Aparna Irodi

Background: The treatment of locally advanced unresectable oral cavity cancers (OCC) is challenging, with limited consensus on optimal management and poor outcomes. Our clinical practice identified a subset of unresectable OCC patients who respond favourably to aggressive alternate treatment with chemotherapy and radiotherapy. We propose a systemat...

Thymic epithelial tumours (TETs) are rare and exhibit varied behaviour and prognosis based on their histological subtype, as classified by the World Health Organization (WHO). These subtypes are further categorized into low–risk and high–risk groups. Low– risk thymomas generally allow for complete surgical resection without adjuvant therapy, while...

Background: Bilateral, spontaneous cerebrospinal fluid rhinorrhoea is extremely rare, with only one previous case report (this patient developed contralateral cerebrospinal fluid leakage four years after successful endoscopic repair). We present the first English-language report of simultaneous, bilateral, spontaneous cerebrospinal fluid rhinorrhoe...

PURPOSE There is a lack of literature on treating stage III non–oncogene-driven non–small cell lung cancer (NSCLC) with low-dose immunotherapy in combination with chemotherapy for patients who are not candidates for local therapy up front. MATERIALS AND METHODS We performed an institutional retrospective analysis of patients with stage III non–onc...

Background In this period following the COVID-19 pandemic, there is increasing evidence to indicate the presence of long-term sequelae in individuals who were infected with COVID-19. This study was performed to assess the proportion of CT abnormalities in patients who underwent CT imaging of the thorax at least 4 weeks after the date of RT-PCR conf...

The large number of medical conferences held per year has a significant impact on the environment. Climate change and global warming then lead to deleterious effects on human health. We aim to highlight that it is our responsibility as doctors to promote eco-friendly events and encourage sustainable practices, thus reducing harm to our environment....

Objective: To compare perioperative and oncological outcomes between stapler and manual closure in patients undergoing total laryngectomy for advanced endolaryngeal squamous cell carcinoma. Methods: Patients with advanced endolaryngeal tumours operated between July 2017 and July 2023 were retrospectively dichotomised into stapler closure and man...

Background Nearly 24,000 new cases of oropharyngeal cancers (OPCs) are reported per year in India, constituting 3.9% of cancers in all sites. By 2009, Human papilloma virus (HPV), in particular HPV-16, was established as an etiological factor and even a causative agent in OPCs being associated with up to 70% OPCs. Prior imaging-based studies have d...

Tuberculosis (TB) remains a leading cause of morbidity and mortality worldwide and in India. Immunocompromised individuals, including those with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), cancer, diabetes, or those undergoing immunosuppressive therapy, are at a heightened risk of developing TB, often presenting wi...

Schwannomas are rare benign neurogenic tumours. About 25–45% of extracranial schwannomas are found in the head and neck region. In the head and neck, they can arise from various cranial, peripheral and autonomic nerves. Due to this, they have varied clinical presentations. This retrospective cohort includes 97 patients diagnosed with extra cranial...

This report describes a male in his late 20s who presented with a 2-month history of recurrent haemoptysis and chest pain. A chronic infection, such as tuberculosis, was suspected. He had undergone surgical resection of an intrapericardial hydatid cyst in the past. His blood investigations showed peripheral eosinophilia, and his chest X-ray showed...

Background: Point-of care ultrasound is considered to hold promise in tuberculosis (TB) screening. However, most available abdominal ultrasound data focuses on HIV-infected cohorts and for lung ultrasound (LUS) data is very sparse. We aimed to determine accuracy of lung and abdominal ultrasound in a cohort of presumed TB in a tertiary care hospital...

Background: Tracheobronchopathia osteochondroplastica (TPO) is a rare idiopathic disease involving the tracheobronchial tree. It is mostly an incidental finding with non-specific clinical manifestations. It has typical bronchoscopic, radiological features and biopsy is usually considered non-essential. The study aimed to determine whether biopsy m...

