magnetic Resonance Imaging. Med Res Arch 2022; 10:10.18103/mra.v10i6.2813. [PMID: 36276660 PMCID: PMC9583456 DOI: 10.18103/mra.v10i6.2813] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE To identify the MRI features that aid in the characterization of ovarian granulosa cell tumors. MATERIALS AND METHODS 11 MR pelvis of an adult woman with pathology-proven ovarian granulosa cell tumors with surgical pathology.We evaluated the patient's age, Ca-125, size, laterality, and with MRI features such as indirect signs (i.e., thickened endometrium > 0.9 cm), morphology (cystic, solid-cystic, or solid), subacute hemorrhage, T2 signal (low or intermediate-to-high), restricted diffusion (B values: 0, 50, 1000 sec/mm3/ADC), and dynamic enhancement (intense or similar to myometrium). Also, the presence of ascites, peritoneal implants, or adenopathy. RESULTS The final cohort included 11 women with a surgical-pathological diagnosis of granulosa cell tumors. The median age was 52.4 years (range, 17-80). The Ca-125 level was with a median within normal limits. The median size was 9.4 cm. Most cases were unilateral (81.8%) and more frequent on the left (54.5%). MRI ANALYSIS 36.4% had endometrial thickening. Ovarian granulosa cell tumors were polymorphous: cystic (54.6%), mixed solid-cystic (9.1%), and solid (36.3%). Most GC had intermediate to high signal on T2 (90.9%), restricted diffusion (81.8%), intense enhancement (81.8%), and 36.4% had intraparenchymal bleeding. 9.1% had associated implants/adenopathy/ascites at diagnosis. CONCLUSION The MRI features characteristic of ovarian granulosa cell tumors were the polymorphous morphology, an intense enhancement to the myometrium, restricted diffusion, and the presence of intraparenchymal hemorrhage.
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Affiliation(s)
| | - Refky Nicola
- Roswell Park Comprehensive Cancer Center, United States
| | | | - Daniel Adri
- Radiology Service. Hospital Italiano de Buenos Aires, Argentina
| | | | - Melina Pol
- Pathology Service. Hospital Italiano de Buenos Aires, Argentina
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12
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Cau R, Mantini C, Monti L, Mannelli L, Di Dedda E, Mahammedi A, Nicola R, Roubil J, Suri JS, Cerrone G, Fanni D, Faa G, Carriero A, Scuteri A, Francone M, Saba L. Role of imaging in rare COVID-19 vaccine multiorgan complications. Insights Imaging 2022; 13:44. [PMID: 35286509 PMCID: PMC8919150 DOI: 10.1186/s13244-022-01176-w] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/25/2022] [Indexed: 12/19/2022] Open
Abstract
As of September 18th, 2021, global casualties due to COVID-19 infections approach 200 million, several COVID-19 vaccines have been authorized to prevent COVID-19 infection and help mitigate the spread of the virus. Despite the vast majority having safely received vaccination against SARS-COV-2, the rare complications following COVID-19 vaccination have often been life-threatening or fatal. The mechanisms underlying (multi) organ complications are associated with COVID-19, either through direct viral damage or from host immune response (i.e., cytokine storm). The purpose of this manuscript is to review the role of imaging in identifying and elucidating multiorgan complications following SARS-COV-2 vaccination-making clear that, in any case, they represent a minute fraction of those in the general population who have been vaccinated. The authors are both staunch supporters of COVID-19 vaccination and vaccinated themselves as well.
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Affiliation(s)
- Riccardo Cau
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, 09045, Cagliari, Italy
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University, Chieti, Italy
| | - Lorenzo Monti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | | | - Emanuele Di Dedda
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Abdelkader Mahammedi
- Department of Neuroradiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Refky Nicola
- Roswell Park Cancer Institute, Jacobs School of Medicine and Biomedical Science, Buffalo, NY, USA
| | - John Roubil
- Roswell Park Cancer Institute, Jacobs School of Medicine and Biomedical Science, Buffalo, NY, USA
| | - Jasjit S Suri
- Stroke Diagnosis and Monitoring Division, Atheropoint LLC, Roseville, CA, USA
| | - Giulia Cerrone
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari, Cagliari, Italy
| | - Daniela Fanni
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari, Cagliari, Italy
| | - Gavino Faa
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari, Cagliari, Italy
| | - Alessandro Carriero
- Department of Diagnostic and Interventional Radiology, AOU Ospedale Maggiore Della Carità Di Novara, Novara, Italy
| | - Angelo Scuteri
- Department of Diagnostic and Interventional Radiology, AOU Ospedale Maggiore Della Carità Di Novara, Novara, Italy
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, 09045, Cagliari, Italy.
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13
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Valente T, Guarino S, Lassandro G, Picchi S, Romano F, Massimo C, Rea G, Lieto R, Nicola R, Lassandro F. Cystic lung diseases: radiological aspects. Clin Radiol 2022; 77:e337-e345. [DOI: 10.1016/j.crad.2022.01.044] [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: 07/13/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
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14
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Scialpi M, Scalera G, Bellini A, Biagelli A, Chiodi M, Nicola R. Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19. Lung India 2022; 39:174-176. [PMID: 35259801 PMCID: PMC9053914 DOI: 10.4103/lungindia.lungindia_654_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives: There are scant data available in the published literature providing chest computed tomography (CT) findings on pulmonary interstitial emphysema (PIE), complications and associated parenchymal abnormalities. We report the incidence of PIE and complications by chest CT in patients with COVID-19. Methods: We retrospective analyzed 897 chest CT scans performed with 64-slice CT scanners during the COVID-19 pandemic period from March 2020 to September 2021. Two radiologists and two physicians in training in diagnostic radiology, independently and in consensus, assessed PIE as air within the perilobular (low-attenuation area) and perivascular interstitium such as its complications, parenchymal anomalies and pleural effusion; in addition, the complications of PIE, parenchymal anomalies and pleural effusion were evaluated. Descriptive statistics were used to summarize the data, and the results were expressed as counts and percentages. Results: PIE was revealed in 25 out of 897 patients (2.8%) and associated with pneumomediastinum, subcutaneous emphysema, and pneumothorax in 25 (100%), 16 (64%), and 7 (28%), patients, respectively. Out of 25 patients, 24 patients had ground-glass opacity (GGO), 23 patients had crazy paving, 22 patients had consolidation and 2 patients had pleural effusion. Eighteen out of 25 patients had noninvasive ventilation before CT scan, initially treated with continuous positive airway pressure (positive end expiratory pressure [PEEP] of 10 cmH2O) and subsequently with bilevel positive airway pressure (range PEEP of 8–12 cmH2O). The remaining seven patients had invasive mechanical ventilation via orotracheal intubation (pressure plateau at approximately 25 cmH2O). Six out of 25 (24%) patients died. Conclusion: Chest CT allows the detection of complications associated with PIE and parenchyma abnormalities. The timely detection of PIE and minimal pneumomediastinum could aid the optimization of ventilation modalities and parameters based on patients clinical status therefore potentially reducing complications.
