Devasenathipathy Kandasamy

• Doctor of Medicine
• Professor at All India Institute of Medical Sciences

A BSTRACT Background Despite being a technically demanding procedure, the laparoscopic approach for choledochal cyst excision (LEC) has gained popularity in the last two decades. We conducted a study to evaluate the outcomes of the initial cohort of LEC and Roux-en-Y hepaticojejunostomy performed at our center. Subjects and Methods A retrospectiv...

A BSTRACT Nocardial infections in neonates are exceptionally rare, posing significant diagnostic challenges due to their atypical presentations and the rarity of such cases. This case report delves into a unique instance of nocardial pneumonia in a neonate, initially misdiagnosed due to its unconventional clinical presentation and the absence of tr...

This prospective study was done to compare the initial presentation and treatment outcomes of tuberculosis among adult patients who have diabetes mellitus with those without diabetes mellitus. In this study, all adult patients (age 18 years old or older) with microbiologically confirmed drug-sensitive pulmonary tuberculosis who were put on treatmen...

A BSTRACT This case report describes a rare presentation of a congenital intrathoracic stomach (CIS) managed successfully through laparoscopic surgery in an 11-month-old girl. The condition was complicated by symptoms of vomiting and failure to thrive. Imaging confirmed significant intrathoracic displacement of the stomach, necessitating prompt sur...

Urinary tract pathologies are frequently seen in pediatric age groups and constitute the most common pediatric imaging referrals. The spectrum of abnormalities is wide, including rare congenital abnormalities apart from the usual pathologies seen in adults. The common modalities include intravenous urography (IVU), retrograde urography (RGU), voidi...

PURPOSE To explore the perceived utility and effect of simplified radiology reports on oncology patients' knowledge and feasibility of large language models (LLMs) to generate such reports. MATERIALS AND METHODS This study was approved by the Institute Ethics Committee. In phase I, five state-of-the-art LLMs (Generative Pre-Trained Transformer-4o...

Objective Early diagnosis of primary and metastatic lung nodules is critical for effective therapeutic planning. Manual delineation of lung nodules is not time-efficient and is prone to human error as well as interobserver and intraobserver variability. This study aimed to address the unmet need for an open-source computer-aided detection (CAD) sys...

Background Patients admitted with acute severe ulcerative colitis (ASUC) respond to medical therapy in upto two-third cases but monitoring and early detection of non-response is of prime importance to prevent colectomy or mortality, through use of rescue medical therapy. This study evaluates the utility of ultrasonography (USG) in prognostication a...

Background. Metastasis of alveolar soft part sarcoma (ASPS) to the adrenal gland is infrequent, with only eight patients reported in the literature. Here we present an ASPS in an adolescent girl presented as a hypervascular adrenal incidentaloma along with a review of the available literature. This study aims to serve as a reference to aid in the p...

Endocrinopathies often present challenges in diagnosis due to the limitations of morphological imaging like CT and MRI. Venous sampling is crucial in such cases. It helps differentiate between various sources of hormone production, such as pituitary vs. ectopic source in Cushing’s syndrome, unilateral vs. bilateral in primary hyperaldosteronism, an...

Purpose To compare the volume, fat content, and T1 relaxation time of the pancreas in participants with and without prior gestational diabetes mellitus (GDM). Methods In this prospective case-control study, we enrolled 29 women with prior GDM, and divided them into three groups (normoglycemic, prediabetic, and diabetic) based on their glycaemic st...

The aim of this study was to investigate the utility of ureteral diameter ratio (UDR) as a tool to prognosticate and manage vesicoureteral reflux (VUR). Four scientific databases (PubMed, EMBASE, Web of Science, and Scopus) were systematically searched. Inclusion criteria were all studies in which UDR was used in prognostication and/or management o...

Germ cell tumors (GCTs) arise from primordial germ cells and can occur in any region along the path of migrating primordial germ cells. Retroperitoneal teratomas are such tumors usually arising in para-renal locations. These tumors have the propensity to grow to large sizes leading to distortion of the local anatomy and compressive symptoms. Surgic...