Background Differential diagnosis in radiology is a critical aspect of clinical decision-making. Radiologists in the early stages may find difficulties in listing the differential diagnosis from image patterns. In this context, the emergence of large language models (LLMs) has introduced new opportunities as these models have the capacity to access...

Background: In April 2021, during the peak of the second wave of the COVID-19 pandemic in India, hospitals overflowed with COVID-19 patients, and people hesitated to seek necessary care due to fear of contracting the disease. The UDHAVI helpline was set up by a tertiary care hospital in Vellore with the help of district administration, nongovernmen...

We aimed to compare the demography, clinical profile, histopathology, fungal culture, radiology, surgery performed, medical therapy and outcomes of patients with acute invasive fungal sinusitis seen during the first and second waves of the COVID-19 pandemic by retrospectively reviewing their case records. Of 238 patients, 43(18.1%) presented during...

Background and purpose Radiomics models trained with limited single institution data are often not reproducible and generalisable. We developed radiomics models that predict loco-regional recurrence within two years of radiotherapy with private and public datasets and their combinations, to simulate small and multi-institutional studies and study t...

The recommendations from the Society of Chest Imaging and Interventions expert group comprehensively cover all the aspects of management of hemoptysis, highlighting the role of diagnostic and interventional radiology. The diversity existing in etiopathology, imaging findings, and management of hemoptysis has been addressed. The management algorithm...

Sinonasal tumors are a relatively rare and heterogeneous group of tumors. Owing to their nonspecific presentation and rarity, they can be potentially overlooked resulting in delayed diagnosis and management, and increased patient morbidity. Imaging is crucial for the detection, staging, surgical planning, follow-up as well as surveillance of sinona...

Globally and in India, lung cancer is one of the leading malignancies in terms of incidence and mortality. Smoking and environmental pollution are the common risk factors for developing lung cancer. Traditionally, lung cancer is divided into small cell and nonsmall cell types, with nonsmall cell carcinomas including squamous cell carcinoma, adenoca...

Purpose Usual interstitial pneumonia (UIP) pattern of interstitial lung disease (ILD) can have varied etiology, with connective tissue disease (CTD) being a common known cause. The anterior upper lobe (AUL) sign, exuberant honeycombing (EHC), and straight edge (SE) sign are recently described computed tomography (CT) signs in CTD-related UIP. We te...

Background Malignancy-associated secondary spontaneous pneumothorax (MSSP) has an incidence of 1% with a risk for recurrence of 9.4% reported in association with sarcomas, histiocytoma, malignant thymoma, and cancers of the breast and thyroid. Case presentation We report a series of four patients who presented to us with MSSP associated with pulmo...

Purpose/Objective(s) Delta radiomics which refers to longitudinal changes of radiomic features over time has shown the potential to predict treatment response. However, its role in predicting normal lung toxicity has not been studied extensively. This study evaluates the potential for CBCT based delta radiomics in predicting radiotherapy induced lu...

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of neonatal respiratory distress. We report a case series of four infants with similar radiological dimensions but while two needed surgery, two could be managed conservatively. The clinical presentation of the child and the response to conservative treatment, rather than the radio...

Background: Neoadjuvant chemoradiotherapy (nCRT) has improved the resectability and survival of operable oesophageal squamous cell carcinoma (OSCC). We aimed to study if nCRT for OSCC makes minimally invasive oesophagectomy (MIO) technically more challenging and if the peri-operative and oncological outcomes are acceptable for MIO following nCRT. M...

Context Growing teratoma syndrome (GTS) is a rare entity seen following chemotherapy for metastatic nonseminomatous germ cell tumors, characterized by increase in size of the metastatic deposits, with normal serum tumor markers. Aims In this article, we aim to describe the various clinicoradiological presentations of GTS treated at our center. Desi...

Purpose To determine the diagnostic efficacy of balanced steady-state free precession (bSSFP) and time-of-flight (TOF)-based noncontrast magnetic resonance angiography (NC-MRA) in lower limb peripheral arterial disease (PAD). Material and Methods 10 patients with suspected PAD underwent both NC-MRA (bSSFP and 2D TOF) and contrast-enhanced MR angiog...