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15
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Brook OR, Vernuccio F, Nicola R, Cannella R, Altinmakas E. Visual abstract for Abdominal Radiology: what it is, why we need it and how to make it. Abdom Radiol (NY) 2021; 46:2403-2406. [PMID: 33484282 PMCID: PMC7823171 DOI: 10.1007/s00261-020-02941-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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16
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Lakhman Y, Vargas HA, Reinhold C, Akin EA, Bhosale PR, Huang C, Kang SK, Khanna N, Kilcoyne A, Nicola R, Paspulati R, Rauch GM, Shinagare AB, Small W, Glanc P. ACR Appropriateness Criteria® Staging and Follow-up of Vulvar Cancer. J Am Coll Radiol 2021; 18:S212-S228. [PMID: 33958115 DOI: 10.1016/j.jacr.2021.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 11/21/2022]
Abstract
Vulvar cancer is an uncommon gynecologic tumor and one of several human papillomavirus-associated malignancies. Squamous cell carcinoma is the most prevalent histologic subtype of vulvar cancer, accounting for the majority of cases. Imaging plays an important role in managing vulvar cancer. At initial diagnosis, imaging is useful to assess the size and extent of primary tumor and to evaluate the status of inguinofemoral lymph nodes. If recurrent disease is suspected, imaging is essential to demonstrate local extent of tumor and to identify lymph node and distant metastases. In this publication, we summarize the recent literature and describe the panel's recommendations about the appropriate use of imaging for various phases of patient management including initial staging, surveillance, and restaging of vulvar cancer. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Yulia Lakhman
- Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Hebert Alberto Vargas
- Memorial Sloan Kettering Cancer Center, New York, New York, Chief, Body Imaging Service, Memorial Sloan Kettering Cancer Center
| | | | - Esma A Akin
- George Washington University Hospital, Washington, District of Columbia
| | | | - Chenchan Huang
- New York University Langone Medical Center, New York, New York
| | - Stella K Kang
- New York University Medical Center, New York, New York
| | - Namita Khanna
- Emory University, Atlanta, Georgia, Society of Gynecologic Oncology
| | | | - Refky Nicola
- Roswell Park Cancer Institute, Jacobs School of Medicine and Biomedical Science, Buffalo, New York
| | | | - Gaiane M Rauch
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Atul B Shinagare
- Brigham & Women's Hospital Dana-Farber Cancer Institute, Boston, Massachusetts
| | - William Small
- Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, Illinois, Professor and Chairman, Department of Radiation Oncology, Loyola University, Director, Cardinal Bernardin Cancer Center
| | - Phyllis Glanc
- Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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17
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Affiliation(s)
- Michele Scialpi
- Division of Diagnostic Imaging, Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, S. Andrea delle Fratte, 06159 Perugia, Italy, e-mail:
| | - Maria Emanuela Vitale
- Division of Diagnostic Imaging, Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, S. Andrea delle Fratte, 06159 Perugia, Italy, e-mail:
| | - Elena Gallo
- Division of Diagnostic Imaging, Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, S. Andrea delle Fratte, 06159 Perugia, Italy, e-mail:
| | - Refky Nicola
- Department of Radiology, Roswell Park Cancer Institute, Buffalo, NY
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18
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Affiliation(s)
- Michele Scialpi
- Full Professor of Radiology, Department of Surgical and Biomedical Sciences, Chairman of Diagnostic Imaging Division, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Ewa Barbara Sielaszuk
- Full Professor of Radiology, Department of Surgical and Biomedical Sciences, Chairman of Diagnostic Imaging Division,, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Maria Emanuela Vitale
- Full Professor of Radiology, Department of Surgical and Biomedical Sciences, Chairman of Diagnostic Imaging Division,, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Giovanni Battista Scalera
- Division of Radiology 1, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Refky Nicola
- Department of Radiology, Roswell Park Cancer Institute, Radiology, Buffalo, NY, USA
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19
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Scaglione M, Basilico R, Delli Pizzi A, Iacobellis F, Dick E, Wirth S, Linsenmaier U, Calli C, Berger FH, Nieboer KH, Blanco Barrio A, Dumba M, Grassi R, Katulska K, Schueller G, Patlas MN, Laghi A, Muto M, Nicola R, Zins M, Miele V, Hartley R, Katz DS, Derchi L. Correction to: The practice of emergency radiology throughout Europe: a survey from the European Society of Emergency Radiology on volume, staffing, equipment, and scheduling. Eur Radiol 2020; 31:4407-4408. [PMID: 33289875 DOI: 10.1007/s00330-020-07520-2] [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: 11/29/2022]
Affiliation(s)
- Mariano Scaglione
- Department of Radiology, James Cook University Hospital, Middlesbrough, UK.,School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, UK.,Department of Radiology, Pineta Grande Hospital, Castel Volturno, CE, Italy
| | - Raffaella Basilico
- Department of Neuroscience Imaging and Clinical Science, Gabriele D'Annunzio University, Chieti, Italy
| | - Andrea Delli Pizzi
- Department of Neuroscience Imaging and Clinical Science, Gabriele D'Annunzio University, Chieti, Italy
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli St 9, 80131, Naples, Italy.
