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Wiener DM, Huynh E, Jeyakumar I, Bax S, Sama S, Cabrera JP, Todorova V, Vangipuram M, Vaid S, Otsuka F, Sakai Y, Leonetti MD, Gómez-Sjöberg R. An open-source FACS automation system for high-throughput cell biology. PLoS One 2024; 19:e0299402. [PMID: 38512845 PMCID: PMC10956866 DOI: 10.1371/journal.pone.0299402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 02/08/2024] [Indexed: 03/23/2024] Open
Abstract
Recent advances in gene editing are enabling the engineering of cells with an unprecedented level of scale. To capitalize on this opportunity, new methods are needed to accelerate the different steps required to manufacture and handle engineered cells. Here, we describe the development of an integrated software and hardware platform to automate Fluorescence-Activated Cell Sorting (FACS), a central step for the selection of cells displaying desired molecular attributes. Sorting large numbers of samples is laborious, and, to date, no automated system exists to sequentially manage FACS samples, likely owing to the need to tailor sorting conditions ("gating") to each individual sample. Our platform is built around a commercial instrument and integrates the handling and transfer of samples to and from the instrument, autonomous control of the instrument's software, and the algorithmic generation of sorting gates, resulting in walkaway functionality. Automation eliminates operator errors, standardizes gating conditions by eliminating operator-to-operator variations, and reduces hands-on labor by 93%. Moreover, our strategy for automating the operation of a commercial instrument control software in the absence of an Application Program Interface (API) exemplifies a universal solution for other instruments that lack an API. Our software and hardware designs are fully open-source and include step-by-step build documentation to contribute to a growing open ecosystem of tools for high-throughput cell biology.
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Affiliation(s)
- Diane M. Wiener
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Emily Huynh
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Ilakkiyan Jeyakumar
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Sophie Bax
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Samia Sama
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Joana P. Cabrera
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Verina Todorova
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Madhuri Vangipuram
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Shivanshi Vaid
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Fumitaka Otsuka
- Medical Business Group, Sony Corporation, San Jose, California, United States of America
| | - Yoshitsugu Sakai
- Medical Business Group, Sony Corporation, San Jose, California, United States of America
| | - Manuel D. Leonetti
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
| | - Rafael Gómez-Sjöberg
- Chan Zuckerberg Biohub–San Francisco, San Francisco, California, United States of America
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2
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Dang LT, Vaid S, Lin G, Swaminathan P, Safran J, Loughman A, Lee M, Glenn T, Majolo F, Crino PB, Parent JM. STRADA-mutant human cortical organoids model megalencephaly and exhibit delayed neuronal differentiation. Dev Neurobiol 2021; 81:696-709. [PMID: 33619909 DOI: 10.1002/dneu.22816] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/31/2022]
Abstract
Genetic diseases involving overactivation of the mechanistic target of rapamycin (mTOR) pathway, so-called "mTORopathies," often manifest with malformations of cortical development (MCDs), epilepsy, and cognitive impairment. How mTOR pathway hyperactivation results in abnormal human cortical development is poorly understood. To study the effect of mTOR hyperactivity on early stages of cortical development, we focused on Pretzel Syndrome (polyhydramnios, megalencephaly, symptomatic epilepsy; PMSE syndrome), a rare mTORopathy caused by homozygous germline mutations in the STRADA gene. We developed a human cortical organoid (hCO) model of PMSE and examined morphology and size for the first 2 weeks of organoid growth, and cell type composition at weeks 2, 8, and 12 of differentiation. In the second week, PMSE hCOs enlarged more rapidly than controls and displayed an abnormal Wnt pathway-dependent increase in neural rosette structures. PMSE hCOs also exhibited delayed neurogenesis, decreased subventricular zone progenitors, increased proliferation and cell death, and an abnormal architecture of primary cilia. At week 8, PMSE hCOs had fewer deep layer neurons. By week 12, neurogenesis recovered in PMSE organoids, but they displayed increased outer radial glia, a cell type thought to contribute to the expansion of the human cerebral cortex. Together, these findings suggest that megalencephaly in PMSE arises from the expansion of neural stem cells in early corticogenesis and potentially also from increased outer radial glial at later gestational stages. The delayed neuronal differentiation in PMSE organoids demonstrates the important role the mTOR pathway plays in the maintenance and expansion of the stem cell pool.