Background and purpose: Craniofacial giant cell granulomas are rare lesions with varied appearances on imaging. We aimed to describe the imaging features of giant cell granulomas of the craniofacial bones. Materials and methods: A retrospective analysis of the clinical features and imaging findings of 20 histopathology-proved cases of craniofaci...

Purpose: Excessive accumulation of free fatty acids in the coronary arteries can lead to coronary artery disease (CAD). Quantification of epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) is beneficial to understand its relationship with CAD, hypertension (HT), and diabetes. Material and methods: This retrospective study inclu...

Objective We aimed to study the literature on chronic granulomatous invasive fungal sinusitis to elucidate the changing trends in the management of the disease. Data Sources Using specific keywords, we searched the PubMed, PubMed Central, and Scopus databases over the past 50 years, which yielded 938 articles in the English language. Review Metho...

Purpose Pathological complete response correlates with better clinical outcomes in locally advanced esophageal cancer (LA-EC). However, there is lack of prognostic markers to identify patients in the current setting of neoadjuvant chemoradiotherapy (NACRT) followed by surgery. This study evaluates the utility of mid-treatment diffusion-weighted ima...

Background: Idiopathic pulmonary fibrosis(IPF) is a form of progressive fibrosing interstitial lung disease with a poor prognosis. Pirfenidone is an oral antifibrotic agent used in the treatment of IPF, and it reduces the rate of decline of lung function. However, the tolerable dose and adverse effect profile appear to be different in the Indian po...

Context: Cancer Radiomics is an emerging field in medical imaging and refers to the process of converting routine radiological images that are typically qualitatively interpreted to quantifiable descriptions of the tumor phenotypes and when combined with statistical analytics can improve the accuracy of clinical outcome prediction models. However,...

The diverse etiopathogenesis of pulsatile tinnitus (PT) makes it a difficult condition to diagnose and treat. To describe the clinical features, investigations and diagnosis of patients presenting with pulsatile tinnitus (PT). Retrospective chart review in an otology unit of a tertiary care referral centre. All medical records of patients who had a...

Introduction There is a paucity of real-world data on mycophenolate mofetil/mycophenolate sodium in systemic sclerosis-related interstitial lung disease. Aim To study the efficacy of mycophenolate mofetil/ mycophenolate sodium in systemic sclerosis-related interstitial lung disease. Methods In this single-centre study, clinical, laboratory and im...

PurposeThe study aims to analyse patterns of recurrence following neoadjuvant treatment and surgery in carcinoma oesophagus with an intent to postulate optimal nodal radiation.MethodologyA retrospective review of patients who presented to our centre within a 5-year period (2014–2018), with recurrence following sequential neoadjuvant treatment and r...

Background: Objective of the study was to assess the prevalence of respiratory and related GI morbidity in children who had undergone repair of oesophageal atresia/tracheoesophageal fistula (TEF) in the neonatal period.Methods: Patients operated during the period 2008–2015 were evaluated in 2017 by clinical evaluation, radiological imaging (chest X...

Background: Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary gland cancer with high morbidity and mortality and poor response to treatment. The current options of treatment include radical surgery followed by radiotherapy (RT) with or without chemotherapy. The aim of this study was to analyse the patterns of rec...

Purpose: Primary mediastinal germ cell tumours (PMGCTs) are rare; with limited data available about their outcomes and optimal treatment in the low middle income countries setting. We studied the clinical profile of patients with PMGCT treated at our centre in order to estimate their survival outcomes and to identify prognostic factors affecting t...

Vascular rings and slings are anomalous vascular anatomy that forms a ring or sling around the trachea and esophagus which potentially can cause compression. Anatomically, vascular rings can be complete or incomplete. A complete ring fully encircles the trachea and esophagus whereas an incomplete ring only partially does the same. These rings could...

