Mukesh G Harisinghani

Massachusetts General Hospital | MGH · Department of Radiology

Background: Accurate in-vivo prostate volume (PV) estimation is important for obtaining prostate-specific antigen density (PSAD) and further predicting clinically significant prostate cancer (csPCa). We aimed to evaluate the accuracy of multiparametric magnetic resonance imaging (mpMRI) estimated PV compared to both volume and weight of radical pr...

Purpose To assess diagnostic performance of MR defecographic findings in diagnosis of dyssynergic defecation (DD). Methods This retrospective study included 46 patients with chronic constipation who met the Rome IV criteria for diagnosis of present or absent DD and underwent MRI between Jan 2015 and June 2020. Patients were divided into DD group (...

Purpose: The aim of this study was to assess the prevalence of reportable cardiac findings detected on abdominopelvic CTs and the association with subsequent cardiovascular events. Materials and methods: We performed a retrospective search of electronic medical record of patients who underwent abdominopelvic CT between November 2006 and November...

TPS762 Background: Overcoming resistance to chemotherapy and immune checkpoint inhibitors remains an unmet need for PDAC. In this context, TGF-β plays a key role in PDAC by promoting the activation of fibroblasts and extracellular matrix deposition, facilitating epithelial-to-mesenchymal transition, immune evasion, and resistance to chemotherapy. C...

Objective: To evaluate the Gleason grade (GG) discrepancy between biopsy (Bx) techniques (transperineal [TP] /transrectal [TR] approaches or multiparametric magnetic resonance imaging [mpMRI] targeted biopsy [TBx] / standard template biopsies [SBx]) and radical prostatectomy (RP) specimens. Patients and methods: We identified 310 prostate cancer...

Objective: To compare standard (STD-DWI) single-shot echo-planar imaging DWI and simultaneous multislice (SMS) DWI during whole-body positron emission tomography (PET)/MRI regarding acquisition time, image quality, and lesion detection. Methods: Eighty-three adults (47 females, 57%), median age of 64 years (IQR 52-71), were prospectively enrolle...

Rationale and Objectives To evaluate whether addition of a computer-aided diagnostic (CAD) generated MRI series improves detection of clinically significant prostate cancer. Materials and Methods Nine radiologists retrospectively interpreted 150 prostate MRI examinations without and then with an additional random forest-based CAD model-generated M...

Background Mass-forming cholangiocarcinoma is the most common form of intrahepatic cholangiocarcinoma and is associated with a worse prognosis. This study aimed to assess the role of diffusion-weighted imaging and other imaging features as prognostic markers to predict the survival of patients with intrahepatic mass-forming cholangiocarcinoma (IMCC...

Purpose Transperineal (TP) multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy (TBx) has been shown to detect more clinically significant (cs) prostate cancer (PCa) than standard template biopsies (SBx). Current data supports the inclusion of both TBx and SBx in obtaining an optimal csPCa detection rate. We compared csPCa detection r...

Objective To review existing structured MRI reports for primary staging of rectal cancer and create a new, freely available structured report based on multidisciplinary expert opinion and literature review. Methods Twenty abdominal imaging experts from the Society of Abdominal Radiology (SAR)’s Disease Focused Panel (DFP) on Rectal and Anal Cancer...

Rectal MR is the key diagnostic exam at initial presentation for rectal cancer patients. It is the primary determinant in establishing clinical stage for the patient and greatly impacts the clinical decision-making process. Consequently, structured reporting for MR is critically important to ensure that all required information is provided to the c...

The advent of prostate specific antigen (PSA) testing led to increased early prostate cancer (PCa) detection and has decreased PCa-related death. However, PSA is not cancer-specific, and the challenge persists of differentiating those PCa patients with indolent tumors from those requiring definitive therapy. Metabolomic profiles have the potential...

PurposeThe purpose of this study was to identify the significant imaging predictors of transmural intestinal necrosis in patients with acute mesenteric ischemia (AMI).Methods The medical records and CT imaging of 48 patients between 2011 and 2019 suspected of having AMI that underwent exploratory laparotomy with bowel resection and pathological con...

