1
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Anderson MA, Mercaldo S, Cao J, Mroueh N, Furtado FS, Cochran RL, Chung R, Goiffon RJ, Sertic M, Pierce TT, Kilcoyne A, Mojtahed A, Shenoy-Bhangle AS, Catalano OA, Kambadakone A. Society of Radiologists in Ultrasound Consensus Conference Recommendations for Incidental Gallbladder Polyp Management: Interreader Agreement Among 10 Radiologists. AJR Am J Roentgenol 2024:1-9. [PMID: 38353447 DOI: 10.2214/ajr.23.30720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND. The 2022 Society of Radiologists in Ultrasound (SRU) consensus conference recommendations for small gallbladder polyps support management that is less aggressive than earlier approaches and may help standardize evaluation of polyps by radiologists. OBJECTIVE. The purpose of the present study was to assess the interreader agreement of radiologists in applying SRU recommendations for management of incidental gallbladder polyps on ultrasound. METHODS. This retrospective study included 105 patients (75 women and 30 men; median age, 51 years) with a gallbladder polyp on ultrasound (without features highly suspicious for invasive or malignant tumor) who underwent cholecystectomy between January 1, 2003, and January 1, 2021. Ten abdominal radiologists independently reviewed ultrasound examinations and, using the SRU recommendations, assessed one polyp per patient to assign risk category (extremely low risk, low risk, or indeterminate risk) and make a possible recommendation for surgical consultation. Five radiologists were considered less experienced (< 5 years of experience), and five were considered more experienced (≥ 5 years of experience). Interreader agreement was evaluated. Polyps were classified pathologically as nonneoplastic or neoplastic. RESULTS. For risk category assignments, interreader agreement was substantial among all readers (k = 0.710), less-experienced readers (k = 0.705), and more-experienced readers (k = 0.692). For surgical consultation recommendations, inter-reader agreement was substantial among all readers (k = 0.795) and more-experienced readers (k = 0.740) and was almost perfect among less-experienced readers (k = 0.811). Of 10 readers, a median of 5.0 (IQR, 2.0-8.0), 4.0 (IQR, 2.0-7.0), and 0.0 (IQR, 0.0-0.0) readers classified polyps as extremely low risk, low risk, and indeterminate risk, respectively. Across readers, the percentage of polyps classified as extremely low risk ranged from 32% to 72%; as low risk, from 24% to 65%; and as indeterminate risk, from 0% to 8%. Of 10 readers, a median of zero change to 0 (IQR, 0.0-1.0) readers recommended surgical consultation; the percentage of polyps receiving a recommendation for surgical consultation ranged from 4% to 22%. Of a total of 105 polyps, 102 were nonneo-plastic and three were neoplastic (all benign). Based on readers' most common assessments for nonneoplastic polyps, the risk category was extremely low risk for 53 polyps, low risk for 48 polyps, and indeterminate risk for one polyp; surgical consultation was recommended for 16 polyps. CONCLUSION. Ten abdominal radiologists showed substantial agreement for polyp risk categorizations and surgical consultation recommendations, although areas of reader variability were identified. CLINICAL IMPACT. The findings support the overall reproducibility of the SRU recommendations, while indicating opportunity for improvement.
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Affiliation(s)
- Mark A Anderson
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Sarah Mercaldo
- Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Jinjin Cao
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Nayla Mroueh
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Felipe S Furtado
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Rory L Cochran
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Ryan Chung
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Reece J Goiffon
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Madeleine Sertic
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Theodore T Pierce
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Aoife Kilcoyne
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Amirkasra Mojtahed
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Anuradha S Shenoy-Bhangle
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Onofrio A Catalano
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
| | - Avinash Kambadakone
- Department of Radiology, Abdominal Imaging Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White Bldg, Rm 270, Boston, MA 02114
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Hesami M, Blake M, Anderson MA, Asmundo L, Kilcoyne A, Najmi Z, Caravan PD, Catana C, Czawlytko C, Abdar Esfahani S, Kambadakone AR, Samir A, McDermott S, Domachevsky L, Ursprung S, Catalano OA. Diagnostic Anatomic Imaging for Neuroendocrine Neoplasms: Maximizing Strengths and Mitigating Weaknesses. J Comput Assist Tomogr 2024:00004728-990000000-00316. [PMID: 38657156 DOI: 10.1097/rct.0000000000001615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
ABSTRACT Neuroendocrine neoplasms are a heterogeneous group of gastrointestinal and lung tumors. Their diverse clinical manifestations, variable locations, and heterogeneity present notable diagnostic challenges. This article delves into the imaging modalities vital for their detection and characterization. Computed tomography is essential for initial assessment and staging. At the same time, magnetic resonance imaging (MRI) is particularly adept for liver, pancreatic, osseous, and rectal imaging, offering superior soft tissue contrast. The article also highlights the limitations of these imaging techniques, such as MRI's inability to effectively evaluate the cortical bone and the questioned cost-effectiveness of computed tomography and MRI for detecting specific gastric lesions. By emphasizing the strengths and weaknesses of these imaging techniques, the review offers insights into optimizing their utilization for improved diagnosis, staging, and therapeutic management of neuroendocrine neoplasms.
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Affiliation(s)
- Mina Hesami
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Michael Blake
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Mark A Anderson
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Aoife Kilcoyne
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Zahra Najmi
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Peter D Caravan
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ciprian Catana
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Cynthia Czawlytko
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Shadi Abdar Esfahani
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Avinash R Kambadakone
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Anthony Samir
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Shaunagh McDermott
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Liran Domachevsky
- Department of Nuclear Medicine, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Stephan Ursprung
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Onofrio A Catalano
- From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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3
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Shenoy-Bhangle AS, Kilcoyne A. Beyond the AJR: Preoperative MRI Scoring in Patients With Endometriosis Optimizes Patient Counseling and Surgical Planning. AJR Am J Roentgenol 2024; 222:e2329911. [PMID: 37466186 DOI: 10.2214/ajr.23.29911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Anuradha S Shenoy-Bhangle
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114
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4
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Shenoy-Bhangle AS, Pires-Franco IV, Ray LJ, Cao J, Kilcoyne A, Horvat N, Chamie LP. Imaging of Urinary Bladder and Ureteral Endometriosis with Emphasis on Diagnosis and Technique. Acad Radiol 2023:S1076-6332(23)00608-6. [PMID: 37996365 DOI: 10.1016/j.acra.2023.10.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 11/25/2023]
Abstract
Endometriosis is a chronic inflammatory gynecological condition affecting 10-15% of women in the reproductive age group. The urinary tract is the second most common extragenital organ system affected by endometriosis, and the urinary bladder and ureter are the two most common sites involved. Involvement of the urinary bladder can cause chronic debilitating symptoms, whereas ureteral involvement may lead to asymptomatic loss of renal function. Both conditions are frequently unsuspected, leading to a delay in diagnosis. Therefore, it is important to recognize this entity early, for which knowledge of imaging appearances and techniques is helpful. In this review article, we describe (a) endometriosis background, pathogenesis, definitions and clinical symptoms, (b) imaging appearance, with emphasis on ultrasound and MRI findings of urinary bladder and ureteric endometriosis, (c) ultrasound technique and MRI sequences useful for making the correct diagnosis, (d) overview of the treatment options and key imaging findings that are important to the surgeon for surgical planning, and (e) a structured reporting template useful for multidisciplinary patient management.
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Affiliation(s)
- Anuradha S Shenoy-Bhangle
- Harvard Medical School, Massachusetts General Hospital, MassGeneral Brigham Radiology, 55 Fruit Street, WHT-2- 270, Boston, Massachusetts, 02114, USA (A.S.S.B.).
| | | | - Lauren J Ray
- Massachusetts General Hospital, Department of Pathology, 55 Fruit Street, Boston, Massachusetts, 02114, USA (L.J.R.)
| | - Jinjin Cao
- Massachusetts General Hospital, 55 Fruit Street, WHT-2-207, Boston, Massachusetts, 02114, USA (J.C.)
| | - Aoife Kilcoyne
- Massachusetts General Hospital, MassGeneral Brigham Radiology, 55 Fruit Street, WHT-2- 270, Boston, Massachusetts, 02114, USA (A.K.)
| | - Natally Horvat
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA (N.H.)
| | - Luciana Pardini Chamie
- Chamie Imagem da Mulher, Casa do Ator street. 1117, 72 suite, São Paulo, 04546-004, Brazil (L.P.C.)
