Mylene T Truong

NYU Langone Medical Center, New York City, New York, United States

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Publications (74)283.19 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Oncologic therapy is constantly evolving to improve patient outcomes, especially with regard to chemotherapy. The use of combination therapies and development and implementation of molecular targeted therapy lead to iatrogenic conditions that the radiologist must be aware of in interpreting studies of and caring for the oncologic patient. Knowledge of the chemotherapeutic agents and the imaging appearances of associated toxicities can impact patient management and decrease patient morbidity and mortality.
    Radiologic Clinics of North America 09/2014; 52(5):1029-1040. · 1.95 Impact Factor
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    ABSTRACT: Oncologic patients are treated with a combination of chemotherapy, radiation therapy, and surgery. Advances in therapeutic options have greatly improved the survival of patients with cancer. Examples of these advances are newer chemotherapeutic agents that target the cell receptors and advanced radiation therapy delivery systems. It is imperative that radiologists be aware of the variety of imaging findings seen after therapy in patients with cancer. Complications may occur with classic cytotoxic therapies (eg, 5-fluorouracil), usually at higher or prolonged doses or when administered to radiosensitive areas. Newer targeted systemic agents, such as bevacizumab and imatinib, have associated characteristic toxicities because their effects on cells do not depend on dose. Radiation may induce early and late effects in local normal tissues that may be seen at imaging. Imaging findings after chemotherapy include fatty liver, pseudocirrhosis, hepatic veno-occlusive disease, and splenic rupture. Complications of radiation therapy include large and small bowel strictures and radiation-induced hepatitis and tumors. Awareness of the various therapeutic options and knowledge of the spectrum of posttherapeutic complications allows radiologists to provide a comprehensive report that may impact patient management. ©RSNA, 2014.
    Radiographics : a review publication of the Radiological Society of North America, Inc. 07/2014; 34(4):941-961.
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    ABSTRACT: Richter's syndrome (RS) is associated with poor outcome. The prognosis of patients with histologically aggressive chronic lymphocytic leukemia (CLL), HAC, has not been studied. We aimed to correlate 2-Deoxy-2-[(18)F]fluoroglucose/positron emission tomography (FDG/PET) data, histological diagnosis, clinical characteristics and survival in patients with CLL. 332 patients with CLL were histologically classified as: 95 RS, 117 HAC, and 120 histologically indolent CLL (HIC). HAC and RS patients had higher maximum standardized uptake value (SUVmax), more frequent constitutional symptoms, poorer PS, lower hemoglobin and platelets, higher LDH and beta-2-microglobulin. A SUVmax≥10 strongly correlated with mortality (overall survival, OS, 56.7 vs 6.9 months in patients with SUVmax<10 vs ≥10). Survival of patients with RS and HAC was similar among patients with SUVmax<10 or ≥10. SUVmax≥10, PS≥2, bulky disease, and age≥65 were independently associated with shorter OS. In patients undergoing both fine-needle aspiration (FNA) and biopsy, FNA proved diagnostically inadequate in 23%, 29% and 53% of HIC, HAC and RS, respectively. FDG/PET is a useful diagnostic tool in patients with CLL and suspected transformation. Patients with HAC show different characteristics and worse prognosis compared to those with HIC. Patients with different CLL phases, but similar SUVmax have similar outcome. Tissue biopsy should be preferred for diagnosing RS.
    Blood 03/2014; · 9.78 Impact Factor
  • Radiologic Clinics of North America 01/2014; 52(1):85–103. · 1.95 Impact Factor
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    ABSTRACT: PET/CT is widely used in the staging and assessment of therapeutic response in patients with malignancies. Accurate interpretation of PET/CT requires knowledge of the normal physiologic distribution of [18F]-fluoro-2-deoxy-d-glucose, artifacts due to the use of CT for attenuation correction of the PET scan and potential pitfalls due to malignancies that are PET negative and benign conditions that are PET positive. Awareness of these artifacts and potential pitfalls is important in preventing misinterpretation that can alter patient management.
    Radiologic Clinics of North America 01/2014; 52(1):17-25. · 1.95 Impact Factor
  • Radiologic Clinics of North America 01/2014; 52(1):17–25. · 1.95 Impact Factor
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    ABSTRACT: Thoracotomy with lung resection produces postoperative changes that can be challenging for the radiologist. Complications related to anatomic and physiologic changes, infection, and breakdown of surgical anastomoses can significantly increase morbidity and mortality. Prompt and accurate diagnosis of serious postoperative complications is essential.