Multiparametric MRI of the prostate gland has become the initial evaluation of biopsy naïve men with a clinical suspicion for prostate cancer. PI-RADS 2.1 is a joint initiative and framework for prostate MRI acquisition and reporting, which aims to standardize technique and interpretation across centers. Building upon experience accrued following t...

Purpose To investigate practice patterns related to MR technique and structured reporting for MRI of rectal cancer at academic centers and private practice groups in the United States. Methods and materials A survey developed by active members of the Society of Abdominal Radiology Rectal and Anal Cancer Disease Focus Panel was sent to 100 private...

Background Mutations in Kirsten rat sarcoma proto-oncogene (KRAS) have been shown to be associated with advanced-stage colorectal cancer (CRC), negative disease outcomes, and poor response to treatment. The purpose of this study was to investigate which CT features are biomarkers for KRAS gene mutation and impact the survival outcomes of colorectal...

Objective: Volumetric assessment with computed tomography (CT), known as CT volumetry, is the preferred method for estimating future liver remnant. However, the data regarding the usage of CT volumetry to estimate future liver remnant of the diseased liver is still lacking. This study was designed to evaluate the correlation between the liver volum...

Purpose To identify correlation between CT imaging features and histologic subtypes of Malignant Peritoneal Mesothelioma (MPM). Methods This was a retrospective single-center study of 51 consecutive patients with the diagnosis of Malignant Peritoneal Mesothelioma (MPM). The tumors were classified into pure epithelioid type and those with sarcomato...

In 2009, a new lung cancer lymph node map was proposed by the International Association for the Study of Lung Cancer (IASLC) to reconcile the difference between the Naruke et al. (J Thorac Cardiovasc Surg. 76:832–9, 1978) and the Mountain–Dresler–American Thoracic Society (ATS) (Mountain and Dresler CM. Chest. 111:1718–23, 1997) maps and redefine t...

A good basic understanding of the anatomy and nomenclature of the inguino-pelvic nodal groups is essential for accurate staging of male and female urogenital pelvic neoplasms. Lymph nodes are not only crucial for staging and management but also important factors in prognosticating the disease.

Cancers of the head and neck—including cancers of the buccal cavity, head and neck subset, larynx, pharynx, thyroid, salivary glands, and nose/nasal passages—account for approximately 6% of all malignancies in the United States and accounted for approximately 3% of new malignancy cases in 2020 (Howlader et al. SEER cancer statistics review, 1975–20...

Lymph node metastases are frequently seen in most primary abdominal malignant tumors. The tumor cells enter lymphatic vessels and travel to the lymph nodes along lymphatic drainage pathways. The lymphatic vessels and lymph nodes generally accompany the blood vessels supplying or draining the organs. They are all located in the subperitoneal space w...

Purpose: Gleason grade (GG) on prostate biopsy is important for risk stratification and clinical decision making. Multiparametric MRI (mpMRI) improved detection of clinically significant disease and some studies suggest that MRI-fusion biopsy combined with systematic biopsy results in fewer upgrades on final surgical pathology. However, the downgr...

Goals: To encourage radiologists to initiate MR defecography study in their hospitals Learning Objectives:  To show the advantages and limitation of MR defecography  To demonstrate imaging techniques used for static and dynamic imaging in pelvic floor dysfunction.  To describe the MR quantitative parameters and their use to assess the degree of...

Background Extraprostatic extension (EPE) of prostate cancer is associated with a poor prognosis. The broad-based capsule-tumor interface has been recognized as one of the worrisome imaging features in multiparametric prostate MRI (mpMRI). However, there was significant heterogeneity among the measurement method used in prior studies.Objectives Thi...

Purpose To evaluate the feasibility of Quantitative Ultrashort-Time-to-Echo Contrast-Enhanced (QUTE-CE) MRA using ferumoxytol as a contrast agent for abdominal angiography in the kidney. Methods Four subjects underwent ferumoxytol-enhanced MRA with the 3D UTE Spiral VIBE WIP sequence at 3 T. Image quality metrics were quantified, specifically the...