Objective was to assess the precision and reproducibility of spatial penalty-based intravoxel incoherent motion (IVIM) methods in comparison to the conventional bi-exponential (BE) model-based IVIM methods. IVIM-MRI (11 b-values; 0–800 s/mm²) of forty patients (N = 40; Age = 17.7 ± 5.9 years; Male:Female = 30:10) with biopsy-proven osteosarcoma wer...

A bstract Diffuse esophageal leiomyomatosis (DEL) is a rare condition characterized by the growth of multiple benign smooth muscle tumors (leiomyomas) in the esophagus. These tumors can cause obstruction and functional impairment of the esophagus, leading to symptoms such as difficulty swallowing, chest pain, and weight loss. The disease can presen...

Introduction: Lithium is a gold-standard agent for bipolar disorder (BD) and can affect the size, structure and/or function of thyroid gland with long-term exposure. Thyroid ultrasound can detect structural thyroid abnormalities, but it is under-reported with few prior studies in lithium users. The study aimed to evaluate thyroid volume and echoge...

Hemoptysis in the pediatric population, while infrequent, poses significant challenges for both the family and healthcare practitioners. The severity of hemoptysis dictates management decisions. Most cases being mild and self-limiting are treated conservatively. However, “life-threatening hemoptysis” may occur, and is defined as any degree of blood...

A 37-year-old male patient with a past history of fluctuating hypertension and insulin-treated diabetes mellitus presented to our clinic with a 1-year history of sudden-onset cough, dyspnea, and frank hemoptysis. Examination showed asthenia, moderate anemia, uncontrolled blood pressure, and a past history of one admission for management of hemoptys...

Objective There is limited information on population‐specific norms of trabecular‐bone‐score (TBS) and its associated factors. Here, we provide norms of TBS in Asian‐Indians and its relationship with serum 25‐hydroxyvitamin D [25(OH)D] and intact‐parathyroid hormone (iPTH). Participants and Measurements TBS, bone‐mineral‐density (BMD), and vertebr...

Tuberculosis (TB) remains a significant global health challenge, with musculoskeletal TB accounting for a notable proportion of cases. The spine is the most commonly affected site, followed by the hip, knee, and ankle joints. Prompt and accurate diagnosis is essential to prevent joint destruction, deformity, and neurological complications. Given th...

Highlights • Compared to chest X-ray, the current gold standard for confirming correct endotracheal tube position (ETT), ultrasonography (USG) is safer, faster to obtain and easily accessible in ICUs. • In this prospective cross-sectional study that included 62 patients, we tested three techniques: suprasternal method; cricoid method and tracheal r...

Diagnosis of abdominal tuberculosis is challenging due to its variable imaging appearance, which can mimic several other conditions. This review covers the imaging spectrum of tubercular involvement of abdominal lymph nodes, peritoneum, solid abdominal viscera, and the gastrointestinal tract. Tubercular lymphadenitis is the most frequent manifestat...

The current study explores the application of 3D U-Net architectures combined with Inception and ResNet modules for precise lung nodule detection through deep learning-based segmentation technique. This investigation is motivated by the objective of developing a Computer-Aided Diagnosis (CAD) system for effective diagnosis and prognostication of lu...

Purpose To evaluate comprehensive bone health among young Indian women, including bone mass, microarchitecture, and turnover, in relation to their non-alcoholic fatty liver disease (NAFLD) status. Methods This cross-sectional study (May 2018–November 2019) recruited women with a history of gestational diabetes mellitus (GDM) and normoglycemia in t...

Background Perianal fistulas (PF) affect one-third patients with Crohn’s disease (CD) with limited therapeutic options. There is dearth of literature on safety and efficacy of bone marrow-derived mesenchymal stromal cells (BMSCs) in this population. Methods An open-label, phase I/II, single-arm study was conducted involving local administration of...

Background Currently, clinical assessment is the main tool for the evaluation of brachial plexus injury, complemented by electrophysiologic studies (EPS), and imaging studies whenever available. Imaging plays an important role as it enables the differentiation of pre-ganglionic and postganglionic injuries, and adds objectivity to presurgical evalua...

