Myles Todd Taffel

George Washington University, Washington, Washington, D.C., United States

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Publications (6)6.22 Total impact

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    ABSTRACT: The ampulla of Vater is an important anatomic landmark where the common bile duct and main pancreatic duct converge in the major duodenal papilla. Imaging evaluation of the ampulla and periampullary region poses a unique diagnostic challenge to radiologists because of the region's complex and variable anatomy and the variety of lesions that can occur. Lesions intrinsic to the ampulla and involved segment of the biliary tree can be neoplastic, inflammatory, or congenital. Neoplastic lesions include ampullary adenocarcinomas and adenomas, which often are difficult to differentiate, as well as pancreatic or duodenal adenocarcinomas, pancreatic neuroendocrine tumors, and cholangiocarcinomas. Ultrasonography (US), computed tomography, magnetic resonance (MR) imaging, and MR cholangiopancreatography are commonly used to evaluate this region. Endoscopic retrograde cholangiopancreatography or endoscopic US examination may be necessary for more definitive evaluation. Periampullary conditions in the duodenum that may secondarily involve the ampulla include neoplasms, duodenitis, duodenal diverticula, and Brunner's gland hyperplasia or hamartomas. Because these lesions can exhibit a wide overlap of imaging features and subtle or nonspecific imaging findings, diagnosis is made on the basis of patient age, clinical history, and imaging and laboratory findings. Given the complexity of imaging evaluation of the ampulla and periampullary region, it is essential for radiologists to understand the variety of lesions that can occur and recognize their imaging characteristics. ©RSNA, 2014.
    Radiographics 05/2014; 34(3):624-41. DOI:10.1148/rg.343125191 · 2.60 Impact Factor
  • Myles T Taffel · Nadia J Khati · Nabila Hai · Vahid Yaghmai · Paul Nikolaidis ·
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    ABSTRACT: Mesenteric abnormalities are often incidentally discovered on cross-sectional imaging performed during daily clinical practice. Findings can range from the vague "misty mesentery" to solid masses, and the possible etiologic causes encompass a wide spectrum of underlying pathologies including infectious, inflammatory, and neoplastic processes. Unfortunately, the clinical and imaging findings are often non-specific and may overlap. This article discusses the various diseases that result in mesenteric abnormalities. It provides a framework to non-invasively differentiate these entities, when possible.
    Abdominal Imaging 03/2014; 39(4). DOI:10.1007/s00261-014-0113-1 · 1.63 Impact Factor
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    ABSTRACT: The discovery of an incidental adrenal mass (adrenal incidentaloma) continues to rise with the increasing use of cross-sectional imaging. Although most adrenal lesions are benign and asymptomatic, radiologists should guide evaluation of these lesions, whether benign or malignant. This article reviews the various imaging techniques used to evaluate adrenal masses and their relative strengths and weaknesses. It focuses on the most prevalent adrenal pathologies and their typical imaging characteristics, and concludes with a brief discussion of developing techniques, including diffusion-weighted imaging and dual-energy CT.
    Radiologic Clinics of North America 03/2012; 50(2):219-43, v. DOI:10.1016/j.rcl.2012.02.009 · 1.98 Impact Factor
  • Nabila Hai · Myles Todd Taffel · Nadia Juliet Khati · Paul Nikolaidis · Vahid Yaghmai ·
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    ABSTRACT: PURPOSE/AIM The mesentery can host a multitude of pathologies. While rare, these lesions can have a wide overlap in imaging features and often present with non-specific imaging findings. Furthermore, pseudolesions often occur and can be difficult to distinguish from true pathology. This interactive exhibit will provide a case based review of the mesenteric lesions and their imaging features. Salient clinical aspects of each pathology will be discussed to help aid in differential diagnosis construction. CONTENT ORGANIZATION Using case based/interactive questions, the following will be reviewed: • Mesenteric Anatomy • Infection such as tuberculosis & MAI • Malignancies such as desmoid tumors and metastatic disease • Inflammatory conditions such as sclerosing mesenteritis • Trauma • Pseudolesions such as mesenteric edema SUMMARY This exhibit will provide a case based interactive review of the anatomy of the mesentery and the pathologies that occur in this area. Through this exhibit, the reviewer will become aware of the clinical aspects that can help differentiate mesenteric pathologies.
    Radiological Society of North America 2012 Scientific Assembly and Annual Meeting;
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    ABSTRACT: PURPOSE/AIM Imaging plays a significant role in the diagnosis of adrenal lesions, both benign and malignant. While common entities such as adenomas and metastases are frequently encountered, there are numerous additional lesions that may occur in the adrenal gland that may pose a significant diagnostic challenge. This exhibit will provide an overview of the imaging features and associated pathology of a wide variety of adrenal lesions, with an emphasis on the unusual. CONTENT ORGANIZATION • Introduction: Brief review of normal adrenal anatomy and physiology • Review of diagnostic modalities with emphasis on CT and MR, including more recent advances • Unusual benign and neoplastic lesions (including ACTH-independent macronodular adrenal hyperplasia (AIMAH), hemangioma, ganglioneuroma, schwannoma, adult neuroblastoma, oncocytic adrenocortical neoplasms, sarcomas, rare metastases) • Inflammatory and infectious processes (including TB, histoplasmosis, paracoccidiomycosis) • Cysts, hemorrhage and hemorrhagic lesions • Collision tumors SUMMARY This exhibit is an overview of a wide spectrum of adrenal pathology, with an emphasis on uncommonly encountered and challenging lesions.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting;
  • Myles Todd Taffel · Sunny C. Rhee · Shahriar Haji-Momenian · Paul Nikolaidis ·
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    ABSTRACT: PURPOSE/AIM The purpose of this exhibit is: 1. Discuss the differences in structure and dosing of common MRI contrast agents used in abdominal imaging and how they affect imaging 2. Review general concepts of intravenous contrast kinetics 3. Discuss techniques to optimize contrast timing CONTENT ORGANIZATION CONTENT ORGANIZATION •MRI Contrast in 2013: A Big Business •Contrast Pharmacokinetics/Relaxivity •Post contrast imaging techniques •Agent Comparison with Diagrams: What does the literature say? (special attention to Magnevist/Multihance/Gadovist/Eovist) •Agent selection for hepatic imaging •Future uses SUMMARY MRI contrast is a multi-billion dollar business worldwide. As health care reimbursements decline, it will be imperative to understand the relative diagnostic value of the many gadolinium contrast agents that are available for abdominal MR imaging (many of which are off-label). This presentation will discuss the relative strengths and weaknesses of various agents. It will provide a review of the various gadolinium contrast agents, and how their molecular structure, stability, relaxitivity, and excretion impact the detection and characterization of abdominal pathology. The presentation will also discuss contrast kinetics and techniques to optimize post contrast imaging.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting;