Kartik S Jhaveri

University of Toronto, Toronto, Ontario, Canada

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Publications (64)172.78 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: 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.
    American Journal of Roentgenology 10/2015; DOI:10.2214/AJR.14.14065 · 2.73 Impact Factor
  • Kartik S Jhaveri ·

    Cancer Imaging 10/2015; 15(Suppl 1):O18. DOI:10.1186/1470-7330-15-S1-O18 · 2.07 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the diagnostic performance of chemical-shift MRI in the differentiation of clear cell renal cell carcinoma (RCC) from minimal-fat angiomyolipoma (AML) and non-clear cell RCC. In this retrospective study, 97 patients with solid renal tumors without macroscopic fat and with a pathologic diagnosis of clear cell RCC (n = 40), non-clear cell RCC (n = 31), or minimal-fat AML (n = 26) who had undergone renal chemical-shift MRI were included. Size, location, morphology, and signal intensity (SI) of the tumors and the contralateral normal kidneys on T2-weighted and in-phase and opposed-phase images were recorded by readers blinded to the pathology. Percentage tumor-to-renal parenchymal SI drop (percentage SI drop) was calculated and correlated to tumor histology. The statistical analysis was done using Kruskal-Wallis, one-way ANOVA, chi-square, and Fisher exact tests. The percentage SI drop was significantly higher in clear cell RCC compared with non-clear cell RCC and minimal-fat AML (p < 0.001). Percentage SI drop of greater than 20% had 57.5% sensitivity, 96.5% specificity, and 92% positive predictive value (PPV); and percentage SI drop greater than 29% had 40% sensitivity and 100% specificity for diagnosis of clear cell RCC within the cohort of clear cell RCC, minimal-fat AML, and non-clear cell RCC. A significant proportion of minimal-fat AML (46.2%) displayed homogeneous low T2-weighted SI as opposed to clear cell RCC (5%) and non-clear cell RCC (29%) (p < 0.001). The percentage SI drop on chemical-shift MRI had high specificity and moderate sensitivity in predicting clear cell RCC over non-clear cell RCC and minimal-fat AML. A percentage SI drop greater than 20% in a renal mass without macroscopically visible fat has high PPV for clear cell RCC over minimal-fat AML and non-clear cell RCC. Among morphologic features, homogeneous low T2 SI favors minimal-fat AML over RCC.
    American Journal of Roentgenology 07/2015; 205(1-1):W79-86. DOI:10.2214/AJR.14.13245 · 2.73 Impact Factor
  • Kartik S Jhaveri · Hooman Hosseini-Nik ·
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    ABSTRACT: MRI is the modality of choice for rectal cancer staging. The high soft-tissue contrast of MRI accurately assesses the extramural tumor spread and relation to mesorectal fascia and the sphincter complex. This article reviews the role of MRI in the staging and treatment of rectal cancer. The relevant anatomy, MRI techniques, preoperative staging, post-chemoradiation therapy (CRT) imaging, and tumor recurrence are discussed with special attention to recent advances in knowledge. MRI is the modality of choice for staging rectal cancer to assist surgeons in obtaining negative surgical margins. MRI facilitates the accurate assessment of mesorectal fascia and the sphincter complex for surgical planning. Multiparametric MRI may also help in the prediction and estimation of response to treatment and in the detection of recurrent disease.
    American Journal of Roentgenology 07/2015; 205(1-1):W42-55. DOI:10.2214/AJR.14.14201 · 2.73 Impact Factor
  • Kartik Jhaveri ·

    Journal of Magnetic Resonance Imaging 04/2015; 41(4). DOI:10.1002/jmri.24622 · 3.21 Impact Factor
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    ABSTRACT: OBJECTIVE. This systematic review presents evidence-based consensus statements as reported by a multidisciplinary expert panel (six abdominal radiologists, four hepatobiliary surgeons, and two hepatologists) regarding the use of gadoxetic acid for liver MRI. CONCULSION. Although this review highlights the incremental diagnostic value of hepatobiliary phase imaging with gadoxetic acid-enhanced liver MRI in multiple clinical scenarios, there remains a need for further impact studies for some clinical applications, such as hepatocellular carcinoma in cirrhosis.
    American Journal of Roentgenology 04/2015; 204(204):498-509. DOI:10.2214/AJR.13.12399 · 2.73 Impact Factor

