elliot k fishman

Corrigendum to: ‘CT of a pulmonary artery intimal sarcoma: A case report’ [Radiology Case Reports 18 (2023) 3840–3843] - PMC Back to Top Skip to main content NIH NLM Logo Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation Search PMC Full-Text Archive Search in PMC Advanced Search User Guide Journal List Radiol Case Rep v.19(2); 2024 Feb PMC10726318 Other Formats PDF (202K) Actions Cite Collections Share Permalink Copy RESOURCES Similar articles Cited by other articles Links to NCBI Databases Journal List Radiol Case Rep v.19(2); 2024 Feb PMC10726318 As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice Logo of rcr Radiol Case Rep. 2024 Feb; 19(2): 831. …

Images in a 56-year-old male patient with gastrointestinal graft-versus-host disease.(A) Coronal contrast-enhanced CT image shows diffuse small bowel wall thickening, mucosal hyperenhancement, and vasa recta engorgement.(B) Coronal cinematic rendering captures a large volume of tissue, better visualizing the diffusely increased mesenteric vascularity.(C) Axial cinematic rendering shows the wall thickening of the colon and adjacent dilated vessels (arrowhead). Small ulcerations can be seen in the mucosal layer of the colon.A 56-year-old male patient developed large-volume blood-tinged stool, nausea, and vomiting 3 months after peripheral blood stem cell transplant for chronic myelogenous leukemia. Esophagogastroduodenoscopy and colonoscopy were performed, and biopsies of the duodenum and sigmoid colon showed apoptotic bodies and glandular dropout consistent with graftversus-host disease …

PurposeAccurate staging of disease is vital in determining appropriate care for patients with pancreatic ductal adenocarcinoma (PDAC). It has been shown that the quality of scans and the experience of a radiologist can impact computed tomography (CT) based assessment of disease. The aim of the current study was to evaluate the impact of the rereading of outside hospital (OH) CT by an expert radiologist and a repeat pancreatic protocol CT (PPCT) on staging of disease.MethodsPatients evaluated at the our institute's pancreatic multidisciplinary clinic (2006 to 2014) with OH scan and repeat PPCT performed within 30 days were included. In-house radiologists staged disease using OH scans and repeat PPCT, and factors associated with misstaging were determined.ResultsThe study included 100 patients, with a median time between OH scan and PPCT of 19 days (IQR: 13 – 23 days.) Stage migration was …

Liposarcomas are infrequent malignant tumors of mesenchymal origin most commonly seen in the extremities. Although infrequent, these can develop as primary lesions in the soft tissue of the kidney, making them difficult to diagnose through imaging modalities alone. Primary renal liposarcomas are associated with poor prognoses, increasing the importance of timely and accurate diagnosis. In extremely rare instances, the tumor can arise directly from the fat in the epicenter of the kidney, disguised as an angiomyolipoma. In this article, we report the case of a 54-year-old female who was diagnosed with a well-differentiated liposarcoma of the kidney and underwent radical nephrectomy. Our objective is to evaluate unique radiological imaging findings and correlate with histopathological analysis to optimize diagnosis

Pancreatic intraepithelial neoplasias (PanINs) are the most common precursors of pancreatic cancer, but their small size and inaccessibility in humans make them challenging to study. Critically, the number, dimensions and connectivity of human PanINs remain largely unknown, precluding important insights into early cancer development. Here, we provide a microanatomical survey of human PanINs by analysing 46 large samples of grossly normal human pancreas with a machine-learning pipeline for quantitative 3D histological reconstruction at single-cell resolution. To elucidate genetic relationships between and within PanINs, we developed a workflow in which 3D modelling guides multi-region microdissection and targeted and whole-exome sequencing. From these samples, we calculated a mean burden of 13 PanINs per cm3 and extrapolated that the normal intact adult pancreas harbours hundreds of …

Cinematic rendering is a recently developed photorealistic display technique for standard volumetric data sets. It has broad-reaching applications in cardiovascular, musculoskeletal, abdominopelvic, and thoracic imaging. It has been used for surgical planning and has emerging use in educational settings. We review the logistics of performing this post-processing step and its integration into existing workflow.

Uncertainty regarding the future of radiologists is largely driven by the emergence of artificial intelligence (AI). If AI succeeds, will radiologists continue to monopolize imaging services? As AI accuracy progresses with alacrity, radiology reads will be excellent. Some articles show that AI can make non-radiologists experts. However, eminent figures within AI development have expressed concerns over its possible adverse uses. Bad actors, not bad AI, may account for a future in which AI is not as successful as we might hope and, as some fear, even pernicious. More relevant to current predictions over the course of AI in medicine, and radiology in particular, is how the evolution of AI is often seen in a vacuum. We cannot predict the future with certainty. But as we contemplate the potential impact of AI in radiology, we should remember that radiology does not exist in a vacuum; while AI is changing, so is everything else …

Gastrointestinal basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum, a saprophytic fungus primarily found in soil and decaying vegetables. Basidiobolomycosis typically presents as a chronic subcutaneous swelling and rarely infects the gastrointestinal tract. Thus, the infrequency of gastrointestinal infections, along with nonspecific clinical symptoms, often results in misdiagnosed cases and delays in treatment. In this article, we report the case of a 68-year-old male with gastrointestinal basidiobolomycosis masquerading as metastatic cancer. We focus on the use of radiological imaging modalities and histopathological analysis to optimize the diagnosis and treatment of this rare gastrointestinal infection.

“Half of what you study must be from outside of medicine.. For the necessary advances will come at the interface of disciplines,” taught my undergraduate mentor, Dr E. James Potchen, at Michigan State University (MSU). Dr Potchen taught undergraduate philosophy, but he was also an economist, a lawyer, a horticulturist, a family medicine doctor, and chair of radiology. My decision to remain at MSU for medical school was inspired by the opportunity to observe and adopt the approaches of a truly renaissance person. My father, an engineer, stressed living life as a gap analysis. Analyze what you can do, what you wish you could do, and what others can do. Consequently, when I arrived at Johns Hopkins for residency, I studied faculty members, peers, individuals in other departments, and leadership in the institution and outside. I analyzed what I needed to learn to become the best version of myself. One of the …

Sclerosing epithelioid fibrosarcoma is a rare fibrosarcoma variant in which more than half of patients experience local recurrence or metastatic spread. In the current literature, there is limited and nonspecific imaging data, contributing to frequent misdiagnosis and delays in treatment intervention. Given the poor prognosis associated with this malignancy and the high probability of metastases, accurate and prompt diagnoses are critical. In this article, we report the case of a 27-year-old female diagnosed with metastatic sclerosing epithelioid fibrosarcoma following the discovery of a growing palpable mass on her right gluteus maximus muscle. We focus on the use of radiological imaging modalities in optimizing diagnosis and correlate our imaging and pathological findings.

Non-traumatic thoracic aorta emergencies are acute conditions associated with substantial morbidity and mortality. In the emergency setting, timely detection of aortic injury through radiological imaging is crucial for prompt treatment planning and favorable patient outcomes. 3D cinematic rendering (CR), a novel rendering algorithm for computed tomography (CT) image processing, allows for life-like visualization of spatial details and contours of highly complex anatomic structures such as the thoracic aorta and its vessels, generating a photorealistic view that not just adds to diagnostic confidence, but is especially useful for non-radiologists, including surgeons and emergency medicine physicians. In this pictorial review, we demonstrate the utility of CR in the setting of non-traumatic thoracic aorta emergencies through 10 cases that were processed at a standalone 3D CR station at the time of presentation, including …

PurposeDelay in diagnosis can contribute to poor outcomes in pancreatic ductal adenocarcinoma (PDAC), and new tools for early detection are required. Recent application of artificial intelligence to cancer imaging has demonstrated great potential in detecting subtle early lesions. The aim of the study was to evaluate global and local accuracies of deep neural network (DNN) segmentation of normal and abnormal pancreas with pancreatic mass.MethodsOur previously developed and reported residual deep supervision network for segmentation of PDAC was applied to segment pancreas using CT images of potential renal donors (normal pancreas) and patients with suspected PDAC (abnormal pancreas). Accuracy of DNN pancreas segmentation was assessed using DICE simulation coefficient (DSC), average symmetric surface distance (ASSD), and Hausdorff distance 95% percentile (HD95) as compared to …

