Jeffrey C Mottola

Harvard Medical School, Boston, Massachusetts, United States

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Publications (3)5.06 Total impact

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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; DOI:10.1097/RCT.0000000000000083 · 1.60 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 · 1.73 Impact Factor
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    ABSTRACT: To determine the utility of 3.0-Tesla diffusion-weighted (DW) magnetic resonance imaging (MRI) for focal cystic pancreatic lesion (FCPL) characterization. 55 FCPL (34 IPMN, 5 serous cystadenoma, and 16 inflammatory) were evaluated. Two radiologists reviewed in consensus DW-MRI images. Reference standard was obtained from patient history, cytological and histopathology data, FCPL fluid analysis, and follow-up imaging results. Signal intensity (SI) and apparent diffusion coefficient values (ADC) of FCPL and normal pancreas were measured. FCPL-to-pancreas SI and ADC ratios were also calculated. Qualitatively, 11 of 21 non-mucinous vs. 4 of 34 mucinous lesions appeared hyperintense at b value of 1,000 s/mm(2) (P = 0.02). Three FCPL demonstrated restricted diffusion: all inflammatory. Significant differences in mean ADC between neoplastic vs. non-neoplastic (P = 0.009), and mucinous vs. non-mucinous (P = 0.013) lesions were demonstrated. FCPL-to-pancreas ADC and SI ratios demonstrated significant differences between neoplastic vs. non-neoplastic lesions [ADC, (P = 0.019); SI for b values 750 (P = 0.010) and 1,000 s/mm(2) (P = 0.017)] and mucinous vs. non-mucinous lesions [ADC (P = 0.018); SI for b values 750 (P = 0.013) and 1,000 s/mm(2) (P = 0.015)]. Although mean ADC values and FCPL-to-pancreas SI and ADC ratios may be helpful in differentiating FCPL, characterization of individual FCPL by means of 3.0-Tesla DW-MRI appears limited.
    Abdominal Imaging 04/2011; 37(1):110-7. DOI:10.1007/s00261-011-9737-6 · 1.73 Impact Factor