Faculty Bibliography
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person:rosena23
Total Results:
548
Investigation of Multisequence Magnetic Resonance Imaging for Detection of Recurrent Tumor After Transurethral Resection for Bladder Cancer
PURPOSE: The aim of this study was to evaluate multisequence magnetic resonance imaging (MRI) in detecting local recurrence after transurethral resection for bladder cancer. METHODS: Thirty-six patients with bladder cancer with previous transurethral resection underwent bladder MRI incorporating T2-weighted imaging, diffusion-weighted imaging, and delayed contrast-enhanced T1-weighted imaging, followed by cystoscopy. Two radiologists (R1 and R2) evaluated examinations for suspicious findings. RESULTS: Forty-seven percent of patients had recurrent tumor at cystoscopy and biopsy. Using multisequence MRI, sensitivity and specificity were 67% and 81% for R1 and 73% and 62% for R2. Both readers missed 1 high-grade pathologic stage T1 recurrent tumor; otherwise, all missed tumors were low-grade pathologic stage Ta lesions. All false positives for R1 and 7 of 9 false positives for R2 were in patients receiving previous bacillus Calmette-Guerin therapy. Furthermore, 40% to 50% of solitary abnormalities and 83% to 100% of multifocal abnormalities were tumor recurrences; 12% to 20% of smooth wall thickening, 50% to 75% of irregular wall thickening, and 88% to 100% of papillary masses were tumor recurrences. CONCLUSIONS: Although multisequence MRI exhibited moderate performance for detecting recurrent tumor, nearly all missed tumors were low grade and noninvasive.
PMID: 26760195
ISSN: 1532-3145
CID: 1912622
Performance of Simultaneous High Temporal Resolution Quantitative Perfusion Imaging of Bladder Tumors and Conventional Multi-phase Urography Using a Novel Free-Breathing Continuously Acquired Radial Compressed-Sensing MRI Sequence
PURPOSE: To investigate the feasibility of high temporal resolution quantitative perfusion imaging of bladder tumors performed simultaneously with conventional multi-phase MR urography (MRU) using a novel free-breathing continuously acquired radial MRI sequence with compressed-sensing reconstruction. METHODS: 22 patients with bladder lesions underwent MRU using GRASP (Golden-angle RAdial Sparse Parallel) acquisition. Multi-phase contrast-enhanced abdominopelvic GRASP was performed during free-breathing (1.4x1.4x3.0mm3 voxel size; 3:44min acquisition). Two dynamic datasets were retrospectively reconstructed by combining different numbers of sequentially acquired spokes into each dynamic frame: 110 spokes per frame for 25-second temporal resolution (serving as conventional MRU for clinical interpretation) and 8 spokes per frame for 1.7-second resolution. Using 1.7-second resolution images, ROIs were placed within bladder lesions and normal bladder wall, a femoral artery arterial input function was generated, and the Generalized Kinetic Model was applied. RESULTS: Biopsy/cystectomy demonstrated 16 bladder tumors (13 stage>/=T2, 3 stage/=T2 than stage
PMCID:4896486
PMID: 26740058
ISSN: 1873-5894
CID: 1901182
Public Interest in Imaging-Based Cancer Screening Examinations in the United States: Analysis Using a Web-Based Search Tool
OBJECTIVE: The objective of this study was to identify geographic and temporal patterns related to the frequencies of online searches within the United States for information on imaging-based cancer screening tests. MATERIALS AND METHODS: Google Trends, a web-based tool for identifying the frequency of online searches, was used to determine, on both a monthly and a geographic basis, the relative frequency of searches for imaging-based cancer screening tests in the United States from 2004 through 2014. Findings were evaluated qualitatively. RESULTS: Searches for "mammography" decreased slightly overall, although they peaked in October (Breast Cancer Awareness Month) in most years and spiked in November 2009 (when the updated U.S. Preventive Services Task Force screening mammography guidelines were released). The frequency of searches for "tomosynthesis" increased rapidly from 2009 through 2014. On the other hand, the frequency of searches for "lung cancer screening" decreased slightly from 2006 through 2010, increased rapidly from 2011 through 2014, and exhibited a spike in November 2010 (when the results of the National Lung Screening Trial were released). Searches for "virtual colonoscopy" decreased substantially from 2004 through 2010, remained stable from 2011 through 2014, and spiked in months coinciding with the publication of the results of large relevant clinical trials and a press release announcing that the president of the United States was undergoing virtual colonoscopy. The frequency of searches for "prostate MRI" was stable from 2006 through 2010 and increased rapidly from 2011 through 2014. Searches for "prostate MRI biopsy" increased rapidly in 2013 and 2014. These searches occurred predominantly in densely populated areas (e.g., searches for "lung cancer screening," "prostate MRI," and "tomosynthesis" were highest in New York City). CONCLUSION: Online search patterns indicate geographic and short- and long-term temporal variation in the interest in cancer screening examinations among the U.S. POPULATION: These trends may indicate pending shifts in the use of these examinations.