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Gallo-Bernal S, Kilcoyne A, Gee MS, Paul E. Cystic kidney disease in tuberous sclerosis complex: current knowledge and unresolved questions. Pediatr Nephrol 2023; 38:3253-3264. [PMID: 36445479 DOI: 10.1007/s00467-022-05820-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 12/02/2022]
Abstract
Tuberous sclerosis complex (TSC) is an autosomal dominant disorder with an estimated incidence of one in 5000 to 10,000 live births worldwide. Two million people of all races and genders are estimated to have TSC secondary to mutations in one of two tumor suppressor genes, TSC1 or TSC2. The respective TSC1 and 2 gene products - hamartin and tuberin - form cytoplasmic heterodimers that inhibit mTOR-mediated cell growth and division. When mTOR inhibition is lost, people with TSC develop characteristic and usually benign tumors in various organ systems. Kidney tumors and cysts are common, particularly in the setting of TSC2 gene mutations. In most TSC patients, the number of kidney cysts is limited, their morphology is simple, their size is small, and their clinical significance is negligible. In some, cyst morphology progresses from simple to complex with the risk of malignant transformation. In others, aggressive accumulation and growth of kidney cysts can cause hypertension, impaired kidney function, and progression to kidney failure. This educational review summarizes current knowledge and remaining open questions regarding cystic kidney disease in TSC, emphasizing detection, classification, surveillance, and treatment options.
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Affiliation(s)
- Sebastian Gallo-Bernal
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Elahna Paul
- Department of Pediatric Nephrology, Massachusetts General Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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Lupinelli M, Sbarra M, Kilcoyne A, Venkatesan AM, Nougaret S. MR Imaging of Gynecologic Tumors: Pearls, Pitfalls, and Tumor Mimics. Radiol Clin North Am 2023; 61:687-711. [PMID: 37169432 DOI: 10.1016/j.rcl.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
MR imaging is the modality of choice for the pre-treatment evaluation of patients with gynecologic malignancies, given its excellent soft tissue contrast and multi-planar capability. However, it is not without pitfalls. Challenges can be encountered in the assessment of the infiltration of myometrium, vagina, cervical stroma, and parametria, which are crucial prognostic factors for endometrial and cervical cancers. Other challenges can be encountered in the distinction between solid and non-solid tissue and in the identification of peritoneal carcinomatosis for the sonographically indeterminate adnexal mass.
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Affiliation(s)
- Michela Lupinelli
- Department of Radiology, Morgagni-Pierantoni Hospital, Via Carlo Forlanini 34, 47121, Forlì, Italy.
| | - Martina Sbarra
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-medico, Via Alvaro Del Portillo, 200, Roma 00128, Italy
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA
| | - Aradhana M Venkatesan
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030, USA
| | - Stephanie Nougaret
- Department of Radiology, IRCM, Montpellier Cancer Research Institute, Montpellier 34090, France; INSERM, U1194, University of Montpellier, Montpellier 34295, France
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7
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Furtado FS, Wu MZ, Esfahani SA, Ferrone CR, Blaszkowsky LS, Clark JW, Ryan DP, Goyal L, Franses JW, Wo JY, Hong TS, Qadan M, Tanabe KK, Weekes CD, Cusack JC, Crafa F, Mahmood U, Anderson MA, Mojtahed A, Hahn PF, Caravan P, Kilcoyne A, Vangel M, Striar RM, Rosen BR, Catalano OA. Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) Versus the Standard of Care Imaging in the Diagnosis of Peritoneal Carcinomatosis. Ann Surg 2023; 277:e893-e899. [PMID: 35185121 DOI: 10.1097/sla.0000000000005418] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare positron emission tomography (PET)/magnetic resonance imaging (MRI) to the standard of care imaging (SCI) for the diagnosis of peritoneal carcinomatosis (PC) in primary abdominopelvic malignancies. SUMMARY BACKGROUND DATA Identifying PC impacts prognosis and management of multiple cancer types. METHODS Adult subjects were prospectively and consecutively enrolled from April 2019 to January 2021. Inclusion criteria were: 1) acquisition of whole-body contrast-enhanced (CE) 18F-fluorodeoxyglucose PET/MRI, 2) pathologically confirmed primary abdominopelvic malignancies. Exclusion criteria were: 1) greater than 4 weeks interval between SCI and PET/MRI, 2) unavailable follow-up. SCI consisted of whole-body CE PET/computed tomography (CT) with diagnostic quality CT, and/or CE-CT of the abdomen and pelvis, and/or CE-MRI of the abdomen±pelvis. If available, pathology or surgical findings served as the reference standard, otherwise, imaging followup was used. When SCI and PET/MRI results disagreed, medical records were checked for management changes. Follow-up data were collected until August 2021. RESULTS One hundred sixty-four subjects were included, 85 (52%) were female, and the median age was 60 years (interquartile range 50-69). At a subject level, PET/MRI had higher sensitivity (0.97, 95% CI 0.86-1.00) than SCI (0.54, 95% CI 0.37-0.71), P < 0.001, without a difference in specificity, of 0.95 (95% CI 0.90-0.98) for PET/MRI and 0.98 (95% CI 0.93-1.00) for SCI, P ¼ 0.250. PET/MRI and SCI results disagreed in 19 cases. In 5/19 (26%) of the discordant cases, PET/MRI findings consistent with PC missed on SCI led to management changes. CONCLUSION PET/MRI improves detection of PC compared with SCI which frequently changes management.
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Affiliation(s)
- Felipe S Furtado
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA
| | - Mark Z Wu
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Shadi A Esfahani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA
| | - Cristina R Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Lawrence S Blaszkowsky
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Jeffrey W Clark
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - David P Ryan
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Lipika Goyal
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Joseph W Franses
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Jennifer Y Wo
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Theodore S Hong
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kenneth K Tanabe
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Colin D Weekes
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - James C Cusack
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Umar Mahmood
- Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA
| | - Mark A Anderson
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Amirkasra Mojtahed
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Peter F Hahn
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Peter Caravan
- Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Mark Vangel
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Robin M Striar
- Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA
| | - Bruce R Rosen
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA
| | - Onofrio A Catalano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA
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8
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Sertic M, Devins KM, Oliva E, Lee SI, Kilcoyne A. Sex Cord-Stromal Tumors of the Ovary. Radiol Clin North Am 2023; 61:595-608. [PMID: 37169426 DOI: 10.1016/j.rcl.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Ovarian sex cord-stromal tumors (OSCSTs) are a rare group of ovarian neoplasms that can be benign or malignant. They are classified into pure sex cord tumors, pure stromal tumors, and mixed SCST. The most common malignant OSCSTs are adult granulosa cell tumors. In contrast to the more common ovarian epithelial malignancies, OSCSTs present in younger patients, often at early stages, with better prognoses. Imaging features are variable, and pathology is required for diagnosis. However, certain tumors demonstrate characteristic imaging appearances that can be useful in narrowing the differential diagnosis.
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9
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Xu L, Lee SI, Kilcoyne A. MR Imaging of Epithelial Ovarian Neoplasms Part II. Magn Reson Imaging Clin N Am 2023; 31:53-64. [DOI: 10.1016/j.mric.2022.07.002] [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: 11/09/2022]
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10
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Mojtahed A, Kilcoyne A, Crowley C, Furtado F, Anderson MA, Catalano OA, Gee MS, Kambadakone A, Saini S, Pandharipande PV. Introduction of a daily peer learning process with added value for faculty and trainees. Clin Imaging 2022; 92:83-87. [DOI: 10.1016/j.clinimag.2022.10.001] [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: 08/01/2022] [Revised: 09/25/2022] [Accepted: 10/02/2022] [Indexed: 11/03/2022]
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11
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Sertic M, Kilcoyne A, Catalano OA, Lee SI. Quantitative imaging of uterine cancers with diffusion-weighted MRI and 18-fluorodeoxyglucose PET/CT. Abdom Radiol (NY) 2022; 47:3174-3188. [PMID: 34302185 DOI: 10.1007/s00261-021-03218-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/18/2023]
Abstract
Imaging plays an important role in the diagnosis and treatment of women with uterine cervical and endometrial cancers. Quantitative imaging, through MRI, PET/CT, and hybrid PET/MRI, allows for characterization of primary tumors beyond anatomic and qualitative descriptors. MRI diffusion-weighted imaging (DWI) yields an apparent diffusion coefficient (ADC), which can be applied in both the pre-and post-treatment assessment of uterine tumors. PET/CT assesses metabolic activity, and measurement of tumor standardized uptake value (SUV) is a useful metric in the staging of uterine malignancies. Hybrid PET/MRI is an emerging modality that combines the soft tissue contrast of MRI with the molecular imaging capability of PET. This review provides an overview of these quantitative imaging modalities, and their current and potential roles in the assessment of uterine cervical and cancer.
