Aaron W.P. Maxwell

• Doctor of Medicine
• Professor (Assistant) at Brown University

Enteral feeding plays a vital role for patients who are unable to meet their nutritional needs through oral intake, providing benefit to those with conditions such as inflammatory bowel disease, postsurgical recovery, chronic dysphagia, dysfunctional gastrointestinal tract, and critical illness. The role of interventional radiologists in enteral ac...

Purpose To evaluate the performance of a software algorithm developed to streamline microwave liver ablation parameter selection and to compare performance of this algorithm to that of experienced interventional radiologists. Methods Patients who underwent microwave ablation for treatment of liver tumors were retrospectively identified. An automat...

Purpose: To evaluate various Segmental Anything Model (SAM) prompt strategies across four lesions datasets and to subsequently develop a reinforcement learning (RL) agent to optimize SAM prompt placement. Materials and Methods: This retrospective study included patients with four independent ovarian, lung, renal, and breast tumor datasets. Manual s...

To predict survival and tumor recurrence following image-guided thermal ablation (IGTA) of lung tumors segmented using a deep learning approach. A total of 113 patients who underwent IGTA for primary and metastatic lung tumors at a single institution between January 1, 2004 and July 14, 2022 were retrospectively identified. A pretrained U-Net model...

To evaluate the relationship between prospectively generated ablative margin estimates and local tumor progression (LTP) among patients undergoing microwave ablation (MWA) of small renal masses (SRMs). Between 2017 and 2020, patients who underwent MWA for SRM were retrospectively identified. During each procedure, segmented kidney and tumor shapes...

Background: Treatment options for patients with interstitial lung disease (ILD) who develop stage I-II non-small cell lung cancer (NSCLC) are severely limited, since surgical resection, radiation, and systemic therapy are associated with significant morbidity and mortality. Objective: The aim of this study was to evaluate the safety and efficacy of...

Interventional oncology is a rapidly growing field with advances in minimally invasive image-guided local-regional treatments for hepatocellular carcinoma (HCC), including transarterial chemoembolization, transarterial radioembolization, and thermal ablation. However, current standardized clinical staging systems for HCC are limited in their abilit...

Simple Summary The association between hypoxia, cancer aggressiveness and decreased therapeutic response is well-established. With a significant body of evidence suggesting that tumor hypoxia is a poor prognostic indicator, it is important to identify and quantify the presence and magnitude of hypoxia within the tumor microenvironment. In this revi...

Objective: To examine whether incorrect AI results impact radiologist performance, and if so, whether human factors can be optimized to reduce error. Methods: Multi-reader design, 6 radiologists interpreted 90 identical chest radiographs (follow-up CT needed: yes/no) on four occasions (09/20-01/22). No AI result was provided for session 1. Sham...

Fire-prone landscapes found throughout the world are increasingly managed with prescribed fire for a variety of objectives. These frequent low-intensity fires directly impact lower forest strata, and thus estimating surface fuels or understory vegetation is essential for planning, evaluating, and monitoring management strategies and studying fire b...

Hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (CRCLM) are leading causes of death worldwide, with therapeutic options limited to surgical resection and trans-arterial chemoembolization (TACE). TACE is a minimally-invasive approach to induce cancer cell death through a local hypoxia-dependent mechanism, and intrahepatic cathe...

Our Laboratory was established in 1994 at Univ. of Pennsylvania. Lab members demonstrated initial competencies by performing cell culture, western blots, immunofluorescence, and flow cytometry showing induction of p53/p21(WAF1) in cells treated with chemotherapy. Years later, our Laboratory of Translational Oncology & Experimental Cancer Therapeuti...

This study evaluated the feasibility of measuring patient recovery following locoregional therapies (LRT) using a wearable activity tracker (WAT). Twenty adult cancer patients were provided with a WAT device to wear for a minimum of seven days prior to their procedure (baseline) and for up to 30 days after their procedure (recovery). Daily step cou...

Fire-prone landscapes found throughout the world are increasingly managed with prescribed fire for a variety of objectives. These frequent low-intensity fires directly impact lower forest strata, and thus estimating surface fuels or understory vegetation is essential for planning, evaluating, and monitoring management strategies and studying fire b...

Introduction: E-cigarettes have engendered a great deal of controversy within the public health and medical communities. Methods: Two cross-sectional surveys were administered. First, patients at an annual lung cancer screening appointment who self-identified as former smokers were asked about strategies for achieving and maintaining smoking cessa...

Purpose: To determine how particle density affects dose distribution and outcomes after lobar radioembolization. Methods: Matched pairs of patients, treated with glass versus resin microspheres, were selected by propensity score matching (114 patients), in this single-institution retrospective study. For each patient, tumor and liver particle de...

Background: Transbronchial microwave ablation (MWA) is a promising novel therapy. Despite advances in bronchoscopy and virtual navigation, real time image guidance of probe delivery is lacking, and distal maneuverability is limited. Cone-beam computed tomography (CBCT) based augmented fluoroscopy guidance using steerable sheaths may help overcome...

Tumor cells upregulate myriad proteins that are important for pH regulation, resulting in the acidification of the extracellular tumor microenvironment (TME). Abnormal pH is known to dampen immune function, resulting in a worsened anti-tumor immune response. Understanding how extrinsic alterations in pH modulate the interactions between immune cell...