| | - Elizabeth Dick
- Department of Radiology, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Stefan Wirth
- Department of Radiology and Nuclear Medicine, Schwarzwald-Baar Hospital, Klinikstr. 11, 78052, Villingen-Schwenningen, Germany
| | - Ulrich Linsenmaier
- Institute for Diagnostic and Interventional Radiology, HELIOS Klinikum Munich West and Munich Perlach, Munich, Germany
| | - Cem Calli
- Radiology Department, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ferco H Berger
- Department of Medical Imaging, Sunnybrook Health Science Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Koenraad H Nieboer
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Ana Blanco Barrio
- Servicio de Radiodiagnóstico, Sección de Radiología de Urgencias, Hospital G.U. Morales Meseguer, Av. Marqués de los Vélez s/n, 30008, Murcia, Spain
| | - Maureen Dumba
- Department of Radiology, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Roberto Grassi
- Department of Radiology, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - Katarzyna Katulska
- Department of Radiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Gerd Schueller
- ERS Emergency Radiology Schueller, 6302, Zug, Switzerland
| | - Michael N Patlas
- Department of Radiology, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario, L8L 2X2, Canada
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, "Sapienza" - University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Mario Muto
- Department of Neuroradiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli St 9, 80131, Naples, Italy
| | - Refky Nicola
- Department of Radiology, SUNY-Upstate University and Medical Center, Syracuse, NY, USA
| | - Marc Zins
- Radiology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Richard Hartley
- Department of Radiology, James Cook University Hospital, Middlesbrough, UK.,School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, UK
| | - Douglas S Katz
- Department of Radiology, NYU Wintrop Hospital, Mineola, NY, USA
| | - Lorenzo Derchi
- Department of Health Sciences, Radiology Section, University of Genoa, Genoa, Italy.,Department of Emergency Radiology, San Martino Policlinico Hospital, Genoa, Italy
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20
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Reinhold C, Ueno Y, Akin EA, Bhosale PR, Dudiak KM, Jhingran A, Kang SK, Kilcoyne A, Lakhman Y, Nicola R, Pandharipande PV, Paspulati R, Shinagare AB, Small W, Vargas HA, Whitcomb BP, Glanc P. ACR Appropriateness Criteria® Pretreatment Evaluation and Follow-Up of Endometrial Cancer. J Am Coll Radiol 2020; 17:S472-S486. [PMID: 33153558 DOI: 10.1016/j.jacr.2020.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 11/19/2022]
Abstract
To date, there is little consensus on the role of pelvic imaging in assessing local disease extent during initial staging in patients with endometrial carcinoma, with practices differing widely across centers. However, when pretreatment assessment of local tumor extent is indicated, MRI is the preferred imaging modality. Preoperative imaging of endometrial carcinoma can define the extent of disease and indicate the need for subspecialist referral in the presence of deep myometrial invasion, cervical extension, or suspected lymphadenopathy. If distant metastatic disease is clinically suspected, preoperative assessment with cross-sectional imaging or PET/CT may be performed. However, most patients with low-grade disease are at low risk of lymph node and distant metastases. Thus, this group may not require a routine pretreatment evaluation for distant metastases. Recurrence rates in patients with endometrial carcinoma are infrequent. Therefore, radiologic evaluation is typically used only to investigate suspicion of recurrent disease due to symptoms or physical examination and not for routine surveillance after treatment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | - Yoshiko Ueno
- Research Author, Kobe University Graduate School of Medicine, Kobe, Japan, McGill University, Montreal, Quebec, Canada
| | - Esma A Akin
- George Washington University Hospital, Washington, District of Columbia
| | | | | | - Anuja Jhingran
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stella K Kang
- New York University Medical Center, New York, New York
| | | | - Yulia Lakhman
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Refky Nicola
- Roswell Park Cancer Institute, Jacobs School of Medicine and Biomedical Science, Buffalo, New York
| | | | - Rajmohan Paspulati
- University Hospitals Medical Group Radiology, Cleveland, Ohio, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Atul B Shinagare
- Brigham & Women's Hospital Dana-Farber Cancer Institute, Boston, Massachusetts
| | - William Small
- Stritch School of Medicine Loyola University Chicago, Maywood, Illinois
| | | | - Bradford P Whitcomb
- University of Connecticut, Farmington, Connecticut; Society of Gynecologic Oncology
| | - Phyllis Glanc
- Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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21
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Scialpi M, Improta A, Carpini DD, Tonto M, Nicola R, Mancioli F. Biparametric magnetic resonance imaging in the surveillance of testicular tumors following radical orchiectomy. Turk J Urol 2020; 46:436-441. [DOI: 10.5152/tud.2020.20353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 11/22/2022]
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22
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Dudiak KM, Maturen KE, Akin EA, Bell M, Bhosale PR, Kang SK, Kilcoyne A, Lakhman Y, Nicola R, Pandharipande PV, Paspulati R, Reinhold C, Ricci S, Shinagare AB, Vargas HA, Whitcomb BP, Glanc P. ACR Appropriateness Criteria® Gestational Trophoblastic Disease. J Am Coll Radiol 2020; 16:S348-S363. [PMID: 31685103 DOI: 10.1016/j.jacr.2019.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Abstract
Gestational trophoblastic disease (GTD), a rare complication of pregnancy, includes both benign and malignant forms, the latter collectively referred to as gestational trophoblastic neoplasia (GTN). When metastatic, the lungs are the most common site of initial spread. Beta-human chorionic gonadotropin, elaborated to some extent by all forms of GTD, is useful in facilitating disease detection, diagnosis, monitoring treatment response, and follow-up. Imaging evaluation depends on whether GTD manifests in one of its benign forms or whether it has progressed to GTN. Transabdominal and transvaginal ultrasound with duplex Doppler evaluation of the pelvis are usually appropriate diagnostic procedures in either of these circumstances, and in posttreatment surveillance. The appropriateness of more extensive imaging remains dependent on a diagnosis of GTN and on other factors. The use of imaging to assess complications, typically hemorrhagic, should be guided by the location of clinical signs and symptoms. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | - Esma A Akin
- George Washington University Hospital, Washington, District of Columbia
| | - Maria Bell
- Sanford Health, Sioux Falls, South Dakota, American College of Obstetricians and Gynecologists
| | | | - Stella K Kang
- New York University Medical Center, New York, New York
| | | | - Yulia Lakhman
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Refky Nicola
- State University of New York Upstate Medical University, Syracuse, New York
| | | | | | | | - Stephanie Ricci
- Cleveland Clinic, Cleveland, Ohio, American College of Obstetricians and Gynecologists
| | - Atul B Shinagare
- Brigham & Women's Hospital Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Bradford P Whitcomb
- University of Connecticut, Farmington, Connecticut, Society of Gynecologic Oncology
| | - Phyllis Glanc
- Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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23
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Abstract
Acute pyelonephritis is a bacterial infection of the renal parenchyma and collecting system. Diagnosis is based on clinical findings of fever, flank pain, and urinary tract infection. Computed tomography findings include renal enlargement with wedge-shaped heterogeneous areas of decreased enhancement, known as a "striated nephrogram." Imaging is primarily used to diagnose complications such as emphysematous pyelonephritis, renal abscess, and pyonephrosis. Chronic pyelonephritis can have varying appearances on imaging ranging from xanthogranulomatous pyelonephritis or, in extreme cases, renal replacement lipomatosis.