Purpose To evaluate the role of conventional diffusion weighted imaging, diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) in distinguishing benign from malignant adnexal masses. Methods 38 patients with 45 adnexal masses were enrolled in this prospective study and assessed with multiparametric MRI, including the IVIM-DKI s...

Von Hippel–Lindau disease is a rare multisystem disorder that shows autosomal dominant inheritance. It is a cancer syndrome that is characterized by the development of a variety of benign and malignant tumors—CNS hemangioblastomas, retinal angiomas, endolymphatic sac tumors, renal cysts and tumors, pancreatic cysts and tumors, adrenal pheochromocyt...

A BSTRACT Zinner syndrome, a rare congenital anomaly affecting males, is characterized by atresia of the ejaculatory duct, seminal vesicle cysts, and ipsilateral renal agenesis. This case report details a 2-year-old boy successfully treated with laparoscopic excision of a dilated vas deferens and seminal vesicle cyst. The rarity of Zinner syndrome...

The trajectory from the clinical identification of a benign liver mass to establishing a precise diagnosis is perplexing and arduous. Related contributory factors are that such lesions are encountered infrequently and that there is a nonavailability of dedicated paediatric radiologists in the developing world. The objective of this study was to rev...

Background Perianal fistulas affect one-third patients with Crohn’s disease with limited therapeutic options. There is dearth of literature on safety and efficacy of bone marrow-derived mesenchymal stromal cells in this population. Methods An open-label, phase I/II, single-arm study was conducted involving local administration of human allogeneic...

Aim The aim is to study intrahepatic biliary architecture in patients following Kasai’s portoenterostomy for extrahepatic biliary atresia using magnetic resonance cholangiopancreatography (MRCP). Materials and Methods It is a prospective observational study in a cohort of patients who have survived with a complete jaundice-free period for at least...

We aimed to evaluate the utility of simple, cost-effective, and non-invasive strategies alternative to BIPSS and peripheral CRH stimulation in differential diagnosis of ACTH-dependent CS. We performed ROC analysis to evaluate the performance of various tests for differential diagnosis of ACTH-dependent CS in our cohort (CD, n=76 and EAS, n=23) and...

Background Perianal fistulas affect one-third patients with Crohn’s disease with limited therapeutic options. There is dearth of literature on safety and efficacy of bone marrow-derived mesenchymal stromal cells in this population. Methods An open-label, phase I/II, single-arm study was conducted involving local administration of human allogeneic...

Background Whole-body magnetic resonance imaging (MRI) has been investigated by multiple authors as a radiation-free alternative to positron emission tomography computed tomography (PET-CT) in children with lymphoma. Objective To evaluate the sensitivity, specificity, and diagnostic odds ratio of whole-body MRI compared to PET-CT for the staging o...

Introduction Successful surgical treatment for primary hyperparathyroidism requires accurate localization of abnormal parathyroid tissue in terms of location and number. Imaging is important for localizing the parathyroid adenoma, and there has been significant interest in ¹⁸ F-fluorocholine (FCH) positron emission tomography/computed tomography (P...

Disclosure: K. Kumar P: None. Y. Gupta: None. A. Goyal: None. D. Kandasamy: None. N. Tandon: None. Background: Multiple endocrine neoplasia type 2 (MEN2) syndrome is a rare disorder with autosomal dominant inheritance, characterised by the presence of two of the following three endocrine manifestations: medullary thyroid carcinoma (MTC), pheochromo...

Background Predominantly macrofollicular architecture in invasive encapsulated follicular variant of papillary thyroid carcinoma (IEFVPTC-MF) is rare and often a cause of misinterpretation during pre-operative work-up and histopathology evaluation. We comprehensively evaluated the radiological, cytological, gross, microscopic, molecular and follow-...

Objective: The objective was to assess qualitative interpretability and quantitative precision and reproducibility of intravoxel incoherent motion (IVIM) parametric images evaluated using novel IVIM analysis methods for diagnostic accuracy. Methods: Intravoxel incoherent motion datasets of 55 patients (male/female = 41:14; age = 17.8 ± 5.5 years...

