Demetrios J Agriantonis

Texas Tech University Health Sciences Center, Lubbock, Texas, United States

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Publications (6)16.9 Total impact

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    ABSTRACT: Spontaneous perirenal hemorrhage (SPH), also known as Wünderlich's syndrome, is a rare urological emergency. This article reviews the most common causes of SPH and the role of imaging in establishing the correct diagnosis and in guiding the appropriate therapy. A thorough understanding of underlying etiologies, imaging appearances, optimal imaging techniques, and follow-up protocols are crucial to recognize patients with SPH due to benign disease and avoid unnecessary nephrectomies.
    Emergency Radiology 02/2011; 18(4):329-34. DOI:10.1007/s10140-011-0944-9
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    ABSTRACT: To compare colonic cleansing and fluid retention of double-dose magnesium citrate with those of single-dose sodium phosphate in patients undergoing computed tomographic (CT) colonography. This retrospective HIPAA-compliant clinical study had institutional review board approval; informed consent was waived. The study included 118 consecutive patients given single-dose sodium phosphate for bowel catharsis and 115 consecutive patients at risk for phosphate nephropathy, who were instead given double-dose magnesium citrate. The bowel preparation regimen was otherwise identical. Four-point scales were used to assess residual stool and fluid in the six colonic segments, and attenuation of residual fluid was measured. An a priori power analysis was performed, and unpaired t tests with Welch correction were used to compare the two groups on stool and fluid scores and fluid attenuation. Both cathartic regimens offered excellent colon cleansing, with no significant difference for residual stool in any of the six segments. Stool scores of 1 or 2 (ie, no residual stool or residual stool <5 mm) were recorded in 88.6% (627 of 708) of colonic segments in the sodium phosphate group and in 88.1% (608 of 690) in the magnesium citrate group. No clinically important differences were seen in residual fluid scores in any of the six segments, with the only significant difference seen in the sigmoid colon (2.17 for sodium phosphate vs 2.44 for magnesium citrate; P< 0.01). Fluid attenuation was significantly different between magnesium citrate and sodium phosphate groups (790 HU +/- 216 vs 978 HU +/- 160; P <.001). Both sodium phosphate and magnesium citrate provided excellent colon cleansing for CT colonography. Residual stool and fluid were similar in both groups, and fluid attenuation values were closer to optimal in the magnesium citrate group. Since bowel preparation provided by both cathartics was comparable, magnesium citrate should be considered for CT colonography, particularly in patients at risk for phosphate nephropathy.
    Radiology 01/2010; 254(1):138-44. DOI:10.1148/radiol.09090398 · 6.21 Impact Factor
  • Demetrios J Agriantonis, Lance Hall, Michael A Wilson
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    ABSTRACT: One of the major limitations of planar I-131 imaging is its lack of anatomic precision. SPECT/CT offers the benefit of precise anatomic localization that planar imaging lacks. Whether for confirmation of physiologic uptake or true pathology, SPECT/CT has an important role to play in clarifying equivocal findings. We present a case of papillary thyroid cancer metastatic to the liver, a relatively rare scenario. SPECT/CT allowed definitive lesion characterization at the time of the patient's visit to the nuclear medicine department.
    Clinical nuclear medicine 05/2009; 34(4):247-8. DOI:10.1097/RLU.0b013e31819a1eb3 · 3.92 Impact Factor
  • Demetrios John Agriantonis, J. Louis Hinshaw, David H. Kim, Perry J. Pickhardt
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    ABSTRACT: PURPOSE Bowel preparation for computed tomographic colonography (CTC) with sodium phosphate has been associated with adverse effects, particularly in patients with renal or cardiac failure. As a result, alternative cathartic agents (including magnesium citrate) that are safer in this patient population are being evaluated. The purpose of this study was to compare the quality of bowel preparation obtained with sodium phosphate as compared with magnesium citrate. METHOD AND MATERIALS The study is a retrospective review of 230 patients who underwent screening CTC and received either sodium phosphate (n = 115) or magnesium citrate (n = 115) for bowel catharsis. Stool/fluid tagging remained constant. The colon was separated into six standard segments and the bowel preparation was subjectively evaluated for residual stool and fluid utilizing a 4-point scale. Density of the residual fluid was measured. RESULTS Both cathartic regimens were associated with a consistently excellent bowel preparation and there was no significant difference based on residual stool or fluid. A stool score of 1 or 2 (indicating no stool or only minimal residual < 5 mm) was seen in 93.3% (644/690) of colonic segments in the sodium phosphate group and 92.3% (637/690) in the magnesium citrate group. More importantly, a residual stool score of 4 was rarely seen in either group (by segment, 1.5% (10/690) versus 0.4% (3/690), p < 0.05; by patient, 2.6% (3/115) versus 1.7% (2/115), respectively). The attenuation of the residual fluid was significantly lower in the magnesium citrate group as compared with the sodium phosphate group (790 ± 216, range 170-1130 versus 978 ± 160, range 120-1250). CONCLUSION Both magnesium citrate and sodium phosphate resulted in excellent bowel cleansing in preparation for CTC without significant differences. Therefore, one should not hesitate to utilize magnesium citrate for bowel catharsis, particularly in patients with any level of renal or cardiac failure. CLINICAL RELEVANCE/APPLICATION This study establishes that the bowel preparation obtained with magnesium citrate (safer for patients with renal/cardiac failure) is equivalent to that obtained with sodium phosphate.
    Radiological Society of North America 2008 Scientific Assembly and Annual Meeting; 12/2008
  • Demetrios J Agriantonis, Scott B Perlman, Walter L Longo
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    ABSTRACT: F-18 FDG PET imaging has an established role in the management of lymphoma patients, many of whom receive hematopoietic stern cell transplantation (HSCT). Myositis is a rare manifestation of chronic graft-versus-host disease (GVHD), a common complication of HSCT. We present a case of GVHD-associated polymyositis presenting as intense, diffuse muscle uptake on F-18 FDG PET. The patient is a 35-year-old man with a history of recurrent Hodgkin disease. He presented with low-grade fever, malaise, and diffuse musculoskeletal pain just less than 5 years after HSCT. Chronic GVHD-associated polymyositis is readily treatable with immunosuppressive therapy. Without treatment it can have devastating consequences, notably myoglobin-induced renal failure. Therefore, the interpreting physician should have familiarity with this potential scan finding as suggestive of a treatable complication of HSCT.
    Clinical nuclear medicine 11/2008; 33(10):688-9. DOI:10.1097/RLU.0b013e318184b3c6 · 3.92 Impact Factor
  • Demetrios J Agriantonis, Lance Hall, Michael A Wilson
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    ABSTRACT: Whole body iodine scans are routinely performed in the nuclear medicine department as part of the management of differentiated thyroid carcinoma. Similarly, radioactive iodine has a well-established role as an adjunct to thyroidectomy in the treatment of these patients. A thorough understanding of the normal, benign, and pathologic biodistribution of iodine is imperative for the nuclear medicine physician. This knowledge leads to the accurate determination of the presence of metastatic or recurrent carcinoma, and may even facilitate the accurate detection of an undiagnosed condition. Above all, correct image interpretation avoids unnecessary therapeutic doses. The authors describe 2 unusual examples of false positive findings in fluid-filled cavities that showcase the variety of nonmalignant entities one may encounter when interpreting metastatic surveys.
    Clinical Nuclear Medicine 06/2008; 33(5):325-7. DOI:10.1097/RLU.0b013e31816a7a63 · 2.86 Impact Factor