Vani Vijayakumar

Louisiana State University Health Sciences Center New Orleans, New Orleans, Louisiana, United States

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Publications (50)74.82 Total impact

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    ABSTRACT: The aim of the study was to evaluate outcomes with an examination of individual predictors influencing survival at a single institution.
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    ABSTRACT: Graves orbitopathy (GO) is an autoimmune disorder representing the most frequent extrathyroidal manifestation of Graves disease. It is rare, with an age-adjusted incidence of approximately 16.0 cases per 100,000 population per year in women and 2.9 cases per 100,000 population per year in men. GO is an inflammatory process characterized by edema and inflammation of the extraocular muscles and an increase in orbital connective tissue and fat. Despite recent progress in the understanding of its pathogenesis, GO often remains a major diagnostic and therapeutic challenge. It has become increasingly important to classify patients into categories based on disease activity at initial presentation. A Hertel exophthalmometer measurement of >2 mm above normal for race usually categorizes a patient as having moderate-to-severe GO. Encouraging smoking cessation and achieving euthyroidism in the individual patient are important. Simple treatment measures such as lubricants for lid retraction, nocturnal ointments for incomplete eye closure, prisms in diplopia, or botulinum toxin injections for upper-lid retraction can be effective in mild cases of GO. Glucocorticoids, orbital radiotherapy, and decompression/rehabilitative surgery are generally indicated for moderate-to-severe GO and for sight-threatening optic neuropathy. Future therapies, including rituximab aimed at treating the molecular and immunological basis of GO, are under investigation and hold promise for the future.
    Southern medical journal 01/2014; 107(1):34-43. DOI:10.1097/SMJ.0000000000000038 · 1.12 Impact Factor
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    ABSTRACT: B-Precursor acute lymphoblastic leukemia (B-ALL) is the most common childhood cancer. Although 80% of B-ALL patients are able to be cured, significant challenges persist. Significant disparities in clinical outcomes and mortality rates exist between racial/ethnic populations. The objective of this study was to determine whether gene expression levels significantly differ between ethnic populations. We compared gene expression levels between four ethnic populations (Whites, Blacks, Hispanics, and Asians) in the United States. Additionally, we performed network and pathway analysis to identify gene networks and pathways. Gene expression data involved 198 samples distributed as follows: 126 Whites, 51 Hispanics, 13 Blacks, and 8 Asians. We identified 300 highly significantly (P < 0.001) differentially expressed genes between the four ethnic populations. Among the identified genes included the genes PHF6, BRD3, CRLF2, and RNF135 which have been implicated in pediatric B-ALL. We identified key pathways implicated in B-ALL including the PDGF, PI3/AKT, ERBB2-ERBB3, and IL-15 signaling pathways.
    Cancer informatics 08/2013; 12:155-73. DOI:10.4137/CIN.S11831
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    ABSTRACT: Data on coexisting Graves’ disease (GD), hypoparathyroidism, and systemic lupus erythematosus (SLE) are limited. The thyroid and parathyroid glands may be extra sensitive to irradiation damage in an underlying autoimmune condition. A 34-year-old black woman presented with tetanic-like cramps, easy skin bruising, fatigue, weight gain, nocturia and back pain. She was previously diagnosed with GD in 2001 and underwent radioiodine therapy (RAI) in 9/01 using 6 mCi. PostRAI (November 2001) she developed hypocalcemia and hypothyroidism (2/02). In 2007, SLE was diagnosed. In October 2009, s-calcium and PTH were still low at 7.1 mg/dl and 9 pg/mL, respectively, although the patient denied symptoms on vitamin D and calcium supplementation. To identify possible autoimmune damage of the parathyroids, we evaluated the presence of activating antibodies to the CaSR and also analyzed the DNA sequence of all 6 translated exons and flanking intronic sequences of her CaSR gene for a functionally significant CaSR mutation but neither was positive. The initial autoimmune damage to her thyroid and possibly parathyroid glands followed by irradiation of them seems to have contributed to her developing both hypoparathyroidism (11/01) and hypothyroidism (2002). The patient could potentially have had parathyroid autoantibodies in 2001 that disappeared by 2009 when she was tested for them. We consider that the multiple autoimmune conditions developed over the past decade of her life with the concurrent irradiation contributing to her brittle hypoparathyroidism. Select patients with GD and perhaps parathyroid autoantibodies with a slowly developing destructive impact on the parathyroid glands may then develop overt hyoparathyroidism with rather low dose RAI ablation. This patient adds to the evolving spectrum of polyglandular syndrome variants.