First grade is usually the time when you are expected to read books on your own. To some, this is an exciting milestone; for me, it induced significant embarrassment and frustration. While many were reading through novels, I struggled through rhyming picture books with three words per page. Assignments seemingly easy to classmates were much harder for me. Already accommodated with extra time, I fought to complete tests and grew exceedingly anxious before exams, which impeded my ability to study for them. I regularly finished my homework the morning it was due, after spending hours procrastinating the previous night. Upon entering high school, I was diagnosed with dyslexia and attention deficit hyperactivity disorder (ADHD), labels I’ve lived with ever since.My story is a testament to the advantages of financial resources, overly attentive parents, and, especially, early detection and intervention. These …

When found in the cecum or rectosigmoid junction, primary colorectal B-cell lymphoma is a rare malignant non-Hodgkin's lymphoma often associated with an unfavorable prognosis. Due to the nonspecific clinical symptoms, these uncommon tumors are often left undefined or misdiagnosed, resulting in delays in treatment and adverse patient outcomes. Contrast-enhanced computed tomography is the most commonly used medical imaging process for primary colorectal lymphoma, but due to the rarity of this disorder, accurate imaging diagnosis remains a clinical challenge. In this article, we report the case of a 70-year-old male who was diagnosed with primary B-cell lymphoma of the cecum. We focus on improving diagnosis through the utilization of radiological imaging modalities, particularly computed tomography (CT) and fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18-F …

According to the World Health Organization,“Ageism refers to stereotypes (how we think), prejudice (how we feel), and discrimination (how we act) towards others or oneself based on age”(1). Our own internalized beliefs also play an important role. Beliefs that we have about aging, maybe before identifying as an older adult, greatly impact how we age. A recent study examining ageism and the prevalence of health conditions looked at ways to quantify ageism and tied it to health care costs (2). Surprisingly, an estimated $63 billion, or one in every seven dollars spent on the top eight health conditions, could be attributed to internalized ageism or ageist treatment.Unfortunately, the average American spends the last decade of their lifespan in poor health, with a current 12-year gap between healthspan and lifespan. Bold’s mission is to close this gap by creating preventative, engaging services and programs that return …

A plasmacytoma is a cancerous growth of abnormal plasma cells that arise within osseous or soft tissue structures. In soft tissue structures, plasmacytomas can present as solitary or multiple masses in the absence of systemic involvement. Solitary plasmacytomas can be subcategorized as extramedullary plasmacytoma (derived from plasma cells located in soft tissues) or osseous plasmacytoma (derived from plasma cells located in the bone marrow). Infrequently, these tumors can arise as extramedullary lesions from the pancreas and present similarly to other tumors, such as pancreatic neuroendocrine tumors (PNETs). In this article, we report the case of a 62-year-old male with a diagnosis of solitary plasmacytoma of the pancreas. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, specifically computed tomography (CT) scans and positron emission …

Generative artificial intelligence (AI), and specifically the large-language models (LLMs) that underlie impressive new applications such as ChatGPT, are already fundamentally changing medicine. Unlike more traditional AI systems that produce simple outputs like a number (say, the predicted length of stay for a patient in the hospital) or a category (say “malignant” or “benign” for a radiologic system),“Generative AI” refers broadly to systems whose outputs take the form of more unstructured media objects, like images or documents. Under the hood, many of these systems are actually built by executing models that serve a more classical purpose. Generative text models, for example, generate whole documents by iteratively predicting “what word comes next”. But the ability to produce a whole document with desired properties unlocks a host of exciting applications. Prior to starting Abridge AI, Inc., I led the provider …

There has been a proliferation of new concepts and terms in recent years that are related to Web3. There are many misconceptions about what those terms mean. In our current discussion, we are going to debunk many of those meanings. The core of my job is based on thinking about all of the bad decisions that you make–particularly, those made on the basis of lack of confidence and fear (eg you don’t want to look bad in front of your colleagues), which are particularly common when dealing with new terms and concepts.Through education, you gain confidence. Everything I do when I write, and the goal of this discussion, is education. Specifically, we will walk through more humanized meanings of the technology “buzzwords” that are being increasingly used, such as “Web3”,“cryptocurrency”,“non-fungable tokens”(“NFTs”), and the “Metaverse”. These terms are often mis-used in the media. We’ll discuss what these …

Black blood cinematic rendering (BBCR) is a newly described preset for cinematic rendering, which creates photorealistic displays from volumetric data sets with the contrast-enhanced blood pool displayed as dark and transparent. That set of features potentially provides for enhanced visualization of endomyocardial and intraluminal pathology, as well as cardiac devices. The similarity of the images to black-blood magnetic resonance imaging (MRI) may allow for expansion of the evaluation of certain types of pathology into patient populations unable to undergo MRI. In the emergency setting, the rapid acquisition time and reasonable post-processing time make this technique clinically feasible. In this expanded experience, we demonstrate an expanded clinical experience with the BBCR technique, highlighting the applications for intraluminal cardiovascular evaluation, especially focused on current and potential …

Placenta accreta spectrum disorder (PASD) encompasses various types of abnormal placentation in which chorionic villi directly adhere to or invade the myometrium. The incidence of PASD has dramatically risen in the US over the past 3 decades owing to the increased rates of patients undergoing cesarean sections. While PASD remains a significant cause of maternal morbidity and mortality, accurate prenatal identification and characterization of PASD is associated with improved outcomes. Although ultrasound is the first-line imaging modality in the evaluation of PASD, with MRI serving as an adjunct, computed tomography angiography (CTA) may also offer unique diagnostic advantages in cases of advanced PASD by providing superior visualization of placental and abdominopelvic vasculature and enabling the creation of comprehensive vascular maps to roadmap complex surgical interventions. This paper …

Pancreatic neuroendocrine tumours (PNETs) are a rare subset of pancreatic tumours that have historically comprised up to 3% of all clinically detected pancreatic tumours. In recent decades, however, advancements in imaging have led to an increased incidental detection rate of PNETs and imaging has played an increasingly central role in the initial diagnostics and surgical planning of these tumours. Cinematic rendering (CR) is a 3D post-processing technique that generates highly photorealistic images through more realistically modelling the path of photons through the imaged volume. This allows for more comprehensive visualization, description, and interpretation of anatomical structures. In this 2-part review article, we present the first description of the various CR appearances of PNETs in the reported literature while providing commentary on the unique clinical opportunities afforded by the adjunctive …

A 60-year-old woman with a history of cardiac surgery 40 years ago (records unavailable) presented with chest pain for 3 days. ECG revealed ST-segment elevation in inferior leads, right bundle branch block and sinüs rhythm. Troponin I was significantly elevated. Transthoracic echocardiography showed mild aortic regurgitation. Coronary angiogram demonstrated abnormally enlarged tortuous left anterior descending and left circumflex arteries connected to the right coronary artery (RCA), which drained to the pulmonary artery (Video 1). The right coronary artery could not be cannulated via the aorta. Cardiac computed tomographic angiography confirmed an anomalous origin of the RCA from the pulmonary artery (ARCAPA; Fig. 1a–d). ARCAPA is a rare condition usually diagnosed in symptomatic children and adults or during an autopsy. Presentation with acute coronary syndrome in adults is rare. The …

PurposeThe purpose of this study was to develop a radiomics-signature using computed tomography (CT) data for the preoperative prediction of grade of nonfunctional pancreatic neuroendocrine tumors (NF-PNETs).Materials and methodsA retrospective study was performed on patients undergoing resection for NF-PNETs between 2010 and 2019. A total of 2436 radiomic features were extracted from arterial and venous phases of pancreas-protocol CT examinations. Radiomic features that were associated with final pathologic grade observed in the surgical specimens were subjected to joint mutual information maximization for hierarchical feature selection and the development of the radiomic-signature. Youden-index was used to identify optimal cutoff for determining tumor grade. A random forest prediction model was trained and validated internally. The performance of this tool in predicting tumor grade was …

CT urography (CTU) and MR urography (MRU) are commonly used imaging modalities in the evaluation of hematuria. Are these techniques equivalent and interchangeable? We believe that CTU should be the primary imaging modality based on technical factors, patient factors, pathology detection, and value for the healthcare system. MRU should be reserved for a minority of patients, including children, pregnant patients, and patients with severe contraindication to iodinated contrast media.Our institutional CTU protocol consists of non-contrast images through the kidneys, arterial phase images from the kidneys to the bladder, venous phase images through the kidneys, and 5-7 minute excretory phase images from the kidneys to the bladder. In young patients with low risk of bladder cancer, we acquire the arterial phase only through the kidneys to reduce radiation dose.

