V Anik Sahni

Harvard Medical School, Boston, Massachusetts, United States

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Publications (43)113.85 Total impact

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    ABSTRACT: Introduction: Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. Methods: We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impact of ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports. Results: The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (p<0.0001, Cochran-Armitage trend test). The proportion of provider-communicated reports with non-critical results remained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test). Conclusions: A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting the system did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm.
    BMJ quality & safety 09/2015; DOI:10.1136/bmjqs-2015-004276 · 3.99 Impact Factor
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    ABSTRACT: Objective: To assess whether integrating critical result management software-Alert Notification of Critical Results (ANCR)-with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). Materials and methods: This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts ("alerts") within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Results: Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Conclusions: Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts.
    Journal of the American Medical Informatics Association 09/2015; DOI:10.1093/jamia/ocv105 · 3.50 Impact Factor
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    ABSTRACT: The purpose of this study is to assess the impact of implementing a structured report template on the quality of MRI reports for rectal cancer staging. After excluding examinations performed after surgery or neoadjuvant therapy, we analyzed all rectal cancer staging MRI reports finalized at an academic medical center 12 months before and after an intervention consisting of implementing a structured report template integrated into the institution's speech recognition system. The primary outcome measure was the quality of rectal cancer staging MRI reports classified as optimal, satisfactory, or unsatisfactory, on the basis of the documentation of 14 quality measures predefined by a consensus of the institution's abdominal radiology subspecialists. Chi-square and t tests were used to assess differences in report quality and documentation of each discrete quality measure before and after the intervention. The study cohort included 106 MRI reports from 104 patients (mean age, 60 years; 58.5% male); 52 (49.1%) of the reports were completed before implementation of the structured report template. After implementation, the proportion of total reports classified as optimal or satisfactory increased from 38.5% (20/52) to 70.4% (38/54) (p = 0.0010). No reports generated before the intervention were classified as optimal, whereas 40.7% (22/54) of reports were classified as optimal after the intervention. Implementation and voluntary use of a structured report template improved the quality of MRI reports for rectal cancer staging compared with free-text format.
    American Journal of Roentgenology 09/2015; 205(3):584-588. DOI:10.2214/AJR.14.14053 · 2.73 Impact Factor
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    ABSTRACT: OBJECTIVE. The purpose of this study was to evaluate the yield of repeat CT urography (CTU) in detecting urinary tract malignancies in patients with hematuria. MATERIALS AND METHODS. A review of 5525 patients who underwent CTU between 2000 and 2011 revealed 751 (13.6%) patients who underwent repeat CTU. We excluded 127 patients with more than 3 years between examinations, 409 with nonhematuria indications, and 13 with less than 1 year of follow-up from a negative repeat examination. An additional 54 patients with malignancy diagnosed on the initial evaluation were excluded, leaving 148 patients in the study cohort (77 men and 71 women; mean age, 57 years). Patients were categorized on the basis of the presence or absence of findings suspicious for malignancy on initial CTU reports. Repeat CTU reports were correlated with cystoscopy, pathology, and clinical follow-up to determine the incidence of malignancy. Examinations negative for malignancy were confirmed with at least 1 year of clinical follow-up. CTU examinations of patients diagnosed with malignancy on repeat examination were reviewed by two radiologists in consensus. RESULTS. Initial CTU showed no findings suspicious for malignancy in 103 (70%) of 148 patients; of these, none had malignancy identified on repeat CTU. Among 45 (30%) patients with suspicious initial CTU findings, four malignancies were identified on repeat CTU (8.9%). Three were incidental to the initial suspicious finding; in retrospect, two were present on the initial CTU examination. CONCLUSION. In patients with hematuria, repeat CTU within 3 years is unlikely to show a urinary tract malignancy. These results support currently published guidelines.