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Affiliation(s)
- Madeleine Sertic
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Onofrio Antonio Catalano
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Susanna I Lee
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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12
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O'Shea A, Kilcoyne A, McDermott E, O'Grady M, McDermott S. Can radiomic feature analysis differentiate adrenal metastases from lipid-poor adenomas on single-phase contrast-enhanced CT abdomen? Clin Radiol 2022; 77:e711-e718. [DOI: 10.1016/j.crad.2022.06.015] [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: 01/04/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
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13
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Harrington SG, Wood M, Porter KK, Gupta Y, Esfahani SA, Daye D, Kilcoyne A, Donelan K, Narayan AK. Promoting Lactation Support: Challenges and Solutions to Supporting Breastfeeding Radiologists. Acad Radiol 2022; 29:175-180. [PMID: 33293255 DOI: 10.1016/j.acra.2020.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/13/2020] [Accepted: 11/14/2020] [Indexed: 01/20/2023]
Abstract
RATIONALE AND OBJECTIVES Although the evidence for the benefits of breastfeeding is strong, parents are often unable to continue breastfeeding upon returning from maternity leave for a variety of reasons. Breastfeeding parents in medicine face unique challenges upon returning to the workforce after maternity leave. Current research on breastfeeding radiologists is limited. The objective of this research is to evaluate breastfeeding barriers and identify potential solutions to help radiologists reach their breastfeeding goals. MATERIALS AND METHODS A 17-question survey was developed from validated surveys and pilot tested using focus groups. The survey was emailed to members of the American Association for Women in Radiology and promoted through social media. Bivariate analyses were performed using chi-square tests. p values <0.05 were considered statistically significant. Institutional review board deemed that this anonymous voluntary survey met criteria for exemption. RESULTS 50 respondents met criteria for study inclusion (estimated response rate 42%). Of the respondents, 60% were trainees, 80% practiced in academic institutions and 92% were full-time. 100% intended to breastfeed, of whom 56% met personal breastfeeding goals (12-month median duration). Available lactation facilities included: Dedicated lactation room (38%), private space (58%), hospital grade pump (30%), refrigerator (46%), dedicated PACS (8%). Cited workplace challenges included lack of time (82%), lack of space (34%), and unsupportive work culture (42%). Having adequate time was associated with meeting breastfeeding goals (p = 0.028). No other factors were statistically significant (p > 0.05). CONCLUSION Almost half of breastfeeding radiologists (44%) did not meet breastfeeding goals, citing a variety of facility-based and institutional barriers. Among these, having sufficient time to pump/breastfeed was associated with achieving breastfeeding goals. Given the barriers faced by breastfeeding radiologists, there is an opportunity to make structural and cultural changes to provide lactation support at work.
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14
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Harrington SG, Gee MS, Williams V, Best S, Kilcoyne A. Impact of COVID-19 on radiology trainee safety, education and wellness: challenges experienced and proposed solutions for the future. J Am Coll Radiol 2022; 19:446-449. [PMID: 35081396 PMCID: PMC8747968 DOI: 10.1016/j.jacr.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022]
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15
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Kilcoyne A, Gottumukkala RV, Kang SK, Akin EA, Hauck C, Hindman NM, Huang C, Khanna N, Paspulati R, Rauch GM, Said T, Shinagare AB, Stein EB, Venkatesan AM, Maturen KE. ACR Appropriateness Criteria® Staging and Follow-up of Primary Vaginal Cancer. J Am Coll Radiol 2021; 18:S442-S455. [PMID: 34794599 DOI: 10.1016/j.jacr.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
Primary vaginal cancer is rare, comprising 1% to 2% of gynecologic malignancies and 20% of all malignancies involving the vagina. More frequently, the vagina is involved secondarily by direct invasion from malignancies originating in adjacent organs or by metastases from other pelvic or extrapelvic primary malignancies. Data on the use of imaging in vaginal cancer are sparse. Insights are derived from the study of imaging in cervical cancer and have reasonable generalizability to vaginal cancer due to similar tumor biology. Given the trend toward definitive chemoradiation for both cancers in all but early stage lesions, principles of postchemoradiation tumor response evaluation are largely analogous. Accordingly, many of the recommendations outlined here are informed by principles translated from the literature on cervical cancer. For pretreatment assessment of local tumor burden and in the case of recurrent vaginal cancer, MRI is the preferred imaging modality. PET/CT has demonstrated utility for the detection of nodal metastatic and unexpected distant metastatic disease. 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)
- Aoife Kilcoyne
- Panel Vice Chair, Massachusetts General Hospital, Boston, Massachusetts.
| | | | - Stella K Kang
- Panel Chair, New York University Medical Center, New York, New York
| | - Esma A Akin
- The George Washington University Medical Center, Washington, District of Columbia; ABNM Board Member; and IAC Board Member
| | - Carlin Hauck
- Sutter Medical Center Sacramento, Sacramento, California
| | - Nicole M Hindman
- Associate Chair, Diversity & Health Equity, MR Safety Officer, and Director, Female Pelvic Imaging, New York University Medical Center, New York, New York; and Fellow Rep., Board of the Society for Advanced Body Imaging
| | - Chenchan Huang
- New York University Langone Medical Center, New York, New York
| | - Namita Khanna
- Emory University, Atlanta, Georgia; Society of Gynecologic Oncology
| | | | - Gaiane M Rauch
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tamer Said
- Program Director, Family Medicine Residency Program, University Hospitals Cleveland Medical Center, Cleveland, Ohio; and Primary care physician
| | - Atul B Shinagare
- Chief, Abdominal Imaging and Intervention, Brigham & Women's Hospital Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Erica B Stein
- Director, Body CT, University of Michigan Medical Center, Ann Arbor, Michigan
| | | | - Katherine E Maturen
- Specialty Chair, University of Michigan, Ann Arbor, Michigan; and Member, Society of Abdominal Radiology Board of Directors
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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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McDermott E, Kilcoyne A, O'Shea A, Cahalane AM, McDermott S. The role of percutaneous CT-guided biopsy of an adrenal lesion in patients with known or suspected lung cancer. Abdom Radiol (NY) 2021; 46:1171-1178. [PMID: 32945923 DOI: 10.1007/s00261-020-02743-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/26/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the sensitivity, specificity, and complication rate of percutaneous adrenal biopsy in patients with known or suspected lung cancer. METHODS This study was approved by the Institutional Review Board at our institution as a retrospective analysis; therefore, the need for informed consent was waived. All percutaneous adrenal biopsies performed between April 1993 and May 2019 were reviewed. 357 of 582 biopsies were performed on 343 patients with known or suspected lung cancer (M:F 164:179; mean age 66 years). The biopsy results were classified into malignant, benign, or non-diagnostic. The final diagnosis was established by pathology (biopsy and/or surgical resection) or imaging follow-up on CT for at least 12 months following the biopsy. Patients with less than 12 months follow-up were excluded (n = 44). Complications were recorded. RESULTS The final diagnosis was metastatic lung cancer in 235 cases (77.8%), metastasis from an extrapulmonary primary in 2 cases (0.7%), pheochromocytoma in 2 cases (0.7%), and benign lesions in 63 cases (20.9%). Percutaneous adrenal gland biopsy had a sensitivity of 97% and specificity of 100% for lung cancer metastases. The non-diagnostic rate was 0.6%. Larger lesions were more likely to be malignant (p = 0.0000) and to be correctly classified as a lung metastasis (p = 0.025). The incidence of minor complications was 1.1%. There were no major complications. CONCLUSION Over 20% of adrenal lesions in patients with known or suspected lung cancer were not related to lung cancer. Percutaneous adrenal gland biopsy is a safe procedure, with high sensitivity and specificity for lung cancer metastases.
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Affiliation(s)
- E McDermott
- Tallaght University Hospital, Tallaght, Dublin, Ireland
| | - A Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
| | - A O'Shea
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - A M Cahalane
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - S McDermott
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
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18
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Anderson MA, Kurra V, Bradley W, Kilcoyne A, Mojtahed A, Lee SI. Abdominal immune-related adverse events: detection on ultrasonography, CT, MRI and 18F-Fluorodeoxyglucose positron emission tomography. Br J Radiol 2021; 94:20200663. [PMID: 33112648 DOI: 10.1259/bjr.20200663] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Immune checkpoint inhibitor and chimeric antigen receptor T-cell therapies are associated with a unique spectrum of complications termed immune-related adverse events (irAEs). The abdomen is the most frequent site of severe irAEs that require hospitalization with life-threatening consequences. Most abdominal irAEs such as enterocolitis, hepatitis, cholangiopathy, cholecystitis, pancreatitis, adrenalitis, and sarcoid-like reaction are initially detected on imaging such as ultrasonography (US), CT, MRI and fusion 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT during routine surveillance of cancer therapy. Early recognition and diagnosis of irAEs and immediate management with cessation of immune modulator cancer therapy and institution of immunosuppressive therapy are necessary to avert morbidity and mortality. Diagnosis of irAEs is confirmed by tissue sampling or by follow-up imaging demonstrating resolution. Abdominal radiologists reviewing imaging on patients being treated with anti-cancer immunomodulators should be familiar with the imaging manifestations of irAEs.
