Browsing by Author "Lall, Chandana"

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    Chemotherapy-related complications in the kidneys and collecting system: an imaging perspective
    (Springer Berlin Heidelberg, 2015-08) Jia, Jemianne Bautista; Lall, Chandana; Tirkes, Temel; Gulati, Rajesh; Lamba, Ramit; Goodwin, Scott C.; Department of Radiology and Imaging Sciences, IU School of Medicine
    Nephrotoxicity is a common adverse effect of many chemotherapeutic agents. The agents most commonly associated with chemotherapy-associated nephrotoxicity are methotrexate, semustine, streptozocin, mithramycin, and cisplatin. Certain chemotherapeutic agents have adverse effects on the kidneys and urothelium that can be visualized radiographically, including cystic change, interstitial nephritis, papillary necrosis, urothelial changes, haemorrhagic cystitis, acute tubular necrosis, and infarction. This review focuses on imaging features identifying complications of chemotherapy in the kidneys and collecting system and provides didactic cases to alert referring clinicians.
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    Comparison of Dynamic Phase Enhancement of Hepatocellular Carcinoma using Gadoxetate Disodium versus Gadobenate Dimeglumine
    (Lippincott Williams & Wilkins, 2015-07) Tirkes, Temel; Mehta, Peter; Aisen, Alex M.; Lall, Chandana; Akisik, Fatih; Department of Radiology and Imaging Sciences, IU School of Medicine
    Objective: To determine the differences in enhancement of hepatocellular carcinoma during the first 5 minutes of postcontrast phases with gadoxetic acid (Gd-EOB-DTPA) vs gadobenate dimeglumine. Methods: Ninety-five cirrhotic patients with hepatocellular carcinoma were examined on a 1.5-T scanner: 74 patients with Gd-BOPTA and 21 patients with Gd-EOB-DTPA. Same magnetic resonance imaging parameters were used for both groups. Gadoxetate isodium was administered at a dose of 0.025 mmol/kg; and Gd-BOPTA, at a dose of 0.1 mmol/kg. Results: Mean contrast-to-noise ratios (CNR) were similar in arterial (P = 0.3), portal venous (P = 0.1), and 5-minute delayed phases (P = 0.73). The CNRs of lesions in the Gd-EOB-DTPA group were lower in arterial phase, although this did not reach statistical significance. The CNRs of Gd-EOB-DTPA during the equilibrium phase was higher (P = 0.006). Conclusions: Gadoxetate isodium resulted in lower CNR during the arterial phase and higher CNR during the portal venous, equilibrium, and 5-minute delayed phases compared with gadobenate dimeglumine using the Food and Drug Administration–approved doses; however, overall, there was no statistical significance (P = 0.077).
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    Magnetic resonance imaging following treatment of advanced hepatocellular carcinoma with sorafenib
    (Korean Association for the Study of the Liver, 2014) Choi, Joon-Il; Imagawa, David K.; Bhosale, Priya; Bhargava, Puneet; Tirkes, Temel; Seery, Tara E.; Lall, Chandana; Radiology and Imaging Sciences, School of Medicine
    Hepatocellular carcinomas are highly vascular tumors, showing progressive hypervascularity by the process of neoangiogenesis. Tumor angiogenesis is critical for tumor growth as well as metastatic spread therefore, imaging and quantification of tumor neo-angiogenesis is essential for monitoring response to targeted therapies and predicting disease progression. Sorafenib is a molecular targeting agent used for treating hypervascular tumors. This drug is now the standard of care in treatment of patients with advanced hepatocellular carcinoma. Due to its anti-angiogenic and anti-proliferative actions, imaging findings following treatment with Sorafenib are quite distinct when compared to conventional chemotherapeutic agents. Liver MRI is a widely adopted imaging modality for assessing treatment response in hepatocellular carcinoma and imaging features may reflect pathophysiological changes within the tumor. In this mini-review, we will discuss MRI findings after Sorafenib treatment in hepatocellular carcinoma and review the feasibility of MRI as an early biomarker in differentiating responders from non-responders after treatment with molecular targeting agents.
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    MR features of primary and secondary malignant lymphoma of the pancreas: a pictorial review
    (Springer, 2013) Fujinaga, Yasunari; Lall, Chandana; Patel, Aashish; Matsushita, Tsuyoshi; Sanyal, Rupan; Kadoya, Masumi; Radiology and Imaging Sciences, School of Medicine
    Objective: To describe the imaging findings of primary and secondary pancreatic malignant lymphoma on magnetic resonance imaging (MRI), to help differentiate lymphoma of the pancreas from primary adenocarcinoma and autoimmune pancreatitis among others, and to discuss a few atypical presentations of pancreatitis mimicking lymphoma. Conclusion: Knowledge of these imaging manifestations of lymphoma may be helpful to arrive at an accurate diagnosis and avoid unnecessary morbidity and mortality from inadvertent surgery. Main messages: • Pancreatic malignant lymphoma is shown as a nodular low-density area with mild enhancement on CT. • It sometimes shows variable manifestations mimicking other tumours and inflammatory conditions. • MRI provides useful information for differentiating malignant lymphoma from other mimickers.