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Affiliation(s)
- Maria Zulfiqar
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St Louis, MO 63110, USA.
| | - Cristián Varela Ubilla
- Radiology Department, Clinica Davila, Avenida Recoleta 464, Recoleta, Santiago 8431657, Chile
| | - Refky Nicola
- Division of Body Imaging, Department of Radiology, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14203, USA
| | - Christine O Menias
- Mayo Clinic School of Medicine, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
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24
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Jha P, Sakala M, Chamie LP, Feldman M, Hindman N, Huang C, Kilcoyne A, Laifer-Narin S, Nicola R, Poder L, Shenoy-Bhangle A, Tong A, VanBuren W, Taffel MT. Endometriosis MRI lexicon: consensus statement from the society of abdominal radiology endometriosis disease-focused panel. Abdom Radiol (NY) 2020; 45:1552-1568. [PMID: 31728612 DOI: 10.1007/s00261-019-02291-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 12/15/2022]
Abstract
Endometriosis is a common gynecologic disorder characterized by the presence of ectopic endometrial tissue outside the endometrial cavity. Magnetic Resonance Imaging (MRI) has become a mainstay for diagnosis and staging of this disease. In the literature, significant heterogeneity exists in the descriptions of imaging findings and anatomic sites of involvement. The Society of Abdominal Radiology's Endometriosis Disease-Focused Panel presents this consensus document to establish an MRI lexicon for endometriosis MRI evaluation and anatomic localization.
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Affiliation(s)
- Priyanka Jha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA, USA.
| | - Michelle Sakala
- Department of Radiology, Michigan Medicine (University of Michigan), Ann Arbor, MI, USA
| | - Luciana Pardini Chamie
- Department of Diagnostic Imaging, Chamié Imagem da Mulher, Fleury Medicina e Saúde, São Paulo, Brazil
| | - Myra Feldman
- Cleveland Clinic Imaging Institute, Cleveland, OH, USA
| | - Nicole Hindman
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Chenchan Huang
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Sherelle Laifer-Narin
- Department of Radiology, Columbia University / New York Presbyterian Hospital, New York, NY, USA
| | - Refky Nicola
- Roswell Park Cancer Institute, Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, NY, USA
| | - Liina Poder
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA, USA
| | - Anuradha Shenoy-Bhangle
- Division of Abdominal Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Angela Tong
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Wendy VanBuren
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Myles T Taffel
- Department of Radiology, New York University School of Medicine, New York, NY, USA
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25
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Tong A, VanBuren WM, Chamié L, Feldman M, Hindman N, Huang C, Jha P, Kilcoyne A, Laifer-Narin S, Nicola R, Poder L, Sakala M, Shenoy-Bhangle AS, Taffel MT. Recommendations for MRI technique in the evaluation of pelvic endometriosis: consensus statement from the Society of Abdominal Radiology endometriosis disease-focused panel. Abdom Radiol (NY) 2020; 45:1569-1586. [PMID: 32193592 DOI: 10.1007/s00261-020-02483-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 12/15/2022]
Abstract
Endometriosis is a common entity causing chronic pain and infertility in women. The gold standard method for diagnosis is diagnostic laparoscopy, which is invasive and costly. MRI has shown promise in its ability to diagnose endometriosis and its efficacy for preoperative planning. The Society of Abdominal Radiology established a Disease-Focused Panel (DFP) to improve patient care for patients with endometriosis. In this article, the DFP performs a literature review and uses its own experience to provide technical recommendations on optimizing MRI Pelvis for the evaluation of endometriosis.
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Affiliation(s)
- Angela Tong
- Department of Radiology, New York University Langone Health, 660 1st Ave, 3rd Floor, New York, NY, 10016, USA.
| | | | - Luciana Chamié
- Department of Diagnostic Imaging, Chamié Imagem da Mulher, Fleury Medicina e Saúde, São Paulo, Brazil
| | - Myra Feldman
- Cleveland Clinic Imaging Institute, Cleveland, OH, USA
| | - Nicole Hindman
- Department of Radiology, New York University Langone Health, 660 1st Ave, 3rd Floor, New York, NY, 10016, USA
| | - Chenchan Huang
- Department of Radiology, New York University Langone Health, 660 1st Ave, 3rd Floor, New York, NY, 10016, USA
| | - Priyanka Jha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Refky Nicola
- Roswell Park Cancer Institute, University of Buffalo Jacobi Medical Center, Buffalo, NY, USA
| | - Liina Poder
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Michelle Sakala
- Department of Radiology, Michigan Medicine (University of Michigan), Ann Arbor, MI, USA
| | - Anuradha S Shenoy-Bhangle
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Myles T Taffel
- Department of Radiology, New York University Langone Health, 660 1st Ave, 3rd Floor, New York, NY, 10016, USA
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Iacobellis F, Laccetti E, Tamburrini S, Altiero M, Iaselli F, Di Serafino M, Gagliardi N, Danzi R, Rengo A, Romano L, Nicola R, Scaglione M. Role of multidetector computed tomography in the assessment of pancreatic injuries after blunt trauma: a multicenter experience. Gland Surg 2019; 8:184-196. [PMID: 31183328 DOI: 10.21037/gs.2019.02.02] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/17/2022]
Abstract
Pancreatic injuries can occur from either penetrating or blunt abdominal trauma. While there are rare, especially in the setting of blunt abdominal trauma, they are associated with a mortality of up to 30%, and a morbidity of 60%. Multidetector computed tomography (MDCT) is the preferred imaging modality in patients with acute blunt abdominal trauma and for the detection of acute pancreatic injury. Magnetic resonance (MR) and magnetic resonance cholangiopancreatography (MRCP) plays an important role in the follow-up of pancreatic injury. In this brief review, we discuss the main MDCT acute imaging findings as well as the complications. Finally, we discuss the role of MR and MRCP in follow up of patients with pancreatic injuries.
