Browsing by Subject "imaging"
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Item Advances in Multimodality Imaging in Cardio-Oncology: JACC State-of-the-Art Review(Elsevier, 2022-10-18) Baldassarre, Lauren A.; Ganatra, Sarju; Lopez-Mattei, Juan; Yang, Eric H.; Zaha, Vlad G.; Wong, Timothy C.; Ayoub, Chadi; DeCara, Jeanne M.; Dent, Susan; Deswal, Anita; Ghosh, Arjun K.; Henry, Mariana; Khemka, Abhishek; Leja, Monika; Rudski, Lawrence; Villarraga, Hector R.; Liu, Jennifer E.; Barac, Ana; Scherrer-Crosbie, Marielle; ACC Cardio-Oncology and the ACC Imaging Councils; Medicine, School of MedicineThe population of patients with cancer is rapidly expanding, and the diagnosis and monitoring of cardiovascular complications greatly rely on imaging. Numerous advances in the field of cardio-oncology and imaging have occurred in recent years. This review presents updated and practical approaches for multimodality cardiovascular imaging in the cardio-oncology patient and provides recommendations for imaging to detect the myriad of adverse cardiovascular effects associated with antineoplastic therapy, such as cardiomyopathy, atherosclerosis, vascular toxicity, myocarditis, valve disease, and cardiac masses. Uniquely, we address the role of cardiovascular imaging in patients with pre-existing cardiomyopathy, pregnant patients, long-term survivors, and populations with limited resources. We also address future avenues of investigation and opportunities for artificial intelligence applications in cardio-oncology imaging. This review provides a uniform practical approach to cardiovascular imaging for patients with cancer.Item Association between intracranial carotid artery calcifications and periodontitis: A cone-beam computed tomography study(AAP, 2021-10) AlSakr, Abdulaziz; Blanchard, Steven; Wong, Phillip; Thyvalikakath, Thankam; Hamada, Yusuke; Periodontology, School of DentistryBackground Intracranial carotid artery calcifications (ICACs) are one type of calcification that may be detected as incidental findings in cone-beam computed tomography (CBCT). This retrospective study aimed to examine the prevalence of ICACs on CBCT images and their associations among age, gender, chronic periodontitis, and patient-reported cardiovascular diseases (CVDs). Methods A total of 303 CBCT scans were reviewed and a total of 208 patients met the inclusion criteria. The presence or absence of ICACs was evaluated in the ophthalmic and cavernous segments of each scan. Patient demographic data, including age, gender, and medical history, specifically focused on CVDs were recorded. The presence or absence of periodontitis was recorded from each subject with full mouth radiographs and clinical measurements. Odds ratios (ORs) were calculated as part of the logistic regression analysis. Results Overall, ICACs were found in 93 subjects (45%). The bilateral ICACs were found in 43 subjects (21% of the total subjects, 46% of the subjects with ICACs). There were statistically significant associations between presence of ICACs and periodontitis (OR = 4.55), hypertension (OR = 3.02), hyperlipidemia (OR = 2.87), increasing age (OR = 2.24), and the male gender (OR = 1.85). Smoking status was not significantly correlated with ICACs. Conclusion This study revealed that nearly half (45%) of the subjects displayed ICACs on the CBCT images. ICACs are significantly related to the status of chronic periodontitis, age, gender, and CVDs. A more careful review of CBCT scans is highly recommended to detect these calcifications and refer patients for further medical evaluation.Item Brain Rehabilitation, Advanced Imaging, and Neuroscience (BRAIN): An IUPUI Signature Center Initiative (SCI)(Office of the Vice Chancellor for Research, 2014-04-11) Hammond, Flora; Saykin, Andrew J.; Malec, James; Keiski, MichelleThe Mission of the Indiana Center for Brain Rehabilitation, Advanced Imaging, and Neuroscience (ICBRAIN) is: to develop and disseminate techniques and methodologies for combining advanced neuroimaging, neurogenetics and other neurophysiological measures with precision behavioral measurement to evaluate novel rehabilitation interventions for people with acquired brain injury. Traumatic and other types of acquired brain injury (ABI) affect millions of U.S. citizens each year, many of whom experience persistent disabilities. Over the past