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Affiliation(s)
- Mark A Anderson
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Vikram Kurra
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - William Bradley
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Amirkasra Mojtahed
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Susanna I Lee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
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19
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Critchley HOD, Babayev E, Bulun SE, Clark S, Garcia-Grau I, Gregersen PK, Kilcoyne A, Kim JYJ, Lavender M, Marsh EE, Matteson KA, Maybin JA, Metz CN, Moreno I, Silk K, Sommer M, Simon C, Tariyal R, Taylor HS, Wagner GP, Griffith LG. Menstruation: science and society. Am J Obstet Gynecol 2020; 223:624-664. [PMID: 32707266 PMCID: PMC7661839 DOI: 10.1016/j.ajog.2020.06.004] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/13/2020] [Accepted: 06/03/2020] [Indexed: 12/11/2022]
Abstract
Women's health concerns are generally underrepresented in basic and translational research, but reproductive health in particular has been hampered by a lack of understanding of basic uterine and menstrual physiology. Menstrual health is an integral part of overall health because between menarche and menopause, most women menstruate. Yet for tens of millions of women around the world, menstruation regularly and often catastrophically disrupts their physical, mental, and social well-being. Enhancing our understanding of the underlying phenomena involved in menstruation, abnormal uterine bleeding, and other menstruation-related disorders will move us closer to the goal of personalized care. Furthermore, a deeper mechanistic understanding of menstruation-a fast, scarless healing process in healthy individuals-will likely yield insights into a myriad of other diseases involving regulation of vascular function locally and systemically. We also recognize that many women now delay pregnancy and that there is an increasing desire for fertility and uterine preservation. In September 2018, the Gynecologic Health and Disease Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development convened a 2-day meeting, "Menstruation: Science and Society" with an aim to "identify gaps and opportunities in menstruation science and to raise awareness of the need for more research in this field." Experts in fields ranging from the evolutionary role of menstruation to basic endometrial biology (including omic analysis of the endometrium, stem cells and tissue engineering of the endometrium, endometrial microbiome, and abnormal uterine bleeding and fibroids) and translational medicine (imaging and sampling modalities, patient-focused analysis of menstrual disorders including abnormal uterine bleeding, smart technologies or applications and mobile health platforms) to societal challenges in health literacy and dissemination frameworks across different economic and cultural landscapes shared current state-of-the-art and future vision, incorporating the patient voice at the launch of the meeting. Here, we provide an enhanced meeting report with extensive up-to-date (as of submission) context, capturing the spectrum from how the basic processes of menstruation commence in response to progesterone withdrawal, through the role of tissue-resident and circulating stem and progenitor cells in monthly regeneration-and current gaps in knowledge on how dysregulation leads to abnormal uterine bleeding and other menstruation-related disorders such as adenomyosis, endometriosis, and fibroids-to the clinical challenges in diagnostics, treatment, and patient and societal education. We conclude with an overview of how the global agenda concerning menstruation, and specifically menstrual health and hygiene, are gaining momentum, ranging from increasing investment in addressing menstruation-related barriers facing girls in schools in low- to middle-income countries to the more recent "menstrual equity" and "period poverty" movements spreading across high-income countries.
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Affiliation(s)
- Hilary O D Critchley
- Medical Research Council Centre for Reproductive Health, The University of Edinburgh, United Kingdom.
| | - Elnur Babayev
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Serdar E Bulun
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Iolanda Garcia-Grau
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico, INCLIVA, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, School of Medicine, University of Valencia, Valencia, Spain
| | - Peter K Gregersen
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY
| | | | | | | | - Erica E Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI
| | - Kristen A Matteson
- Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Jacqueline A Maybin
- Medical Research Council Centre for Reproductive Health, The University of Edinburgh, United Kingdom
| | - Christine N Metz
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY
| | - Inmaculada Moreno
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico, INCLIVA, Valencia, Spain
| | - Kami Silk
- Department of Communication, University of Delaware, Newark, DE
| | - Marni Sommer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Carlos Simon
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico, INCLIVA, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, School of Medicine, University of Valencia, Valencia, Spain; Beth Israel Deaconess Medical Center, Harvard University, Boston, MA; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
| | | | - Hugh S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
| | - Günter P Wagner
- Department of Ecology and Evolutionary Biology, Department of Obstetrics, Gynecology and Reproductive Sciences, Systems Biology Institute, Yale University, New Haven, CT; Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
| | - Linda G Griffith
- Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, MA
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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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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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22
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O'Shea A, Tam AL, Kilcoyne A, Flaherty KT, Lee SI. Image-guided biopsy in the age of personalised medicine: strategies for success and safety. Clin Radiol 2020; 76:154.e1-154.e9. [PMID: 32896425 DOI: 10.1016/j.crad.2020.08.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/04/2020] [Indexed: 12/28/2022]
Abstract
Oncology has progressed into an era of personalised medicine, whereby the therapeutic regimen is tailored to the molecular profile of the patient's cancer. Determining personalised therapeutic options is achieved by using tumour genomics and proteomics to identify the specific molecular targets against which candidate drugs can interact. Several dozen targeted drugs, many for multiple cancer types are already widely in clinical use. Molecular profiling of tumours is contingent on high-quality biopsy specimens and the most common method of tissue sampling is image-guided biopsy. Thus, for radiologists performing these biopsies, the paradigm has now shifted away from obtaining specimens simply for histopathological diagnosis to acquiring larger amounts of viable tumour cells for DNA, RNA, or protein analysis. These developments have highlighted the central role now played by radiologists in the delivery of personalised cancer care. This review describes the principles of molecular profiling assays and biopsy techniques for optimising yield, and describes a scoring system to assist in patient selection for percutaneous biopsy.
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Affiliation(s)
- A O'Shea
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - A L Tam
- Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - A Kilcoyne
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - K T Flaherty
- Department of Medicine, Division of Oncology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - S I Lee
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA
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23
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Abstract
PURPOSE Accurate nodal staging for male urogenital malignancies has important implications for therapy and prognosis. Male pelvic malignancies, including prostatic, penile, testicular, and bladder cancer, typically metastasize to regional lymph nodes first which is reported by the N-stage. Spread beyond these groups to non-regional nodes is regarded as M-stage disease. METHODS In this review, we discuss the typical patterns of male pelvic lymphatic drainage and the tumor-specific regional nodal chains. RESULTS The impact of tumor-specific imaging features and the implications of previous treatments on staging are discussed. CONCLUSIONS While anatomic imaging, including CT and MRI, is the most widely employed imaging modality at present, newer functional imaging techniques have demonstrated promise in the accurate identification and characterization of nodal metastases.
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Affiliation(s)
- Aileen O'Shea
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
| | - Aoife Kilcoyne
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Sandeep S Hedgire
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Mukesh G Harisinghani
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Abstract
Endometriosis is often seen and sometimes initially diagnosed on hysterosalpingography (HSG), an imaging exam routinely performed on patients with infertility. Here we discuss the role of HSG in the evaluation of patients with infertility with a focus on patients with endometriosis. The HSG technique, including patient preparation as well as potential risks and complications, is detailed. Imaging findings in patients with endometriosis are illustrated and a template for exam reporting is presented. Common imaging pitfalls are described with examples.