My appreciation for art led me to Gustav Klimt, who, in 1901, presented a controversial painting titled “Medicine.” The goddess Hygeia, who symbolized health, hygiene, and well-being appears in the center; she stands between a beautiful woman representing the river of life and an abundance people in various states of despair representing the suffering often associated with illness. Klimt presented this painting to the medicine faculty at the University of Vienna, but they found it offensive, as it implicitly acknowledged their inadequacies in addressing the health needs of the disenfranchised. Although modern medicine has improved the life expectancy and quality of life of our populations at large, over twelve decades after Klimt articulated the need to address the vulnerable, there remain significant health disparities that stem partly from social determinants of health. Artificial intelligence (AI) not only has the potential …

Abdominal cancers continue to pose daily challenges to clinicians, radiologists and researchers. These challenges are faced at each stage of abdominal cancer management, including early detection, accurate characterization, precise assessment of tumor spread, preoperative planning when surgery is anticipated, prediction of tumor aggressiveness, response to therapy, and detection of recurrence. Technical advances in medical imaging, often in combination with imaging biomarkers, show great promise in addressing such challenges. Information extracted from imaging datasets owing to the application of radiomics can be used to further improve the diagnostic capabilities of imaging. However, the analysis of the huge amount of data provided by these advances is a difficult task in daily practice. Artificial intelligence has the potential to help radiologists in all these challenges. Notably, the applications of AI in the …

The radiologic finding of focal stenosis of the main pancreatic duct is highly suggestive of pancreatic cancer. Even in the absence of a mass lesion, focal duct stenosis can lead to surgical resection of the affected portion of the pancreas. We present four patients with distinctive pathology associated with non-neoplastic focal stenosis of the main pancreatic duct. The pathology included stenosis of the pancreatic duct accompanied by wavy, acellular, serpentine-like fibrosis, chronic inflammation with foreign body–type giant cell reaction, and calcifications. In all cases, the pancreas toward the tail of the gland had obstructive changes including acinar drop-out and interlobular and intralobular fibrosis. Three of the four patients had a remote history of major motor vehicle accidents associated with severe abdominal trauma. These results emphasize that blunt trauma can injure the pancreas and that this injury can result in …

Ehlers-Danlos syndrome comprises 13 hereditary connective tissue disorders associated with skin hyperelasticity, joint hypermobility, atrophic scarring, and blood vessel fragility. Hypermobile EDS, the most common subtype, has no clear genetic or molecular source. When presented with wide-ranging clinical symptoms, it requires effective clinical diagnosis. A 31-year-old female with hypermobile EDS underwent an abdominal Computed Tomography (CT) scan displaying a 2.9 cm soft-tissue mass possibly arising from the terminal ileum, which was revealed to be a desmoid fibromatosis. It is believed that Gastrointestinal (GI) manifestations may be associated with EDS, specifically the hypermobile subtype. The patient demonstrated manifestations commonly seen throughout the literature on hypermobile EDS, including abdominal pain, nausea, and diarrhoea. With symptoms worsening, a follow-up CT disclosed …

Atrioesophageal fistula (AEF) after atrial fibrillation ablation is the most serious and feared complication. AEF is difficult to diagnose, and delays in diagnosis are common. Highly variable symptoms usually do not start to appear for 1 week or longer postprocedure, and when they appear, the patient often presents to a community hospital staffed by providers with little knowledge of AEF

Figure 1. A) 71-year-old man with pancreatic mass. Axial IV-contrast enhanced arterial phase CT image shows hypervascular mass in pancreatic tail (arrow). Differential diagnosis includes pancreatic neuroendocrine tumor and intrapancreatic accessory spleen. BC) Cinematic rendered IV-contrast-enhanced arterial phase CT images in axial (B) and coronal (C) planes highlight difference in enhancement between pancreatic mass (arrow) and spleen, thus favoring diagnosis of pancreatic neuroendocrine tumor rather than intrapancreatic accessory spleen.

Esophageal disorders are commonly encountered by radiologists on computed tomography. Characteristic computed tomography findings of various esophageal pathologies have been extensively described and are important for the radiologist to know to facilitate accurate and timely diagnosis. Esophageal disorders can be broadly classified as infectious and inflammatory, congenital/structural, or neoplastic. This paper reviews the most common presentations of various esophageal pathologies within each classification.

This chapter gives an overview of the current status of the science of 3D imaging. Loosely, 3D imaging refers to all processing operations that are applied to acquired multidimensional image data to facilitate visualization, manipulation, and analysis of the information captured in the image data. The chapter also identifies the major challenges currently faced and point out the opportunities available for advancing the science of 3D imaging. The target audience is developers of 3D imaging methods and systems, developers of 3D imaging applications, and clinicians using 3D imaging methods and systems. The description will assume some familiarity with medical imaging modalities and some knowledge of rudimentary concepts related to digital images. The purpose of 3D imaging is: given a set of multidimensional images pertaining to an object/object system, to output qualitative/quantitative information about the …

Castleman disease is a rare lymphoproliferative disease commonly occurring as a benign localized mass of lymph nodes in the mediastinum. Given that Castleman disease presents as asymptomatic or through non-specific thoracic symptoms, detection is considered complex. Ultimately, surgical resection is the preferred course of action with a greater than 90% relapse-free survival and no malignant transformation reported. In this article, we describe the case of a 34-year-old male with an unclear smoking history who was diagnosed with hyaline-vascular Castleman disease. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, including computed tomography scans.

Secondary osteosarcoma is a rare complication of radiation therapy for a primary tumor. Here we report a unique presentation of radiation-induced osteosarcoma of the chest wall after radiation treatment for thymoma. This patient underwent multiple imaging studies, including magnetic resonance imaging and computed tomography with cinematic rendering. Diagnosis of osteosarcoma was confirmed through imaging features and histology. Several surgical procedures were performed to evaluate and attempt resection of the tumor, but ultimately the tumor location and involvement prevented adequate resection and chemotherapy was initiated. This case highlights the importance of identifying clear cumulative dose thresholds for radiation therapy and rare complications of radiotherapy.

With an MBA from Columbia University, I was well positioned for a successful varied 20-year career with Johnson & Johnson, including building iconic consumer brands such as Aveeno and Neutrogena, working in the MedTech sector on diabetes and orthopedics, and living internationally in China and Europe. The onset of the COVID-19 pandemic prompted me to alter course, to a health technology role leading Google Cloud’s MedTech Strategy and Solutions division. I partnered with Fortune 500 companies and digital health start-ups to help drive healthcare transformation with technology, including data analytics, artificial intelligence (AI) and machine learning (ML), and consumer wearables. Technology has the potential to improve healthcare, and I have aligned the lessons I have learned at Google around five themes:1. 10X Thinking: 10X thinking is coming up with radical solutions to big problems and …

There was always music playing at my house. My mother was a child prodigy on the piano and my sister became a world-class harpist. I would hear my mother play at night, but when I would ask her the next day what she was playing, she would tell me she was just improvising while she was thinking about all of the things she had to do. Her artistry and creativity flowed out through her fingertips. My father was also drawn to music, specifically jazz, and he played the vibraphone. However, he was more “paint-by-numbers” and technical, lacking my mother’s intuition. My father would focus on the science of music, whereas the rest of the family was more instinctive.Interestingly, my father was a doctor–an OB/GYN–who believed deeply in the value of the human touch. When I would go with him to the hospital, I was never comfortable about the smells or the sickness. But, he would remind me that hospitals are places that …

Radiology plays an important role in the initial diagnosis and staging of patients with pancreatic ductal adenocarcinoma (PDAC). CT is the preferred modality over MRI, due to wider availability, greater consistency in image quality, and lower cost. MRI and PET/CT are usually reserved as problem-solving tools in select patients. The National Comprehensive Cancer Network (NCCN) guidelines define resectability criteria based on tumor involvement of the arteries and veins, and triage patients into resectable, borderline resectable, locally advanced, and metastatic categories. Patients with resectable disease are eligible for upfront surgical resection, while patients with high-stage disease are treated with neoadjuvant chemotherapy and/or radiation therapy with hopes of downstaging the disease. The accuracy of staging critically depends on imaging technique and the experience of the radiologists. Several …

Pulmonary artery intimal sarcomas are rare, malignant tumors often associated with poor prognoses. These highly lethal tumors are difficult to distinguish given their nonspecific symptoms and challenging imaging interpretations, often being misdiagnosed as acute or chronic pulmonary embolisms, tumor emboli, or mediastinal masses. Given the poor survival rate associated with this malignancy and surgical resection is the absolute choice of treatment, early and accurate diagnoses are essential. In this article, we report the case of a 78-year-old female who was diagnosed with a pulmonary artery intimal sarcoma. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, specifically computed tomography angiography scans.