    Radiologic Clinics of North America 01/2014; 52(1):85-103. · 1.95 Impact Factor
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    ABSTRACT: In oncological imaging, staging with computed tomography (CT) is widely used to determine treatment. Misinterpretation of fluid in pericardial recesses as mediastinal adenopathy can lead to inaccurate clinical staging and inappropriate management. In this review, we describe normal pericardial anatomy and illustrate imaging features to differentiate fluid in pericardial sinuses and recesses from mediastinal adenopathy.
    Clinical radiology 11/2013; · 1.65 Impact Factor
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    ABSTRACT: Cancer patients are a high-risk population for venous thromboembolism (VTE); the natural history of gonadal vein thrombosis (GVT) occurring in cancer patients is not well described in the medical literature. Utilizing a software program the computerized tomographic scan reports of patients at a single cancer center from January 1, 2004 to June 30, 2011 were searched for the term GVT. Patients included in this analysis had a diagnosis of cancer, an isolated GVT (i.e. no evidence of thrombosis at another site), no symptoms referable to the GVT, and at least six months of follow-up information. All subsequent recurrent VTE events were confirmed by imaging studies. 196 cancer patients with GVT were identified. The majority of patients in this analysis had metastatic disease (118, 61.2%) as well as active cancer (167, 85.2%). Twenty patients (10.8%) developed recurrent VTE (median follow-up 14.5months); median time to recurrent VTEs was 5.5months (range 0-19months). When considering only patients with without a recent history of gynecologic surgery, VTE recurrence rates were 14.3%. Active cancer was the only risk factor significantly associated with recurrent VTE (P=0.047). Based upon the patient's risk factors for VTE, treatment of an incidentally detected GVT in cancer patients with anticoagulation, as per guidelines for other VTE sites, may be indicated in certain high risk subgroups, especially those patients with active cancer who have not had prior pelvic surgery.
    Thrombosis Research 10/2013; · 3.13 Impact Factor
  • Seminars in roentgenology 10/2013; 48(4):295-307. · 0.70 Impact Factor
  • Seminars in roentgenology 10/2013; 48(4):323-34. · 0.70 Impact Factor
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    ABSTRACT: OBJECTIVE. Vulvar carcinoma is a rare malignancy, most commonly seen in elderly women. Survival depends on the lymph node status. Lymph node-negative patients have a 5-year survival of 90%, whereas survival drops to about 50% in patients with positive lymph nodes. The purpose of this article is to familiarize the reader with the revised International Federation of Gynecology and Obstetrics (FIGO) staging of vulvar cancer and incorporate it into daily practice when interpreting cross-sectional imaging studies. CONCLUSION. Although vulvar cancer is diagnosed clinically, cross-sectional imaging plays an important complimentary role in staging of the tumor, assessing extent of disease, and selecting operable versus inoperable candidates to ultimately help in decreasing morbidity and increasing survival in these patients.
    American Journal of Roentgenology 06/2013; 200(6):1387-1400. · 2.90 Impact Factor
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    ABSTRACT: Esophageal cancer is among the leading causes of cancer-related deaths worldwide. The management of patients with esophageal cancer is determined to a large extent by patient performance status, location of the primary cancer, and stage of disease at presentation. Multimodality regimens combining neoadjuvant chemotherapy and/or radiotherapy followed by surgery have been increasingly used in suitable candidates with locally advanced cancer. There is substantial morbidity and mortality associated with this treatment strategy, which makes appropriate patient selection important. Endoscopic esophageal ultrasound is the optimal modality to evaluate the local extent of the primary tumor and diagnose locoregional nodal metastasis. Computed tomography is more useful in detecting distant nodal and systemic metastasis. Positron emission tomography/CT is increasingly being used in patient management and improves the accuracy of staging, particularly in the detection of distant nodal and systemic metastatic disease. In this article, we review the role of imaging in the staging, assessment of therapeutic response, and detection of recurrent disease, as well as the evaluation of therapeutic complications in patients with esophageal cancer.