  • Advances in Molecular Imaging 01/2015; 05(03):49-60. DOI:10.4236/ami.2015.53005
  • Kartik S. Jhaveri · Hooman Hosseini-Nik ·
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    ABSTRACT: Cholangiocarcinomas are the second most common primary hepatobiliary tumors after hepatocellular carcinomas. They can be categorized either based on their location (intrahepatic/perihilar/extrahepatic distal) or their growth characteristics (mass-forming/periductal-infiltrating/intraductal) because they exhibit varied presentations and outcomes based on their location and or pattern of growth. The increased risk of cholangiocarcinoma in PSC necessitates close surveillance of these patients by means of imaging and laboratory measures; and because currently surgical resection is the only effective treatment for cholangiocarcinoma, the need for accurate pre-operative staging and assessment of resectability has emphasized the role of high quality imaging in management. Today magnetic resonance imaging (MRI) is the modality of choice for detection, pre-operative staging and surveillance of cholangiocarcinoma. J. Magn. Reson. Imaging 2014.
    Journal of Magnetic Resonance Imaging 11/2014; 42(5). DOI:10.1002/jmri.24810 · 3.21 Impact Factor
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    Article: MR imaging
    Kartik Jhaveri ·

    Cancer imaging : the official publication of the International Cancer Imaging Society 10/2014; 14(Suppl 1):O5-O5. DOI:10.1186/1470-7330-14-S1-O5 · 2.07 Impact Factor
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    ABSTRACT: Objective: Inflammatory hepatocellular adenoma (HCA) is a recently categorized entity of hepatocellular neoplasms. We investigated whether gadoxetic acid-enhanced MRI can distinguish inflammatory HCA from focal nodular hyperplasia (FNH). Materials and methods: From January 1, 2009, through January 1, 2013, gadoxetic acid-enhanced MRI examinations from two institutions were reviewed for HCA, with specific histologic features of inflammatory HCA. Biopsy and resection slides were reviewed, and immunohistochemistry for glutamine synthetase was performed in a subset to confirm the initial diagnosis. Results: A total of 10 possible cases of inflammatory HCA were identified in the pathology database. On the basis of glutamine synthetase staining performed for this study, three cases were rediagnosed as FNH and thus were excluded from the study. Therefore, a total of seven patients with inflammatory HCA were identified. On gadoxetic acid-enhanced MRI, four of these patients had classic features of FNH (group A, FNH mimics), and three had imaging features suggestive of HCA (group B, typical inflammatory HCA). Imaging features that were considered diagnostic of FNH included isointense or minimal T2 hyperintensity, arterial enhancement, and diffuse hyperintensity on hepatobiliary phase. Three of the four patients with FNH mimics had slides available for pathologic rereview, and the diagnosis of inflammatory HCA was supported by glutamine synthetase immunohistochemistry findings. The pathology reports of the remaining four cases were rereviewed and were also found to have features consistent with inflammatory HCA. Conclusion: Inflammatory HCA can mimic FNH on MRI, including hepatobiliary phase hyperintensity. Moreover, conventional pathology using histopathology alone may lead to misclassification of inflammatory HCA.
    American Journal of Roentgenology 07/2014; 203(4):W1-W7. DOI:10.2214/AJR.13.12251 · 2.73 Impact Factor
  • Elizabeth Furey · Kartik S Jhaveri ·
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    ABSTRACT: MR imaging plays a key role in staging evaluation of rectal cancer. The cornerstone of staging MR involves high-resolution T2 imaging orthogonal to the rectal lumen. The goals of MR staging are identification of patients who will benefit from neoadjuvant therapy prior to surgery to minimize postoperative recurrence and planning of optimal surgical approach. MR provides excellent anatomic visualization of the rectum and mesorectal fascia, allowing for accurate prediction of circumferential resection margin status and tumor stage. MR has an evolving role for the evaluation of neoadjuvant treatment response, further triaging optimal patient treatment and surgical approach.
    Magnetic resonance imaging clinics of North America 05/2014; 22(2):165-190. DOI:10.1016/j.mric.2014.01.004 · 0.99 Impact Factor

  • The Journal of Urology 04/2014; 191(4):e110. DOI:10.1016/j.juro.2014.02.448 · 4.47 Impact Factor