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Affiliation(s)
- Louis T Dang
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA.,Department of Neurology, Michigan Medicine, Ann Arbor, MI, USA.,Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, USA
| | - Shivanshi Vaid
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA.,Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, USA
| | - Grace Lin
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, USA.,Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, USA
| | | | - Jordan Safran
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA
| | - Anna Loughman
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA
| | - Monica Lee
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA
| | - Trevor Glenn
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, USA
| | - Fernanda Majolo
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, USA
| | - Peter B Crino
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jack M Parent
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, USA.,Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, USA.,Neurology Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
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3
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Crane AT, Chrostek MR, Krishna VD, Shiao M, Toman NG, Pearce CM, Tran SK, Sipe CJ, Guo W, Voth JP, Vaid S, Xie H, Lu WC, Swanson W, Grande AW, Schleiss MR, Bierle CJ, Cheeran MCJ, Low WC. Zika virus-based immunotherapy enhances long-term survival of rodents with brain tumors through upregulation of memory T-cells. PLoS One 2020; 15:e0232858. [PMID: 33002018 PMCID: PMC7529292 DOI: 10.1371/journal.pone.0232858] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/24/2020] [Indexed: 02/02/2023] Open
Abstract
Zika virus (ZIKV) exhibits a tropism for brain tumor cells and has been used as an oncolytic virus to target brain tumors in mice with modest effects on extending median survival. Recent studies have highlighted the potential for combining virotherapy and immunotherapy to target cancer. We postulated that ZIKV could be used as an adjuvant to enhance the long-term survival of mice with malignant glioblastoma and generate memory T-cells capable of providing long-term immunity against cancer remission. To test this hypothesis mice bearing malignant intracranial GL261 tumors were subcutaneously vaccinated with irradiated GL261 cells previously infected with the ZIKV. Mice also received intracranial injections of live ZIKV, irradiation attenuated ZIKV, or irradiated GL261 cells previously infected with ZIKV. Long-term survivors were rechallenged with a second intracranial tumor to examine their immune response and look for the establishment of protective memory T-cells. Mice with subcutaneous vaccination plus intracranial irradiation attenuated ZIKV or intracranial irradiated GL261 cells previously infected with ZIKV exhibited the greatest extensions to overall survival. Flow cytometry analysis of immune cells within the brains of long-term surviving mice after tumor rechallenge revealed an increase in the number of T-cells, including CD4+ and tissue-resident effector/ effector memory CD4+ T-cells, in comparison to long-term survivors that were mock-rechallenged, and in comparison to naïve untreated mice challenged with intracranial gliomas. These results suggest that ZIKV can serve as an adjuvant to subcutaneous tumor vaccines that enhance long-term survival and generate protective tissue-resident memory CD4+ T-cells.
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Affiliation(s)
- Andrew T. Crane
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Matthew R. Chrostek
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Venkatramana D. Krishna
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, United States of America
| | - Maple Shiao
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Nikolas G. Toman
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Clairice M. Pearce
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Sarah K. Tran
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Christopher J. Sipe
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Winston Guo
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Joseph P. Voth
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Shivanshi Vaid
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Hui Xie
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Wei-Cheng Lu
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Will Swanson
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Andrew W. Grande
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Mark R. Schleiss
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Craig J. Bierle
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Maxim C-J. Cheeran
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, United States of America
| | - Walter C. Low
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America
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4
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Dang LT, Glanowska KM, Iffland Ii PH, Barnes AE, Baybis M, Liu Y, Patino G, Vaid S, Streicher AM, Parker WE, Kim S, Moon UY, Henry FE, Murphy GG, Sutton M, Parent JM, Crino PB. Multimodal Analysis of STRADA Function in Brain Development. Front Cell Neurosci 2020; 14:122. [PMID: 32457579 PMCID: PMC7227375 DOI: 10.3389/fncel.2020.00122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/14/2020] [Indexed: 12/22/2022] Open
Abstract