    American Journal of Roentgenology 02/2015; 204(2):318-323. DOI:10.2214/AJR.14.12825 · 2.73 Impact Factor
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    ABSTRACT: Acute necrotizing pancreatitis is a severe form of acute pancreatitis characterized by necrosis in and around the pancreas and is associated with high rates of morbidity and mortality. Although acute interstitial edematous pancreatitis is diagnosed primarily on the basis of signs, symptoms, and laboratory test findings, the diagnosis and severity assessment of acute necrotizing pancreatitis are based in large part on imaging findings. On the basis of the revised Atlanta classification system of 2012, necrotizing pancreatitis is subdivided anatomically into parenchymal, peripancreatic, and combined subtypes, and temporally into clinical early (within 1 week of onset) and late (>1 week after onset) phases. Associated collections are categorized as "acute necrotic" or "walled off" and can be sterile or infected. Imaging, primarily computed tomography and magnetic resonance imaging, plays an essential role in the diagnosis of necrotizing pancreatitis and the identification of complications, including infection, bowel and biliary obstruction, hemorrhage, pseudoaneurysm formation, and venous thrombosis. Imaging is also used to help triage patients and guide both temporizing and definitive management. A "step-up" method for the management of necrotizing pancreatitis that makes use of imaging-guided percutaneous catheter drainage of fluid collections prior to endoscopic or surgical necrosectomy has been shown to improve clinical outcomes. The authors present an algorithmic approach to the care of patients with necrotizing pancreatitis and review the use of imaging and interventional techniques in the diagnosis and management of this pathologic condition. ©RSNA, 2014.
    Radiographics 09/2014; 34(5):1218-1239. DOI:10.1148/rg.345130012 · 2.60 Impact Factor
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    ABSTRACT: Purpose: Assess the utility of CT and MRI in patients with acute pancreatitis (AP) presenting to emergency department (ED). Materials and methods: In this Institutional Review Board-approved retrospective study, we identified all patients with AP from March 2012 through February 2013 in ED of a teaching hospital with approximately 60,000 annual visits. Patients were initially identified via ICD-9 code for AP (577.0); diagnosis was confirmed by chart review using established diagnostic criteria (presence of two of the following: typical abdominal pain, elevated lipase/amylase >3 times normal, or imaging findings of pancreatitis). Abdominal CT or MRI obtained in the ED and within 24 h of admission was reviewed by a fellowship-trained abdominal radiologist. Results: Of 101 patients admitted with AP (60 women, 41 men; mean age 52 years, range 20-89), 63 (62.4%) underwent imaging; only one (1.6%) showed pancreatic necrosis. 88 (87.1%) patients could have been clinically diagnosed without imaging based on presence of abdominal pain and elevated laboratory values; 13 (12.9%) required imaging for diagnosis. Of 88 patients who met AP diagnostic criteria without imaging, 50 (56.8%) nonetheless underwent imaging, with AP without necrosis seen in 34 (68.0%), pancreatic necrosis in one (2.0%), sequelae of prior AP in four (8.0%), and no abnormality in 11 (22.0%). Conclusion: Early imaging is common in patients with AP, even when the diagnosis can be established based on non-imaging criteria, rarely demonstrating pancreatic necrosis. Reducing overuse of early imaging in patients with confident diagnosis of AP may improve quality and reduce waste.
    Abdominal Imaging 07/2014; 40(2). DOI:10.1007/s00261-014-0210-1 · 1.63 Impact Factor
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    ABSTRACT: To determine if gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) cholangiography can detect and localize bile duct leaks in postcholecystectomy patients. Four blinded independent radiologists performed a retrospective review of 16 consecutive patients who underwent MR cholangiography with intravenous Gd-EOB-DTPA for the evaluation of possible biliary leak. Image quality, ductal opacification, and presence and location of any bile leak were evaluated. An independent observer determined the criterion standard using a consensus of all chart, clinical, and imaging findings. All 6 bile leaks confirmed at endoscopic retrograde cholangiopancreatography were diagnosed by all reviewers (sensitivity, 100%). Of the 10 patients with no leak, only one reader incorrectly diagnosed a bile leak in a single case (specificity, 98%). The accuracy for detection of the site of leak with Gd-EOB-DTPA-enhanced MR cholangiography was 80%. Gadolinium-EOB-DTPA-enhanced MR can detect bile leaks with a high sensitivity and specificity.
    Journal of computer assisted tomography 03/2014; 38(4). DOI:10.1097/RCT.0000000000000083 · 1.41 Impact Factor
  • V Anik Sahni · Stuart G Silverman ·
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    ABSTRACT: Both imaging and intervention play an increasingly important role in the management of renal masses in general and renal cancer in particular. Indeed, radiologists are often the first to detect and diagnose renal cancer, and now with the burgeoning role of percutaneous ablation, they are often the treating physicians. Renal mass management begins with imaging, and although most can be diagnosed with a high degree of certainty using imaging, some remain indeterminate and require biopsy or observation, now referred to as active surveillance. Although active surveillance strategies have been employed for indeterminate renal masses that have a reasonable chance of being benign, recent data suggest that some renal cancers can undergo active surveillance safely. This article reviews the current imaging-based diagnostic evaluation of incidentally detected small renal masses, the burgeoning role of percutaneous biopsy, and how both imaging and biopsy are used to help select which patients need treatment and which can undergo active surveillance.
    Seminars in Interventional Radiology 03/2014; 31(1):9-19. DOI:10.1055/s-0033-1363838
  • Cheryl A. Sadow · V. Anik Sahni ·
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    ABSTRACT: The purpose of this pictorial review is to discuss causes of female infertility, in particular, those etiologies in which imaging plays a key role in detection. Included are disorders of cervical, ovarian, fallopian tube, and uterine origin. We also discuss the role of various imaging modalities including hysterosalpingography, pelvic ultrasonography, hysterosonography, and pelvic MR imaging in elucidating the cause of female infertility. Radiologists need to know the conditions to be aware of when these patients are sent for diagnostic imaging, as well as how to direct further management, if necessary, should an abnormality be detected.
    Abdominal Imaging 02/2014; 39(1). DOI:10.1007/s00261-013-0040-6 · 1.63 Impact Factor
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    ABSTRACT: To determine whether a single 20 s breath-hold positron-emission tomography (PET) acquisition obtained during combined PET/computed tomography (CT)-guided percutaneous liver biopsy or ablation procedures has the potential to target 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG)-avid liver masses as accurately as up to 180 s breath-hold PET acquisitions. This retrospective study included 10 adult patients with 13 liver masses who underwent FDG PET/CT-guided percutaneous biopsies (n = 5) or ablations (n = 5). PET was acquired as nine sequential 20 s, monitored, same-level breath-hold frames and CT was acquired in one monitored breath-hold. Twenty, 40, 60, and 180 s PET datasets were reconstructed. Two blinded readers marked tumour centres on randomized PET and CT datasets. Three-dimensional spatial localization differences between PET datasets and either 180 s PET or CT were analysed using multiple regression analyses. Statistical tests were two-sided and p < 0.05 was considered significant. Targeting differences between 20 s PET and 180 s PET ranged from 0.7-20.3 mm (mean 5.3 ± 4.4 mm; median 4.3) and were not statistically different from 40 or 60 s PET (p = 0.74 and 0.91, respectively). Targeting differences between 20 s PET and CT ranged from 1.4-36 mm (mean 9.6 ± 7.1 mm; median 8.2 mm) and were not statistically different from 40, 60, or 180 s PET (p = 0.84, 0.77, and 0.35, respectively). Single 20 s breath-hold PET acquisitions from PET/CT-guided percutaneous liver procedures have the potential to target FDG-avid liver masses with equivalent accuracy to 180 s summed, breath-hold PET acquisitions and may facilitate strategies that improve image registration and shorten procedure times.