The role of imaging in clinically staging colorectal cancer has grown substantially in the 21st century with more widespread availability of multi-row detector computed tomography (CT), high-resolution magnetic resonance imaging (MRI) with diffusion weighted imaging (DWI), and integrated positron-emission tomography (PET)/CT. In contrast to staging...

Objective: To correlate non-restricted diffusion magnetic resonance imaging (MRI) patterns of hepatocellular carcinoma (HCC), with histopathology and clinical outcome.Material and Methods: We retrospectively evaluated pre-treatment MRIs showing non-restricted diffusion HCC lesions (≥1-centimeter), excluding lesions with poor quality/non-available d...

Positron emission tomography (PET) using fluorodeoxyglucose (18F-FDG) combined with magnetic resonance imaging (MR) is an emerging hybrid modality that has shown utility in evaluating abdominal and pelvic disease entities. Together, the high soft tissue contrast and metabolic/functional imaging capabilities make this modality ideal for oncologic im...

Objective The purpose of the study was to evaluate the utility of MR texture analysis for differentiating tumor deposits from mesorectal nodes in rectal cancer.Materials and methodsPretreatment MRI of 40 patients performed between 2006 and 2018 with pathologically proven tumor deposits and/or malignant nodes in the setting of rectal cancer were ret...

Acute and chronic inflammation of the prostate gland can be attributed to several underlying aetiologies, including but not limited to, bacterial prostatitis, granulomatous prostatitis, and Immunoglobulin G4-related prostatitis. In this review, we provide an overview of the general imaging appearances of the different types of prostatitis, their di...

Objective: Prostate involvement by IgG4-related disease (IgG4-RD) is a rarely described organ manifestation and knowledge regarding its frequency and clinical features is limited. Methods: From a single-center cohort, 168 male patients were examined who satisfied the 2019 ACR/EULAR classification criteria or 2012 consensus histopathologic criter...

Background: PI-RADS v2.1 modifications primarily address transition zone (TZ) interpretation. The revisions also impact peripheral zone (PZ) interpretation, which has received less attention. Objective: To compare interobserver agreement of PI-RADS v2 and v2.1 in the prostate PZ and TZ, and perform a pilot comparison of their diagnostic performance...

Background Colorectal cancer (CRC) is one of the leading causes of cancer deaths and is associated with various genetic mutations. BRAF mutations, found in approximately 10% of all CRCs, are associated with negative predictive outcomes. The goal of this study was to assess the relationship between the imaging findings and BRAF statuses of CRC patie...

The utility of tumour biomarkers has increased considerably in the era of personalised medicine and individualised therapy in oncology. Biomarkers may be prognostic or predictive, and only a handful of markers are currently US Food and Drug Administration (FDA)-approved for clinical use. Tumour markers have a wide array of uses such as screening, e...

Purpose/Objectives In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary (GU) members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTV). Data has emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas....

While the use of iron oxide nanoparticles as magnetic resonance contrast agents for clinical imaging is established, they are more recently experiencing renewed interest as alternatives to gadolinium-based contrast agents. Ultra-small iron oxide nanoparticles have unique pharmacokinetics, metabolic and imaging properties. These properties have led...

Purpose Accurate nodal staging for male urogenital malignancies has important implications for therapy and prognosis. Male pelvic malignancies, including prostatic, penile, testicular, and bladder cancer, typically metastasize to regional lymph nodes first which is reported by the N-stage. Spread beyond these groups to non-regional nodes is regarde...

MR is the radiologic test of choice when evaluating rectal cancer both for staging and restaging following neoadjuvant chemoradiotherapy (nCRT) prior to surgery. Evaluation after treatment should include a description of interval change in the primary tumor location, extent and signal characteristics with particular attention to fibrosis and/or muc...

Background Angiotensin converting enzyme 2 (ACE2), a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrates its highest surface expression in the lung, small bowel, and vasculature, suggesting abdominal viscera may be susceptible to injury. Purpose To report abdominal imaging findings in patients with coronavirus disea...