    Abdominal Imaging 05/2013; · 1.91 Impact Factor
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    ABSTRACT: The reversed halo sign is characterised by a central ground-glass opacity surrounded by denser air-space consolidation in the shape of a crescent or a ring. It was first described on high-resolution CT as being specific for cryptogenic organising pneumonia. Since then, the reversed halo sign has been reported in association with a wide range of pulmonary diseases, including invasive pulmonary fungal infections, paracoccidioidomycosis, pneumocystis pneumonia, tuberculosis, community-acquired pneumonia, lymphomatoid granulomatosis, Wegener granulomatosis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. In this article, we present the spectrum of neoplastic and non-neoplastic diseases that may show the reversed halo sign and offer helpful clues for assisting in the differential diagnosis. By integrating the patient's clinical history with the presence of the reversed halo sign and other accompanying radiological findings, the radiologist should be able to narrow the differential diagnosis substantially, and may be able to provide a presumptive final diagnosis, which may obviate the need for biopsy in selected cases, especially in the immunosuppressed population.
    The British journal of radiology 05/2012; 85(1017):1226-35. · 2.11 Impact Factor
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    ABSTRACT: Positron emission tomography (PET)/computed tomographic scanning, using 18F-2-deoxy-D-glucose, complements conventional imaging evaluation of patients with lung cancer. The strength of PET scanning lies in the detection of nodal and extrathoracic metastases. PET scanning is also currently being studied in the assessment of prognosis and therapeutic response and has the potential to alter management of oncologic patients. This review will discuss the role of PET/computed tomographic scanning in the diagnosis, staging, and evaluation of prognosis and treatment response in patients with lung cancer.
    Journal of thoracic imaging 05/2011; 26(2):132-46. · 1.42 Impact Factor
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    ABSTRACT: To assess whether the type of immune suppression in patients with hematologic malignancies affects the appearance of invasive pulmonary aspergillosis (IPA) on computed tomography (CT), we retrospectively reviewed the CT findings of 66 consecutive patients who were diagnosed with hematologic malignancies and IPA and correlated the findings to patients' IPA risk factors. In our study these risk factors included neutropenia (n = 34, 52%), stem cell transplantation (SCT; n = 30, 45%), graft versus host disease (GVHD; n = 22, 33%), and steroid use (n = 29, 44%). Nodular lesions were the most common finding on CT (n = 54, 82% of the entire patient population). These were seen in 74% of neutropenic patients (n = 25, P > 0.07), 87% of patients following SCT (n = 26, P > 0.35), 95% of patients with GVHD (n = 21, P = 0.04)), and 83% of those receiving steroids (n = 24, P > 0.45). The hypodense sign was often seen in patients without GVHD (n = 17, 39%; P = 0.003). Tree-in-bud opacities were often observed in patients who underwent SCT (n = 10, 33%; P = 0.03). Thus, peripheral nodular lesions are the most common initial finding of IPA in patients with hematologic malignancies, regardless of the mechanism of immunosuppression.
    Medical mycology: official publication of the International Society for Human and Animal Mycology 09/2010; 48(6):817-23. · 2.13 Impact Factor
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    ABSTRACT: BACKGROUND AE-941 is a standardized aqueous shark cartilage extract with antiangiogenic properties that has previously been evaluated in phase I and II clinical trials. Our objective was to determine the effect of adding AE-941 to chemoradiotherapy on overall survival of patients with unresectable stage III non-small cell lung cancer (NSCLC). METHODS A randomized, double-blinded, placebo-controlled, phase III clinical trial was designed to test the efficacy of AE-941 in unresectable stage III NSCLC patients who were treated with chemoradiotherapy. Between June 5, 2000, and February 6, 2006, 379 eligible patients were enrolled in community and academic oncology centers across the United States and Canada. In February 2006, the trial was closed to new patient entry before meeting the target sample size because of insufficient accrual. All subjects received induction chemotherapy followed by concurrent chemotherapy with chest radiotherapy. Each participating center administered one of the two chemotherapy regimens, either carboplatin and paclitaxel, or cisplatin and vinorelbine. The primary endpoint was overall survival, and secondary endpoints were time to progression, progression-free survival, tumor response rate, and toxic effects. Event-time distributions were estimated by the Kaplan-Meier method. All statistical tests were two-sided. RESULTS There was no statistically significant difference in overall survival between the chemoradiotherapy plus AE-941 group (n = 188; median survival = 14.4 months, 95% confidence interval = 12.6 to 17.9 months) and the chemoradiotherapy plus placebo group (n = 191; median survival = 15.6 months, 95% confidence interval = 13.8 to 18.1 months) (P = .73). Time to progression, progression-free survival, and tumor response rates were not statistically significantly different between the AE-941 and the placebo groups. No differences between the two groups were observed in common grade 3 or higher toxic effects attributable to chemoradiotherapy. CONCLUSIONS The addition of AE-941 to chemoradiotherapy did not improve overall survival in patients with unresectable stage III NSCLC. This study does not support the use of shark cartilage-derived products as therapy for lung cancer.