Echocardiogram is the main modality for assessing simple cardiac shunts such as atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). Contrast-enhanced CT is not primarily used to detect the shunts but is useful in evaluating associated anomalies like anomalous pulmonary venous drainage. Septal defects may...

Introduction: In patients with coronary artery disease and left ventricular dysfunction, the assessment of myocardial viability, prior to revascularisation has been shown to be of significant benefit. Most methods to assess myocardial viability such as Positron Emission Tomography (PET) and Cardiac MRI (CMR) are not readily available in resource co...

Introduction: Sarcoidosis is commonly mistaken for tuberculosis in India. Imaging is of paramount importance in making a correct diagnosis, but, most of the published literature available on radiological findings of sarcoidosis is from the Western population. Aim: To study the radiological findings of thoracic sarcoidosis in Indian patients. Materi...

Introduction Nasal dermoid sinus cyst (NDSC) are uncommon congenital lesions in children. Objective To review the clinical and radiological presentation and study the surgical outcomes of this uncommon lesion. Method Retrospective chart review of all children diagnosed with nasal dermoid from 2010 to 2020 at a tertiary referral hospital in South...

Cross sectional anatomy had enjoyed wide popularity during 19th century, but its application declined during 20th century. With the advent of radiologic techniques like computed tomography, magnetic resonance imaging, cross sectional anatomy regains its importance. However, there were differences in the ways anatomists and radiologists approach cro...

Context and aims: Inflammatory myofibroblastic tumour (IMT) is a rare mesenchymal neoplasm with intermediate malignant potential. The aim of this study is to describe and compare the clinical presentation, computed tomography (CT) findings and anaplastic lymphoma kinase -1 (ALK-1) expression of IMT of the thorax in children and adults. We also sou...

Background: Accurate imaging assessment of cardiovascular invasion by mediastinal masses is essential for determining surgical feasibility. This can sometimes be difficult on CT owing to limited space available in the mediastinum, resulting in mediastinal masses abutting and indenting adjacent cardiovascular structures. Cine MRI may aid in such si...

Knowledge of lateral nasal wall landmarks in relation to lacrimal apparatus is essential for successful endoscopic dacryocystorhinostomy. This descriptive study of right and left sagittally sectioned ten adult cadaver head specimens was done measuring various lateral nasal wall anatomical landmarks including lacrimal apparatus with digital calipers...

Purpose: The aim of the study was to evaluate the role of high-resolution computed tomography (HRCT) in the prediction of presence and severity of chronic obstructive pulmonary disease (COPD), based on the pulmonary function test (PFT), to correlate the various quantitative and qualitative indices of COPD in HRCT with PFT values, and to derive at...

Introduction: Ventilator Associated Pneumonia (VAP), continues to complicate a significant proportion of critically ill mechanically ventilated patients, resulting in increased morbidity, mortality and hospital costs. Probiotics offer a novel approach to the prevention of VAP. Uncertainty still exists regarding its benefit for the prevention of VAP...

Computed Tomography (CT) is the mainstay of diagnostic imaging evaluation of thoracic disorders. However, there are a number of CT protocols ranging from a simple non-contrast CT at one end of the spectrum, and CT perfusion as a complex protocol available only on high-end scanners.With the growing diversity, there is a pressing need for radiologist...

Objective Age‐based formulas for selecting the appropriate size of tracheostomy tubes in children are based on data on tracheal dimensions. This study aims to measure the tracheal dimensions of Indian children by computerized tomography (CT) and to compare this with the dimensions of age‐appropriate tracheostomy tubes. Methods CT scans of children...

A 17-year-old girl presented with history of intermittent palpitations and episodes of syncope for the past 5 years. History of sudden unexplained death of an aunt at the age of 15 was present. Her family members were asympto-matic for cardiac disease, and no screening echo-cardiography was performed. Her general and cardiovascular examinations wer...