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Affiliation(s)
- Aoife Kilcoyne
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - Aileen O'Shea
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Debra A Gervais
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Susanna I Lee
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA
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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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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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27
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Bhayana R, Som A, Li MD, Carey DE, Anderson MA, Blake MA, Catalano O, Gee MS, Hahn PF, Harisinghani M, Kilcoyne A, Lee SI, Mojtahed A, Pandharipande PV, Pierce TT, Rosman DA, Saini S, Samir AE, Simeone JF, Gervais DA, Velmahos G, Misdraji J, Kambadakone A. Abdominal Imaging Findings in COVID-19: Preliminary Observations. Radiology 2020; 297:E207-E215. [PMID: 32391742 PMCID: PMC7508000 DOI: 10.1148/radiol.2020201908] [Citation(s) in RCA: 217] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Angiotensin-converting enzyme 2, a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrates its highest surface expression in the lung, small bowel, and vasculature, suggesting abdominal viscera may be susceptible to injury. Purpose To report abdominal imaging findings in patients with coronavirus disease 2019. Materials and Methods In this retrospective cross-sectional study, patients consecutively admitted to a single quaternary care center from March 27 to April 10, 2020, who tested positive for SARS-CoV-2 were included. Abdominal imaging studies performed in these patients were reviewed, and salient findings were recorded. Medical records were reviewed for clinical data. Univariable analysis and logistic regression were performed. Results A total of 412 patients (average age, 57 years; range, 18 to >90 years; 241 men, 171 women) were evaluated. A total of 224 abdominal imaging studies were performed (radiography, n = 137; US, n = 44; CT, n = 42; MRI, n = 1) in 134 patients (33%). Abdominal imaging was associated with age (odds ratio [OR], 1.03 per year of increase; P = .001) and intensive care unit (ICU) admission (OR, 17.3; P < .001). Bowel-wall abnormalities were seen on 31% of CT images (13 of 42) and were associated with ICU admission (OR, 15.5; P = .01). Bowel findings included pneumatosis or portal venous gas, seen on 20% of CT images obtained in patients in the ICU (four of 20). Surgical correlation (n = 4) revealed unusual yellow discoloration of the bowel (n = 3) and bowel infarction (n = 2). Pathologic findings revealed ischemic enteritis with patchy necrosis and fibrin thrombi in arterioles (n = 2). Right upper quadrant US examinations were mostly performed because of liver laboratory findings (87%, 32 of 37), and 54% (20 of 37) revealed a dilated sludge-filled gallbladder, suggestive of bile stasis. Patients with a cholecystostomy tube placed (n = 4) had negative bacterial cultures. Conclusion Bowel abnormalities and gallbladder bile stasis were common findings on abdominal images of patients with coronavirus disease 2019. Patients who underwent laparotomy often had ischemia, possibly due to small-vessel thrombosis. © RSNA, 2020
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Affiliation(s)
- Rajesh Bhayana
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Avik Som
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Matthew D Li
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Denston E Carey
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Mark A Anderson
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Michael A Blake
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Onofrio Catalano
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Michael S Gee
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Peter F Hahn
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Mukesh Harisinghani
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Aoife Kilcoyne
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Susanna I Lee
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Amirkasra Mojtahed
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Pari V Pandharipande
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Theodore T Pierce
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - David A Rosman
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Sanjay Saini
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Anthony E Samir
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Joseph F Simeone
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Debra A Gervais
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - George Velmahos
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Joseph Misdraji
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
| | - Avinash Kambadakone
- From the Division of Abdominal Imaging, Department of Radiology (R.B., A.S., M.D.L., M.A.A., M.A.B., O.C., M.S.G., P.F.H., M.H., A. Kilcoyne, S.I.L., A.M., P.V.P., T.T.P., D.A.R., S.S., A.E.S., J.F.S., D.A.G., A. Kambadakone), Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), and Department of Pathology (J.M.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696; and Harvard Medical School, Boston, Mass (D.E.C.)
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Affiliation(s)
- Brian K Alverson
- From the Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI (B.K.A.); and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Harvard Medical School - both in Boston
| | - Aoife Kilcoyne
- From the Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI (B.K.A.); and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Harvard Medical School - both in Boston
| | - Alison M Friedmann
- From the Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI (B.K.A.); and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Harvard Medical School - both in Boston
| | - Aliyah R Sohani
- From the Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI (B.K.A.); and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Pediatrics (A.M.F.), and Pathology (A.R.S.), Harvard Medical School - both in Boston
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Abstract
Fluorodeoxyglucose positron emission tomography computed tomography (FDG-PET/CT) provides a comprehensive whole body evaluation in patients with endometrial and vulvar cancer. Here, we discuss the role of FDG-PET/CT in defining the disease extent in patients presenting with these cancers. Detection of lymph node and distant metastases has implications for staging, treatment planning, and patient prognosis. Procedures for image acquisition and interpretation for optimum accuracy and essential elements that should be included in the PET-CT report are described. Common imaging pitfalls are presented and illustrated with examples.
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Affiliation(s)
- Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - David Z Chow
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Susanna I Lee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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30
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Affiliation(s)
- Noelle N Saillant
- From the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Massachusetts General Hospital, and the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Harvard Medical School - both in Boston
| | - Aoife Kilcoyne
- From the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Massachusetts General Hospital, and the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Harvard Medical School - both in Boston
| | - Peter J Fagenholz
- From the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Massachusetts General Hospital, and the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Harvard Medical School - both in Boston
| | - Raymond Lui
- From the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Massachusetts General Hospital, and the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Harvard Medical School - both in Boston
| | - Melissa Krystel-Whittemore
- From the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Massachusetts General Hospital, and the Departments of Surgery (N.N.S., P.J.F.), Radiology (A.K.), Obstetrics and Gynecology (R.L.), and Pathology (M.K.-W.), Harvard Medical School - both in Boston
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Vitolo U, Witzig T, Gascoyne R, Scott D, Zhang Q, Jurczak W, Özcan M, Hong X, Zhu J, Jin J, Belada D, Bergua J, Piazza F, Mócikova H, Molinari A, Yoon D, Cavallo F, Tani M, Izutsu K, Kato K, Czuczman M, Hersey S, Kilcoyne A, Russo J, Hudak K, Zhang J, Chiappella A, Nowakowski G. ROBUST: First report of phase III randomized study of lenalidomide/R-CHOP (R2
-CHOP) vs placebo/R-CHOP in previously untreated ABC-type diffuse large B-cell lymphoma. Hematol Oncol 2019. [DOI: 10.1002/hon.5_2629] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- U. Vitolo
- Division of Hematology; A.O.U. Città della Salute e della Scienza Hospital and University; Torino Italy
| | - T.E. Witzig
- Division of Hematology; Mayo Clinic; Rochester MN United States
| | - R.D. Gascoyne
- Centre for Lymphoid Cancer; British Columbia Cancer; Vancouver BC Canada
| | - D.W. Scott
- Centre for Lymphoid Cancer; British Columbia Cancer; Vancouver BC Canada
| | - Q. Zhang
- Harbin Medical University Cancer Hospital; Harbin Heilongjiang China
| | - W. Jurczak
- Department of Hematology; Jagiellonian University; Krakow Poland
| | - M. Özcan
- Department of Hematology; Ankara University; Ankara Turkey
| | - X. Hong
- Cancer Hospital; Fudan University; Shanghai China
| | - J. Zhu
- Beijing Cancer Hospital; Beijing China
| | - J. Jin
- The First Affiliated Hospital of Medical School of Zhejiang University; First Hospital of Zhejiang Province; Zhejiang Hangzhou China
| | - D. Belada
- Fourth Department of Internal Medicine-Hematology; Charles University Hospital and Faculty of Medicine; Hradec Králové Czech Republic
| | - J.M. Bergua
- Servicio de Hematologia; Hospital Universitario San Pedro de Alcántara; Cáceres Spain
| | - F. Piazza
- Division of Hematology, Department of Medicine; University of Padova and Azienda Ospedaliera di Padova; Padova Italy
| | - H. Mócikova
- Department of Internal Medicine and Haematology; Faculty Hospital Kralovske Vinohrady; Prague Czech Republic
| | | | - D.H. Yoon
- Department of Oncology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea Republic of Korea
| | - F. Cavallo
- AOU Città della Salute e della Scienza di Torino; Turin Italy
| | - M. Tani
- U.O. Ematologia, Dipartimento Oncologia e Ematologia; Ospedale Santa Maria delle Croci; Ravenna Italy
| | - K. Izutsu
- National Cancer Center Hospital; Tokyo Japan
| | - K. Kato
- Department of Medicine and Biosystemic Science; Kyushu University Faculty of Medicine; Fukuoka City Japan
| | - M. Czuczman
- Clinical Research & Development; Celgene Corporation; Summit NJ USA
| | - S. Hersey
- Clinical Research & Development; Celgene Corporation; Summit NJ USA
| | - A. Kilcoyne
- Clinical Research & Development; Celgene Corporation; Summit NJ USA
| | - J. Russo
- Clinical Research & Development; Celgene Corporation; Summit NJ USA
| | - K. Hudak
- Clinical Research & Development; Celgene Corporation; Summit NJ USA
| | - J. Zhang
- Clinical Research & Development; Celgene Corporation; Summit NJ USA
| | - A. Chiappella
- Division of Hematology; A.O.U. Città della Salute e della Scienza Hospital and University; Torino Italy
| | - G.S. Nowakowski
- Division of Hematology; Mayo Clinic; Rochester MN United States
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Cahalane AM, Kilcoyne A, Tabari A, McDermott S, Gee MS. Computed tomography texture features can discriminate benign from malignant lymphadenopathy in pediatric patients: a preliminary study. Pediatr Radiol 2019; 49:737-745. [PMID: 30741316 DOI: 10.1007/s00247-019-04350-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 11/26/2018] [Accepted: 01/24/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Differentiation of benign from malignant lymphadenopathy remains challenging in pediatric radiology. Textural analysis (TA) quantitates heterogeneity of tissue signal intensities and has been applied to analysis of CT images. OBJECTIVE The purpose of this study was to establish whether CT textural analysis of enlarged lymph nodes visualized on pediatric CT can distinguish benign from malignant lymphadenopathy. MATERIALS AND METHODS We retrospectively identified enlarged lymph nodes measuring 10-20 mm on contrast-enhanced CTs of patients age 18 years and younger that had been categorized as benign or malignant based on the known diagnoses. We placed regions of interest (ROIs) over lymph nodes of interest and performed textural analysis with and without feature size filtration. We then calculated test performance characteristics for TA features, along with multivariate logistic regression modeling using Akaike Information Criterion (AIC) minimization, to determine the optimal thresholds for distinguishing benign from malignant lymphadenopathy. RESULTS We identified 34 enlarged malignant nodes and 29 benign nodes from 63 patients within the 10- to 20-mm size range. Filtered image TA exhibited 82.4% sensitivity, 86.2% specificity and 84.1% accuracy for detecting malignant lymph nodes using mean and entropy parameters, whereas unfiltered TA exhibited 88.2% sensitivity, 72.4% specificity and 81.0% accuracy using mean and mean value of positive pixels parameters. CONCLUSION This preliminary study demonstrates that the use of TA features improves the utility of pediatric CT to distinguish benign from malignant lymphadenopathy. The addition of TA to pediatric CT protocols has great potential to aid the characterization of indeterminate lymph nodes. If definitive differentiation between benign and malignant lymphadenopathy is possible by TA, it has the potential to reduce the need for follow-up imaging and tissue sampling, with reduced associated radiation exposure. However future studies are needed to confirm the clinical applicability of TA in distinguishing benign from malignant lymphadenopathy.