Objective To evaluate the role of Shear wave elastography in characterizing adnexal masses. Design A prospective study. Setting Tertiary care hospital and research institute in India. Population Patients aged >12 years with an adnexal mass. Methods 95 adnexal masses in 85 patients were included in the analysis. The mean, minimum, and maximum elasti...

Introduction and Aim: Acute kidney Injury (AKI) is common and is associated with poor outcomes in critically ill patients. Current diagnosis and staging of AKI depends on measurement of urine output and serum creatinine. Both of them have their own fallacies and therefore diagnosis of AKI is often delayed. Use of novel biomarkers for diagnosis of...

Background and Objectives This prospective longitudinal study aims to evaluate and compare the incidence of prediabetes/diabetes among women stratified at the baseline postpartum visit according to the prior GDM and NAFLD status. Methods Of the 309 women with baseline postpartum assessment at a median of 16 months following the index delivery, 200...

The presence of lung metastases in patients with primary malignancies is an important criterion for treatment management and prognostication. Computed tomography (CT) of the chest is the preferred method to detect lung metastasis. However, CT has limited efficacy in differentiating metastatic nodules from benign nodules (e.g., granulomas due to tub...

Purpose: The proposed work aims to develop an algorithm to precisely segment the lung parenchyma in thoracic CT scans. To achieve this goal, the proposed technique utilized a combination of deep learning and traditional image processing algorithms. The initial step utilized a trained convolutional neural network (CNN) to generate preliminary lung...

Objective: Accurate demarcation between multiple endocrine neoplasia, type 1 (MEN1)- related primary hyperparathyroidism (MPHPT) and sporadic PHPT (SPHPT) is important to plan the management of primary parathyroid disease and surveillance for other endocrine and nonendocrine tumours. The objective of this study is to compare the clinical, biochemi...

Objectives: To make sonographic evaluation for biliary atresia (BA) more objective and reproducible using scoring systems, and evaluate hepatic shear wave elastography (SWE) as an adjunct in sonographic diagnosis of BA. Methods: Sixty-four infants with cholestatic jaundice were enrolled between June 2016 and March 2018 in this prospective observ...

Predictive performance of penalty-based IVIM analysis methodologies BE+TV and BE+HPF for response to Neoadjuvant Chemotherapy have been evaluated using clinical dataset with osteosarcoma in comparison with existing IVIM analysis methods. IVIM datasets before and after chemotherapy were analyzed using 5 IVIM analysis methods – Bi-exponential model a...

Available at: https://rdcu.be/ddPvW Abstract Objectives To evaluate the sensitivity and specificity of inferior vena cava (IVC) distensibility index (∆IVC) and respiratory variation in peak aortic blood flow velocity (∆Vpeak) to predict fluid responsiveness in ventilated children with shock and to find out the best cut-off values for predicting flu...

Lipoblastomatosis of mesentery is an extremely rare benign fat-containing mesenchymal tumour in infants and young children. On imaging, it appears as a solid infiltrating mass interspersed with macroscopic fat. We describe the distinctive imaging features of a large mesenteric Lipoblastomatosis, corroborated with intraoperative and histopathologica...

Background: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome associated with phosphaturic mesenchymal tumors (PMTs). Localization of the causative tumor in these cases is an arduous task since the culprit lesions are usually small, slow-growing, and can be located almost anywhere from head to toe. Purpose: To describe the morph...

Adrenal glands are affected by a wide variety of tumors apart from infective and inflammatory lesions and their noninvasive characterization on imaging is important for the management of these patients. Incidentalomas form the major bulk of adrenal tumors and differentiation of benign adenomas from other malignant lesions, especially in patients wi...

Context: Pheochromocytomas/paragangliomas (PPGLs) have recently been shown to be associated with lower bone mineral density (BMD) and trabecular bone score as compared to healthy controls suggesting low bone mineral concentration and disrupted bone microarchitecture. There is paucity of data on prevalence and clinical predictors of low BMD/osteopo...

Background Non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are prevalent in the community, especially among those with metabolic syndrome. Patients with fibrotic NASH are at increased risk of liver-related-events. Currently available non-invasive tests have not been utilized for screening for fibrotic NASH among the community....