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Affiliation(s)
- Francesca Iacobellis
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Naples, Italy
| | - Ettore Laccetti
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno, CE, Italy
| | - Stefania Tamburrini
- Department of Radiology, "Ospedale del Mare" ASL NA1 Centro-Napoli, Naples, Italy
| | - Michele Altiero
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno, CE, Italy
| | - Francesco Iaselli
- Department of Radiology, "Ospedale del Mare" ASL NA1 Centro-Napoli, Naples, Italy
| | - Marco Di Serafino
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Naples, Italy
| | - Nicola Gagliardi
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Naples, Italy
| | - Roberta Danzi
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno, CE, Italy
| | - Alessandro Rengo
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno, CE, Italy
| | - Luigia Romano
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Naples, Italy
| | - Refky Nicola
- Department of Radiology, SUNY-Upstate University and Medical Center, Syracuse, NY, USA
| | - Mariano Scaglione
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno, CE, Italy.,Department of Radiology, Sunderland Royal Hospital, NHS, Sunderland, UK
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27
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Kang SK, Reinhold C, Atri M, Benson CB, Bhosale PR, Jhingran A, Lakhman Y, Maturen KE, Nicola R, Pandharipande PV, Salazar GM, Shipp TD, Simpson L, Small W, Sussman BL, Uyeda JW, Wall DJ, Whitcomb BP, Zelop CM, Glanc P. ACR Appropriateness Criteria ® Staging and Follow-Up of Ovarian Cancer. J Am Coll Radiol 2019; 15:S198-S207. [PMID: 29724422 DOI: 10.1016/j.jacr.2018.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 02/23/2018] [Accepted: 03/04/2018] [Indexed: 12/12/2022]
Abstract
In the management of epithelial ovarian cancers, imaging is used for cancer detection and staging, both before and after initial treatment. The decision of whether to pursue initial cytoreductive surgery for ovarian cancer depends in part on accurate staging. Contrast-enhanced CT of the abdomen and pelvis (and chest where indicated) is the current imaging modality of choice for the initial staging evaluation of ovarian cancer. Fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT and MRI may be appropriate for problem-solving purposes, particularly when lesions are present on CT but considered indeterminate. In patients who achieve remission, clinical suspicion for relapse after treatment prompts imaging evaluation for recurrence. Contrast-enhanced CT is the modality of choice to assess the extent of recurrent disease, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT is also usually appropriate, as small metastatic foci may be identified. If imaging or clinical examination confirms a recurrence, the extent of disease and timing of disease recurrence then determines the choice of treatments, including surgery, chemotherapy, and radiation therapy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | - Stella K Kang
- Principal Author, New York University Medical Center, New York, New York.
| | | | - Mostafa Atri
- Toronto General Hospital, Toronto, Ontario, Canada
| | | | | | - Anuja Jhingran
- University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yulia Lakhman
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Refky Nicola
- State University of New York Upstate Medical University, Syracuse, New York
| | | | | | - Thomas D Shipp
- Brigham & Women's Hospital, Boston, Massachusetts; American Congress of Obstetricians and Gynecologists
| | - Lynn Simpson
- Columbia University, New York, New York; American Congress of Obstetricians and Gynecologists
| | - William Small
- Stritch School of Medicine Loyola University Chicago, Maywood, Illinois
| | - Betsy L Sussman
- The University of Vermont Medical Center, Burlington, Vermont
| | | | | | - Bradford P Whitcomb
- Tripler Army Medical Center, Honolulu, Hawaii; Society of Gynecologic Oncology
| | - Carolyn M Zelop
- Valley Hospital, Ridgewood, New Jersey, and NYU School of Medicine, New York, New York; American Congress of Obstetricians and Gynecologists
| | - Phyllis Glanc
- Specialty Chair, Sunnybrook Health Sciences Centre Bayview Campus, Toronto, Ontario, Canada
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Abstract
Oncologic emergencies can be either the result of the primary tumor, its metastasis, a paraneoplastic syndrome or reaction to the chemotherapy. Imaging plays a crucial role in ensuring a prompt diagnosis as well as assisting in the therapeutic management. In this article, we discuss the common thoracic and abdominal oncological emergencies that may be encountered in an emergency department.
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Affiliation(s)
- Francesca Iacobellis
- Department of Radiology, "Pineta Grande" Hospital, Castel Volturno (CE), Italy; Department of Radiology, "A. Cardarelli" Hospital, Naples, Italy; Department of Radiology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alessandra Perillo
- Department of Radiology, "Pineta Grande" Hospital, Castel Volturno (CE), Italy; Department of Radiology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Isabella Iadevito
- Department of Radiology, "Pineta Grande" Hospital, Castel Volturno (CE), Italy
| | - Michela Tanga
- Department of Radiology, "Pineta Grande" Hospital, Castel Volturno (CE), Italy
| | - Luigia Romano
- Department of Radiology, "A. Cardarelli" Hospital, Naples, Italy
| | - Roberto Grassi
- Department of Radiology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Refky Nicola
- Department of Radiology, SUNY-Upstate University and Medical Center, Syracuse, NY
| | - Mariano Scaglione
- Department of Radiology, "Pineta Grande" Hospital, Castel Volturno (CE), Italy; Department of Radiology, Sunderland Royal Hospital, NHS, Sunderland, UK.