    CancerSpectrum Knowledge Environment 06/2010; 102(12):859-65. · 14.07 Impact Factor
  • Mylene T Truong, Bradley S Sabloff, Jane P Ko
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    ABSTRACT: With the increasing use of MDCT, more solitary pulmonary nodules are being detected. Although the majority of these lesions are benign, lung cancer constitutes an important consideration in the differential diagnosis of solitary pulmonary nodules. The goal of management is to correctly differentiate malignant from benign nodules to ensure appropriate treatment. Stratifying patients' risk factors for malignancy, including patient age, smoking history, and history of malignancy, is essential in the management of solitary pulmonary nodules. In terms of radiologic evaluation, obtaining prior films is important to assess for nodule growth. The detection of certain patterns of calcification and stability for 2 years or more have historically been the only useful findings for determining whether a nodule is or is not benign. However, recent technological advances in imaging, including MDCT and PET/CT, have improved nodule characterization and surveillance. For solid nodules, CT enhancement of less than 15 HU and hypometabolism on PET (SUVmax <2.5) favor a benign etiology. Potential pitfalls in nodule enhancement and PET evaluation of solitary pulmonary nodules include infectious and inflammatory conditions. Stratified according to patient risk factors for malignancy and nodule size, recent guidelines for the management of incidentally detected small pulmonary nodules have been useful in decision analysis. An important exception to these guidelines is the evaluation and management of the subsolid nodule. These lesions are not suitable for CT enhancement studies and may show low metabolic activity on PET imaging. Due to their association with bronchioloalveolar carcinoma and adenocarcinoma, subsolid nodules require a more aggressive approach in terms of reassessing serial imaging and/or obtaining tissue diagnosis. As data from the low-dose CT lung cancer screening trials are analyzed and further studies with new imaging techniques are performed, management strategies for the imaging evaluation of the solitary pulmonary nodule will continue to evolve.
    Thoracic Surgery Clinics 02/2010; 20(1):9-23.
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    ABSTRACT: OBJECTIVE: The purpose of this review is to assist interpreting radiologists in becoming familiar with the role of PET/CT in baseline staging and therapeutic response assessment in the management of lymphoma, in becoming aware of imaging pitfalls, and in understanding the natural behavior of lymphoma and the therapeutic options. CONCLUSION: Therapeutic strategies for the management of lymphoma are constantly being refined to improve long-term survival with the lowest risk of toxicity to the patient. PET/CT is accurate for baseline staging and yields important prognostic information for determining the most appropriate initial treatment. Used for evaluation of treatment response, PET/CT can depict residual viable malignant lesions with greater accuracy than can other imaging techniques. The findings thereby influence decisions about the need for additional or alternative treatment.
    American Journal of Roentgenology 01/2010; 194(1):W91-W103. · 2.90 Impact Factor
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    ABSTRACT: Endomyocardial fibrosis is a disorder of the tropical/subtropical regions of the world, of unknown etiology, characterized by the development of restrictive cardiomyopathy involving the ventricles. We report the case of a 65-year-old Brazilian woman with dyspnea and abdominal distension. Delayed contrast enhanced cardiac MRI showed apical obliteration of both ventricles with a lesion in the right ventricle free wall mimicking a mass protruding into the ventricular cavity.
    European Journal of Radiology Extra 01/2010; 73(1).

Publication Stats

2k Citations
283.19 Total Impact Points

Institutions

  • 2014
    • NYU Langone Medical Center
      • Department of Radiology
      New York City, New York, United States
  • 2000–2014
    • University of Texas MD Anderson Cancer Center
      • Division of Diagnostic Imaging
      Houston, Texas, United States
  • 2013
    • University of Texas Medical School
      • Department of Diagnostic and Interventional Imaging
      Houston, Texas, United States