    Clinical Radiology 01/2014; 69(4). DOI:10.1016/j.crad.2013.11.013 · 1.76 Impact Factor
  • Atul Bhanudas Shinagare · Ivan Ip · Ali Raja · Vikram Anik Singh Sahni · Peter A. Banks · Ramin Khorasani ·
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    ABSTRACT: PURPOSE To assess the use of CT in patients with acute pancreatitis (AP) presenting to the emergency department (ED). METHOD AND MATERIALS In this IRB-approved HIPAA-compliant retrospective study, we identified all patients with AP presenting from March 2012 through February 2013 to ED of an academic teaching hospital with approximately 60,000 annual visits. Patients were initially identified using ICD-9 code for AP (577.0) and diagnosis was then confirmed using clinical criteria from chart reviews. Based on existing literature, AP was confirmed when two of the following three were present: typical abdominal pain, elevated lipase/amylase >3 times normal and CT findings of pancreatitis. Abdominal CT scans obtained in ED or within 24 hours of admission were reviewed by a fellowship-trained abdominal radiologist. RESULTS Of total 103 patients diagnosed with AP (62 women; mean age 52 years, range 20-89), 90 (87.4%) could be diagnosed without CT based on abdominal pain and elevated labs; 13 (12.6%) required CT for diagnosis (Fig. 1). Abdominal CT was obtained in ED or within 24 hours of admission in total 65 (63.1%) patients. Of 90 patients in whom AP could be diagnosed based on clinical criteria alone, 52 (57.8%) underwent CT; of these, findings of AP were present in 36 (69.2%), sequela of a prior acute pancreatitis episode in one (1.9%) and normal CT in 15 (28.9%). None of the 65 patients who underwent CT showed presence of complications of pancreatitis (pancreatic/peripancreatic necrosis, peripancreatic fluid collections, pseudocyst or walled-off necrosis, vascular complications, pleural effusion) or alternate explanation for patient's symptoms. CONCLUSION CT is frequently obtained in patients with AP presenting to ED even if diagnosis can be made based on established clinical criteria of typical abdominal pain and markedly elevated labs. CT is unlikely to be useful in these patients in the acute setting, as complications of AP in this setting may be rare. CLINICAL RELEVANCE/APPLICATION Abdominal CT rarely shows complications of acute pancreatitis in the acute phase, and it may not be necessary if diagnosis can be confidently made based on typical abdominal pain and elevated labs.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
  • V.A. Sahni · A.B. Shinagare · S G Silverman ·
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    ABSTRACT: Aim: To determine how representative virtual unenhanced (VNE) images are of true unenhanced (TNE) images when performing computed tomography (CT) urography on a dual-energy CT (DECT) system, and whether the images are affected by the contrast material phase. Materials and methods: In this retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant study, TNE were compared with VNE images derived from the nephrographic (VNEn) and excretory (VNEe) phases in 100 consecutive CT urograms. Two readers in consensus measured attenuation values of abdominal organs, fat, and renal lesions (>1 cm). Image noise was correlated with patient thickness. Detectability of renal stones was evaluated. Image quality and acceptability was assessed using a five-point scale. Expected dose saving by removing the TNE phase was calculated. Results: VNE attenuation values of liver, renal parenchyma, and aorta were significantly different to TNE values (p < 0.05); spleen and fat attenuation values showed no significant difference. No significant difference was found between VNEn and VNEe images. Image noise was significantly greater in TNE images (p < 0.0001) and correlated with patient thickness. VNEn and VNEe images had sensitivities of 76.6 and 65.6% for detection of stones, identifying all stones greater than 3 and 4 mm, respectively. Both VNE images received significantly lower image quality scores than TNE images (p < 0.0001); however, the majority of images were deemed acceptable. The mean theoretical dose saving by removing the TNE phase was 35%. Conclusion: Although VNE images demonstrate high reader acceptability, accuracy of attenuation values and detection of small stones is limited. The contrast material phase, however, does not affect attenuation values. Further validation of VNE images is recommended prior to clinical implementation.
    Clinical Radiology 09/2012; 68(3). DOI:10.1016/j.crad.2012.08.004 · 1.76 Impact Factor
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    V Anik Sahni · Michelle S Hirsch · Stuart G Silverman ·
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    ABSTRACT: Renal angiomyoadenomatous tumour is a rare, recently described neoplasm with a distinctive histological appearance. Although reported in the pathology literature, to our knowledge, no prior reports have described its imaging appearance. We describe the computed tomography and magnetic resonance imaging features of an incidentally detected renal angiomyoadenomatous tumour that appeared as a well-marginated, solid T2-hypointense enhancing mass, in a 50-year-old woman. It is indistinguishable from a variety of benign and malignant renal neoplasms.