In patients with tuberous sclerosis complex (TSC) the upregulation of the mechanistic target of rapamycin (mTOR) pathway leads to the development and growth of subependymal giant cell tumors (SGCTs) and renal angiomyolipomas (AMLs). Drugs that inhibit the mTOR pathway, such as sirolimus, can reduce the size of both SGCTs and AMLs. Recent preclinica...

Advances in MRI technologies have the potential to detect, characterize, and monitor a wide variety of diseases.

Nodal involvement is a significant prognostic factor in rectal cancer and difficult to assess preoperatively. An understanding of the patterns of nodal spread from different regions of the rectum can assist in this process and is essential for the purposes of surgical planning. In this article we define patterns of spread to mesenteric and pelvic s...

OBJECTIVE. The objective of our study was to evaluate the utility of ferumoxytol-enhanced MR lymphography (MRL) in detection of metastatic lymph nodes (LNs) in patients with prostate, bladder, and kidney cancer. SUBJECTS AND METHODS. This phase 2 single-institution study enrolled patients with confirmed prostate (arm 1), bladder (arm 2), and kidney...

Though gadolinium-based contrast agents are the most widely used contrast media in MR for clinical use, problems with nephrogenic systemic fibrosis and tissue deposition render their safety debatable, at least in a selected patient population. Ferumoxytol has the potential to be used as an alternate contrast medium for various clinical applications...

Standardized terminology is critical to providing consistent reports to referring clinicians. This lexicon aims to provide a reference for terminology frequently used in rectal cancer and reflects the consensus of the Society of Abdominal Radiology Disease Focused Panel in Rectal cancer. This lexicon divided the terms into the following categories:...

Purpose To evaluate magnetic resonance imaging findings that differentiate among periurethral bulking agents (primarily collagen), urethral diverticulum, and periurethral cyst. Methods We searched our radiologic database retrospectively from 2001 to 2017 for periurethral cystic lesions, identifying a total of 50 patients with 68 lesions. Final dia...

Purpose To evaluate the impact of complex-averaging on image quality (IQ) and diagnostic accuracy of acquired and calculated high b value (aHBV, cHBV) images in diffusion-weighted prostate MRI. Materials and methods This retrospective study included 84 patients who underwent multiparametric prostate MRI at 3 Tesla without endorectal coil. DWIs wer...

Purpose: There exists a growing debate as to whether multiparametric MRI (mpMRI) with fusion transrectal ultrasound (TRUS) guided prostate biopsy (PBx) alone without standard template is sufficient for evaluation of patients with suspected prostate cancer (PCa). Our objective was to describe our experience with fusion targeted PBx and assess wheth...

Purpose PI-RADS v2 dictates that dynamic contrast-enhanced (DCE) imaging be used to further classify peripheral zone (PZ) cases that receive a diffusion-weighted imaging equivocal score of three (DWI3), a positive DCE resulting in an increase in overall assessment score to a four, indicative of clinically significant prostate cancer (csPCa). Howeve...

Purpose To compare the diagnostic performance of qualitative and quantitative 18F-FDG PET/CT in detection of regional and distant lymph node metastasis in patients with anal cancer. Methods Between 2004 and 2017, 28 patients with anal cancer who had staging PET/CT and pathological assessment of suspicious lymph nodes were included. For qualitative...

93 Background: Multiparametric MRI is increasingly used in prostate cancer detection. Previous studies have shown that detection rate of clinically significant cancer is higher in MRI targeted biopsy than systematic biopsy. However, the concordance between the Gleason score on fusion biopsy and radical prostatectomy is less well known. The objectiv...

Introduction Cholangiocarcinoma (CCA) is the primary tumor found in the bile duct and is associated with a high incidence of lymph node (LN) metastases and poor outcomes. The presence of metastatic lymph nodes, when shown by imaging, can influence patient treatment and prognosis. DWI is a promising, non-invasive imaging technique for differentiatin...

PurposeTo evaluate the diagnostic efficacy between pre- and post-contrast MRI sequences in perianal fistulas using intra-operative findings as the gold standard. Materials and methodsRetrospective analysis of 50 patients with a history of perianal fistula and MRI performed between January 2006 and January 2018 was performed. The inclusion criteria...