Takayasu arteritis (TA) is a well-known but uncommon chronic granulomatous large-vessel vasculitis that predominantly affects young women. Middle aortic syndrome constitutes part of the TA disease spectrum where lower body blood flow is supplemented by multiple systemic and visceral collateral pathways. One such systemic-systemic collateral pathway...

Context: The pattern of myocardial nulling in the inversion scout sequence [time of inversion scout (TIS)] of cardiac magnetic resonance imaging (MRI) is an accurate tool to detect cardiac amyloidosis. The pattern of nulling of myocardium and blood at varying times post gadolinium injection and its relationship with left ventricular mass (LVM) in...

Context: The pattern of myocardial nulling in the inversion scout sequence [time of inversion scout (TIS)] of cardiac magnetic resonance imaging (MRI) is an accurate tool to detect cardiac amyloidosis. The pattern of nulling of myocardium and blood at varying times post gadolinium injection and its relationship with left ventricular mass (LVM) in a...

Takotsubo cardiomyopathy (TTC) is a syndrome of acute left ventricular dysfunction with a clinical presentation often mimicking acute coronary syndrome. Without a high index of suspicion, this clinical entity often goes unrecognized. Although initially categorized as a benign completely reversible condition, it is no longer considered to be so. Rec...

Introduction: Although pulmonary hydatid cysts can be diagnosed on computed tomography (CT), sometimes findings can be atypical. Other hypodense infective or neoplastic lesions may mimic hydatid cysts. We proposed that magnetic resonance imaging (MRI) may act as a problem-solving tool, aiding the definite diagnosis of hydatid cysts and differentia...

Background Interstitial lung disease [ILD] is a leading cause of mortality in scleroderma.¹ Scleroderma lung study-II clearly illustrates the equivalent efficacy and a better side-effect profile of mycophenolate mofetil [MMF] as compared to cyclophosphamide. Objectives To study the long term outcomes of mycophenolate mofetil in scleroderma related...

Background: Rhinocerebral mucormycosis is a life-threatening infection caused by saprophytic fungi seen almost exclusively in immunocompromised patients.The objective of this study was to describe the imaging findings in patients with rhinocerebral mucormycosis. Materials and methods: The case records of patients with biopsy/culture proven invasive...

Etiologic diagnosis of an eosinophilic pleural effusion (EPE) presents a diagnostic challenge when intrapleural air and blood have been ruled out as its proximate causes. Among the causes of EPE, those that require immunosuppression for the underlying disease include connective tissue diseases, sarcoidosis, vasculitis, and eosinophilic pneumonia. W...

To test whether there are variations in cochlear orientation with respect to age and sex, and its relevance in cochlear implant surgery. Implant otologists rely upon the anatomic landmarks including the facial recess and round window niche and round window membrane for accessibility and placement of electrode array into scala tympani of basal turn...

High minute ventilation is required to lower intracranial pressures in patients with intracranial bleed. Respiratory acidemia consequent to ventilatory difficulty is dangerous in such patients as it further raises intracranial tension. We describe such a case. A 24-year-old man had to be intubated and mechanically ventilated after he met with a roa...

Rhinosporidiosis is a granulomatous infection of mucocutaneous tissue caused by Rhinosporidium seeberi that most commonly occurs in the nasal cavity. Ocular rhinosporidiosis affects primarily the conjunctiva. Diagnosis of rhinosporidiosis is based on strong clinical suspicion and is confirmed by histopathological examination. We report a rare case...

An allogeneic stem cell transplant (SCT) remains the only curative option for patients with β thalassemia major (TM). Conventional pre-transplant risk stratification is limited by its subjective nature of definition of hepatomegaly, adequacy of chelation therapy and also the need for an invasive liver biopsy. We have previously reported on the sign...

Pulmonary venoocclusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) form a sinister subgroup of pulmonary arterial hypertension where the predominant pathology lies in the pulmonary veins and capillaries, thus making the use of pulmonary vasodilators potentially dangerous in these patients. Radiologically, the presence of centrilob...