  • European Urology Supplements 04/2014; 13(1):e319. DOI:10.1016/S1569-9056(14)60314-6 · 3.37 Impact Factor
  • Ajay Tokala · Korosh Khalili · Ravi Menezes · Gideon Hirschfield · Kartik S Jhaveri ·
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    ABSTRACT: Objective: The purpose of this study was to perform a retrospective MRI-based comparative analysis of the morphologic patterns of bile duct disease in IgG4-related systemic disease (ISD, also called autoimmune pancreatitis) compared with primary sclerosing cholangitis (PSC) and the autoimmune liver diseases autoimmune hepatitis and primary biliary cirrhosis. Materials and methods: This study included 162 consecutively registered patients (47 with ISD, 73 with PSC, and 42 with autoimmune liver diseases). Two abdominal radiologists retrospectively reviewed MR images in consensus. Imaging findings on the bile ducts, liver, pancreas, and other organs were analyzed to establish disease patterns. Results: ISD was associated with contiguous thickening of intrahepatic and extrahepatic bile ducts (p<0.001), pancreatic parenchymal abnormalities (p<0.001), renal abnormalities (p<0.001), and gallbladder wall thickening (p<0.03). The severity of common bile duct wall thickness was significantly different in ISD (p<0.001). The mean single wall thickness in the ISD group was 3.00 (SD, 1.47) mm, in the PSC group was 1.89 (SD, 0.73) mm, and in the autoimmune liver disease group was 1.80 (SD, 0.67) mm. PSC was associated with liver parenchymal abnormalities (p<0.001). We did not find statistical significance between the three groups in location (p=0.220) or length (p=0.703) of extrahepatic bile duct strictures, enhancement of bile duct stricture (p=0.033), upper abdominal lymphadenopathy, or retroperitoneal fibrosis. Although presence of intrahepatic bile duct stricture was statistically significant when all three groups were compared, it was not useful for differentiating ISD from PSC. Conclusion: The presence of continuous as opposed to skip disease in the bile ducts, gallbladder involvement, and single-wall common bile duct thickness greater than 2.5 mm supports a diagnosis of ISD over PSC. ISD and PSC could not be differentiated on the basis of location and length of common bile duct stricture.
    American Journal of Roentgenology 03/2014; 202(3):536-43. DOI:10.2214/AJR.12.10360 · 2.73 Impact Factor
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    ABSTRACT: Objective: The purpose of this study is to evaluate the interval growth, tumor recurrence, and metastatic disease occurrence of cystic renal cell carcinoma (RCC). Materials and methods: Pre-and posttreatment imaging of 47 histologically proven cystic RCCs, with at least 6 months of pretreatment imaging monitoring or at least 2 years of posttreatment imaging follow-up, or both, was retrospectively reviewed. Tumor morphologic features, preoperative growth, histologic typing and grading, and the incidence of tumor recurrence or metastasis were evaluated. Growth rate of tumors were compared among various histologic subtypes and Fuhrman grades. Results: Of 47 tumors, 27 (57.5%) were clear cell RCCs, 12 (25.5%) were multilocular RCCs, and eight (17%) were papillary cystic RCCs. Overall, 26 (55.3%) tumors were graded as Fuhrman grade 2, 17 (36.1%) were Fuhrman grade 1, and one tumor was Fuhrman grade 3. Of the 26 tumors with a minimum of 6 months of pretreatment imaging monitoring, 19 (73%) did not show a significant increase in tumor size. The differences in mean growth among the Fuhrman grades and different subtypes were not statistically significant. The average duration of posttreatment follow-up was 51 months. There were no local recurrences among the 43 patients who underwent posttreatment imaging, except for one patient who had metastasis at preoperative clinical presentation. Conclusion: Cystic RCCs exhibit slow indolent growth, if any, and show no significant metastatic or recurrence potential, with excellent clinical outcomes. We raise the need for revisiting current imaging protocols that may involve frequent pre-and posttreatment imaging in cystic RCCs.
    American Journal of Roentgenology 08/2013; 201(2):W292-6. DOI:10.2214/AJR.12.9414 · 2.73 Impact Factor
  • Phillip V.P. Tran · Kartik S Jhaveri ·
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    ABSTRACT: Purpose: To assess if a high resolution respiratory triggered inversion recovery prepared GRE sequence (RT) improved image quality and detection of lesions compared with breathhold GRE T1 weighted MR sequence (BH) in the hepatobiliary uptake phase of MR of the liver using gadoxetic acid (Gd-EOB-DTPA). Materials and methods: Thirty-eight consecutive patients from July 2009 to September 2010 who had undergone Gd-EOB-DTPA enhanced liver exams were retrospectively identified. Qualitative assessment performed on reference lesions and background liver by two independent readers. Quantitative assessment performed by one reader. Results: Liver parenchyma signal-to-noise ratio for BH was 90.3 ± 23.9 (mean ± SD) and RT, 106.1 ± 40.4 (P = 0.119). For BH, 320 lesions were detected compared with 257 for RT. Lesion to liver contrast was significantly better on RT sequences (0.26 ± 0.24; mean ± SD) compared with BH sequence (0.21 ± 0.20; P = 0.044). Fifty-seven reference lesions assessed. Both reviewers rated BH better for lesion margin and hepatic vessel sharpness. BH was rated with less artifact (P < 0.05). Lesion to liver contrast on BH was significantly better for one reviewer. Conclusion: BH sequence had better overall image quality than RT in several quantitative and qualitative factors including number of lesions detected and level of artifact.
    Journal of Magnetic Resonance Imaging 03/2013; 37(3). DOI:10.1002/jmri.23864 · 3.21 Impact Factor
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    ABSTRACT: Purpose: To assess Blood Oxygen Level-Dependent (BOLD) Magnetic Resonance Imaging (MRI) for noninvasive preoperative prediction of Microvascular Invasion (MVI) in Hepatocellular Carcinoma (HCC). Materials and methods: In this prospective, institutional review board approved study, 26 patients (21 men and 5 women age range, 34-77 years with mean age of 61 years) with HCC were evaluated preoperatively with liver MRI including baseline and post oxygen (O2) breathing BOLD MRI. Post processing of MRI data was performed to obtain R2* values (1/s) and correlated with histopathological assessment of MVI. Statistical analysis was performed to assess correlation of baseline R2*, post O2 R2* and R2* ratios to presence of MVI in HCC by binary logistic regression analysis. Results: MVI was present in 15/26 (58%) of HCC on histopathology. The mean R2* values ± SD at baseline and post O2 with and without MVI were 35 ± 12, 36 ± 12, 38 ± 10, 42 ± 17. The R2* values between the groups with and without MVI were not significantly different statistically. Conclusion: BOLD MRI is unable to accurately predict MVI in HCC. The noninvasive preoperative MRI detection of MVI in HCC remains elusive.
    Journal of Magnetic Resonance Imaging 03/2013; 37(3). DOI:10.1002/jmri.23858 · 3.21 Impact Factor
  • Kartik S Jhaveri · Mukesh G Harisinghani ·