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Affiliation(s)
- Alexis M Cahalane
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA.
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Azadeh Tabari
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Shaunagh McDermott
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
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33
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Bregar A, Mojtahed A, Kilcoyne A, Kurra V, Melamed A, Growdon W, Alejandro Rauh-Hain J, Del Carmen M, Lee SI. CT prediction of surgical outcome in patients with advanced epithelial ovarian carcinoma undergoing neoadjuvant chemotherapy. Gynecol Oncol 2019; 152:568-573. [PMID: 30642626 DOI: 10.1016/j.ygyno.2018.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 10/09/2018] [Revised: 12/02/2018] [Accepted: 12/10/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE A scoring system has been proposed to predict gross residual disease at primary debulking surgery (PDS) for advanced epithelial ovarian cancer. This scoring system has not been assessed in patients undergoing neoadjuvant chemotherapy (NACT). The aim of this study is to assess the reproducibility and prognostic significance of the scoring system when applied to women undergoing NACT followed by interval debulking surgery (IDS). METHODS A retrospective cohort study was conducted of patients with advanced ovarian cancer who underwent NACT and IDS between 2005 and 2014. Change in tumor burden using computed tomography (CT) at diagnosis (T0) and after initiation of NACT but before IDS (T1) was independently assessed by two radiologists blinded to outcomes using two read criteria: a scoring system utilizing clinical and radiologic criteria and RECIST 1.1. Relationship between CT assessments to surgical outcome, progression free survival (PFS) and overall survival (OS) were evaluated. Reader agreement was measured using Fleiss's kappa (ĸ). RESULTS 76 patients were analyzed. Optimal surgical outcome was achieved in 69 (91%) of patients. Median progression free survival was 13.2 months and overall survival was 32.6 months, respectively. Predictive score change from T0 to T1 of >1 (denoting an improvement in disease burden) was associated with optimal cytoreduction (p = 0.02 and 0.01 for readers 1 and 2, respectively). Neither predictive score nor RECIST 1.1 assessment was predictive of OS or PFS. Reader agreement was substantial for predictive score (κ = 0.77) and moderate for RECIST (κ = 0.51) assessments. CONCLUSIONS A change in score before and after neoadjuvant chemotherapy minimizes reader variability and predicts surgical outcome.
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Affiliation(s)
- Amy Bregar
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
| | - Amirkasra Mojtahed
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Aoife Kilcoyne
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Vikram Kurra
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Alexander Melamed
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Whitfield Growdon
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - J Alejandro Rauh-Hain
- University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Marcela Del Carmen
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Susanna I Lee
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
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34
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Berek JS, Matsuo K, Grubbs BH, Gaffney DK, Lee SI, Kilcoyne A, Cheon GJ, Yoo CW, Li L, Shao Y, Chen T, Kim M, Mikami M. Multidisciplinary perspectives on newly revised 2018 FIGO staging of cancer of the cervix uteri. J Gynecol Oncol 2018; 30:e40. [PMID: 30740962 PMCID: PMC6393641 DOI: 10.3802/jgo.2019.30.e40] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 12/23/2018] [Indexed: 12/24/2022] Open
Affiliation(s)
- Jonathan S Berek
- Stanford Women's Cancer Center, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Brendan H Grubbs
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - David K Gaffney
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA
| | - Susanna I Lee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Chong Woo Yoo
- Department of Pathology, National Cancer Center, Goyang, Korea
| | - Lu Li
- College of Basic Medical Sciences, Zhejiang Chinese Medical University (ZCMU), Hangzhou, China.,Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
| | - Yifeng Shao
- Department of Obstetrics and Gynecology, 1st affiliated hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Tianhui Chen
- Group of Molecular Epidemiology & Cancer Precision Prevention (GMECPP), Zhejiang Academy of Medical Sciences (ZJAMS), Hangzhou, China
| | - Miseon Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan.
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Affiliation(s)
- Christos Coutifaris
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, and the Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (C.C.); and the Departments of Radiology (A.K.), Urology (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Surgery (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Harvard Medical School - both in Boston
| | - Aoife Kilcoyne
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, and the Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (C.C.); and the Departments of Radiology (A.K.), Urology (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Surgery (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Harvard Medical School - both in Boston
| | - Adam S Feldman
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, and the Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (C.C.); and the Departments of Radiology (A.K.), Urology (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Surgery (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Harvard Medical School - both in Boston
| | - Mary E Sabatini
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, and the Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (C.C.); and the Departments of Radiology (A.K.), Urology (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Surgery (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Harvard Medical School - both in Boston
| | - Esther Oliva
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, and the Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (C.C.); and the Departments of Radiology (A.K.), Urology (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Massachusetts General Hospital, and the Departments of Radiology (A.K.), Surgery (A.S.F.), Obstetrics and Gynecology (M.E.S.), and Pathology (E.O.), Harvard Medical School - both in Boston
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36
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Hedgire S, Kilcoyne A, Tonyushkin A, Mao Y, Uyeda JW, Gervais DA, Harisinghani MG. Effect of androgen deprivation and radiation therapy on MRI fiber tractography in prostate cancer: can we assess treatment response on imaging? Br J Radiol 2018; 92:20170170. [PMID: 30209952 DOI: 10.1259/bjr.20170170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate quantitative changes in Diffusion Tensor Magnetic Resonance Tractography in prostate cancer following androgen deprivation and radiation therapy. METHODS 22 patients with elevated PSA and biopsy proven prostate carcinoma who underwent MRI of the prostate at 1.5 T with an endorectal coil were included. Group A) was the study group (n = 11), participants who underwent androgen deprivation and/or radiation therapy and group B) were Gleason-matched control group (n = 11) participants who did not undergo such therapy. Diffusion weighted images were used to generate three-dimensional (3D) map of fiber tracts from DTI. 3D regions of interest (ROI) were drawn over the tumor and healthy prostatic parenchyma in both groups to record tract number and tract density. Tumor region and normal parenchymal tract densities within each group were compared. RESULTS Mean tract density in the tumor region and normal parenchyma was 2.3 and 3.3 in study group (tract numbers: 116.6 and 170.2 respectively) and 1.6 and 2.7 in the control group respectively (tract numbers: 252.5 and 346.3 respectively). The difference between these values was statistically significant for the control group (p = 0.0018) but not for the study group (p = 0.11). The difference between the tract numbers of tumor and normal parenchyma appears to narrow following therapy. CONCLUSION The study demonstrated utility in using tractography as a biomarker in prostate cancer patients post treatment. ADVANCES IN KNOWLEDGE Quantitative DTI fiber tractography is a promising imaging biomarker to quantitatively assess treatment response in the setting of post-androgen deprivation and radiation therapy for prostate cancer.