decade there has been a notable rise in research activities to address serious gaps in the knowledge base of ABI, including neuroimaging, outcome measurement, and intervention studies to change function. However, brain injury researchers have not yet established solid links between these research agendas. The BRAIN SCI fills this gap in neuroscience by bringing together an interdisciplinary team of clinical researchers to (1) advance basic science and clinical knowledge to the next level of integration, (2) translate the knowledge gained directly into clinical care for improved patient outcomes, and (3) use the newly integrated knowledge to drive the leading edge of translational research. BRAIN research includes the Indiana Traumatic Brain Injury Model System, funded by the National Institute for Disability and Rehabilitation Research (NIDRR), the InterFACE Center for the study of emotions and interpersonal interactions after neurologic injury, and nine other externally funded research projects. BRAIN research ranges from development of a neurogenetic respository and advanced neuroimaging studies to determine critical elements in recovery from brain injury to intervention studies to improve recovery to a multi-national study of an intervention for phantom limb pain. BRAIN research is interdisciplinary. Disciplines currently involved in BRAIN research include physiatry, neuropsychology, neuroradiology, rehabilitation science, biomedical engineering, and psychiatry. The Indiana School of Medicine Neuroscience Center of Excellence provides a home for BRAIN and supports its interdisciplinary Steering Committee. In addition to partnerships with the Neuroscience Center, the Center for Neuroimaging, and the InterFACE Center, BRAIN collaborates with the Rehabilitation Hospital of Indiana, the Stark Neuroscience Institute, and the School of Health and Rehabilitation Sciences. This presentation will describe BRAIN’s mission, vision, organization, partnerships, and ongoing research projects in greater detail.Item Dynamic assessment of the tear film muco-aqueous and lipid layers using a novel tear film imager (TFI)(BMJ, 2020) Segev, Fani; Geffen, Noa; Galor, Anat; Cohen, Yoel; Gefen, Raanan; Belkin, Avner; Arieli, Yoel; Epshtein, Shlomi; Oren, Anat; Harris, Alon; Ophthalmology, School of MedicinePurpose The objective of the study was to assess a new technology, the tear film imager (TFI), which can dynamically image the muco-aqueous and lipid layers. Methods Prospective pilot case series of individuals with and without dry eye (DE). Two sequential images were obtained with the TFI. Measurements were assessed for reproducibility and compared with clinically derived DE metrics. Individuals were grouped into DE categories based on signs of DE. Results 49 patients participated in the study with a mean age of 58.8 years (SD 15.9) and a female majority (69%). Reproducibility of the muco-aqueous layer thickness (MALT) was excellent (r=0.88). MALT measurements significantly correlated with the Schirmer score (r=0.31). Lipid break up time (LBUT) as measured by the TFI significantly correlated with the clinical measure of tear break up time (TBUT) (r=0.73). MALT and LBUT were significantly thinner and shorter, respectively, in the DE groups (mild–moderate and severe) compared with the control group. When comparing TFI parameters to clinically assessed signs, sensitivity of the device was 87% and specificity was 88%. Conclusion The TFI is the first machine capable of reproducibly measuring muco-aqueous thickness in human subjects which correlates with Schirmer score. In parallel, it assesses other important aspects of tear film function which correlate with clinician assessed DE metrics.Item Evaluation of the accuracy of the soft tissue thickness measurements with three different methodologies: an in-vitro study(Wiley, 2022) Ferry, Katherine; AlQallaf, Hawra; Blanchard, Steven; Dutra, Vinicius; Lin, Wie-Shao; Hamada, Yusuke; Prosthodontics, School of DentistryBackground Soft tissue thickness (STT) influences esthetics, peri-implant, and periodontal health. Non-invasive methods of STT evaluation include cone-beam computed tomography (CBCT) with Digital Imaging and Communications in Medicine (DICOM) files and registration of DICOM files with an intraoral scan or Standard Tessellation Language (STL) files. This