Corrigendum to “Response to letter to the editor Re: Case report CT of rhabdomyolysis as a sequela of drug abuse” [Radiology Case Reports 18 (2023) 729] - PMC Back to Top Skip to main content NIH NLM Logo Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation Search PMC Full-Text Archive Search in PMC Advanced Search User Guide Journal List Radiol Case Rep v.18(4); 2023 Apr PMC9989444 Other Formats PDF (203K) Actions Cite Collections Share Permalink Copy RESOURCES Similar articles Cited by other articles Links to NCBI Databases Journal List Radiol Case Rep v.18(4); 2023 Apr PMC9989444 As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice Logo of rcr Radiol Case …

Pancreatoblastoma (PB), a rare malignant epithelial neoplasm, is the most common pancreatic neoplasm of childhood. It is exceptionally rare in the adult population and its occurrence is limited to case reports. Although the neoplastic cells of PB can have a number of different directions of differentiation, PB is defined by the combination of neoplastic cells with acinar differentiation and squamoid morules. We report a case of a female patient in her 70s who presented with elevated creatinine level, concerning a kidney disorder, and was found to have an abdominal mass on CT scan. Fine needle aspiration (FNA) showed cellular smears with numerous 3‐dimentional clusters of acinar cells and scattered squamoid morules. A cell block showed sheets of cells, some of which formed acini. Numerous squamoid morules were noted and were highlighted by nuclear labelling with antibodies to B‐catenin in the cell block …

PURPOSE: Phalloplasty is one of the fastest-growing areas of gender-affirming surgery. Patients report great satisfaction after phalloplasty, with significant improvements in sexual health. However, the urologic complication rate remains high. Despite these common urologic complication rates after masculinizing genital surgery, existing methods for post-surgical evaluation after phalloplasty have drawbacks. Fluoroscopic studies like retrograde urethrogram have limitations like user-dependence and meticulous positioning and are also inadequate for the evaluation of the anatomically distinct post-phalloplasty urethra. We developed a novel protocol that utilizes CT urethrography with 3D reconstruction using cinematic rendering (3DUG) for neo-urethral imagingMETHODS: Patients who underwent 3DUG after either phalloplasty, metoidioplasty, or prior to revision surgery at one institution from 2017 to 2021 were …

The relationship of pancreatic ductal adenocarcinoma (PDAC) to important peripancreatic vasculature dictates resectability. As per the current guidelines, tumors with extensive, unreconstructible venous or arterial involvement are staged as unresectable locally advanced pancreatic cancer (LAPC). The introduction of effective multiagent chemotherapy and development of surgical techniques, have renewed interest in local control of PDAC. High-volume centers have demonstrated safe resection of short-segment encasement of the common hepatic artery. Knowledge of the unique anatomy of the patient’s vasculature is important in surgical planning of these complex resections. Hepatic artery anomalies are common and insufficient knowledge can result in iatrogenic vascular injury during surgery. Here, we discuss different strategies to resect and reconstruct replaced hepatic arteries during pancreatectomy for …

3037Background: Less than 20% of cancers are diagnosed as a result of standard-of-care (SOC) screening in the US. MCED tests may expand screening to more cancers, but the long-term outcomes of MCED test-detected cancers are unknown. DETECT-A was the first large prospective interventional clinical trial to evaluate an MCED blood test. The test used was an early version of CancerSEEK and was evaluated in 9,911 women without history of cancer (Science 369:6499, 2020). CancerSEEK, coupled with diagnostic PET-CT, safely identified cancers including those not detected by SOC screening, the majority of which were localized or regional. This follow-up observational study evaluated longitudinal clinical outcomes of cancers diagnosed as a result of an abnormal CancerSEEK test with a median follow up of 4.4 (IQR:4.1-4.6) years from initial CancerSEEK testing. Methods: Nine cancer types were …

ConclusionsA revolution in medicine began in the late 19th century, in which medicine became viewed as a public trust whose DNA is triple stranded: caring, science, and justice. Delivering the promise of medicine in the 21st century requires a commitment to humanizing medicine that is as strong as the commitment to scientific excellence.

Dr. John L. Cameron was appointed the chair of surgery at Johns Hopkins in 1984. He subsequently built the largest group of clinician-scientists anywhere in the world who were focused on pancreatic cancer. Many of the trainees that were molded by that group have perpetuated its ideals by pursuing academic careers. Dr. Cameron's approach can be distilled to three key points:1 work hard and lead by example,2 make diamonds by applying the right amount of pressure, and3 serve your people and give the impression that you are working for your trainees and junior people. With those leadership principles, it should still be possible to build successful academic programs, despite the significant challenges that have arisen.

BackgroundCocaine use exacerbates human immunodeficiency virus (HIV)–associated subclinical coronary atherosclerosis. We investigated whether cocaine abstinence or reduced use achieved with contingency management (CM) intervention would retard high-risk coronary plaque progression among cocaine users with HIV and subclinical coronary atherosclerosis.MethodsBetween March 2014 and August 2017, 76 cocaine users with HIV and coronary plaques were enrolled in a study designed to decrease cocaine use and determine whether doing so impacted progression of subclinical coronary atherosclerosis as measured by coronary artery computed tomography examinations. Of the 76, 7 did not complete the study, resulting in 69 participants. A 12-month cash-based CM intervention was implemented to promote cocaine abstinence or reduced cocaine use. Generalized estimating equation approach …

Artificial intelligence (AI) has the potential to transform the diagnosis and management of pancreatic cystic neoplasms. Preliminary studies have shown that AI can assist in automatic detection of pancreatic pathology from medical images, thus leading to earlier detection of pancreatic malignancy. AI can also improve the accuracy of pancreatic cyst classification compared to current guideline‐based features, and the combination of AI prediction and clinical features offers the best predictive power for accurate pancreatic cyst classification. This chapter will provide a brief overview of AI, review current AI applications in pancreatic cysts, and discuss future directions for the role of AI in the management of pancreatic cysts.

In conjunction with Ian Hogarth, I realized the rapid growth in machine learning (ML) was making it increasingly difficult to keep up with significant developments. Consequently, we thought there should be an open access report on artificial intelligence (AI), where we could capture research dynamics, as well as provide exposés on the industry. Also, we saw that AI was becoming nationalized and part of the geopolitical landscape, which was important to address. We publish our “State of AI Report” as an open source presentation every year to inform conversation and level the understanding across different parts of the technology world with the hope of facilitating sensible decisions and postures regarding these advanced technologies.(1) In the following, we will endeavor to provide an abstraction of information from the latest such report. Recently, there has been a surge of individuals operating on open-source ML …

Response to the Letter to the Editor Regarding Renegades, Rebels, and Revolutionaries: Making Medicine a Better Public Trust. - Abstract - Europe PMC Sign in | Create an account https://orcid.org Europe PMC Menu About Tools Developers Help Contact us Helpdesk Feedback Twitter Blog Tech blog Developer Forum Europe PMC plus Search life-sciences literature (42,912,383 articles, preprints and more) Search Advanced search Feedback This website requires cookies, and the limited processing of your personal data in order to function. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. Abstract Full text Response to the Letter to the Editor Regarding Renegades, Rebels, and Revolutionaries: Making Medicine a Better Public Trust. Hellmann DB 1 , Fishman EK 2 , Lugo-Fagundo E 2 , Chu LC 2 , Rowe SP 3 Author information Affiliations 1. Department of Medicine, …

It is not that unusual to find that Americans are unaware that Puerto Rico is a territory of the United States, and, like them, Puerto Ricans are U.S citizens enjoying the same liberties, freedoms, and rights. It may be less expected to face such incognizance or ignorance within the medical community as careers in medicine offer healthcare professionals the opportunity to serve patients spanning race, ethnicity, gender, sexual orientation, religion, and other demographic differences. Unfortunately, some of the personal experiences of the primary author have prompted us to cull four personal narratives of Puerto Rican individuals (Boricuas), who comprise 20.8% of the Hispanic, Latino, or Spanish Origin applicants to U.S. medical schools, during various early stages of a medical career. Of course, these personal anecdotes, offered in response to just a few general questions about recent experiences of bias in medical …