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29
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Pandharipande PV, Lowry KP, Reinhold C, Atri M, Benson CB, Bhosale PR, Green ED, Kang SK, Lakhman Y, Maturen KE, Nicola R, Salazar GM, Shipp TD, Simpson L, Sussman BL, Uyeda J, Wall DJ, Whitcomb B, Zelop CM, Glanc P. ACR Appropriateness Criteria ® Ovarian Cancer Screening. J Am Coll Radiol 2017; 14:S490-S499. [DOI: 10.1016/j.jacr.2017.08.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 11/27/2022]
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30
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Iacobellis F, Iadevito I, Ierardi AM, Carrafiello G, Perillo F, Nicola R, Scaglione M. Imaging Assessment of Thoracic Cage Injuries. Semin Musculoskelet Radiol 2017; 21:303-314. [PMID: 28571092 DOI: 10.1055/s-0037-1602413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Thoracic injuries are the third most common traumatic injury. Approximately two thirds of thoracic injuries are due to motor vehicle collisions. They are associated with up to a 20% mortality rate. This is primarily due to the presence of several complex anatomical structures within the thoracic cage such as the heart, great vessels, esophagus, airways, lungs, mediastinum, bones, muscles, diaphragm, and pleura. A chest radiograph is the initial imaging modality in the evaluation of the chest. However, multidetector computer tomography (MDCT) with intravenous contrast is the imaging modality of choice in the assessment of acute thoracic injuries.Endovascular repair is less invasive and has a better outcome than traditional surgical repair. This review article discusses the indications, benefits, and findings of radiographs and MDCT in patients with thoracic injuries, especially with regard to the thoracic aorta.
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Affiliation(s)
- Francesca Iacobellis
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno CE, Italy.,Department of Radiology, Second University of Naples, Naples, Italy
| | - Isabella Iadevito
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno CE, Italy
| | - Anna Maria Ierardi
- Department of Radiology, Unit of Interventional Radiology, University of Insubria, Varese, Italy
| | - Gianpaolo Carrafiello
- Diagnostic and Interventional Radiology Department, University of Milan, San Paolo Hospital, Milan, Italy
| | - Federica Perillo
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno CE, Italy
| | - Refky Nicola
- Department of Radiology, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts
| | - Mariano Scaglione
- Department of Diagnostic Imaging, "Pineta Grande" Hospital, Castel Volturno CE, Italy.,Department of Radiology, Sunderland Royal Hospital, NHS Trust, United Kingdom
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31
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Nicola R, Kawakyu-O'Connor D, Scalgione M. Imaging of Vascular Injuries of the Extremities. Semin Musculoskelet Radiol 2017; 21:336-348. [PMID: 28571094 DOI: 10.1055/s-0037-1602410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Multidetector computed tomography angiography (MDCTA) of the upper and lower extremities is the standard of care in the assessment of trauma patients with vascular trauma of the upper and lower extremities. A MDCTA of the extremities is typically integrated into multiphasic whole-body computed tomography trauma protocols in patients with suspected vascular injury. MDCTA has replaced catheter-directed digital subtraction angiography (DSA) as the modality of choice for the initial detection and characterization of vascular injuries because it is readily available, noninvasive, and faster than DSA. Understanding the imaging findings and pitfalls of upper and lower extremity MDCTA is essential in the diagnosis of vascular injuries such as active hemorrhage, vasospasm and stenosis, hematoma, occlusion and thrombosis, posttraumatic arteriovenous fistula, pseudoaneurysm, and patterns of intimal injury including dissection. We discuss the diagnosis and characterization of vascular injuries of the upper and lower extremities using MDCTA including derived multiplanar reconstructions, maximum intensity projection, and three-dimensional volume rendering techniques.
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Affiliation(s)
- Refky Nicola
- Department of Radiology, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts
| | - Don Kawakyu-O'Connor
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York
| | - Mariano Scalgione
- Department of Radiology Pienta Grande, Hospital Castel Volturno, Italy.,Royal Stoke University Hospital UHNM, Stoke-on-Trent, London, United Kingdom
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32
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Hanna TN, Shekhani H, Lamoureux C, Mar H, Nicola R, Sliker C, Johnson JO. Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction. J Am Coll Radiol 2017; 14:345-352. [DOI: 10.1016/j.jacr.2016.09.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/11/2016] [Accepted: 09/19/2016] [Indexed: 01/27/2023]
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33
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Wong NZ, Rosen T, Sanchez AM, Bloemen EM, Mennitt KW, Hentel K, Nicola R, Murphy KJ, LoFaso VM, Flomenbaum NE, Lachs MS. Imaging Findings in Elder Abuse: A Role for Radiologists in Detection. Can Assoc Radiol J 2016; 68:16-20. [PMID: 27745989 DOI: 10.1016/j.carj.2016.06.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/20/2016] [Accepted: 06/01/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification. METHODS We present 2 cases to begin characterisation of the radiographic findings in elder abuse. RESULTS Findings from these cases demonstrate similarities to suspicious findings in child abuse including high-energy fractures that are inconsistent with reported mechanisms and the coexistence of acute and chronic injuries. Specific injuries uncommon to accidental injury are also noted, including a distal ulnar diaphyseal fracture. CONCLUSIONS We hope to raise awareness of elder abuse among diagnostic radiologists to encourage future large-scale research, increased focus on chronic osseous findings, and the addition of elder abuse to differential diagnoses.
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Affiliation(s)
- Natalie Z Wong
- Division of Emergency Medicine, Weill Cornell Medical College, New York, New York, USA; Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Tony Rosen
- Division of Emergency Medicine, Weill Cornell Medical College, New York, New York, USA.
| | - Allen M Sanchez
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | | | - Kevin W Mennitt
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Keith Hentel
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Refky Nicola
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Kieran J Murphy
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Veronica M LoFaso
- Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Neal E Flomenbaum
- Division of Emergency Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Mark S Lachs
- Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
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34
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Abstract
The advent of multi-detector computed tomography (MDCT) has drastically improved the outcomes of patients with multiple traumatic injuries. However, there are still diagnostic challenges to be considered. A missed or the delay of a diagnosis in trauma patients can sometimes be related to perception or other non-visual cues, while other errors are due to poor technique or poor image quality. In order to avoid any serious complications, it is important for the practicing radiologist to be cognizant of some of the most common types of errors. The objective of this article is to review the various types of errors in the evaluation of patients with multiple trauma injuries or polytrauma with MDCT.
