Browsing by Author "Ladd, Lauren M."

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    Comparison of hepatic MDCT, MRI, and DSA to explant pathology for the detection and treatment planning of hepatocellular carcinoma
    (The Korean Association for the Study of the Liver, 2016-12) Ladd, Lauren M.; Tirkes, Temel; Tann, Mark; Agarwal, David M.; Johnson, Matthew S.; Tahir, Bilal; Sandrasegaran, Kumaresan; Department of Radiology and Imaging Sciences, IU School of Medicine
    BACKGROUND/AIMS: The diagnosis and treatment plan for hepatocellular carcinoma (HCC) can be made from radiologic imaging. However, lesion detection may vary depending on the imaging modality. This study aims to evaluate the sensitivities of hepatic multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) in the detection of HCC and the consequent management impact on potential liver transplant patients. METHODS: One hundred and sixteen HCC lesions were analyzed in 41 patients who received an orthotopic liver transplant (OLT). All of the patients underwent pretransplantation hepatic DSA, MDCT, and/or MRI. The imaging results were independently reviewed retrospectively in a blinded fashion by two interventional and two abdominal radiologists. The liver explant pathology was used as the gold standard for assessing each imaging modality. RESULTS: The sensitivity for overall HCC detection was higher for cross-sectional imaging using MRI (51.5%, 95% confidence interval [CI]=36.2-58.4%) and MDCT (49.8%, 95% CI=43.7-55.9%) than for DSA (41.7%, 95% CI=36.2-47.3%) (P=0.05). The difference in false-positive rate was not statistically significant between MRI (22%), MDCT (29%), and DSA (29%) (P=0.67). The sensitivity was significantly higher for detecting right lobe lesions than left lobe lesions for all modalities (MRI: 56.1% vs. 43.1%, MDCT: 55.0% vs. 42.0%, and DSA: 46.9% vs. 33.9%; all P<0.01). The sensitivities of the three imaging modalities were also higher for lesions ≥2 cm vs. <2 cm (MRI: 73.4% vs. 32.7%, MDCT: 66.9% vs. 33.8%, and DSA: 62.2% vs. 24.1%; all P<0.01). The interobserver correlation was rated as very good to excellent. CONCLUSION: The sensitivity for detecting HCC is higher for MRI and MDCT than for DSA, and so cross-sectional imaging modalities should be used to evaluate OLT candidacy.
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    Computed Tomography and Magnetic Resonance Imaging of Bone Tumors
    (Elsevier, 2017) Ladd, Lauren M.; Roth, Trenton D.; Department of Radiology and Imaging Sciences, IU School of Medicine
    Imaging is the key to diagnosing and guiding management of bone tumors. Although radiographs are the gold standard for initial imaging evaluation and may make the diagnosis, computed tomography (CT) and magnetic resonance (MR) imaging are important adjunct tools for further characterization as a benign or aggressive lesion, accurately determining matrix composition, assessing lesion extent as well as secondary involvement of nearby structures if malignant, and staging tumors when applicable. In this article, we will highlight important features of CT and MR imaging for bone tumor evaluation and review the cross-sectional imaging features of a broad spectrum of benign and malignant bone tumors.
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    A Mentorship and Networking Group for Women in Radiology
    (Elsevier, 2017-07) Ladd, Lauren M.; Bonaminio, Dana N.; Gonda, Angela S.; Gasparis, Pauley T.; Bell, W. Logan; Aaron, Vasantha D.; Heitkamp, Darel E.; Radiology and Imaging Sciences, School of Medicine
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    Optimizing Electronic Release of Imaging Results through an Online Patient Portal
    (RSNA, 2019-01) Woolen, Sean A.; Kazerooni, Ella A.; Steenburg, Scott D.; Nan, Bin; Ma, Tianwen; Wall, Amber; Linna, Nathaniel B.; Gayed, Matthew J.; Kushdilian, Michael V.; Parent, Kelly; Cahalan, Shannon; Alameddine, Mitchell; Ladd, Lauren M.; Davenport, Matthew S.; Radiology and Imaging Sciences, School of Medicine
    Purpose To determine an optimal embargo period preceding release of radiologic test results to an online patient portal. Materials and Methods This prospective discrete choice conjoint survey with modified orthogonal design was administered to patients by trained interviewers at four outpatient sites and two institutions from December 2016 to February 2018. Three preferences for receiving imaging results associated with a possible or known cancer diagnosis were evaluated: delay in receipt of results (1, 3, or 14 days), method of receipt (online portal, physician’s office, or phone), and condition of receipt (before, at the same time as, or after health care provider). Preferences (hereafter, referred to as utilities) were derived from parameter estimates (β) of multinomial regression stratified according to study participant and choice set. Results Among 464 screened participants, the response and completion rates were 90.5% (420 of 464) and 99.5% (418 of 420), respectively. Participants preferred faster receipt of results (P < .001) from their physician (P < .001) over the telephone (P < .001). Each day of delay decreased preference by 13 percentage points. Participants preferred immediate receipt of results through an online portal (utility, –.57) if made to wait more than 6 days to get results in the office and more than 11 days to get results by telephone. Compared with receiving results in their physician’s office on day 7 (utility, –.60), participants preferred immediate release through the online portal without physician involvement if followed by a telephone call within 6 days (utility, –0.49) or an office visit within 2 days (utility, –.53). Older participants preferred physician-directed communication (P < .001). Conclusion The optimal embargo period preceding release of results through an online portal depends on the timing of traditional telephone- and office-based styles of communication.
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    Radiographic imaging, densitometry and disease severity in Autosomal dominant osteopetrosis type 2
    (Springer, 2021) Ladd, Lauren M.; Imel, Erik A.; Niziolek, Paul J.; Liu, Ziyue; Warden, Stuart J.; Liang, Yun; Econs, Michael J.; Radiology and Imaging Sciences, School of Medicine
    Objective: To characterize relationships between quantitative computed tomography bone mineral density measurements and other qualitative and quantitative imaging measures, as well as clinical metrics, in patients with autosomal dominant osteopetrosis type 2 (ADO2). Materials and methods: Clinical and radiologic parameters of 9 adults and 3 children with autosomal dominant osteopetrosis type 2 were assessed including lumbar spine quantitative computed tomography (QCT), radiographic skeletal survey (skull base thickening; Erlenmeyer flask deformity; endobone pattern; and spine density pattern (endplate sclerosis, "anvil" appearance, or diffuse sclerosis)), dual-energy x-ray absorptiometry (DXA), tibial peripheral quantitative computed tomography (pQCT) volumetric bone mineral density (vBMD), bone turnover markers, and bone marrow failure or visual impairment. Results: The skeletal parameter most divergent from normal was lumbar spine QCT Z-score (+ 3.6 to + 38.7). Lumbar QCT Z-score correlated positively with pQCT tibial diaphysis vBMD (Pearson correlation r = 0.73, p = 0.02) and pQCT tibial metaphysis vBMD (r = 0.87, p < 0.01). A trend towards positive lumbar QCT Z-score correlation with serum P1NP/CTX ratio (r = 0.54, p = 0.10) and lumbar DXA Z-score (r = 0.55, p = 0.10) were observed. Bone marrow failure and vision impairment occurred in those with most severe quantitative and qualitative measures, while those with less severe radiographic features had the lowest QCT Z-scores. Conclusion: Lumbar spine QCT provided the most extreme skeletal assessment in ADO2, which correlated positively with other radiologic and clinical markers of disease severity. Given the quantification of trabecular bone and greater variation from normal with wider range of values, lumbar QCT Z-scores may be useful to determine or detect impact of future treatments.