As of this writing, ChatGPT is the world’s fastest adopted software application in history, reaching 100M users in 2 months. While a notable achievement for a wide variety of reasons, it is especially striking when examined in contrast to the software applications dethroned by the meteoric rise of ChatGPT. Preceding record holders like TikTok, Instagram, and Spotify have famously leveraged algorithmically personalized content, manipulative advertisements, and a transparent" dopamine-hacking" strategy to bolster their user base. ChatGPT, in stark contrast, is elegantly simple: a chat window--a portal--offering anyone, anywhere immediate access to the most capable and versatile artificial intelligence (AI) technology humanity has ever created. Even more fascinating is that GPT4 (or the ‘subscription model’) is a phase transition more capable than the GPT3. 5 that underlies ChatGPT across every category--meaning …

BackgroundExisting (artificial intelligence [AI]) tools in radiology are modeled without necessarily considering the expectations and experience of the end user—the radiologist. The literature is scarce on the tangible parameters that AI capabilities need to meet for radiologists to consider them useful tools.ObjectiveThe purpose of this study is to explore radiologists' attitudes toward AI tools in pancreatic cancer imaging and to quantitatively assess their expectations of these tools.MethodsA link to the survey was posted on the www. ctisus. com website, advertised in the www. ctisus. com email newsletter, and publicized on LinkedIn, Facebook, and Twitter accounts. This survey asked participants about their demographics, practice, and current attitudes toward AI. They were also asked about their expectations of what constitutes a clinically useful AI tool. The survey consisted of 17 questions, which included 9 multiple …

ObjectiveTo develop an imaging modality for the postoperative phalloplasty urethra. Despite high urologic complication rates after masculinizing genital surgery, existing methods for postsurgical evaluation after phalloplasty have drawbacks. Fluoroscopic studies like the retrograde urethrogram have limitations like user-dependence and need for meticulous positioning but also are inadequate for the evaluation of the anatomically complex postphalloplasty urethra. We developed a novel protocol utilizing CT urethrography with 3D reconstruction using cinematic rendering (3DUG) for neo-urethral imaging.Materials and MethodsPatients who underwent 3DUG after either phalloplasty, metoidioplasty, or prior to revision surgery were included. Low-dose imaging protocols were used to avoid any increases in radiation exposure. The first iteration of our protocol utilized retrograde contrast administration via the penile …

Pseudoaneurysms arising from the saphenous venous graft (SVGs) are an uncommon complication of the coronary artery bypass graft (CABG). Although angiography is the gold standard, computed tomography angiography (CTA) of the coronary arteries is the most efficient modality to diagnose these cases and their associated complications. Among numerous possible complications of SVG pseudoaneurysms, local mass effect on the cardiac chambers, adjacent pulmonary vasculature or coronary arteries/bypass grafts have been described. Cinematic rendering, an advanced post-processing technique can be valuable for problem solving in complex cases. In this pictorial essay, we report 3 CT cases of SVG pseudoaneurysms that demonstrate a range of CT imaging appearances of SVG pseudoaneurysms and related complications. Additionally, we will emphasize the applications of cinematic rendering in …

Schwannomas are a type of nerve sheath tumor formed by Schwann cells. They typically occur in the head and neck area, the trunk, and flexor surfaces of the upper and lower extremities. Schwannomas are often benign, and pancreatic schwannomas are extremely uncommon. Given the rarity of these tumors and their clinical similarity to other pancreatic lesions, however, pancreatic schwannomas are challenging to diagnose preoperatively. In this article, we report the case of a 69-year-old female who was diagnosed with a pancreatic schwannoma. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, specifically computed tomography scans with cinematic rendering.

IntroductionMost patients with pancreatic cancer present with advanced stage, incurable disease. However, patients with high-grade precancerous lesions and many patients with low-stage disease can be cured with surgery, suggesting that early detection has the potential to improve survival. While serum CA19.9 has been a long-standing biomarker used for pancreatic cancer disease monitoring, its low sensitivity and poor specificity have driven investigators to hunt for better diagnostic markers.Areas coveredThis review will cover recent advances in genetics, proteomics, imaging, and artificial intelligence, which offer opportunities for the early detection of curable pancreatic neoplasms.Expert opinionFrom exosomes, to circulating tumor DNA, to subtle changes on imaging, we know much more now about the biology and clinical manifestations of early pancreatic neoplasia than we did just five years ago. The …

Solitary fibrous tumors are rare tumors of pluripotent fibroblastic or myofibroblastic origin that generally arise among older individuals, with a mean age of onset ranging from 55 to 65 years. Though typically associated with pleural involvement, solitary fibrous tumors can emerge in virtually every anatomic location within the body. Although most solitary fibrous tumors are benign, approximately 20% may exhibit malignant features such as local invasion, recurrence, and metastases. In this article, we report the case of a 58-year-old male with a diagnosis of a retroperitoneal solitary fibrous tumor. We analyze computed tomography imaging findings and additionally correlate imaging features with the patient's unique pathological and genotypic findings to optimize diagnosis.

What Lessons Can Radiologists Learn From the Holocaust Reparations Movement? — Johns Hopkins University Skip to main navigation Skip to search Skip to main content Johns Hopkins University Home Johns Hopkins University Logo Home Profiles Research units Research output Search by expertise, name or affiliation What Lessons Can Radiologists Learn From the Holocaust Reparations Movement? Stuart E. Eizenstat, Edmund M. Weisberg, Steven Rowe, Elliot K. Fishman, Linda C. Chu School of Medicine Research output: Contribution to journal › Article › peer-review Overview Original language English (US) Pages (from-to) 237-238 Number of pages 2 Journal Current Problems in Diagnostic Radiology Volume 52 Issue number 4 DOIs https://doi.org/10.1067/j.cpradiol.2023.03.014 State Published - Jul 1 2023 ASJC Scopus subject areas Radiology Nuclear Medicine and imaging Access to Document …

Pancreatic cancer is currently the third leading cause of cancer death in the United States. The clinical hallmarks of this disease include abdominal pain that radiates to the back, the presence of a hypoenhancing intrapancreatic lesion on imaging, and widespread liver metastases. Technologies such as tissue clearing and three-dimensional (3D) reconstruction of digitized serially sectioned hematoxylin and eosin-stained slides can be used to visualize large (up to 2- to 3-centimeter cube) tissues at cellular resolution. When applied to human pancreatic cancers, these 3D visualization techniques have provided novel insights into the basis of a number of the clinical characteristics of this disease. Here, we describe the clinical features of pancreatic cancer, review techniques for clearing and the 3D reconstruction of digitized microscope slides, and provide examples that illustrate how 3D visualization of human …

Pancreatic cancer is a relatively common malignancy that carries a poor prognosis despite recent advances in medical and surgical treatment. Imaging plays an essential part in the diagnosis and staging of pancreatic carcinoma, specifically determining resectability. Multidetector CT is the most commonly used modality for staging of pancreatic cancer, given its temporal and spatial resolution. This is of utmost importance in determining vascular involvement, which is key to determining resectability. However, advances in MRI have made it an equivalent modality in diagnosis and staging, with advantages in assessing metastatic liver disease. Three‐dimensional imaging techniques including cinematic rendering may also provide advantages for diagnosis, staging, and treatment planning.

The adrenal gland is home to an array of complex physiological and neoplastic disease processes. While dedicated adrenal computed tomography (CT) is the gold standard imaging modality for adrenal lesions, there exists significant overlap among imaging features of adrenal pathology. This can often make radiological diagnosis and subsequent determination of the optimal surgical approach challenging. Cinematic rendering (CR) is a novel CT post-processing technique that utilizes advanced light modeling to generate highly photorealistic anatomic visualization. This generates unique prospects in the evaluation of adrenal masses. As one of the first large tertiary care centers to incorporate CR into routine diagnostic workup, our preliminary experience with using CR has been positive, and we have found CR to be a valuable adjunct during surgical planning. Herein, we highlight the unique utility of CR …

Urban One, the largest black-owned multi-platform media company in the United States, has reached approximately 80% of Black America in any given week since not long after it was founded as Radio One, with one radio station, by Cathy Hughes in 1980. Under her leadership, as well as Alfred Liggins, our CEO and Hughes’ son, we have grown into a multi-platform conglomerate. We own and operate 64 radio stations in 13 markets, nationally syndicated radio networks, digital audio and podcasting, national cable networks, and numerous digital brands under our iOne digital umbrella. Liggins has often said that we are not in the radio or media business, we are in the black people business. As the industry has evolved, we have developed with it, always focusing on that mission. Urban One is not only chaired by an African American woman and has a black male as a CEO, but 50% of our Board of Directors and …

In recent years, artificial intelligence (AI) and machine learning have become increasingly integrated into society. With this shift comes plenty of conflicting information about potential pitfalls and benefits of AI. This information is partial truth and partial hyperbole, which can be confusing as it is hidden in an abundance of jargon. What is AI? The definition of AI has changed over the years, but currently it can be defined as machine learning: algorithms that learn how to generalize from data. In conventional programming humans convert knowledge into rules, but in machine learning the algorithm learns those rules from the data and automatically creates those rules. The power of machine learning is derived from the fact that all we need is data and a success criterion. Machine learning surrounds us with Facebook, YouTube, and Uber, but these same algorithms can be used for much more meaningful endeavors, such …

3D with volume rendering and the more recently described technique of cinematic rendering are post-processing techniques that create reconstructions of cross sectional imaging data which enhance image interpretation. This review illustrates the potential applications of volume rendering, 3D, and cinematic rendering in the evaluation of abdominopelvic pathology in the peripartum period. These techniques show promise in improving visualization of pelvic structures, vascular mapping, highlighting textural differences between tissues, and improving understanding of spatial relationships. Graphical abstract

The speed of change in the world of technology has never been as rapid as it is today. For clinicians-as well as clinical researchers-this can translate to both the best of times and the worst of times. While clinicians and clinical researchers become excited by the development of a new computer chip, CT scanner, or vaccine, they know that time will pass before the new technology impacts our daily workflow. That is, until the introduction of large language models like ChatGPT, an offering that allows us to use the technology as it is being developed. This technology–which has been in development for decades-has the chance to impact everything we do at work or at home. And advancements in this technology, fostered by incredible computing power and amounts of data available for learning, occur so quickly that before you can write and publish an article, your descriptions may be one to two versions behind. The …

Lower extremity trauma is one of the most common injury patterns seen in emergency medical and surgical practice. Vascular injuries occur in less than one percent of all civilian fractures. However, if not treated promptly, such injuries can lead to ischemia and death. Computed tomography angiography (CTA) is the non-invasive imaging gold standard and plays a crucial part in the decision-making process for treating lower extremity trauma. A novel, FDA-approved 3D reconstruction technique known as cinematic rendering (CR) yields photorealistic reconstructions of lower extremity vascular injuries depicting clinically important aspects of those injuries, aiding in patient workup and surgical planning, and thus improving patient outcomes. In this article, we provide clinical examples of the use of CR in evaluating lower extremity vascular injuries, including the relationship of these injuries to adjacent osseous …

Pancreatic ductal carcinoma (PDAC) is one of the leading causes of cancer-related death worldwide. Computed tomography (CT) remains the primary imaging modality for diagnosis of PDAC. However, CT has limitations for early pancreatic tumor detection and tumor characterization so that it is currently challenged by magnetic resonance imaging. More recently, a particular attention has been given to radiomics for the characterization of pancreatic lesions using extraction and analysis of quantitative imaging features. In addition, radiomics has currently many applications that are developed in conjunction with artificial intelligence (AI) with the aim of better characterizing pancreatic lesions and providing a more precise assessment of tumor burden. This review article sums up recent advances in imaging of PDAC in the field of image/data acquisition, tumor detection, tumor characterization, treatment response …

Demonstration of a very dense or hyper-attenuated liver on the pre-contrast CT images of the abdomen can be an unexpected finding. It may present as a diagnostic challenge if the underlying cause of it is not apparent from the provided clinical history. There are about 12 different pathologic conditions that are associated with deposition of radiopaque elements within the hepatic parenchyma, resulting in diffuse or multi-lobar hyperdense appearance of the liver on abdominal radiographs and CT. Most of them are drug-induced or iatrogenic in nature, while others are the sequelae of genetic disorders like thalassemia, Wilson's disease, and primary hemochromatosis. This pictorial essay will present the CT appearance and etiology of hyper-attenuated liver in various clinical entities.

Renal malakoplakia is a rare inflammatory disorder that predominantly affects the bladder, but has also been known to affect the kidneys. We present a case of a young woman with renal malakoplakia and concomitant E. coli bacteremia. The patient underwent numerous imaging studies during her clinical evaluation including ultrasound, magnetic resonance imaging, and computed tomography with 3-dimensional and cinematic renderings. Diagnosis was ultimately confirmed with renal biopsy which demonstrated Michaelis-Gutman bodies, a pathognomonic pathological finding in malakoplakia. She was started on antibiotics as well as bethanechol and ascorbic acid. Although her renal function improved with this treatment, she continued to have signs and symptoms of infection and she is planned for upcoming left nephrectomy.

Abstracts neoplastic progression (incident high grade dysplasia or PDAC). Methods We analyzed prospectively collected data from the Cancer of Pancreas Screening (CAPS 1-5) studies at The Johns Hopkins Hospital from 1998 to 2021, which included HRI with a family history of PDAC with or without an associated genetic mutation undergoing annual or semi-annual endoscopic EUS or (magnetic resonance imaging) MRI. We included HRI with> Z2 imaging studies. We excluded those with prevalent HGD/PDAC or MPD dilation presenting with an obstructing lesion. We defined MPD dilation as a diameter> 4 mm,> 3 mm, or> 2 mm in the head, body, or tail of the pancreas, respectively. The primary endpoint of neoplastic progression was based on surgical pathology or fine needle aspirate cytopathology. We estimated hazard ratios (HR) using a model with MPD dilation as a time-varying covariate. We calculated …

The purpose of this pictorial essay is to highlight atypical and unusual presentations of endometriosis that can be missed or misinterpreted in the emergency setting. Although endometriosis is a chronic disease, it can present acutely with symptoms and imaging mimicking more common acute gynecologic, gastrointestinal, or urinary conditions as well as neoplasms. Furthermore, patients may present emergently prior to an established diagnosis of endometriosis. Here, we present a range of cases including endometrioma rupture and infection, urinary tract involvement and obstruction, bowel obstruction, appendicitis, gastrointestinal infiltration, abdominal masses, and thoracic involvement. Pelvic ultrasound and MRI are the most valuable imaging modalities in the assessment of endometriosis. CT findings are non-specific, but given the widespread use of CT in emergency settings, it is important to recognize CT …

BackgroundMobile applications have become an increasingly popular component of medical education over the past 2 decades. Visual layout and aesthetics are important considerations in app design given Generation Z's strong preference for visually appealing digital content. In this study, we evaluate students’ perceptions of an educational app related to pathology of the lumbar spine before and after a redesign of its workflow and illustrations.Objective, Material and MethodsA professional user experience and interface designer was recruited for the revision of an iOS app focused on anatomy and pathology of the lumbar spine on abdominal computed tomography (CT). Revisions focused on developing the app to make it more visually appealing, increasing ease of use, and fixing bugs. An IRB-approved study was conducted in which participants were asked to interact with the original and revised versions of the …

At first glance, the article by Barat et al might appear to be a classic review on the use of CT and MRI imaging for the evaluation of gastrointestinal stromal tumors (GISTs). 1 We might expect the article to review the CT and MRI appearances of these unique tumors focusing on tumor size, location, and imaging characteristics. These findings would typically include enhancement patterns, the presence of calcification, as well as luminal location, and would be discussed as a way of distinguishing these tumors from other tumors including lymphoma, adenocarcinoma, and metastases. Yet, this is but just the beginning of the information provided with imaging. Barat et al provide the next steps in what information can be extracted from the datasets and how this information can be used not only for lesion detection and identification but for decision making in management and predicting outcomes. The article focuses on how …

BackgroundMCED tests may improve early cancer detection, but the impact of MCED testing on anxiety and standard of care (SOC) screening adherence is unknown. The DETECT-A trial evaluated the CancerSEEK MCED test in 9,911 women without a cancer history (Science, 359: 6499, 2020). DETECT-A participants without a cancer diagnosis were invited to a follow-up observational study involving annual surveys. Here we report on participant satisfaction, anxiety, intent to adhere to SOC cancer screening, and adherence to breast cancer screening.MethodsThe survey, conducted approximately 3 years after DETECT-A enrollment, assessed: a) whether participants regretted DETECT-A participation or would participate again, b) how likely they were to adhere to routine cancer screenings, and c) how participation affected their anxiety. Adherence to biennial mammography screening was assessed at the month …

Artificial Intelligence (AI) is set to transform medical imaging by leveraging the vast data contained in medical images. Deep learning and radiomics are the two main AI methods currently being applied within radiology. Deep learning uses a layered set of self-correcting algorithms to develop a mathematical model that best fits the data. Radiomics converts imaging data into mineable features such as signal intensity, shape, texture, and higher-order features. Both methods have the potential to improve disease detection, characterization, and prognostication. This article reviews the current status of artificial intelligence in pancreatic imaging and critically appraises the quality of existing evidence using the radiomics quality score.