    International journal of immunopathology and pharmacology 01/2013; 26(1):217-22. · 2.51 Impact Factor
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    Encyclopedia of Otolaryngology, Head and Neck Surgery, First edited by S.E. Kountakis, 01/2013: chapter Parathyroid Imaging: pages 2061-2066; Springer-Verlag, Berlin, Heidelberg, New York.
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    Vani Vijayakumar, Christian A Koch, M Elizabeth Oates
    Encyclopedia of Otolaryngology, Head and Neck Surgery, First edited by S.E. Kountakis, 01/2013: chapter Radioiodine Therapy for Thyroid Malignancy: pages 2237-2242; Springer Verlag, New York, Berlin, Heidelberg.
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    ABSTRACT: Euthyroid Graves' orbitopathy (GO) combined with incidental papillary thyroid microcarcinoma has rarely been reported. A 61-year-old Caucasian woman initially presented with progressive fatigue, exophthalmos, and thyroid function tests within normal limits. She underwent thyroidectomy, was found to have two incidental papillary thyroid microcarcinomas, and received radioactive iodine ablation to eliminate thyroid antigen. In addition to following her eye disease, TSH-receptor antibodies, thyroid stimulating immunoglobulins, and serum thyroglobulin measurements were recorded, demonstrating no evidence of thyroid cancer at four-year follow-up. At first, she had mild GO, developing into moderate-to-severe GO, and at 4 years she had Hertel measurements of 20 mm in both eyes. This report underscores the difficulty of managing GO even when thyroid function is normal(ized) and thyroid antigen exposure has been minimized. In addition, it illustrates why antithyroidal antibodies should be considered in cases of concomitant papillary thyroid cancer, as thyroid cells can be stimulated not only by TSH but also by TSH-receptor stimulating antibodies.
    Hormones (Athens, Greece) 04/2012; 12(2):298-304. DOI:10.14310/horm.2002.1414 · 1.24 Impact Factor
  • Poyan Rafiei, Vani Vijayakumar
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    ABSTRACT: PURPOSE/AIM To understand the pathophysiology of various neuroendocrine tumors (NET) and to review the current radiopharmaceuticals used in nuclear medicine for imaging neuroendocrine cells To demonstrate how various radiopharmaceuticals help to localize different sites of NET CONTENT ORGANIZATION Pathophysiology of neuroendocrine tumors Radiopharmaceutical imaging agents: I-123/131 MIBG, In-111 pentetreotide, Ga-68 somatostatin analogs, F-18 FDG, C-11/F-18 DOPA, C-11 5-HTP, Tc-99m (V) DMSA, and F-18 DOPA Various neuroendocrine tumors (each discussed separately): Gastroenteric tumors, Pancreatic neuroendocrine tumors, Neuroendocrine tumors of the lung, Thymic neuroendocrine tumors, Medullary thyroid carcinoma, Merkel cell carcinoma, and Pheochromocytoma/paragangliomas SUMMARY A number of radiopharmaceuticals used to image neuroendocrine tumors rely upon targeting cell surface receptors, transporters, and/or biochemical pathways that differ among the various types of neuroendocrine tumors. Optimizing imaging protocols depends upon the understanding of tumor characteristics and the mechanisms of uptake of each reagent.
    Radiological Society of North America 2011 Scientific Assembly and Annual Meeting; 11/2011
  • Poyan Rafiei, Vani Vijayakumar
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    ABSTRACT: Sarcoidosis is a multisystem granulomatous disorder of unknown etiology that typically affects young adults. Definitive diagnosis requires compatible clinical and radiologic manifestations and histopathologic detection of noncaseating granulomas. In recent years, F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been proposed to play a role in the diagnosis and management of sarcoidosis. Although disseminated sarcoidosis has been reported in nearly all organs including the skin, subcutaneous sarcoidosis is relatively rare with few reports using F-18 FDG PET. We report a case of disseminated sarcoidosis with diffuse subcutaneous nodules demonstrating avid F-18 FDG uptake on PET.