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Affiliation(s)
- Sandeep Hedgire
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Aoife Kilcoyne
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Alexey Tonyushkin
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA.,Physics Department, University of Massachusetts Boston, Boston, MA, USA
| | - Yun Mao
- Department of Radiology, The first affiliated hospital of Chongqing Medical University, Chongqing, China
| | - Jennifer W Uyeda
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Debra A Gervais
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Mukesh G Harisinghani
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA
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Im H, Pathania D, McFarland PJ, Sohani AR, Degani I, Allen M, Coble B, Kilcoyne A, Hong S, Rohrer L, Abramson JS, Dryden-Peterson S, Fexon L, Pivovarov M, Chabner B, Lee H, Castro CM, Weissleder R. Design and clinical validation of a point-of-care device for the diagnosis of lymphoma via contrast-enhanced microholography and machine learning. Nat Biomed Eng 2018; 2:666-674. [PMID: 30555750 PMCID: PMC6291220 DOI: 10.1038/s41551-018-0265-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/15/2018] [Indexed: 11/21/2022]
Abstract
The identification of patients with aggressive cancer who require immediate therapy is a health challenge in low-income and middle-income countries. Limited pathology resources, high healthcare costs and large-case loads call for the development of advanced standalone diagnostics. Here, we report and validate an automated, low-cost point-of-care device for the molecular diagnosis of aggressive lymphomas. The device uses contrast-enhanced microholography and a deep-learning algorithm to directly analyse percutaneously obtained fine-needle aspirates. We show the feasibility and high accuracy of the device in cells, as well as the prospective validation of the results in 40 patients clinically referred for image-guided aspiration of nodal mass lesions suspicious for lymphoma. Automated analysis of human samples with the portable device should allow for the accurate classification of patients with benign and malignant adenopathy.
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Affiliation(s)
- Hyungsoon Im
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Divya Pathania
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Philip J McFarland
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Aliyah R Sohani
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Ismail Degani
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Matthew Allen
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Benjamin Coble
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Engineering and Management, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Aoife Kilcoyne
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Seonki Hong
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Lucas Rohrer
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | | | - Scott Dryden-Peterson
- Botswana Harvard AIDS Institute, Gaborone, Botswana
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lioubov Fexon
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Misha Pivovarov
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Bruce Chabner
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Hakho Lee
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Cesar M Castro
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA.
- Massachusetts General Hospital Cancer Center, Boston, MA, USA.
| | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA.
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
- Department of Systems Biology, Harvard Medical School, Boston, MA, USA.
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38
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Catalano O, Kilcoyne A, Signore A, Mahmood U, Rosen B. Lower Gastrointestinal Tract Applications of PET/Computed Tomography and PET/MR Imaging. Radiol Clin North Am 2018; 56:821-834. [PMID: 30119776 DOI: 10.1016/j.rcl.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article discusses the role of PET/CT and PET/MR imaging in the evaluation of inflammatory and malignant disorders of the lower gastrointestinal tract. This includes a review of the current literature and a discussion of new and emerging research.
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39
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McCarthy CJ, Kilcoyne A, Li X, Cahalane AM, Liu B, Arellano RS, Uppot RN, Gee MS. Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction. Cardiovasc Intervent Radiol 2018; 41:1935-1942. [PMID: 30132100 DOI: 10.1007/s00270-018-2066-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/17/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses. MATERIALS AND METHODS Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed. The peak skin dose and effective dose were assessed for each procedure. Excess relative risk related to radiation effects was calculated. A logistic regression model was prepared by means of stepwise logistic regression to identify variables predictive of increased radiation exposure. RESULTS Tumor ablations were performed with microwave (n = 220), radiofrequency (n = 74) or irreversible electroporation (IRE) (n = 10). The mean peak skin dose for ablations was 239.2 ± 136.4 mGy, and the mean effective dose was 36.6 ± 22.3 mSv. Of the patient and procedural parameters that were analyzed, increasing weight, use of intravenous contrast and/or hydrodissection during the procedure, together with treatment of multiple lesions in the same sitting were all associated with higher radiation exposure. The mean increase in the absolute risk of fatal malignancy from a single procedure was 0.18% (range 0.02-0.9%). No deterministic skin changes were identified in the patient cohort. CONCLUSION The overall risk of stochastic and deterministic effects from radiation associated with CT-guided ablations is low compared with other inherent procedural complications. This study identifies several factors that are associated with higher radiation dose in percutaneous liver ablation procedures.
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Affiliation(s)
- Colin J McCarthy
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Xinhua Li
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Alexis M Cahalane
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Bob Liu
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Ronald S Arellano
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Raul N Uppot
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
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Affiliation(s)
- Chana A Sacks
- From the Department of Medicine, Brigham and Women's Hospital (C.A.S.), the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Harvard Medical School - all in Boston
| | - Aoife Kilcoyne
- From the Department of Medicine, Brigham and Women's Hospital (C.A.S.), the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Harvard Medical School - all in Boston
| | - Zachary S Wallace
- From the Department of Medicine, Brigham and Women's Hospital (C.A.S.), the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Harvard Medical School - all in Boston
| | - Krzysztof Glomski
- From the Department of Medicine, Brigham and Women's Hospital (C.A.S.), the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., Z.S.W.), Radiology (A.K.), and Pathology (K.G.), Harvard Medical School - all in Boston
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Bregar A, Kilcoyne A, Mojtahed A, Melamed A, Growdon W, Rauh-Hain J, Lee S, del Carmen M. Assessment of a scoring system to predict outcomes after interval debulking surgery for advanced ovarian carcinoma. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.263] [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: 12/01/2022]
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Oliveira IS, Kilcoyne A, Everett JM, Mino-Kenudson M, Harisinghani MG, Ganesan K. Cholangiocarcinoma: classification, diagnosis, staging, imaging features, and management. Abdom Radiol (NY) 2017; 42:1637-1649. [PMID: 28271275 DOI: 10.1007/s00261-017-1094-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [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: 12/14/2022]
Abstract
Cholangiocarcinoma is a relatively uncommon malignant neoplasm with poor prognosis. The distinction between extrahepatic and intrahepatic subtypes is important as epidemiological features, biologic and pathologic characteristics, and clinical course are different for both entities. This review study focuses on the role imaging plays in the diagnosis, classification, staging, and post-treatment assessment of cholangiocarcinoma.
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Affiliation(s)
- Irai S Oliveira
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
- Department of Radiology, Hospital Sírio-Libanês, São Paulo, SP, 01308-050, Brazil.
| | - Aoife Kilcoyne
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jamie M Everett
- Department of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, MA, 02114, USA
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, MA, 02114, USA
| | - Mukesh G Harisinghani
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Karthik Ganesan
- Department of Radiology, Sir HN - Reliance Foundation Hospital, Mumbai, 400004, India
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Wright JD, Schorge JO, Kilcoyne A, Tambouret RH. Case 16-2017 - A 69-Year-Old Woman with Urinary Incontinence. N Engl J Med 2017; 376:2066-2073. [PMID: 28538116 DOI: 10.1056/nejmcpc1616398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jason D Wright
- From the Department of Obstetrics and Gynecology, New York Presbyterian Hospital, and the Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons - both in New York (J.D.W.); and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Massachusetts General Hospital, and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Harvard Medical School - both in Boston
| | - John O Schorge
- From the Department of Obstetrics and Gynecology, New York Presbyterian Hospital, and the Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons - both in New York (J.D.W.); and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Massachusetts General Hospital, and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Harvard Medical School - both in Boston
| | - Aoife Kilcoyne
- From the Department of Obstetrics and Gynecology, New York Presbyterian Hospital, and the Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons - both in New York (J.D.W.); and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Massachusetts General Hospital, and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Harvard Medical School - both in Boston
| | - Rosemary H Tambouret
- From the Department of Obstetrics and Gynecology, New York Presbyterian Hospital, and the Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons - both in New York (J.D.W.); and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Massachusetts General Hospital, and the Departments of Obstetrics and Gynecology (J.O.S.), Radiology (A.K.), and Pathology (R.H.T.), Harvard Medical School - both in Boston
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Prajapati SI, Kilcoyne A, Samano AK, Green DP, McCarthy SD, Blackman BA, Brady MM, Zarzabal LA, Tatiparthi AK, Sledz TJ, Duong T, Ohshima-Hosoyama S, Giles FJ, Michalek JE, Rubin BP, Keller C. Erratum to: MicroCT-Based Virtual Histology Evaluation of Preclinical Medulloblastoma. Mol Imaging Biol 2017; 19:483. [PMID: 28389781 DOI: 10.1007/s11307-017-1079-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Suresh I Prajapati
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
| | - Aoife Kilcoyne
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
- Department of Medicine, University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA
| | - Aislynn K Samano
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
| | - Dustin P Green
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
| | - Steven D McCarthy
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
| | - Barron A Blackman
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
| | - Michelle M Brady
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
| | - Lee Ann Zarzabal
- Epidemiology and Biostatistics, University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA
| | | | | | - Timothy Duong
- Research Imaging Institute, University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA
| | - Sachiko Ohshima-Hosoyama
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA
| | - Francis J Giles
- Department of Medicine, University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA
| | - Joel E Michalek
- Epidemiology and Biostatistics, University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA
| | - Brian P Rubin
- Department of Anatomic Pathology, Cleveland Clinic, Taussig Cancer Center and the Lerner Research Institute, Cleveland, OH, USA
| | - Charles Keller
- Greehey Children's Cancer Research Institute, University of Texas Health Science Center, 8403 Floyd Curl Drive, MC-7784, San Antonio, TX, 78229, USA.