    Radiologic Clinics of North America 11/2012; 50(6):xi. DOI:10.1016/j.rcl.2012.10.006 · 1.98 Impact Factor
  • Syed Arsalan Raza · Kartik S Jhaveri ·
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    ABSTRACT: Detection of muscle invasion is a critical aspect in management of urinary bladder cancer. MR imaging has the potential and promise of delivering this premise noninvasively. This article reviews the current status of MR imaging in evaluation of bladder cancer. Also discussed are other important neoplastic and nonneoplastic conditions affecting the bladder.
    Radiologic Clinics of North America 11/2012; 50(6):1085-110. DOI:10.1016/j.rcl.2012.08.011 · 1.98 Impact Factor
  • Chris Heyn · Derek Sue-Chue-Lam · Kartik Jhaveri · Masoom A Haider ·
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    ABSTRACT: Advances in MR hardware and pulse sequence design over the years have improved the quality and robustness of MR imaging of the pancreas. Today, MRI is an indispensible tool for studying the pancreas and can provide useful information not attainable with other noninvasive or minimally invasive imaging techniques. In the present review, specific cases are reviewed where the strengths of MRI demonstrate the utility of this imaging modality as a problem solving tool. J. Magn. Reson. Imaging 2012;36:1037-1051. © 2012 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 11/2012; 36(5):1037-51. DOI:10.1002/jmri.23708 · 3.21 Impact Factor

Publication Stats

1k Citations
172.78 Total Impact Points


  • 2006-2015
    • University of Toronto
      • Department of Medical Imaging
      Toronto, Ontario, Canada
  • 2009-2014
    • University Health Network
      • Department of Medical Imaging
      Toronto, Ontario, Canada
  • 2008-2010
    • Mount Sinai Hospital, Toronto
      • Department of Medical Imaging
      Toronto, Ontario, Canada
  • 2006-2010
    • The Princess Margaret Hospital
      Toronto, Ontario, Canada
  • 2002-2004
    • Massachusetts General Hospital
      • Department of Radiology
      Boston, Massachusetts, United States
  • 2001-2003
    • Harvard Medical School
      • Department of Radiology
      Boston, Massachusetts, United States
  • 2000
    • P.D Hinduja National Hospital & Medical Research Centre
      Mumbai, Mahārāshtra, India