Purpose To evaluate the role of pelvic MR imaging in differentiating between low rectal and anal cancers using the pathological results as the gold standard. Materials and methods In this study, retrospective analysis of 100 patients with a history of low rectal (n = 50) or anal (n = 50) cancers who underwent staging pelvic MR imaging before treat...

Purpose: Corrected T1 (cT1) value is a novel MRI-based quantitative metric for assessing a composite of liver inflammation and fibrosis. It has been shown to distinguish between non-alcoholic fatty liver disease (NAFL) and non-alcoholic steatohepatitis. However, these studies were conducted in patients at high risk for liver disease. This study es...

Objective: The purpose of this study is to determine both the frequency of repeat CT performed within 1 month after a patient visits the emergency department (ED) and undergoes CT evaluation for abdominal pain and the frequency of worsened or new CT-based diagnoses. Subjects and methods: Secondary analysis was performed on data collected during...

Objectives: To evaluate quantitative changes in Diffusion Tensor Magnetic Resonance Tractography in prostate cancer following androgen deprivation and radiation therapy. Methods: 22 patients with elevated PSA and biopsy proven prostate carcinoma who underwent MRI of the prostate at 1.5 T with an endorectal coil were included. Group A) was the st...

Objective: Radiation therapy for cancer can lead to atherosclerosis by inducing inflammatory changes in the vascular wall. It is difficult to quantitatively measure inflammation on CT and MRI studies. The purpose of this study was to assess the use of ferumoxytol, an ultrasmall superparamagnetic iron oxide nanoparticle, as a noninvasive marker of...

Image segmentation is a critical step in numerous medical imaging studies, which can be facilitated by automatic computational techniques. Supervised methods, although highly effective, require large training datasets of manually labeled images that are labor-intensive to produce. Unsupervised methods, on the contrary, can be used in the absence of...

In this article, we begin with an introduction of the perianal region anatomy, then review the definition, etiology, epidemiology, and 2 major classification systems of perianal fistulas. The role of MR imaging for assessment of perianal fistulas is mainly discussed. Finally, the medical and surgical treatment principles are reviewed.

Purpose: To propose guidelines based on an expert-panel-derived unified approach to the technical performance, interpretation, and reporting of MRI for baseline and post-treatment staging of rectal carcinoma. Methods: A consensus-based questionnaire adopted with permission and modified from the European Society of Gastrointestinal and Abdominal...

We map out a typical prostate cancer care pathway through discussion of updates on modern imaging. Multiparametric MRI (mpMRI) is the most sensitive and specific imaging tool for diagnosis and local staging, transrectal ultrasound remains the most widely used technique for prostate biopsy guidance, CT and bone scan are useful in initial staging and...

Purpose To compare the survival outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) who had regular imaging surveillance with those who had clinical follow-up after Whipple. Method We identified 229 patients, who underwent Whipple for resection of PDAC from 2005 to 2011, and had regular postoperative clinical follow-up at our hospital...

Birt-Hogg-Dube (BHD) disease is an autosomal dominant cancer syndrome characterized by benign skin tumors, renal cancer and spontaneous pneumothorax and is caused by mutations in the Folliculin (FLCN) gene. Benign skin tumors and pneumothorax occur in the majority of patients affected by BHD syndrome, but only 30-45% of them develop renal cell carc...

Cholangiocarcinoma is a relatively uncommon malignant neoplasm with poor prognosis. The distinction between extrahepatic and intrahepatic subtypes is important as epidemiological features, biologic and pathologic characteristics, and clinical course are different for both entities. This review study focuses on the role imaging plays in the diagnosi...

A wide spectrum of extranodal lymphomas in the abdomen and pelvis is commonly encountered by imaging. Diagnosing these lesions generally requires a multimodality approach. This review highlights imaging appearances of extranodal lymphomas in the abdomen and pelvis with emphasis on computed tomography, magnetic resonance imaging, and positron emissi...