Purpose: Bone health in primary ovarian insufficiency (POI) is under-investigated. We assessed patients with spontaneous POI for vertebral fractures (VFs) and related parameters of bone health. Methods: 70 cases with spontaneous POI (age 32.5 ± 7.0 years) and an equal number of controls were assessed for BMD, TBS, and VFs. BMD at the lumbar-spin...

Objective This review aims to explore the current status of magnetic resonance imaging (MRI) as a cephalometric tool, summarize the equipment design and methods, and propose recommendations for future research. Methods A systematic search was conducted in electronic databases, including PubMed, Ovid MEDLINE, Scopus, Embase, Web of Science, EBSCOho...

To investigate IVIM-DKI in diagnosing benign and malignant lymph nodes in lymphoma and its subtypes in comparison to FDG-PET/CT. A total of twenty-one (n = 21) patients diagnosed with biopsy-proven Hodgkin lymphoma(HL: n = 13) and non-Hodgkin lymphoma (NHL: n = 8) were prospectively evaluated. All patients underwent MRI(T1-weighted, Short-Tau-Inver...

Non-invasive characterization of pancreatic masses aids in the management of pancreatic lesions. Intravoxel incoherent motion-diffusion kurtosis imaging (IVIM-DKI) and machine learning-based texture analysis was used to differentiate pancreatic masses such as pancreatic ductal adenocarcinoma (PDAC), pancreatic neuroendocrine tumor (pNET), solid pse...

PurposeWe aimed to evaluate and compare the clinical, biochemical and radiological profile and outcomes of patients with ectopic ACTH syndrome (EAS) and Cushing disease (CD) treated over a period of 10 years (2013–2022).Methods In this ambispective observational study, we collected data for 146 patients with ACTH-dependent CS (EAS, n = 23; CD, n =...

Background: Early prediction of response to neoadjuvant chemotherapy (NACT) is important to aid personalized treatment in osteosarcoma. Diffusion-weighted Intravoxel Incoherent Motion (IVIM) MRI was used to evaluate the predictive value for response to NACT and survival outcome in osteosarcoma. Methods: Total fifty-five patients with biopsy-prov...

An 11-year-old girl presented to the pediatric gastroenterology outpatient department of our institution with gradually increasing painless abdominal distention. The distention started 2 years earlier and was not associated with any other constitutional symptoms, vomiting, diarrhea, jaundice, hematemesis, or melaena. She reported early satiety and...

Context: Patients with chronic hypoparathyroidism (cHypoPT) are prone to intracranial-calcification, cataract, and nephrocalcinosis. In this study, we systematically investigated the possibility of increased coronary-artery calcification (CAC) and coronary-artery disease (CAD) in them. Design: Cross-sectional PATIENTS AND METHODS: 94 non-surgica...

Background: Multiple endocrine neoplasia type 2 (MEN2) syndrome is a rare disorder with autosomal dominant inheritance, characterised by the presence of two of the following three endocrine manifestations: medullary thyroid carcinoma (MTC), pheochromocytoma (PCC) and primary hyperparathyroidism (PHPT). There is a paucity of data on clinical and gen...

Objectives To demonstrate the clinical profile, management options, and outcomes of children with stage 4S neuroblastoma (NB 4S) diagnosed at a tertiary care center in a resource-challenged nation. The authors also intend to highlight the factors associated with an unfavorable prognosis in this series of patients. Methods The archives for children...

Aims: The conventional Seldinger and trocar techniques of percutaneous nephrostomy (PCN) have inherent limitations in infants and younger children. We studied the role of a novel coaxial technique of PCN in children under the age of 5 years in comparison to the conventional techniques. Materials and Methods: This was a single-center feasibility tri...

Background Non-invasive biomarkers for early chemotherapeutic response in Ewing sarcoma family of tumors (ESFT) are useful for optimizing existing treatment protocol. Purpose To assess the role of diffusion-weighted magnetic resonance imaging (MRI) in the early evaluation of chemotherapeutic response in ESFT. Material and Methods A total of 28 pa...