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Affiliation(s)
- Mariano Scaglione
- Department of Diagnostic Imaging, P.O. Pineta Grande, Castel Volturno, Caserta, Italy.,Department of Radiology, Dartford & Gravesham NHS Trust, Dartford, UK
| | - Francesco Iaselli
- Department of Diagnostic Imaging, P.O. Pineta Grande, Castel Volturno, Caserta, Italy. .,, 118, Corso Umberto I, 80138, Naples, Italy.
| | - Giacomo Sica
- U.O. Radiologia, Stabilimento Ospedaliero di Nottola - Montepulciano, Ospedali Riuniti della Valdichiana, Siena, Italy
| | - Beatrice Feragalli
- Section of Diagnostic Imaging, Department of Clinical Sciences and Bioimaging, University Gabriele D'Annunzio, Chieti, Italy
| | - Refky Nicola
- Division of Emergency Imaging, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, 14642, USA
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35
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Nicola R, Shaqdan KW, Aran S, Prabhakar AM, Singh AK, Abujudeh HH. Contrast Media Extravasation of Computed Tomography and Magnetic Resonance Imaging: Management Guidelines for the Radiologist. Curr Probl Diagn Radiol 2016; 45:161-4. [DOI: 10.1067/j.cpradiol.2015.08.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/11/2015] [Accepted: 08/11/2015] [Indexed: 11/22/2022]
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36
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Baheti AD, Nicola R, Bennett GL, Bordia R, Moshiri M, Katz DS, Bhargava P. Magnetic Resonance Imaging of Abdominal and Pelvic Pain in the Pregnant Patient. Magn Reson Imaging Clin N Am 2016; 24:403-17. [PMID: 27150326 DOI: 10.1016/j.mric.2015.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 12/29/2022]
Abstract
The utility of MR imaging in evaluating abdominal and pelvic pain in the pregnant patient is discussed. Details regarding the indications, technical aspects, and imaging findings of various common abdominal and pelvic abnormalities in pregnancy are reviewed.
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Affiliation(s)
- Akshay D Baheti
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195, USA.
| | - Refky Nicola
- Department of Radiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642, USA
| | - Genevieve L Bennett
- Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10016, USA
| | - Ritu Bordia
- Section of Neuroradiology, Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA
| | - Mariam Moshiri
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195, USA
| | - Douglas S Katz
- Section of Neuroradiology, Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA
| | - Puneet Bhargava
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195, USA
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37
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Iacobellis F, Ierardi AM, Mazzei MA, Magenta Biasina A, Carrafiello G, Nicola R, Scaglione M. Dual-phase CT for the assessment of acute vascular injuries in high-energy blunt trauma: the imaging findings and management implications. Br J Radiol 2016; 89:20150952. [PMID: 26882960 DOI: 10.1259/bjr.20150952] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Acute vascular injuries are the second most common cause of fatalities in patients with multiple traumatic injuries; thus, prompt identification and management is essential for patient survival. Over the past few years, multidetector CT (MDCT) using dual-phase scanning protocol has become the imaging modality of choice in high-energy deceleration traumas. The objective of this article was to review the role of dual-phase MDCT in the identification and management of acute vascular injuries, particularly in the chest and abdomen following multiple traumatic injuries. In addition, this article will provide examples of MDCT features of acute vascular injuries with correlative surgical and interventional findings.
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Affiliation(s)
- Francesca Iacobellis
- 1 Department of Diagnostic Imaging, Pineta Grande Medical Center, Castel Volturno, Italy.,2 Department of Radiology, Second University of Naples, Naples, Italy
| | - Anna M Ierardi
- 3 Interventional Radiology Department, Radiology Unit, University of Insubria, Varese, Italy
| | - Maria A Mazzei
- 4 Department of Surgical Sciences, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | | | - Gianpaolo Carrafiello
- 3 Interventional Radiology Department, Radiology Unit, University of Insubria, Varese, Italy
| | - Refky Nicola
- 6 Division of Emergency Imaging, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Mariano Scaglione
- 1 Department of Diagnostic Imaging, Pineta Grande Medical Center, Castel Volturno, Italy.,7 Department of Radiology, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK
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38
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Omer D, Mansouri M, Abujudeh HH, Nicola R. Aortic and Other Vascular Emergencies. Emerg Radiol 2016. [DOI: 10.1093/med/9780190223656.003.0051] [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: 11/14/2022]
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39
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Shaqdan K, Al-Jandali TF, Nicola R, Abujudeh HH. Traumatic Injuries of the Adrenal Gland and Diaphragm. Emerg Radiol 2016. [DOI: 10.1093/med/9780190223656.003.0024] [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: 11/14/2022]
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40
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Shaqdan K, Nicola R, Shaqdan A, Abujudeh HH. Traumatic Injury of the Duodenum and Pancreas. Emerg Radiol 2016. [DOI: 10.1093/med/9780190223656.003.0025] [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: 11/12/2022]
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41
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Karcich J, Patel D, Nicola R, Contractor S. Visceral Venous Thrombosis Imaging and Intervention. Emerg Radiol 2016. [DOI: 10.1093/med/9780190223656.003.0054] [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: 11/14/2022]
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42
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Hassanzadeh E, Nicola R, Aran S, Abujudeh HH. Volvulus. Emerg Radiol 2016. [DOI: 10.1093/med/9780190223656.003.0058] [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: 11/14/2022]
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43
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Abstract
Ultrasound in the emergency department has long been recognized as a powerful screening and diagnostic tool for both physicians and radiologists. In the emergency department, since time is of the essence, it becomes a critical tool in triaging patients. Over the years, ultrasound has gained several advantages over other modalities because of its non-ionizing radiation, portability, accessibility, non-invasive method and simpler learning curve. As a result, ultrasound has become one of the most frequently used diagnostic tools in the emergency department by non-radiologists. The value of ultrasound is implemented in every acute ailment in the emergency department such as trauma, acute abdomen, acute pelvic pain, acute scrotal pain, appendicitis in children and acute deep venous thrombosis. Our objective is to discuss the benefit of using ultrasound as the primary modality for each of these diseases.
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Affiliation(s)
- Refky Nicola
- Division of Emergency Imaging, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Vikram Dogra
- Division of Emergency Imaging, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA
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44
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45
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Nicola R, Shaqdan KW, Aran S, Singh AK, Abujudeh HH. Detecting Aortic Graft Complications: A Spectrum of Computed Tomography Findings. Curr Probl Diagn Radiol 2015; 45:330-9. [PMID: 26321311 DOI: 10.1067/j.cpradiol.2015.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 07/27/2015] [Accepted: 07/28/2015] [Indexed: 11/22/2022]
Abstract
Endovascular aneurysm repair (EVAR) is a successful technique as well as an excellent alternative to the surgical management of abdominal aortic aneurysms. EVAR has improved the mortality and morbidity of many patients who would have otherwise suffered greatly from the consequences of abdominal aortic aneurysms. However, EVAR is not without complications. Some complications require lifelong surveillance, whereas others may necessitate immediate surgical intervention. We discuss the various modalities available for the surveillance as well as the common complications that can be seen on computed tomography.