study compares three methodologies: bone sounding, DICOM data alone, and DICOM and STL registration to absolute histomorphologic values. Materials and Methods Five human maxillas, including teeth #s 6-11, provided 90 sites for analysis. For standardization, reference grooves were placed at the cervical margin and the long axis of each tooth. Direct measurements with a no. 25 K-file were completed at the facial soft tissues at 3.00, 5.00, and 7.00 mm from the apical marginal reference. Indirect measures were performed with implant planning software. Histological measurements were rendered with imaging software. One-way analysis of variance (ANOVA) was used to compare the three techniques for the differences from histologic measurements (α = .05). Results Seventy-two sites were included for final analysis. The overall mean histological STT (mSTT) was 0.73 ± 0.31 mm. Bone sounding overestimated mSTT, 0.22 ± 0.20mm (p<.001); whereas, DICOM alone underestimated mSTT, -0.23 ± 0.19 mm (p<.001). DICOM and STL registration had non-statistically significant differences, -0.04 ± 0.21mm (p = .429). Intraclass correlation coefficient (ICC) of DICOM and STL registration achieved the highest agreement with histology (ICC: 0.74). Conclusions DICOM and STL file registration had the highest agreement with histological STT supporting the use of DICOM and STL registration for the evaluation of soft tissue thickness.Item High‐speed Intraoperative Assessment of Breast Tumor Margins by Multimodal Ultrasound and Photoacoustic Tomography(Wiley, 2018) Lu, Rui; Lan, Lu; Xia, Yan; Wang, Pu; Han, Linda K.; Dunnington, Gary L.; Obeng-Gyasi, Samilia; Sandusky, George E.; Medley, Jennifer A.; Crook, Susan T.; Cheng, Ji-Xin; Medicine, School of MedicineConventional methods for breast tumor margins assessment need a long turnaround time, which may lead to re‐operation for patients undergoing lumpectomy surgeries. Photoacoustic tomography (PAT) has been shown to visualize adipose tissue in small animals and human breast. Here, we demonstrate a customized multimodal ultrasound and PAT system for intraoperative breast tumor margins assessment using fresh lumpectomy specimens from 66 patients. The system provides the margin status of the entire excised tissue within 10 minutes. By subjective reading of three researchers, the results show 85.7% [95% confidence interval (CI), 42.0% ‐ 99.2%] sensitivity and 84.6% (95% CI, 53.7% ‐ 97.3%) specificity, 71.4% (95% CI, 30.3% ‐ 94.9%) sensitivity and 92.3% (95% CI, 62.1% ‐ 99.6%) specificity, and 100% (95% CI, 56.1% ‐ 100%) sensitivity and 53.9% (95% CI, 26.1% ‐ 79.6%) specificity respectively when cross‐correlated with post‐operational histology. Furthermore, a machine learning‐based algorithm is deployed for margin assessment in the challenging ductal carcinoma in situ tissues, and achieved 85.5% (95% CI, 75.2% ‐ 92.2%) sensitivity and 90% (95% CI, 79.9% ‐ 95.5%) specificity. Such results present the potential of using mutlimodal ultrasound and PAT as a high‐speed and accurate method for intraoperative breast tumor margins evaluation.Item IMAGING GENOMICS(2018) Huang, Heng; Shen, L. I.; Thompson, Paul M.; Huang, Kun; Huang, Junzhou; Yang, Lin; Radiology and Imaging Sciences, School of MedicineItem Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus(Elsevier, 2019-09) Moore, Christopher L.; Carpenter, Christopher R.; Heilbrun, Marta E.; Klauer, Kevin; Krambeck, Amy C.; Moreno, Courtney; Remer, Erick M.; Scales, Charles; Shaw, Melissa M.; Sternberg, Kevan M.; Urology, School of MedicineBackground Renal colic is common, and CT is frequently utilized when the diagnosis of kidney stones is suspected. CT is accurate but exposes patients to ionizing radiation and has not been shown to alter either interventional approaches or hospital admission rates. This multi-organizational transdisciplinary collaboration sought evidence-based, multispecialty consensus on optimal imaging across different clinical scenarios in patients with suspected renal colic in the acute setting. Methods In conjunction with the American College of Emergency Physicians (ACEP) eQual network, we formed a nine-member panel with three physician representatives each from ACEP, the ACR, and the American Urology Association. A systematic literature review was used as the basis for a three-step modified Delphi process to