Aim: The aim of our study is to present our experience in the management and outcome of Wilms tumor with intracaval thrombus. Materials and methods: All children with Wilms tumor with intracaval thrombus who presented to us from July 2000 to December 2017 were reviewed retrospectively. We evaluated the tumor stage, management, and outcomes in th...

Purpose The aim of the present study was to assess the effect of Bacillus coagulans Unique IS-2 supplementation on absorption and utilization of protein in resistance-trained males. Methods In this double blind, placebo-control trial, resistance-trained males (21.08 ± 2.84 years) were randomized to consume, either 20 g of whey protein powder {80%...

History: An 11-year-old girl presented to the pediatric gastroenterology outpatient department of our institution with gradually increasing painless abdominal distention. The distention started 2 years earlier and was not associated with any other constitutional symptoms, vomiting, diarrhea, jaundice, hematemesis, or melaena. She reported early sa...

Objective To assess the effectiveness of intranodal lymphangiography using ethiodized oil (Lipiodol; Guerbet Japan, Tokyo, Japan) for the treatment of refractory cases of chylothorax and chylous ascites in the pediatric population. Methods Between 2016 and 2020, eight children having chyle leak resistant to conservative management underwent intran...

Background: Neuraxial techniques provide good postoperative analgesia for painful procedures in the pediatric population. However, any injury to the spinal cord can lead to irreversible long-term effects. Aims: We aimed to evaluate dura-to-cord (DTC) distance from computerized tomography (CT) images of thoracolumbar spine in pediatric age group...

Background Platelet-rich plasma (PRP) may aid functional recovery in compressive neuropathies. Objective To compare the effect of autologous PRP with corticosteroid injection in patients with refractory carpal tunnel syndrome (CTS). Materials and Methods This was a randomized controlled trial on 84 adults, who received either single-dose, ultraso...

Amphicrine phenotype in medullary thyroid carcinoma (MTC) is a rare phenomenon characterized by tumor cells that show both endocrine differentiation (calcitonin secretion) and exocrine differentiation (mucin production and secretion). Not much is known about the pathobiology of amphicrine MTCs. This report undertook a case-based review approach by...

Cholestatic jaundice characterized by elevated conjugated bilirubin can be due to multitude of factors in neonates and childhood. Extrahepatic biliary atresia (EHBA), choledochal cyst, neonatal hepatitis, cytomegalovirus (CMV), and biliary plug are some of the common causes in neonate and early infancy. Causes in late infancy and childhood comprise...

Reproducibility and repeatability of penalty-based IVIM analysis methodologies BE+TV and BE+HPF have been evaluated using clinical dataset with osteosarcoma in comparison with existing IVIM analysis methods. IVIM datasets at three time-points during chemotherapy were analyzed and healthy muscle tissue was used as local control for IVIM analysis and...

The objective of this prospective study was to assess the role of diffusion weighted MRI for early evaluation of chemotherapy response in patients with Ewing sarcoma with RECIST 1.1 criteria correlation. Absolute apparent diffusion coefficient (ADC), normalized ADC (nADC) and tumor diameter at baseline and after 1st cycle of chemotherapy were asses...

Purpose: Patients with hypoparathyroidism are at risk of vertebral fractures (VFs) despite high bone mineral density (BMD). We investigated this paradox by assessing trabecular bone score (TBS) and hip structural analysis (HSA) in non-surgical chronic hypoparathyroidism (cHypoPT) with and without VFs. Methods: 152 cHypoPT patients (age 40.2 ± 13...

Background Evaluation of perfusion characteristics is the key to characterize vascular anomalies. Contrast-enhanced ultrasound (CEUS) is a radiation-free modality to evaluate this in real-time and can be coupled along with Doppler-ultrasound (US). Objective To evaluate the utility of CEUS in characterization of suspected soft-tissue vascular anoma...

There is a lot of ambiguity in the usage of correct terminology in the description of vascular malformations and tumors. Hemangioma and arteriovenous malformation (AVM) are the most commonly used terms and are the mostly incorrectly used as well! The aim of this review article was to lay out the correct nomenclature and describe the correct usage f...