PMID: 26700342
ISSN: 1546-3141
CID: 1884282
Utility of diffusion-weighted MRI for differentiating acute from chronic cholecystitis
PURPOSE: To assess the use of diffusion-weighted imaging (DWI) for differentiating acute from chronic cholecystitis, in comparison with conventional magnetic resonance imaging (MRI) features. MATERIALS AND METHODS: Liver MRI including DWI (b-values 0/500/1000s/mm2 ) was performed at 1.5T
PMID: 26691912
ISSN: 1522-2586
CID: 1884122
Research Challenges and Opportunities for Clinically Oriented Academic Radiology Departments
Between 2004 and 2012, US funding for the biomedical sciences decreased to historic lows. Health-related research was crippled by receiving only 1/20th of overall federal scientific funding. Despite the current funding climate, there is increased pressure on academic radiology programs to establish productive research programs. Whereas larger programs have resources that can be utilized at their institutions, small to medium-sized programs often struggle with lack of infrastructure and support. To address these concerns, the Association of University Radiologists' Radiology Research Alliance developed a task force to explore any untapped research productivity potential in these smaller radiology departments. We conducted an online survey of faculty at smaller clinically funded programs and found that while they were interested in doing research and felt it was important to the success of the field, barriers such as lack of resources and time were proving difficult to overcome. One potential solution proposed by this task force is a collaborative structured research model in which multiple participants from multiple institutions come together in well-defined roles that allow for an equitable distribution of research tasks and pooling of resources and expertise. Under this model, smaller programs will have an opportunity to share their unique perspective on how to address research topics and make a measureable impact on the field of radiology as a whole. Through a health services focus, projects are more likely to succeed in the context of limited funding and infrastructure while simultaneously providing value to the field.
PMID: 26598485
ISSN: 1878-4046
CID: 1856832
The "Unconference" in Radiological Society Meetings
PMID: 26541701
ISSN: 1878-4046
CID: 1825992
Journal of the American College of Radiology : JACR. 2016:13(2):210-6.DOI: 10.1016/j.jacr.2015.08.020
Factors Influencing Patients' Perspectives of Radiology Imaging Centers: Evaluation Using an Online Social Media Ratings Website
PURPOSE: The goal of this study was to use patient reviews posted on Yelp.com, an online ratings website, to identify factors most commonly associated with positive versus negative patient perceptions of radiology imaging centers across the United States. METHODS: A total of 126 outpatient radiology centers from the 46 largest US cities were identified using Yelp.com; 1,009 patient reviews comprising 2,582 individual comments were evaluated. Comments were coded as pertaining to either the radiologist or other service items, and as expressing either a positive or negative opinion. Distribution of comments was compared with center ratings using Fisher's exact test. RESULTS: Overall, 14% of comments were radiologist related; 86% pertained to other aspects of service quality. Radiologist-related negative comments more frequent in low-performing centers (mean rating /=4) pertained to imaging equipment (25% versus 7%), report content (25% versus 2%), and radiologist professionalism (25% versus 2%) (P < .010). Other service-related negative comments more frequent in low-performing centers pertained to receptionist professionalism (70% versus 21%), billing (65% versus 10%), wait times (60% versus 26%), technologist professionalism (55% versus 12%), scheduling (50% versus 17%), and physical office conditions (50% versus 5%) (P < .020). Positive comments more frequent in high-performing centers included technologist professionalism (98% versus 55%), receptionist professionalism (79% versus 50%), wait times (72% versus 40%), and physical office conditions (64% versus 25%) (P < .020). CONCLUSIONS: Patients' perception of radiology imaging centers is largely shaped by aspects of service quality. Schedulers, receptionists, technologists, and billers heavily influence patient satisfaction in radiology. Thus, radiologists must promote a service-oriented culture throughout their practice.