    Canadian Urological Association journal = Journal de l'Association des urologues du Canada 08/2012; 6(4):E140-3. DOI:10.5489/cuaj.11072 · 1.92 Impact Factor
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    ABSTRACT: To describe the multidetector-row computed tomography enterographic (MD-CTE) features of the ileal-anal pouch after ileal pouch anal anastomosis (IPAA) surgery and correlate them with pouch endoscopy and histopathologic findings. All MD-CTE examinations performed on patients who underwent IPAA from July 1, 2005 to December 1, 2010 (n = 35; 16 [45.7%] men; mean age, 37.7 years; age range, 22-72 years) were retrospectively evaluated in consensus by 2 radiologists. All studies were evaluated for the presence of multiple imaging features. Two radiographic scores were then calculated: a total radiographic score and a radiographic active inflammation score. In patients who underwent MD-CTE, pouch endoscopy, and biopsy within 30 days (n = 13), both scores were correlated with findings on pouch endoscopy and histopathology. Of the 35 patients, 33 (94%) had at least one MD-CTE finding of active or chronic pouch inflammation and 27 patients (77%) had at least one MD-CTE finding of active pouch inflammation. Of the 13 patients who underwent endoscopy and biopsy, the total radiographic score demonstrated a strong positive correlation with endoscopic score (r = 0.81; P = 0.001) and a moderate positive correlation with histopathologic score (r = 0.56; P = 0.047). The radiographic active inflammation score demonstrated a strong positive correlation with endoscopic score (r = 0.83; P = 0.0004), but only a weak nonsignificant positive correlation with histopathologic score (r = 0.492, P = 0.087). In patients who had IPAA surgery, findings on MD-CTE correlate positively with findings on pouch endoscopy and histopathology and are sensitive measures for pouch inflammation with high positive predictive value. Thus, MD-CTE can be a useful noninvasive test in the early evaluation of symptomatic patients.
    Journal of computer assisted tomography 07/2012; 36(4):394-9. DOI:10.1097/RCT.0b013e31825b878c · 1.41 Impact Factor
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    ABSTRACT: Benign metastasizing pleomorphic adenoma is a rare condition that occurs in patients with a prior history of pleomorphic adenoma of the salivary glands. Metastases to the kidney are extremely rare, and, to the best of our knowledge, their imaging appearance on multiple cross-sectional imaging modalities has not been described. We present a solitary metastasis to the kidney in a 40-year-old woman. Computed tomography and magnetic resonance imaging demonstrated a 2.4 cm, well-marginated, enhancing mass that protruded into the renal sinus fat. Findings were indistinguishable from a primary renal malignancy. Prior history is crucial in suggesting the correct diagnosis.
    Urology 06/2012; 80(2):e17-8. DOI:10.1016/j.urology.2012.04.055 · 2.19 Impact Factor
  • Nitin Kumar · V. Anik Sahni · Christopher C. Thompson ·

    Gastroenterology 05/2012; 142(5):S-23. DOI:10.1016/S0016-5085(12)60090-0 · 16.72 Impact Factor
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    ABSTRACT: This article describes the features on sonography, computed tomography (CT) and magnetic resonance imaging (MRI) of mucinous tubular and spindle cell carcinoma of the kidney. Six pathologically proven cases of mucinous tubular and spindle cell carcinoma of the kidney were identified (5 females, 1 male); all patients underwent preoperative imaging. The mean age of the patients was 58.5 years. Thirteen imaging studies were available for review: 2 sonograms, 1 unenhanced CT scan, 5 contrast-enhanced CT scans, 1 unenhanced magnetic resonance imaging (MRI) examination, and 4 contrast-enhanced MRI examinations. Two abdominal radiologists evaluated all images retrospectively on a PACS workstation using a standardized data collection sheet until consensus was reached. All mucinous tubular and spindle cell carcinomas presented as well-marginated, small (mean 2.6 cm, range 1.9-3.2 cm) predominantly solid masses. No intratumoral fat or calcification was identified. Unenhanced CT and MRI appearances were variable as was the degree of enhancement following intravenous contrast material administration. There was no evidence of perinephric extension, renal vein involvement or metastatic disease in any of the cases. The radiological appearance of mucinous tubular and spindle cell carcinoma is diverse and therefore indistinguishable from the more common subtypes of renal cell carcinoma.
