Publications (100) View all
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Article: Introduction to business for radiology senior residents.
Journal of the American College of Radiology: JACR 03/2011; 8(3):205-8. -
Article: Amplitude-modulated electromagnetic fields for the treatment of cancer: discovery of tumor-specific frequencies and assessment of a novel therapeutic approach.
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ABSTRACT: Because in vitro studies suggest that low levels of electromagnetic fields may modify cancer cell growth, we hypothesized that systemic delivery of a combination of tumor-specific frequencies may have a therapeutic effect. We undertook this study to identify tumor-specific frequencies and test the feasibility of administering such frequencies to patients with advanced cancer. We examined patients with various types of cancer using a noninvasive biofeedback method to identify tumor-specific frequencies. We offered compassionate treatment to some patients with advanced cancer and limited therapeutic options. We examined a total of 163 patients with a diagnosis of cancer and identified a total of 1524 frequencies ranging from 0.1 Hz to 114 kHz. Most frequencies (57-92%) were specific for a single tumor type. Compassionate treatment with tumor-specific frequencies was offered to 28 patients. Three patients experienced grade 1 fatigue during or immediately after treatment. There were no NCI grade 2, 3 or 4 toxicities. Thirteen patients were evaluable for response. One patient with hormone-refractory breast cancer metastatic to the adrenal gland and bones had a complete response lasting 11 months. One patient with hormone-refractory breast cancer metastatic to liver and bones had a partial response lasting 13.5 months. Four patients had stable disease lasting for +34.1 months (thyroid cancer metastatic to lung), 5.1 months (non-small cell lung cancer), 4.1 months (pancreatic cancer metastatic to liver) and 4.0 months (leiomyosarcoma metastatic to liver). Cancer-related frequencies appear to be tumor-specific and treatment with tumor-specific frequencies is feasible, well tolerated and may have biological efficacy in patients with advanced cancer. clinicaltrials.gov identifier NCT00805337.Journal of Experimental & Clinical Cancer Research 05/2009; 28:51. · 2.15 Impact Factor -
Article: FDG PET-CT Aids in the Preoperative Assessment of Patients with Newly Diagnosed Thymic Epithelial Malignancies.
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ABSTRACT: INTRODUCTION:: Advanced thymoma (stage III and IV) is difficult to detect by computed tomography (CT), yet it is important to distinguish between early (stage I and II) and advanced disease before surgery, as patients with locally advanced tumors require neoadjuvant chemotherapy to enable effective resection. This study assessed whether the amount of fluorodeoxyglucose (FDG) uptake can predict advanced thymoma and whether it can separate thymoma from thymic cancer. METHODS:: We retrospectively reviewed FDG positron emission tomography (PET)-CT scans of 51 consecutive newly diagnosed patients with thymic epithelial malignancy. PET-CT findings documented focal FDG activity: SUVmax, SUVmean, SUVpeak, and total body volumetric standardized uptake value (SUV) measurements. These were correlated with Masaoka-Koga staging and World Health Organization classification. Wilcoxon ranked sum tests were used to assess association between SUV and pathological stage, cancer type, and classification. RESULTS:: Among the study patients, 37 had thymoma, 12 thymic carcinoma, and 2 thymic carcinoid. Higher focal FDG uptake was seen in patients with type B3 thymoma than in those with type A, AB, B1, or B2 thymoma (p < 0.006). FDG uptake was higher in patients with thymic carcinoma or carcinoid than in patients with thymoma (p < 0.0003), with more variable associations with volumetric SUV measurements. There was no significant association observed between higher focal FDG uptake and advanced-stage disease in thymoma patients (p > 0.09), although greater FDG-avid tumor volume was significantly associated with advanced disease (p < 0.03). CONCLUSIONS:: Focal FDG uptake cannot predict advanced thymoma but is helpful in distinguishing thymoma from thymic carcinoma, or the more aggressive thymoma, type B3.Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 02/2013; · 4.55 Impact Factor -
Article: Diaphragmatic Hernia After Esophagectomy for Esophageal Malignancy.
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ABSTRACT: PURPOSE:: Diaphragmatic hernia (DH) is an uncommon complication after esophagectomy, with <150 cases reported in the literature. The objective of our study was to determine the incidence and clinical presentation of this condition and to describe the prospective recognition of this finding in radiologic reports. MATERIALS AND METHODS:: Cross-sectional imaging studies of all patients who underwent an esophagectomy between January 2001 and December 2007 at a single tertiary care center were retrospectively reviewed by 2 radiologists who were blinded to the clinical information and radiologic reports. Patients with DH were identified and their demographics, characteristics of hernia, and patient outcome were recorded. Radiology reports issued at the time of study were reviewed independently by a third reviewer to assess whether the hernia was prospectively reported. RESULTS:: A total of 458 patients underwent esophagectomy during the study time period, of whom 440 patients were eligible to be included in the study. Forty-four patients developed postesophagectomy DH. Thirty-six patients with DH were asymptomatic, whereas 8 had hernia-related symptoms. Only 7 cases were prospectively reported by the radiologists. Of the 37 cases not reported by the radiologists, 6 required surgical intervention during the follow-up. CONCLUSIONS:: Postesophagectomy DH is difficult to diagnose clinically but is usually apparent on cross-sectional imaging. Some asymptomatic patients may develop hernia-related complications, which significantly increases the mortality rate. Hence, radiologists need to be aware of this rare postoperative complication and should report this finding so that affected patients can be optimally managed by surgeons.Journal of thoracic imaging 12/2012; · 1.42 Impact Factor -
Article: Radiology and primary care.
Journal of the American College of Radiology: JACR 08/2012; 9(8):534.