We present the case of a 19-year-old man who was extensively evaluated in multiple centres for long-standing cough, dyspnea, and hemoptysis without a definitive diagnosis. His chest radiograph at presentation showed mediastinal widening, bilateral pleural effusions, and Kerley B lines. Computed tomography of the thorax showed a confluent, fluid-den...

An abnormal fistulous communication between an artery and lymphatic system is a rare occurrence. We report a 38-year-old male presenting with sudden onset, spontaneous, pulsatile swelling in the left supraclavicular region following a recent cardiac catheterisation via right femoral arterial access. On evaluation, he was found to have a femoral art...

Zygomycetes species contains two orders of organisms that infect humans, namely Mucorales and Entomophthorales. Entomophthorales cause chronic infection in immunocompetent patients, invading subcutaneous tissues but are non-angioinvasive. This includes Basidiobolus ranarum, Conidiobolus incongruus and Conidiobolus coronatus. We report a case of dis...

We report a rare case a 15 year old boy who presented with recurrent hemoptysis. There was past history of pancreatitis. A CT scan of thorax revealed a small collection in the region of the tail of the pancreas and a tract from it extending across the diaphragm into the posterobasal segment of left lower lobe, suggesting a pancreatico-pleuro-pulmon...

Background Localization of a cerebrospinal fluid [CSF] fistula is a diagnostic challenge. The choice of an optimal imaging technique is necessary to locate the site of CSF leak which is required for surgical/endoscopic repair of the CSF fistula. Material/Methods Retrospective analysis of imaging was performed in 33 patients who presented with symp...

CT is the preferred cross-sectional imaging modality for detailed evaluation of anatomy and pathology of the lung and tracheobronchial tree, and plays a complimentary role in the evaluation of certain chest wall, mediastinal, and cardiac abnormalities. The article provides an overview of indications and different types of CT chest, findings in comm...

We report the endovascular management of a series of four cases of isolated systemic supply to normal lung or isolated arterial pulmonary malinosculation of the left lung. In these cases, the basal segments of the left lung lacked normal pulmonary arterial supply and instead received systemic arterial blood from the descending thoracic aorta. The r...

Subretinal cysticercosis presenting with anterior uveitis and hypopyon is rare. A 7-year-old boy presented with pain and hypopyon in the right eye. Ultrasonography showed a cystic lesion with scolex. Because visual prognosis was poor, he was treated conservatively. Timely diagnosis would facilitate early therapy and prevent visual loss.

Persistent rhinorrhoea is a common, yet often neglected, problem among Indian children. This study was designed to evaluate the relative etiological importance of adenoid hypertrophy versus sinusitis in children with persistent rhinorrhea. Additionally, the association between S. pneumoniae colonization and adenoid hypertrophy was studied. Children...

Congenital bronchopulmonary vascular malformations (BPVMs) include a broad spectrum of disorders that involve abnormalities in the form of disruptions of normal communication and/or presence of abnormal communication between one or more of the three main systems of the lung, namely, the airways, arteries, and veins. The establishment of abnormal co...

Examinations are necessary rites of passage before a postgraduate radiology student becomes a full-fledged radiologist. Radiology viva voce examination requires candidates to possess thorough knowledge of the subject as well as the ability to express themselves in front of the examiners. It is frequently noted that candidates, despite possessing go...

Seronegative spondyloarthropathy is a group of chronic inflammatory rheumatic diseases that predominantly affect the axial skeleton. Involvement of sacroiliac joint is considered a hallmark for diagnosis of seronegative spondyloarthropathy and is usually the first manifestation of this condition. It is essential for the radiologist to know the comp...

IgG4‑related disease with sinonasal involvement: A case series Abstract We present the imaging findings in two cases of IgG4-related disease involving the sinonasal region in the pediatric age group. Imaging findings in IgG4-related disease affecting the nasal cavity and paranasal sinuses have been rarely reported in literature. The diagnosis is m...