    Cancer Imaging 03/2012; 12(1):66-71. DOI:10.1102/1470-7330.2012.0008 · 2.07 Impact Factor
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    ABSTRACT: The purpose of this study is to assess the feasibility of low-tube-voltage images during excretory phase CT urography. In this retrospective study, we examined 70 consecutive CT urograms (35 men and 35 women; mean age, 58.5 years) performed on a dual-energy CT scanner and compared excretory phase images obtained at 80 kVp and 340 mAs with blended images (0.3 × 140 kVp and 80 mAs; and 0.7 × 80 kVp and 340 mAs). Quantitative measurements of urinary system opacification (Hounsfield units), image noise (Hounsfield units), and effective dose (millisieverts) were compared using Student paired t test. Image noise was correlated with patient thickness. Two independent blinded readers qualitatively assessed opacification, image quality (both compared using Wilcoxon test), overall acceptability (compared using McNemar test), and detectability of urinary and extraurinary findings. The 80-kVp images yielded significantly higher opacification of renal pelvis (p < 0.0001), ureter (p < 0.0001), bladder (p < 0.0001), and aorta (p < 0.0001); higher image noise (p < 0.0001); and lower radiation dose (5.2 vs 11.9 mSv). Image noise increased along with increasing patient thickness (r = 0.86 for 80-kVp images). Qualitative opacification scores were better only in the bladder on 80-kVp images (p = 0.002). Although 80-kVp image quality was lower (p < 0.0001), the overall acceptability was similar. Of 42 urinary findings, 40 were detected on 80-kVp images (< 2-mm calyceal calculus and tiny foci of collecting system gas were missed in one patient each, both large patients). Of 137 extraurinary findings, 130 were detected on 80-kVp images (no findings of high clinical significance were missed). Low tube voltage (80 kVp) during excretory phase CT urography is feasible, with improved urinary system opacification, acceptable image quality, and lower radiation dose.
    American Journal of Roentgenology 11/2011; 197(5):1146-51. DOI:10.2214/AJR.11.6799 · 2.73 Impact Factor
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    ABSTRACT: The objective of this review article is to learn how to recognize anatomic variants and benign entities that mimic bladder cancer at computed tomography (CT) urography. Building on recent data that suggest that CT urography can be used to diagnose bladder cancer, recognition of anatomic variants and benign entities will help improve radiologists' ability to diagnose bladder cancer.
    Cancer Imaging 06/2011; 11(1):100-8. DOI:10.1102/1470-7330.2011.0017 · 2.07 Impact Factor
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    ABSTRACT: Evaluate the utility of multidetector-row computed tomography (MDCT) in assessing the severity of ulcerative colitis (UC) in comparison with clinical assessment, colonoscopy, and histopathology. Patients with UC evaluated with at least one abdominal contrast-enhanced CT study (CECT) within 7 days of colonoscopy with biopsy were included. CECT of 23 patients (12 male; mean age 40 years; age range, 20-72 years) were retrospectively evaluated in consensus by two radiologists. A total of 138 lower GI tract segments were evaluated by CECT and graded for the presence of bowel wall thickening, mucosal hyperenhancement, mural stratification, mesenteric hyperemia, pericolonic stranding, and lymph nodes. A cumulative CT severity score was calculated and correlated with clinical, colonoscopic, and histopathologic severity grades. The cumulative CT score and individual CECT scores for bowel wall thickening, mucosal hyperenhancement, and mural stratification showed positive correlation with clinical severity (P < 0.05). All individual CECT features as well as the cumulative CT score demonstrated statistically significant correlation with colonoscopic severity (P < 0.0001). Only wall thickening on CECT demonstrated significant correlation with histopathologic severity (P = 0.01). Disease severity assessment by MDCT demonstrates positive correlation with severity established by clinical assessment and colonoscopy. Only increasing wall thickness, as graded on MDCT, correlates with histopathologic disease severity.
    Abdominal Imaging 05/2011; 37(1):61-9. DOI:10.1007/s00261-011-9741-x · 1.63 Impact Factor

Publication Stats

309 Citations
113.85 Total Impact Points


  • 2009-2015
    • Harvard Medical School
      • Department of Radiology
      Boston, Massachusetts, United States
    • St. Mark's Hospital
      Salt Lake City, Utah, United States
  • 2008-2014
    • Harvard University
      Cambridge, Massachusetts, United States
    • St. Mark's Hospital
      Harrow, England, United Kingdom