- Cellular and Structural Biology, University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA.
- Pediatrics University of Texas Health Science Center, 7703 Floyd Curl, San Antonio, TX, 78229, USA.
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Oliveira IS, Kilcoyne A, Price MC, Harisinghani M. MRI features of perianal fistulas: is there a difference between Crohn's and non-Crohn's patients? Abdom Radiol (NY) 2017; 42:1162-1168. [PMID: 27885389 DOI: 10.1007/s00261-016-0989-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Though perianal fistulas are commonly seen in patients with Crohn's disease, they can also be seen in patients without inflammatory bowel disease. The purpose of this study was to evaluate MR imaging differences of perianal fistulas in patients with and without Crohn's disease. METHODS Our retrospective search from January 2012 to December 2015 of the Radiology database for perianal fistula yielded 207 patients. Only patients with dedicated MR fistula protocol studies were included, whereas patients with previous anal surgery or anastomosis, anorectal tumors, and equivocal findings that could not be definitely assessed as a fistula were excluded. The following features were assessed: anatomic type of fistula (Parks Classification), luminal origin (hour clock position), anal verge distance, signs of acute inflammation, circumference of anus involved by inflammation, presence of rectal inflammation. and abscess. RESULTS One hundred and twenty six of 207 patients met inclusion criteria. Of these, 96 (76.2%) had Crohn's disease and 30 (23.8%) did not. The most common fistulas identified were transphincteric (38.5% of Crohn's and 50% of non-Crohn's) and intersphincteric (33.3% of Crohn's and 35.4% of non-Crohn's). An abscess was associated in 41 cases, 32 (33.3%) in the Crohn's group and 9 (30.0%) in the non-Crohn's group. Rectal inflammation was present in 29 patients with Crohn's disease (29.2%) and in 2 without Crohn's (6.7%). This finding was statistically significant (p = 0.0009). CONCLUSIONS Our study demonstrates that while both groups can have similar MR imaging features, accompanying rectal inflammation was more commonly seen in Crohn's disease.
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Abstract
Prostate cancer is the second most common cancer in men and is the second highest cause of cancer death in men of all races. Accurate lymph node staging is essential to ensure adequate treatment of prostate cancer. Historically, conventional imaging methods have demonstrated limited sensitivity and specificity in the detection of lymph node metastases. There are many emerging PET tracers that have recently proven to be effective. In addition, the use of ultrasmall iron oxide nanoparticle-enhanced MRI has demonstrated promising results. This review outlines the strengths and limitations of each of the different imaging modalities as well as individual tracers used, including preclinical and clinical agents.
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Affiliation(s)
- Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Melissa C Price
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Shaunagh McDermott
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Mukesh G Harisinghani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA
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Kilcoyne A, Harisinghani MG, Mahmood U. Prostate Cancer Imaging and Therapy: Potential Role of Nanoparticles. J Nucl Med 2016; 57:105S-110S. [DOI: 10.2967/jnumed.115.170738] [Citation(s) in RCA: 8] [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: 04/25/2016] [Accepted: 08/16/2016] [Indexed: 12/17/2022] Open
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Hong S, Pirovich D, Kilcoyne A, Huang CH, Lee H, Weissleder R. Supramolecular Metallo-Bioadhesive for Minimally Invasive Use. Adv Mater 2016; 28:8675-8680. [PMID: 27515068 PMCID: PMC5144581 DOI: 10.1002/adma.201602606] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/12/2016] [Indexed: 05/23/2023]
Abstract
A novel metallo-bioadhesive to be used as tissue sealant in minimally invasive procedures is reported. Metal complexation can be used to render gelatin derivatives adhesive, which occurs in minutes, is efficient, and fully biodegradable within weeks.
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Affiliation(s)
- Seonki Hong
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St., CPZN 5206, Boston, MA, 02114, USA
| | - David Pirovich
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St., CPZN 5206, Boston, MA, 02114, USA
| | - Aoife Kilcoyne
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St., CPZN 5206, Boston, MA, 02114, USA
- Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Chen-Han Huang
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St., CPZN 5206, Boston, MA, 02114, USA
| | - Hakho Lee
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St., CPZN 5206, Boston, MA, 02114, USA
| | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St., CPZN 5206, Boston, MA, 02114, USA.
- Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA.
- Department of Systems Biology, Harvard Medical School, 200 Longwood Ave., Boston, MA, 02115, USA.
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Affiliation(s)
- Richard S Legro
- From the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey (R.S.L.); and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Massachusetts General Hospital, and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Harvard Medical School - both in Boston
| | - Rocío M Hurtado
- From the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey (R.S.L.); and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Massachusetts General Hospital, and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Harvard Medical School - both in Boston
| | - Aoife Kilcoyne
- From the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey (R.S.L.); and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Massachusetts General Hospital, and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Harvard Medical School - both in Boston
| | - Drucilla J Roberts
- From the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey (R.S.L.); and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Massachusetts General Hospital, and the Departments of Infectious Disease (R.M.H.), Radiology (A.K.), and Pathology (D.J.R.), Harvard Medical School - both in Boston
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Giedt RJ, Fumene Feruglio P, Pathania D, Yang KS, Kilcoyne A, Vinegoni C, Mitchison TJ, Weissleder R. Computational imaging reveals mitochondrial morphology as a biomarker of cancer phenotype and drug response. Sci Rep 2016; 6:32985. [PMID: 27609668 PMCID: PMC5017129 DOI: 10.1038/srep32985] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 08/16/2016] [Indexed: 12/27/2022] Open
Abstract
Mitochondria, which are essential organelles in resting and replicating cells, can vary in number, mass and shape. Past research has primarily focused on short-term molecular mechanisms underlying fission/fusion. Less is known about longer-term mitochondrial behavior such as the overall makeup of cell populations’ morphological patterns and whether these patterns can be used as biomarkers of drug response in human cells. We developed an image-based analytical technique to phenotype mitochondrial morphology in different cancers, including cancer cell lines and patient-derived cancer cells. We demonstrate that (i) cancer cells of different origins, including patient-derived xenografts, express highly diverse mitochondrial phenotypes; (ii) a given phenotype is characteristic of a cell population and fairly constant over time; (iii) mitochondrial patterns correlate with cell metabolic measurements and (iv) therapeutic interventions can alter mitochondrial phenotypes in drug-sensitive cancers as measured in pre- versus post-treatment fine needle aspirates in mice. These observations shed light on the role of mitochondrial dynamics in the biology and drug response of cancer cells. On the basis of these findings, we propose that image-based mitochondrial phenotyping can provide biomarkers for assessing cancer phenotype and drug response.
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Affiliation(s)
- Randy J Giedt
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 5206, Boston, MA 02114, USA
| | - Paolo Fumene Feruglio
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 5206, Boston, MA 02114, USA.,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
| | - Divya Pathania
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 5206, Boston, MA 02114, USA
| | - Katherine S Yang
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 5206, Boston, MA 02114, USA
| | - Aoife Kilcoyne
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 5206, Boston, MA 02114, USA
| | - Claudio Vinegoni
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 5206, Boston, MA 02114, USA
| | - Timothy J Mitchison
- Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA
| | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 5206, Boston, MA 02114, USA.,Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA
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