    Clinical nuclear medicine 06/2011; 36(6):e42-4. DOI:10.1097/RLU.0b013e31821739cf · 2.86 Impact Factor
  • Poyan Rafiei, Frederico Souza, Vani Vijayakumar
    Radiology Case Reports 01/2011; 6(1). DOI:10.2484/rcr.v6i1.483
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    ABSTRACT: Diagnosis and management of vertebral metastasis requires a systematic approach to patient identification as well as selection of appropriate therapy. Rapid identification and prompt intervention in the treatment of malignant epidural spinal cord compression (MESCC) is key to maintaining quality of life. This paper provides a series of tools as well as guidance in selecting effective and evidence-based therapy individualized to the specific patient.
    01/2011; 2011:719715. DOI:10.5402/2011/719715
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    ABSTRACT: PURPOSE/AIM: Localization of PA plays a major role for minimally invasive surgery. PA can be detected well with Tc 99m Sestamibi imaging. However, difficulties can occur with associated multinodular goiter, small glands, ectopic parathyroid glands and persisting hyperparathyroidism. Review various imaging modalities in the detection of PA CONTENT ORGANIZATION: • To discuss the clinical presentation of Primary Hyperparathyroidism (PHP) • To review the recent guidelines of managing asymptomatic and symptomatic PHP • To demonstrate the various imaging techniques • To discuss the preoperative and intraoperative gamma probe imaging protocols • To discuss the usefulness of imaging techniques to help minimally invasive surgery • To review imaging techniques in recurrent PHP SUMMARY: Tc 99m Sestamibi imaging is the first imaging modality of choice for preoperative localization of parathyroid adenomas. High frequency ultrasound can be used as a first imaging modality by experienced radiologists, endocrinologists, or surgeons CT, MRI and C11-Methionine PET imaging are reserved for recurrent PHP
    Radiological Society of North America 2010 Scientific Assembly and Annual Meeting; 11/2010
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    Christian A Koch, Vani Vijayakumar
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    ABSTRACT: Objective: Illustrate various endocrine disorders and how these relate to nuclear medicine. Radionuclides play an important role in the diagnosis and therapy of endocrine and neuroendocrine disorders and tumors. In vivo imaging and non-imaging applications in nuclear medicine are most commonly used for disorders of the thyroid, parathyroid, and adrenal glands. 123I- and 131I-MIBG aids in diagnosis and therapy of pheochromocytoma/paraganglioma, neuroblastoma, and neuroendocrine tumors. Combining functional and conventional imaging studies incl. 18F-FDG, 18F-Fluoro-L-DOPA, 18F-Fluorodopamine, 68Ga-DOTATATE and DOTATOC PET/CT, as well as SPECT/CT improves diagnostic sensitivity for detecting endocrine tumors. 18F-Fluoroestriol PET has potential clinical utility not only for patients with breast cancer but also other (endocrine) tumors. Somatostatin analogs are not only helpful for treating patients with endocrine tumors but also for their diagnosis (pituitary, thyroid, breast, lung, GEP-NET, paraganglioma/pheochromocytoma) and for diagnosing Graves’ orbitopathy. This underscores the importance of having multidisciplinary teams from various specialties of medicine (nuclear medicine, radiology, radiation therapy, internal medicine, oncology, endocrinology, gastroenterology, surgery, ENT, neurosurgery, urology, pathology, laboratory medicine, ophthalmology) work together to improve patient care and outcome which will be demonstrated in this lecture.