We are in the midst of a mental health crisis. The National Institutes of Health estimates that over one in five adults live with a mental health issue (1). Similar to how people deal with physical ailments, mental health issues at work need to be addressed appropriately and empathetically. Not everyone experiences mental health symptoms in the same manner. Some people persevere and mask their symptoms, but that is not the case for everyone. Depression is a disease; understanding how it feels can be difficult if you do not have a mental illness. I know this because I have endured mental health issues for most of my life. After a traumatic incident, I started seeing a psychiatrist, which helped somewhat, but my depression and remained, often growing stronger and barely ever waning. In 2013, my doctors convinced me to undergo electroconvulsive therapy (ECT). After one month, I experienced few side effects and …

CT is one of the most widely used modalities for musculoskeletal imaging. Recent advancements in the field include the introduction of four-dimensional CT, which captures a CT image during motion; cone-beam CT, which uses flat-panel detectors to capture the lower extremities in weight-bearing mode; and dual-energy CT, which operates at two different x-ray potentials to improve the contrast resolution to facilitate the assessment of tissue material compositions such as tophaceous gout deposits and bone marrow edema. Most recently, photon-counting CT (PCCT) has been introduced. PCCT is a technique that uses photon-counting detectors to produce an image with higher spatial and contrast resolution than conventional multidetector CT systems. In addition, postprocessing techniques such as three …

Pancreatic solid pseudopapillary tumors (SPTs) are a rare subset of pancreatic neoplasms, accounting for under 2% of exocrine pancreatic tumors. The incidence of SPTs has shown a significant increase in the past two decades, attributed to heightened cross-sectional imaging utilization. These tumors often present with nonspecific clinical symptoms, making imaging a crucial tool in their detection and diagnosis. Cinematic rendering (CR) is an advanced 3D post-processing technique that generates highly photorealistic realistic images by accurately modeling the interaction of light within the imaged volume. This allows improved visualization of anatomic structures which holds potential to improve diagnostics. In this manuscript we present the first description of CR appearances of SPTs in the reported literature. Through showcasing a range of cases, we highlight the potential of CR in illustrating the diverse …

STEFFANIE J. BRISTOL Artificial intelligence(AI) and emerging technologies have the potential to transform health care for the overall betterment of society. My current role is as the Biogen Digital Health head of external innovation and alliance management for AI, machine learning (ML), and imaging at Biogen. I find it critical that we recognize the inflection point at which we can help people lead healthier and happier lives by leveraging the new and emerging technologies that exist, technologies not intended to replace humans but rather to complement and enhance existing abilities. Furthermore, we need to recognize that no one organization can do this by itself, so we must identify and tie companies together that extend one another, build on one another’s core competencies to create meaningful impact, and track, quantify, and bring that to fruition with true use cases for actual value creation.Plenty of hype and …

The success of deep learning relies heavily on large labeled datasets, but we often only have access to several small datasets associated with partial labels. To address this problem, we propose a new initiative, "Label-Assemble", that aims to un-leash the full potential of partial labels from an assembly of public datasets. We discovered that learning from negative examples facilitates both computer-aided disease diagnosis and detection. This discovery will be particularly crucial in novel disease diagnosis, where positive examples are hard to collect, yet negative examples are relatively easier to assemble. For example, assembling existing labels from NIH ChestX-ray14 (available since 2017) significantly improves the accuracy of COVID-19 diagnosis from 96.3% to 99.3%. In addition to diagnosis, assembling labels can also improve disease detection, e.g., the detection of pancreatic ductal adenocarcinoma (PDAC …

ObjectiveTo create our own survey to identify the most recent ways in which the global radiology community is using social media specifically for radiology education.Materials and MethodsWe created a 30-question survey on SurveyMonkey, promoted it on our CTisus Facebook, Twitter, YouTube, LinkedIn, as well as Reddit accounts, and to our newsletter subscribers, sharing it from March 15 to April 5, 2022. The survey requested demographic information, and asked respondents to clarify their role in radiology and how they participated in each social media platform for radiology education.ResultsWe received 254 responses, of which 253 specified their role in radiology: 40.71% were radiologists (n = 103); 24.90% were radiologic technologists (n = 63); 17.79% were residents in radiology (n = 45); and 16.60% engaged in other radiology professions (n = 42). In total, 65 countries were represented (n = 250 …

Recurrent pulmonary infections are caused by a wide spectrum of conditions and structural anomalies that can manifest with characteristic imaging findings, and familiarity with these features will increase diagnostic confidence and assist in guiding management.

The so-called Great Resignation has been the subject of much conversation related to the major changes at the workplace imposed by the coronavirus disease of 2019 (COVID-19). We also talk about the future of work as if it were monolithic and were to impact everyone equally. Instead, we should consider the personal impact that it exerts, try to understand people’s lives, and have more empathy regarding what everyone is going through. We should also recognize that burnout is very real. We have all recently experienced significant changes in how we work and live. When we analyze these changes and contemplate the future of work, we must think about how to improve organizationally and personally and how to use the lessons that we have experienced to think differently. We were all constrained to work in an archaic system developed long ago, but with the confluence of recent technological advancement …

In recording a few disagreements with our work, however, the first couple of notes reveal misinterpretations of our statements. They said,“We disagree with the statement in the introduction that non-traumatic causes of rhabdomyolysis only [emphasis is ours] include alcohol abuse, illicit drugs, and pharmaceutical agents.” We did not say “only,” nor did we intentionally omit the broader spectrum of non-traumatic rhabdomyolysis etiology. We deemed it beyond the scope of this case report to include additional causes, which Drs Finsterer and Mehri ably cited in their letter. Furthermore, the CT reading of myositis includes muscle enlargement and decreased CT attenuation as was shown in this case. We did not cite cocaine usage as a proximate or direct cause of the patient’s rhabdomyolysis, which followed usage of heroin the night before (and 3 months prior, after 14 years of abstinence from multiple drugs, including …

As noted in the Gallop employee engagement survey, friendships are a vitally important part of work-place productivity, engagement, and satisfaction. The recent "Great Resignation" across many industries, including medicine, has underscored the importance of friendship at work. In this manuscript, we will recount aspects of the life of noted author, Dr. Sanford Greenberg, in which remarkable friends and loved ones gave of themselves to help him overcome significant challenges. Dr. Greenberg, who became blind during college, ultimately persevered to pursue scholarship and philanthropy. The manuscript is written predominantly from his first-person perspective.

Among the numerous innovations implemented in medical education since the beginning of the 21st century, small-group learning experiences have worked well for modern students and the application of computer technology provided access to thousands of lectures, images, and slides via the internet. This has helped to build an electronic foundation on which further educational adaptations have arisen in the current era, coupled with the altered communications landscape represented by Apple's introduction of the iPhone and Google's subsequent entrance onto the playing field. With the advent of smartphone applications (apps), education has taken on an even more personalized approach. Data show that the use of educational apps has been embraced by today's nursing and medical students, notably including radiology students. We survey recent research on the use and desirability of medical apps and …

Dr Linda Chu is an associate professor and associate division director in the Diagnostic Division in the Department of Radiology at Johns Hopkins University. Her research interest focuses on artificial intelligence application in pancreatic imaging. Dr Chu is the associate editor of podcasts for Radiology and an associate editor for the Journal of Computer Assisted Tomography. Dr

Beyond chatting: The opportunities and challenges of ChatGPT in medicine and radiology. - Abstract - Europe PMC Sign in | Create an account https://orcid.org Europe PMC Menu About Tools Developers Help Contact us Helpdesk Feedback Twitter Blog Tech blog Developer Forum Europe PMC plus Search life-sciences literature (42,001,099 articles, preprints and more) Search Advanced search Feedback This website requires cookies, and the limited processing of your personal data in order to function. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. Abstract Full text Beyond chatting: The opportunities and challenges of ChatGPT in medicine and radiology. Ferres JML 1 , Weeks WB 1 , Chu LC 2 , Rowe SP 2 , Fishman EK 2 Author information Affiliations 2 authors 1. Microsoft, Inc., AI for Good Research Lab, Redmond, WA 98052, USA. 3 authors 2. The Russell H. …