mTORopathies are a heterogeneous group of neurological disorders characterized by malformations of cortical development (MCD), enhanced cellular mechanistic target of rapamycin (mTOR) signaling, and epilepsy that results from mutations in mTOR pathway regulatory genes. Homozygous mutations (del exon 9–13) in the pseudokinase STE20-related kinase adaptor alpha (STRAD-α; STRADA), an mTOR modulator, are associated with Pretzel Syndrome (PS), a neurodevelopmental disorder within the Old Order Mennonite Community characterized by megalencephaly, intellectual disability, and intractable epilepsy. To study the cellular mechanisms of STRADA loss, we generated CRISPR-edited Strada mouse N2a cells, a germline mouse Strada knockout (KO−/−) strain, and induced pluripotent stem cell (iPSC)-derived neurons from PS individuals harboring the STRADA founder mutation. Strada KO in vitro leads to enhanced mTOR signaling and iPSC-derived neurons from PS individuals exhibit enhanced cell size and mTOR signaling activation, as well as subtle alterations in electrical firing properties e.g., increased input resistance, a more depolarized resting membrane potential, and decreased threshold for action potential (AP) generation. Strada−/− mice exhibit high rates of perinatal mortality and out of more than 100 litters yielding both WT and heterozygous pups, only eight Strada−/− animals survived past P5. Strada−/− mice are hypotonic and tremulous. Histopathological examination (n = 5 mice) revealed normal gross brain organization and lamination but all had ventriculomegaly. Ectopic neurons were seen in all five Strada−/− brains within the subcortical white matter mirroring what is observed in human PS brain tissue. These distinct experimental platforms demonstrate that STRADA modulates mTOR signaling and is a key regulator of cell size, neuronal excitability, and cortical lamination.
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Affiliation(s)
- Louis T Dang
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, United States.,Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, United States
| | - Katarzyna M Glanowska
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, United States.,Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, United States
| | - Philip H Iffland Ii
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Allan E Barnes
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Marianna Baybis
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Yu Liu
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, United States
| | - Gustavo Patino
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, United States
| | - Shivanshi Vaid
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, United States.,Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, United States
| | | | - Whitney E Parker
- Department of Neurosurgery, Weill-Cornell Medical Center, New York, NY, United States
| | - Seonhee Kim
- Louis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Uk Yeol Moon
- Louis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Frederick E Henry
- Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, United States.,Department of Molecular, and Integrative Physiology, Michigan Medicine, Ann Arbor, MI, United States
| | - Geoffrey G Murphy
- Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, United States.,Department of Molecular, and Integrative Physiology, Michigan Medicine, Ann Arbor, MI, United States
| | - Michael Sutton
- Michigan Neuroscience Institute, Michigan Medicine, Ann Arbor, MI, United States.,Department of Molecular, and Integrative Physiology, Michigan Medicine, Ann Arbor, MI, United States
| | - Jack M Parent
- Department of Neurology, Michigan Medicine, Ann Arbor, MI, United States.,Neurology Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Peter B Crino
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
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5
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Shiao M, Bierle C, Chrostek M, Crane A, Danczyk G, Miller Z, Pearce C, Schaible K, Schleiss M, Sipe C, Straub E, Toman N, Vaid S, Voth J, Low W. EXTH-01. ZIKA VIRUS TARGETING OF MALIGNANT HUMAN AND MURINE BRAIN TUMORS. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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6
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Vaid S, Chandorkar A, Atre A, Shah D, Vaid N. Differentiating recurrent tumours from post-treatment changes in head and neck cancers: does diffusion-weighted MRI solve the eternal dilemma? Clin Radiol 2016; 72:74-83. [PMID: 27789026 DOI: 10.1016/j.crad.2016.09.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/16/2016] [Accepted: 09/28/2016] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the utility of diffusion-weighted imaging (DWI) in differentiating post-treatment changes from tumour recurrence in head and neck cancers and to establish a threshold apparent diffusion coefficient (ADC) value to differentiate the two conditions. MATERIALS AND METHODS This was a prospective study of 80 treated head and neck cancer patients. The patient cohort consisted of a wide spectrum of head and neck sites, including the oral cavity, oropharynx, larynx, hypopharynx, paranasal sinuses, orbits, salivary glands, and infra-temporal fossa. Qualitative analysis of the diffusion images and quantitative analysis of the corresponding ADC maps was performed and the data were correlated with histopathological findings and clinical examinations. RESULTS The mean ADC value of recurrent tumours in the present cohort was 0. 932±0.19×10-3 mm2/s and the mean ADC value of lesions representing post-treatment changes was 1.394±0.32×10-3 mm2/s. A threshold ADC value of 1.2×10-3mm2/s used to differentiate post-treatment changes from recurrent head and neck cancers showed the highest combined sensitivity of 90.13%, specificity of 82.5%, accuracy of 86.4%, positive predictive value of 84.4%, negative predictive value of 88.9%, and mean kappa measurement of agreement of 72.8. CONCLUSION Combined qualitative and quantitative analysis of DWI is a useful non-invasive technique to differentiate recurrent head and neck malignancies from post-treatment changes using a threshold ADC value.