Tumor cells upregulate a plethora of proteins that are important for pH regulation, resulting in the acidification of the extracellular tumor microenvironment. Abnormal pH is known to dampen immune function, resulting in a worsened anti-tumor immune response. Understanding how alterations in pH modulate the interactions between immune cells and tum...

Purpose To develop and characterize a porcine model of liver cancer that could be used to test new locoregional therapies. Materials and Methods Liver tumors were induced in 18 Oncopigs (transgenic pigs with Cre-inducible TP53R167H and KRASG12D mutations) by using an adenoviral vector encoding the Cre-recombinase gene. The resulting 60 tumors were...

Tumor cells upregulate myriad proteins that are important for pH regulation, resulting in the acidification of the extracellular tumor microenvironment (TME). Abnormal pH is known to dampen immune function, resulting in a worsened anti-tumor immune response. Understanding how extrinsic alterations in pH modulate the interactions between immune cell...

Background Preclinical testing of new locoregional therapies for pancreatic cancer has been challenging, due to the lack of a suitable large animal model. Purpose To develop and characterize a porcine model of pancreatic cancer. Unlike small animals, pigs have similar physiology, drug dosing, and immune response to humans. Locoregional therapy in...

Purpose To determine the effects of a thermal accelerant gel on temperature parameters during microwave liver ablation. Materials and Methods Sixteen consecutive liver ablations were performed in 5 domestic swine under general anesthesia with (n = 8) and without (n = 8) administration of thermal accelerant gel. Ablation zone temperature was assess...

Background Thermal ablation of cancers may be associated with high rates of local tumor progression. A thermal accelerant gel has been developed to improve the transmission of microwave energy in biologic tissues with the aim of enlarging the thermal ablation zone. Purpose To determine the effects of a thermal accelerant gel on microwave ablation z...

Background and purpose Paraclinoid aneurysms are commonly noted as incidental findings by computed tomography angiography (CTA), and there exists disagreement in the literature as to which patient and aneurysm characteristics predict subsequent rupture. This question is of particular significance given the complex anatomy of the paraclinoid region...

Purpose: To determine diagnostic yield of renal biopsies performed in patients referred for image-guided tumor ablation (IGTA) and the frequency with which biopsy results would have obviated the need for subsequent ablation. Materials and methods: Retrospective review of an internal ablation database of a single institution revealed 401 consecut...

620 Background: Existing data suggest that percutaneous renal mass ablation offers favorable rates of disease control with lower cost and fewer complications relative to surgical interventions. Despite increasing utilization, little is known about changes in practice patterns and patient selection over time as new technologies have emerged and indi...

Objectives To evaluate the rate of short-term complications associated with microwave ablation of lung tumors located near the heart. Methods This HIPAA-compliant study was performed with a waiver for informed consent. Patients who underwent microwave ablation of lung tumors located 10 mm or less from the heart were identified by retrospective char...

Objectives: To investigate the effects of a novel cesium-based thermal accelerant (TA) agent on ablation zone volumes following in vivo microwave ablation of porcine liver and skeletal muscle, and to correlate the effects of TA with target organ perfusion. Materials & Methods: This prospective study was performed following institutional animal care...

Abstract The primary challenge in thermal ablation of liver tumors (eg hepatocellular carcinoma and hepatic colorectal cancer) is the relatively high recurrence rate (~ 30%) for which incomplete ablation at the periphery of the tumor is the most common reason. In an attempt to overcome this, we have developed a novel thermal accelerant (TA) agen...

Purpose To evaluate the performance of the radius, exophytic or endophytic, nearness to collecting system or sinus, anterior or posterior, and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomic classification (PADUA) scoring systems and other tumor biometrics for prediction of local tumor...

Purpose: To evaluate outcomes in a small cohort of patients with local or disseminated small-cell lung cancer (SCLC) who received percutaneous thermal ablation therapy. Materials and methods: Ten biopsy-proven SCLC tumors in 9 consecutive patients (5 men, 4 women; average age, 73.8 y ± 12.4) were retrospectively evaluated. Average tumor sizes we...

We report the case of a 63-year-old female undergoing evaluation of symptomatic anemia, gastroesophageal reflux disease, and abdominal pain. After a thorough diagnostic work-up, a large, ulcerated mass was identified in the patient’s stomach, and surgical pathology in combination with molecular analysis yielded a diagnosis of primary extraskeletal...

To characterize the frequency of identification, clinical importance, and concordance in interpretation of incidental abdominopelvic findings identified on routine lumbar spinal MRI using supplemental expanded field-of-view (FOV) coronal imaging. All lumbar spinal MRI reports over a 12-month period were retrospectively reviewed for the presence of...

To assess the diagnostic performance of computed tomography (CT)-guided transthoracic needle aspiration biopsy (TNAB) in the evaluation of persistent subsolid lung lesions. A retrospective review of all CT-guided TNABs performed at a single institution from January 2002 to November 2012 was conducted to identify patients with persistent subsolid lu...

PURPOSE Radiologic errors are common and primarily represent missed findings. Errors in interpretation occur with less frequency, but are potentially more straightforward to remediate because they result from the faulty analysis of appropriately identified findings. The purpose of this study was to analyze such errors and characterize potentially c...

Background: Despite pharmacological and surgical interventions, some children with periventricular nodular heterotopia (PNH) remain refractory to treatment, which suggests more diffuse pathology potentially involving perilesional white matter. Objective: The purpose of this study was to evaluate MR diffusion tensor imaging (MRDTI) metrics within...