    World Federation of Nuclear Medicine, Cape Town, South Africa; 09/2010
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    ABSTRACT: PURPOSE/AIM To review the variable Clinical Presentation for Carcinoid tumors To discuss the utility of CT, MRI and Various Nuclear Imaging modalities in the diagnosis To present atypical cases with discussion of rare involvement of the genitourinary tract CONTENT ORGANIZATION Pathophysiology of Carcinoids including the confusion over the nomenclature of similar neuroendocrine tumors To discuss common and rare manifestations including tumors involving the genitourinary system Review Imaging Findings: CT, MRI, Nuclear Medicine Imaging ( In 111 Octreoscan, I123 MIBG, F18 DOPA PET, Ga 68 DOTATOC PET, VIP Receptor Imaging, PET/CT) Show Image and Histopathology Correlation Examples Discuss the treatment options for the disease and associated "Carcinoid Syndrome" SUMMARY 1. Rare carcinoid tumor presentations and locations will be reviewed with case examples. Readers will have a chance to review and understand the role of conventional CT and MRI findings with histopathologic correlation. 2. In 111 Octreoscan is commonly used in the work up. Other promising nuclear medicine imaging modalities include F18 DOPA PET, I 123 M IBG, Ga 68 DOTATOC PET, VIP- Receptor and PET/CT imaging. These exciting new imaging findings will be reviewed.
    Radiological Society of North America 2009 Scientific Assembly and Annual Meeting; 12/2009
  • Radiology Case Reports 10/2009; 4(4). DOI:10.2484/rcr.v4i4.314
  • Southern Society of Clinical Investigation Annual Meeting, New Orleans, LA; 02/2009
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    ABSTRACT: This review provides an update on the management of painful bone metastases, with an emphasis on radionuclide therapy, and introduces oligometastases and quantitative imaging evaluations for clinical trials. The current use of radionuclides, alone and in combination with chemotherapy and radiation therapy for painful bone metastases, is discussed, including toxicity, cost and overall outcomes. Radionuclide therapy is shown to be a useful and cost-effective means of alleviating bone pain in metastatic disease and may be more effective when combined with chemotherapy, bisphosphonates and radiation therapy. Early use of radionuclides in pain therapy may limit cancer progression by inhibiting oligometastases development. Thus, radionuclides can significantly decrease patient morbidity, prolong patient survival, and may decrease the occurrence of new bone metastases. Palliative pain therapy is critical for effectively managing bone metastases, with treatment options including analgesics, external beam radiotherapy, chemotherapy and radionuclides. Radionuclide therapy is underutilized. Recent studies using radionuclides with chemotherapy and bisphosponates, or using newer radionuclides or combinations of radionuclides and treatment paradigms (e.g., higher activities, repetitive or cyclic administration, chemo sensitization, chemo supplementation), are encouraging. A comprehensive, inter-disciplinary clinical approach is needed. Clinical collaborations will optimize radionuclide therapy for pain palliation and increase awareness of its benefits.
    Journal of the National Medical Association 08/2007; 99(7):785-94. · 0.91 Impact Factor
  • Vani Vijayakumar, Elma G Briscoe, Nonko D Pehlivanov
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    ABSTRACT: Persistent abdominal pain after cholecystectomy is not uncommon. Sphincter of oddi dysfunction (SOD) is one of the causes for this entity. However, diagnosing SOD is often difficult. Sphincter of oddi manometry (SOM) is the gold standard. Because it is invasive and needs experienced person to perform, simple noninvasive imaging techniques are needed. Other invasive endoscopic methods also play an important role in difficult cases and before therapeutic intervention. Retrospective review of the charts of postcholecystectomy patients who presented with persistent abdominal pain and underwent quantitative hepatobiliary studies (QHBS) as per Sostre et al scoring protocol and simultaneous endoscopic retrograde cholangiopancreatography (ERCP) with SOM between 2003 and 2004. Additional 6 studies with SOM data that had routine nonscoring hepatobiliary study (HBS) were later identified and were included in the study. A total of 24 HBS studies (22 patients) were identified, 19 performed with scoring (Sostre) and 5 with nonscoring methods. ERCP results were available for 16 patients. SOM results were available for 10 patients. Of the 19 who had Sostre's QHBS, 3 were positive and 16 were negative. All 3 QHBS positive patents also had ERCP with SOM findings of SOD. Of the 16 negative Sostre's QHBS, 8 had ERCP with SOM of which 6 had SOD, 1 had no SOD, and 1 was inconclusive. Eight patients who had negative QHBS/ HBS did not undergo further invasive gastrointestinal procedures and were followed conservatively. The rest of 5 patients with negative HBS had ERCP with SOM findings of biliary and pancreatic SOD. From our limited retrospective review, when QHBS by Sostre's is positive there is good correlation to ERCP with SOM. When negative, the agreement with ERCP with SOM is less. However, correlation of Sostre's QHBS is slightly better than nonscoring HBS. Hence, QHBS by Sostre protocol is a simple, noninvasive, and easy to use initial procedure in the management of postcholecystectomy pain syndromes and when positive can guide the gastrointestinal physicians to proceed to invasive ERCP with SOM with confidence.