seek consensus on optimal imaging in 29 specific clinical scenarios. Results From an initial search yielding 6,337 records, there were 232 relevant articles of acceptable evidence quality to guide the literature summary. At the completion of the Delphi process consensus, agreement was rated as perfect in 15 (52%), excellent in 8 (28%), good in 3 (10%), and moderate in 3 (10%) of the 29 scenarios. There were no scenarios where at least moderate consensus was not reached. CT was recommended in 7 scenarios (24%), with ultrasound in 9 (31%) and no further imaging needed in 12 (45%). Summary Evidence and multispecialty consensus support ultrasound or no further imaging in specific clinical scenarios, with reduced-radiation dose CT to be employed when CT is needed in patients with suspected renal colic.Item Indiana Center for Biological Microscopy(Office of the Vice Chancellor for Research, 2014-04-11) Kamocka, Malgorzata; Winfree, Seth; Dunn, Kenneth W.The Indiana Center for Biological Microscopy “ICBM” has provided imaging capabilities since 1996. The primary objective of the Center is to provide state-of-the-art microscopy facility to Indiana University researchers. In 2002 the ICBM was designated as an NIDDK George O'Brien Center for Advanced Microscopic Analysis, whose objective is to develop methods of intravital multiphoton microscopy and 3-dimentional microscopy for renal research. Since that time, the ICBM has worked with various IU investigators to develop methods for intravital microscopy of various organs. One of the recent goals of the Center is to develop an intravital microscopy service for Cancer Center investigators by establishing the Optical Microscopy Core for the CEMH. The Center is available to anyone at the Indiana University and researchers from outside the institution. We are organized around the principle of providing researchers with access to and training on the latest instruments in optical microscopy. We emphasize hands-on access to instruments for individual investigators and unparalleled assistance from on-staff imaging experts.Item Osteomyelitis of the ribs in children: a rare and potentially challenging diagnosis(Springer, 2020) Crone, Allison M.; Wanner, Matthew R.; Cooper, Matthew L.; Fox, Thomas G.; Jennings, S. Gregory; Karmazyn, Boaz; Radiology and Imaging Sciences, School of MedicineBackground Rib osteomyelitis is rare in children and can mimic other pathologies. Imaging has a major role in the diagnosing rib osteomyelitis. Objective To evaluate clinical presentation and imaging findings in children with rib osteomyelitis. Materials and methods We performed a retrospective (2009–2018) study on children with rib osteomyelitis verified by either positive culture or pathology. We excluded children with multifocal osteomyelitis or empyema necessitans. We reviewed medical charts for clinical, laboratory and pathology data, and treatment. All imaging modalities for rib abnormalities were evaluated for presence and location of osteomyelitis and abscess. We calculated descriptive statistics to compare patient demographics, clinical presentation and imaging findings. Results The study group included 10 children (6 boys, 4 girls), with an average age of 7.3 years (range, 3 months to 15.9 years). The most common clinical presentations were fever (n=8) and pain (n=5). Eight children had elevated inflammatory indices (leukocytosis, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]). Localized chest wall swelling was found initially in six children and later in two more children. Rib osteomyelitis was suspected on presentation in only two children. All children had chest radiographs. Rib lytic changes were found on only one chest radiograph, in two of the four ultrasound studies, and in four of eight CTs. Bone marrow signal abnormalities were seen in all eight MRIs. In nine children the osteomyelitis involved the costochondral junction. Six children had an associated abscess. Staphylococcus aureus was cultured in eight children. Osteomyelitis was diagnosed based on pathology in one child with negative cultures. Conclusion While rib osteomyelitis is rare, imaging findings of lytic changes at the costochondral junction combined with a history of fever, elevated inflammatory markers or localized soft-tissue swelling in the chest should raise suspicion for this disease.