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Affiliation(s)
- Refky Nicola
- Division of Emergency Imaging, University of Rochester Medical Center, Rochester, NY
| | - Khalid W Shaqdan
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA
| | - Shima Aran
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA
| | - Ajay K Singh
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA
| | - Hani H Abujudeh
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA.
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46
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Nicola R, Shaqdan KW, Aran K, Mansouri M, Singh A, Abujudeh HH. Contrast-Induced Nephropathy: Identifying the Risks, Choosing the Right Agent, and Reviewing Effective Prevention and Management Methods. Curr Probl Diagn Radiol 2015; 44:501-4. [PMID: 26072134 DOI: 10.1067/j.cpradiol.2015.04.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/08/2015] [Accepted: 04/09/2015] [Indexed: 12/14/2022]
Abstract
With the rise in the use of intravenous iodinated contrast media for both computed tomography scan and angiographic studies, there is a greater likelihood of complications. One of the most well-known adverse effects is contrast-induced media nephropathy, which is also called contrast-induced acute kidney injury. This is third most common cause of hospital acquired acute renal failure. It is associated with an increase in morbidity, mortality, and greater financial burden on healthcare system. Because of these factors, it is important for the radiologist to not only recognize risk factors, as well as the signs and symptoms, but also to know how to manage patients appropriately.
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Affiliation(s)
- Refky Nicola
- Division of Emergency Imaging, University of Rochester Medical Center, Rochester, NY
| | - Khalid W Shaqdan
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA
| | - Khalid Aran
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA
| | - Mohammad Mansouri
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA
| | - Ajay Singh
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA
| | - Hani H Abujudeh
- Division of Emergency Imaging, Massachusetts General Hospital, Boston, MA.
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Kaproth-Joslin KA, Nicola R, Dogra VS. The History of US: From Bats and Boats to the Bedside and Beyond: RSNA Centennial Article. Radiographics 2015; 35:960-70. [PMID: 25822324 DOI: 10.1148/rg.2015140300] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Katherine A Kaproth-Joslin
- From the Department of Imaging Science, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642
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Abstract
The behavior of Heterolepidoderma sp. was studied with the same approach as those already used for many species of ciliates. The ethogram we drew comprehends both helicoidal swimming (n = 20, r = 52.5 +/-12.2 mum, pitch = 512 +/- 101 mum, v--> = 215 +/- 43 mum/sec), periodically interrupted by irregular patterns changing the direction of the swimming of random angles and creeping on the substrate. The latter behavioral state, very common for the species we studied, occurs along tracks formed by successive elements (circular, C, vs linear segments, S) joined to each other by two kinds of reactions, which change their trajectory. The surprising similarities and the unexpected differences between the behavior of this gastrotrich and those of the ciliates already studied from this point of view are discussed, on the basis of the dimensional ranges and ecological niches shared by these two, definitely unrelated groups of organisms.
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Yousafzai S, Butt T, Oezalp F, Wrightson N, Nicola R, Thasee P, Guy M, Parry G, Siddique A, Schueler S. 573 Improved Surgical Technique of Left Ventricular Assist Device Drive Line Placement. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Mazzella G, Rizzo N, Azzaroli F, Simoni P, Bovicelli L, Miracolo A, Simonazzi G, Colecchia A, Nigro G, Mwangemi C, Festi D, Roda E, Nicola R, Francesco A, Patrizia S, Luciano B, Anna M, Giuliana S, Antonio C, Giovanni N, Constance M, Davide F, Enrico R. Ursodeoxycholic acid administration in patients with cholestasis of pregnancy: effects on primary bile acids in babies and mothers. Hepatology 2001; 33:504-8. [PMID: 11230728 DOI: 10.1053/jhep.2001.22647] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Little is known about the effects on the fetus of ursodeoxycholic acid (UDCA) treatment for intrahepatic cholestasis of pregnancy (ICP). Twenty ICP patients were given UDCA at 1.5 to 2 g/d, to our knowledge the highest dosage yet reported. Effects were evaluated on conjugated bile acids (BA) in amniotic fluid (15 of 20 patients) and umbilical cord serum obtained at delivery (20 of 22 newborns), as compared with 10 untreated patients (amniotic fluid, 9 of 10 patients; cord serum, 9 of 10 newborns). Liver function tests, serum BA and UDCA were evaluated on enrollment and then weekly until 1 week after delivery. Maternal serum conjugated cholic (CCA) and chenodeoxycholic (CCDCA) acids levels fell (18.5 +/- 1.9 to 10.5 +/- 1.9 micromol/L, and 5.8 +/- 0.8 to 2.97 +/- 0.7 micromol/L, respectively [P <.01]) in treated patients, and remained unaffected (20.0 +/- 3.1 vs. 20.3 +/- 2.3, and 5.6 +/- 0.6 vs. 5.4 +/- 0.5, respectively [P = not significant]) in untreated ones. Serum conjugated UDCA levels rose to 16.5 +/- 1.8 micromol/L (P<.001). Median values of CCA and CCDCA in amniotic fluid around delivery were 4.9 +/- 12.4 and 4.8 +/- 7.7 micromol/L, respectively, in treated patients, as against 17.9 +/- 27.5 and 18.5 +/- 20.9 micromol/L in untreated ones. In treated mothers, CCA and CCDCA concentrations in cord blood were 6.0 +/- 0.9 and 5.2 +/- 0.95 micromol/L, respectively, as against 21.9 +/- 5.6 and 18.9 +/- 2.1 micromol/L in untreated ones. In treated patients, median UDCA values in amniotic fluid and cord blood were 0.8 +/- 2.4 and 0.9 +/- 0.14 micromol/L, respectively. We conclude that increasing the dose of UDCA more effectively controls ICP and improves maternal clinical outcome after delivery.
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Affiliation(s)
- G Mazzella
- Dipartimento di Malattie dell'Apparato Digerente, del Metabolismo and delle Malattie Infettive, Azienda Ospedaliera di Bologna, Università di Bologna, Italy.
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