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Affiliation(s)
- S Vaid
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India.
| | - A Chandorkar
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India
| | - A Atre
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India
| | - D Shah
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India
| | - N Vaid
- Dept of Otorhinolaryngology, K. E. M. Hospital, Rastapeth, Pune 411011, India
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7
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Vaid S, Vaid N. Imaging for cochlear implantation: Structuring a clinically relevant report. Clin Radiol 2014; 69:e9-e24. [DOI: 10.1016/j.crad.2014.03.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 02/19/2014] [Accepted: 03/13/2014] [Indexed: 11/25/2022]
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Mehta C, Vaid S, Adedeji A, Vibhakar D, Bell T, Grim R, Ahuja V. Epidemiology of Clostridium Difficile Colitis in Hospitalized Patients in the United States. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.063] [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: 10/14/2022]
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9
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Vaid S, Vaid N, Rawat S, Ahuja AT. An imaging checklist for pre-FESS CT: framing a surgically relevant report. Clin Radiol 2011; 66:459-70. [PMID: 21288796 DOI: 10.1016/j.crad.2010.11.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 11/14/2010] [Accepted: 11/16/2010] [Indexed: 11/24/2022]
Abstract
The reference standard for preoperative imaging in functional endoscopic sinus surgery (FESS) is multiplanar high-resolution computed tomography (HRCT). Surgeons require a precise preoperative anatomical road map, and hence it is essential for radiologists to be familiar with the normal three-dimensional sinonasal anatomy and the normal variants encountered in this region. Sagittal imaging has recently emerged as an important tool to visualize additional details in this critical anatomical region. Radiologists also need to report these examinations with special focus on the surgeon's expectations. Constant communication between the radiologist and the surgeon helps to resolve specific issues and improve the overall quality of reports. This results in better preoperative patient counselling and in predicting postoperative improvement in clinical status. This review provides a basic structured format for reporting pre-FESS CT, which can be tailored to meet individual requirements. The CT reporting format follows the order in which the sinonasal structures are approached during surgery.
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Affiliation(s)
- S Vaid
- Department of Radiology and Imaging, Grant Medical Foundation, Pune, India.
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Vaid S, Lee Y, Rawat S, Luthra A, Shah D, Ahuja A. Re: Tuberculosis in the head and neck — A forgotten differential diagnosis. A reply. Clin Radiol 2010. [DOI: 10.1016/j.crad.2010.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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11
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Atre A, Jagtap M, Nanivadekar A, Vaid S, Rawat S. Spontaneous vertebral artery dissection. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.32343] [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: 11/04/2022] Open
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12
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Atre A, Jagtap M, Nanivadekar A, Vaid S, Rawat S. Spontaneous vertebral artery dissection. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.29178] [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: 11/04/2022] Open
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13
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Kulkarni S, Uddar M, Deshpande SG, Vaid S, Wadia RS. Renal cell carcinoma as significant manifestation of tuberous sclerosis complex. J Assoc Physicians India 2000; 48:351-3. [PMID: 11229127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We present a case of renal cell carcinoma diagnosed in 1982; aged 20 years. Regular follow up of the abdomen by USG noted first the presence of 2 nodules in the remaining kidney in 1994, age 30 and more lesions in 1997, aged 35. These were suspected to be angiomyolipomas on USG. The radiologist on this basis raised the question of tuberous sclerosis. Subsequent evaluation by internist/neurologist showed few adenoma sebaceum lesions a single ash leaf macule, a shagreen patch on the back, and characteristic multiple subependymal calcifications diagnostic of tuberous sclerosis on CT scan brain. The mentation was normal, there was history of only a single fit in childhood. The renal cell carcinoma was thus the first significant manifestation of tuberous sclerosis complex (TSC).
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Affiliation(s)
- S Kulkarni
- Ruby Hall Clinic, 40 Sassoon Road, Pune 411 001
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