PMID: 26521969
ISSN: 1558-349x
CID: 1825692
The U.S. Radiologist Workforce: An Analysis of Temporal and Geographic Variation by Using Large National Datasets
Purpose To determine recent trends related to temporal as well as national and statewide geographic variation in the U.S. radiologist and radiology resident workforce. Materials and Methods This retrospective HIPAA-compliant study was exempted from the internal review board. Federal Area Health Resources Files and Medicare 5% research identifiable files were used to compute parameters related to the radiologist workforce. Geographic variation and annual temporal trends were analyzed. Pearson and Spearman correlations were assessed. Results Nationally, the number of radiology trainees increased 84.2% from a nadir in 1997 (3080 trainees) to 2011 (5674 trainees) and showed high state-to-state variation (range, 0-678 trainees in 2011). However, total radiologists nationally increased 39.2% from 1995 (27 906 radiologists) to 2011 (38 875 radiologists), and radiologists per 100 000 population nationally increased by 7.5% from 1995 (10.62%) to 2011 (11.42%), while showing high state-to-state variation (highest-to-lowest state ratio of 4.3). Radiologists' share of the overall physician workforce declined nationally by 8.8% from 1995 (4.0%) to 2011 (3.7%), with moderate state-to-state variation (highest-to-lowest state ratio of 1.7). Radiology trainee numbers exhibited weak-to-moderate positive state-by-state correlation with radiologists per 100 000 population (r = 0.292-0.532), but moderate-to-strong inverse correlation with the percentage of radiologists in rural practice (r = -0.464 to -0.635). Conclusion Although the number of radiology trainees dramatically increased, radiologists per 100 000 population increased only slightly, and radiologists' share of the overall physician workforce declined. State-to-state variations in radiologist and radiology resident workforces are high, which suggests a potential role for geographic redistribution rather than changes in the overall workforce size. (c) RSNA, 2015 Online supplemental material is available for this article.
PMID: 26509294
ISSN: 1527-1315
CID: 1817512
Current Status of Hybrid PET/MRI in Oncologic Imaging
OBJECTIVE: This review article explores recent advancements in PET/MRI for clinical oncologic imaging. CONCLUSION: Radiologists should understand the technical considerations that have made PET/MRI feasible within clinical workflows, the role of PET tracers for imaging various molecular targets in oncology, and advantages of hybrid PET/MRI compared with PET/CT. To facilitate this understanding, we discuss clinical examples (including gliomas, breast cancer, bone metastases, prostate cancer, bladder cancer, gynecologic malignancy, and lymphoma) as well as future directions, challenges, and areas for continued technical optimization for PET/MRI.
PMCID:4915069
PMID: 26491894
ISSN: 1546-3141
CID: 1810582
High-Resolution 3-T Endorectal Prostate MRI: A Multireader Study of Radiologist Preference and Perceived Interpretive Quality of 2D and 3D T2-Weighted Fast Spin-Echo MR Images
OBJECTIVE: The goal of this study was to compare the perceived quality of 3-T axial T2-weighted high-resolution 2D and high-resolution 3D fast spin-echo (FSE) endorectal MR images of the prostate. MATERIALS AND METHODS: Six radiologists independently reviewed paired 3-T axial T2-weighted high-resolution 2D and 3D FSE endorectal MR images of the prostates of 85 men in two sessions. In the first session (n = 85), each reader selected his or her preferred images; in the second session (n = 28), they determined their confidence in tumor identification and compared the depiction of the prostatic anatomy, tumor conspicuity, and subjective intrinsic image quality of images. A meta-analysis using a random-effects model, logistic regression, and the paired Wilcoxon rank-sum test were used for statistical analyses. RESULTS: Three readers preferred the 2D acquisition (67-89%), and the other three preferred the 3D images (70-80%). The option for one of the techniques was not associated with any of the predictor variables. The 2D FSE images were significantly sharper than 3D FSE (p < 0.001) and significantly more likely to exhibit other (nonmotion) artifacts (p = 0.002). No other statistically significant differences were found. CONCLUSION: Our results suggest that there are strong individual preferences for the 2D or 3D FSE MR images, but there was a wide variability among radiologists. There were differences in image quality (image sharpness and presence of artifacts not related to motion) but not in the sequences' ability to delineate the glandular anatomy and depict a cancerous tumor.
PMCID:4721575
PMID: 26491891
ISSN: 1546-3141
CID: 1810572