Inflammatory conditions that affect long segments of bowel and/or the mesentery and mesenteric vasculature are a common cause of emergency department visits and evaluation by cross-sectional imaging. Inflammatory bowel disease, specifically Crohn disease and ulcerative colitis, can be unsuspected at presentation and may only be eventually diagnosed based on initial imaging findings. Traditional 2D axial reconstructions and multi-planar reformations can be limited in their ability to globally assess the extent of disease. 3D methods such as volume rendering (VR) are often used as adjunctive means of visualizing the pathology in such patients. Recently, a novel technique known as cinematic rendering (CR) has emerged, utilizing advanced lighting models and ray tracing to simulate photon interactions with tissues, resulting in realistic shadows and enhanced surface detail compared to VR. Generating CR …

Cross-institution collaborations are constrained by data-sharing challenges. These challenges hamper innovation, particularly in artificial intelligence, where models require diverse data to ensure strong performance. Federated learning (FL) solves data-sharing challenges. In typical collaborations, data is sent to a central repository where models are trained. With FL, models are sent to participating sites, trained locally, and model weights aggregated to create a master model with improved performance. At the 2021 Radiology Society of North America’s (RSNA) conference, a panel was conducted titled “Accelerating AI: How Federated Learning Can Protect Privacy, Facilitate Collaboration and Improve Outcomes.” Two groups shared insights: researchers from the EXAM study (EMC CXR AI Model) and members of the National Cancer Institute’s Early Detection Research Network’s (EDRN) pancreatic cancer …

Background Bladder cancer is the sixth most common malignancy in the United States (US). Despite its high prevalence and the significant potential benefits of early detection, no reliable, cost-effective screening algorithm exists for asymptomatic patients at risk. Nonetheless, reports of incidentally identified early bladder cancer on CT/MRI scans performed for other indications are emerging in the literature. This represents a new opportunity for early detection, with over 80 million CT scans performed in the US yearly, 40% of which are abdominopelvic CTs. This investigation aims to define the imaging features of early bladder cancer, with the mission of facilitating early diagnosis. Methods Following IRB approval with a waiver of informed consent, a retrospective review was performed, identifying 624 patients with non-muscle-invasive bladder cancer diagnosed at Johns Hopkins Hospital between 2000 and 2019. Of these patients, 99 patients underwent pelvic CT within the 5 years preceding pathologic diagnosis. These imaging studies were reviewed retrospectively to evaluate for the presence and features of any focal bladder wall abnormality. Results Median age at the time of pathologic diagnosis was 70 years (range: 51–88 years), and 82% (81/99) of patients were male. A total of 226 CT studies were reviewed. The number of studies per patient ranged from 1 to 33. Median time interval between all available imaging and pathologic diagnosis was 14 months. A total of 62% (141/226) of the scans reviewed were performed for indications other than suspected urinary tract cancer (UTC). A bladder wall mass was visualized in 67% (66/99) of …

Gastrointestinal stromal tumors (GISTs) are defined as CD117-positive primary, spindled or epithelioid, mesenchymal tumors of the gastrointestinal tract, omentum, or mesentery. While computed tomography (CT) is the recommended imaging modality for GISTs, overlap in imaging features between GISTs and other gastrointestinal tumors often make radiological diagnosis and subsequent selection of the optimal therapeutic approach challenging. Cinematic rendering is a novel CT post-processing technique that generates highly photorealistic anatomic images based on a unique lighting model. The global lighting model produces high degrees of surface detail and shadowing effects that generate depth in the final three-dimensional display. Early studies have shown that cinematic rendering produces high-quality images with enhanced detail by comparison with other three-dimensional visualization techniques …

Saxbys is an education company through which students essentially run their own campus cafes. Superficially, Saxbys is a coffee company just like Starbucks, Panera Bread, and Dunkin’Donuts. However, Saxbys’ mission goes beyond selling coffee. The mission is to improve life by supporting the next generation of leaders and entrepreneurs. Through our Experiential Learning Platform (ELP), we partner directly with traditional higher education institutions to build coffee shops on their campuses designed and run exclusively by undergraduate entrepreneurs. Saxbys has distilled our business down to three pillars: team development, community leadership, and financial management. These pillars are carried out by Student CEOs, who earn a full semester of academic credit and wages while taking no classes for their six-month tenure. Student CEOs and their teams are responsible for the entirety of cafe operations …

Introduction: Blood-based multi-cancer early detection (MCED) tests in development may substantially expand the number of “screenable” cancers. Defining an optimal approach for tissue of origin (TOO) localization in individuals with cancer-suspected MCED results is critical. Two recent prospective trials employed differing and distinct approaches for conducting TOO evaluation. The PATHFINDER study conducted molecular TOO testing for localization and DETECT-A used upfront neck-to-thigh imaging-first to rule-in or rule-out and then to localize the cancer. Using mathematical modeling, we examined the diagnostic burden of each approach. Methods: Building upon a published quantitative framework, a mathematical expression for diagnostic burden was derived as a function of positive predictive value (PPV) of the detection module, TOO accuracy of the localization module, and number of procedures …

Radiology errors have been reported in up to 30% of cases when patients have abnormal imaging findings. Although more than half of errors are failures to detect critical findings, over 40% of errors are when findings are recognized but the correct diagnosis or interpretation is not made. One common source of error is when imaging findings from one process simulate imaging findings from another process but the correct diagnosis is not made. This can result in additional imaging studies, unnecessary biopsies, or surgery. Extramedullary hematopoiesis is one of those uncommon disease processes that can produce many imaging findings that may lead to misdiagnosis. The objective of this article is to review the common and uncommon imaging features of extramedullary hematopoiesis while presenting a series of interesting relevant illustrative cases with emphasis on CT.

3039Background: Recommended standard of care (SOC) early detection tests are solely available for four cancer types and fewer than 20% of incident cancers in the US are being diagnosed as a result of screening. Advances in detection of tumor-derived analytes in the blood are enabling the development of MCED tests that may expand early cancer detection. While MCED tests are being designed with high specificity, false positive (FP) results remain a concern for clinicians and patients alike, as no long-term outcomes of individuals with a FP MCED test have been reported. DETECT-A was the first prospective interventional clinical trial to evaluate an MCED blood test. The test used was an early version of CancerSEEK, evaluated in 9,911 women without history of cancer (Science, 369:6499, 2020). This prospectively planned analysis evaluates cancer incidence among DETECT-A participants with FP results …

Rationale and ObjectivesWe post several times daily on our Facebook page, CTisus, to educate radiology students and professionals globally. We aimed to determine how our data compared for different types of posts and ascertain the popularity of videos versus case images, illustrations versus case images, and whether cinematic rendering performed better than traditional computed tomography.Materials and MethodsWe exported data for one year's worth of Facebook posts (November 1, 2020 to October 31, 2021) and categorized posts into 18 types. Our primary outcome was popularity of each post, measured by “reach” and “engagement” counts provided by Facebook.ResultsAmong the 9057 posts exported, “just for fun” posts performed the best, followed by quiz images. Case images performed significantly better than instructional videos (p < 0.0001). However, the opposite was true for engagement, where …

Malignant peripheral nerve sheath tumors are soft tissue sarcomas that typically arise from a neurofibroma. Patients with neurofibromatosis type 1 represent approximately half of the population diagnosed with these tumors. This autosomal-dominant genetic disorder is distinguished by loss-of-function mutations in the neurofibromin 1 gene, which ultimately promotes atypical cellular proliferation. These biologically aggressive tumors are associated with a poor prognosis as they are resistant to available therapies and have high rates of recurrence, progression, and mortality. In this article, we report the case of a 45-year-old male with a history of neurofibromatosis type 1 who was diagnosed with a malignant peripheral nerve sheath tumor. We focus on optimizing diagnosis and treatment through the application of radiological imaging modalities, including cinematic rendering.

Our objective was to evaluate the impact of recent public health crises on radiology CT services in Puerto Rico. We gathered and analyzed CT statistics from 2 of Puerto Rico's major private hospital groups and obtained monthly data from January 2016 to March 2021. We quantified short- and long-term impacts of Hurricane Maria (September 2016-August 2017, September 2017-August 2018, September 2018-August 2019) and COVID-19 (April 2019-March 2020, April 2020-March 2021) by calculating month-to-month and year-to-year percentage differences for each hospital and all hospitals combined for the dates leading up to, in the immediate aftermath, and following these major events. Despite short-term effects throughout September from Hurricane Maria, there were no noticeable year-to-year differences in the total number of CT studies performed. Both March and April 2020 highlighted the instantaneous …