    Surgical laparoscopy, endoscopy & percutaneous techniques 03/2007; 17(1):10-3. DOI:10.1097/01.sle.0000213761.63300.53 · 0.94 Impact Factor
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    ABSTRACT: The objective of this study was to evaluate the factors influencing the occurrence of early hypothyroidism after radioiodine treatment of Graves' hyperthyroidism. Of 147 patients with Graves' disease (GD) treated with radioactive I-131 (RAI) in our thyroid clinic between July 2003 and December 2004, 84 were followed at 2 and 4 to 5 months after treatment. The age range was 12 to 75 years and the dosage range in these patients was 7.4 to 29.9 mCi. Twenty-four were males and 60 were females. Factors possibly contributing to post-RAI hypothyroidism are: dosage of I-131, age, gender, size of the gland, initial serum free T4, free T3, thyroid-stimulating hormone (TSH) levels, pretreatment with antithyroid drugs, radioactive iodine uptake, and duration of disease. All patients had low TSH, elevated FT4, and elevated radioactive iodine uptake (RAIU) at 4 and/or 24 hours. Of the 84 patients followed, 46% of the males and 62% of the females became hypothyroid at 4 to 5 months (57% of the total). Twenty-one patients remained hyperthyroid and 14 patients became euthyroid. Multivariate analysis of these 84 patients showed no statistically significant single contributing factor for the development of early hypothyroidism. The early onset of hypothyroidism after RAI in GD is very common (57%) and unpredictable. Thus, after RAI treatment, all patients must be closely monitored for the development of this disorder.
    Clinical Nuclear Medicine 12/2006; 31(11):688-9. DOI:10.1097/01.rlu.0000242213.26839.20 · 2.86 Impact Factor
  • Ramadass Satya, Vani Vijayakumar
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    ABSTRACT: A 17-year-old adolescent girl from El Salvador presented to the emergency room (ER) with severe abdominal pain associated with one episode of nausea and vomiting. The pain that started 5 days earlier was sharp in nature and epigastric in location with radiation to back and was relieved by half a tablet of Vicodin. The patient has a history of intermittent epigastric pain for the past 2 years and was treated for Helicobacter pylori for 1 year. In the ER, the serum chemistry demonstrated elevated amylase. Further workup with abdominal ultrasonography (US), computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and hepatobiliary scintigraphy confirmed a type IV-a choledochal cyst with intra- and extrahepatic dilation of bile ducts. We report an unusual acute abdomen presentation of type IV-a choledochal cyst in a 17-year-old young adult from El Salvador.
    Emergency Radiology 11/2006; 13(1):39-41. DOI:10.1007/s10140-006-0515-7

Publication Stats

123 Citations
74.82 Total Impact Points

Institutions

  • 2014
    • Louisiana State University Health Sciences Center New Orleans
      New Orleans, Louisiana, United States
  • 2011–2014
    • University of Mississippi Medical Center
      • • Department of Radiation Oncology
      • • Department of Radiology
      Jackson, Mississippi, United States
  • 2010
    • University of Mississippi
      Mississippi, United States
  • 2007
    • University of California, Davis
      Davis, California, United States
  • 2004–2007
    • University of Texas Medical Branch at Galveston
      • Department of Radiology
      Galveston, TX, United States
  • 2005–2006
    • Texas A&M University - Galveston
      Galveston, Texas, United States
  • 1994
    • University of Chicago
      Chicago, Illinois, United States
  • 1991–1993
    • Saint Michael's Medical Center
      Newark, New Jersey, United States
  • 1992
    • Abbott Laboratories
      North Chicago, Illinois, United States