Thomas L. Slovis's research while affiliated with Wayne State University and other places

Publications (216)

Article
Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening response would be associated with developmental and behavioral problems at school age in EPT children. This...
Article
Importance Both preterm birth and increased screen time are known to be associated with an increase in risk of developmental and behavioral sequelae. The association between high screen time or a television or computer in the bedroom in early school age and adverse cognitive, executive function, language, and behavior outcomes of extremely preterm...
Article
Objective: To investigate associations in toddlers born extremely preterm (<28 weeks) between neonatal neuroimaging and 18- to 22-month developmental and behavioral outcomes. Study design: Cohort analysis from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Surfactant Positive Airway...
Article
Full-text available
Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term...
Article
Objective: To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. Study design: Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed....
Article
Full-text available
Background Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients’ brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retenti...
Article
Full-text available
This paper addresses significant misconceptions regarding the etiology of fractures in infants and young children in cases of suspected child abuse. This consensus statement, supported by the Child Abuse Committee and endorsed by the Board of Directors of the Society for Pediatric Radiology, synthesizes the relevant scientific data distinguishing c...
Article
Recent articles on child abuse in this journal discussed the value of ordering a skeletal survey in children age 24-36 months and the need for a computed tomography (CT) of the head in children less than 2 years with an isolated single nonmetaphyseal long bone fracture. The benefits of these and other imaging studies are not merely in the number of...
Article
The foundation for the usefulness of any diagnostic test should be that it is both reliable and accurate in its clinical diagnosis. In this article we present the second of a two-part series on validity and reliability, discussing the assessment of reliability among raters of diagnostic tests and between diagnostics tests themselves. To examine rep...
Article
The intent of this manuscript is to provide guidance and support to clinicians and investigators for reporting the results of screening and diagnostic tests. This article is the first of two parts addressing statistics in imaging research. In this part validity measures are discussed. In part II reliability measures will be discussed. In discussing...
Article
Full-text available
Extremely preterm infants are at risk for neurodevelopmental impairment (NDI). Early cranial ultrasound (CUS) is usual practice, but near-term brain MRI has been reported to better predict outcomes. We prospectively evaluated MRI white matter abnormality (WMA) and cerebellar lesions, and serial CUS adverse findings as predictors of outcomes at 18 t...
Chapter
The chapter begins by discussing the development of imaging techniques and then addresses the tremendous importance of clinical evaluation in selecting the “best” first imaging test. Issues of appropriateness based on indications and cost containment are reviewed. Imaging modalities are presented with their risks and benefits. Techniques for reduci...
Article
Most pediatric CT examinations (as many as 85%) are performed at non-pediatric-focused facilities. In contrast to children's hospitals and pediatric emergency departments, the number of CT examinations is increasing at these non-pediatric facilities. Compliance with diagnostic reference levels (DRLs) for dose has been shown to be poor at several me...
Article
PURPOSE Children with Hodgkin's lymphoma (HL) routinely undergo surveillance computed tomography (CT) imaging for up to 5 years after therapy, resulting in cost and radiation exposure, without clear benefit. The objective of this study was to determine the contribution of surveillance CT, as compared with clinical findings, to detection of disease...
Article
The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but increased potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures,...
Article
Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate...
Article
In the last decade, there has been recognition of the effects of low-dose radiation in children. A critical mass of scientists, health care providers and manufacturers of radiation-producing imaging equipment has come together to educate ordering physicians to request only indicated examinations and radiologists to achieve low-dose examinations wit...
Article
Sedation and anesthesia for pediatric imaging departments has changed dramatically for the following reasons: (1) radiologists have stopped sedating patients; (2) the majority of sedations are not for CT (because of the speed of the procedure) but for MR, which lasts 45 min or greater; (3) a cadre of services--pediatricians, emergency medicine phys...
Article
Retirement can be defined as a new stage of an active lifestyle. It is a unique chapter in life that can be fun and rewarding, if steps are taken to plan the process. Key factors to take into consideration during this process are family, friends, finances, and professional interests. With proper planning, rather than withdrawing from an active life...
Conference Paper
LEARNING OBJECTIVES Learning Objectives: Be familiar with select controversial topics in pediatric imaging, including cervical spine evaluation, evaluation of the acute abdomen, and the use of imaging in trauma. Be able to recognize the arguments for and against differing imaging strategies in these scenarios. Incorporate information from these dis...
Article
The art of communication involves understanding the needs of the person with whom one is interacting. The radiologist must be an expediter and a consultant. Face-to-face, eyeball-to-eyeball communication is almost always best. Nonverbal communication must be aligned with verbal principles. The radiologist must build trust to have successful communi...
Article
Pulmonary deposition of inhaled drugs in ventilated neonates has not been studied in vivo. The objective of this study was to evaluate pulmonary delivery of gadopentetate dimeglumine (Gd-DTPA) following nebulization in ventilated piglets using magnetic resonance imaging. Seven ventilated piglets (5 +/- 2 d old, weight 1.8 +/- 0.5 kg) were scanned i...
Article
To assess interobserver reliability between 2 central readers of cranial ultrasound scanning (CUS) and accuracy of local, compared with central, interpretations. The study was a retrospective analysis of CUS data from the National Institute of Child Health and Human Development (NICHD) trial of inhaled nitric oxide for premature infants. Interobser...
Chapter
Pediatric RadiologyAn Introduction for Medical Students, Residents, and Pediatric Health Care Providers 10.1007/3-540-26442-6_7 7.Skeleton
Article
Most computed and digital radiography manufacturers recognize that pediatric patients are unique and have developed special provisions for pediatric exams, including image processing and accommodations for special exams like scoliosis.
Article
This basic text introduces the reader to all facets of pediatric imaging from the importance of understanding X-ray exposure to children through the appropriate indications for ordering a particular examination. It covers basic problems in each organ system. There is a quiz after most of the clinical chapters. The text is aimed at the novice, while...
Article
Computed tomography (CT) is an extremely valuable diagnostic tool. Recent advances, particularly multidetector technology, have provided increased and more diverse applications. However, there is also the potential for inappropriate use and unnecessary radiation dose. Because some data indicate that low-dose radiation (such as that in CT) may have...
Article
The Society for Pediatric Radiology, with an unrestricted grant from GE Medical Systems, organized a multidisciplinary conference to discuss dose issues in pediatric CT (As Low as Reasonably Achievable, or ALARA, Concept in Pediatric CT-Intelligent Dose Reduction) in August 2001.
Article
The objective of this report was to study the elimination pharmacokinetics of iodixanol in children. Iodixanol (Visipaque®, Nycomed Inc., Wayne, PA, USA) is a new iso-osmolar iodinated radiocontrast agent. We hypothesized that elimination of this agent would be dependent on age-related differences in renal clearance. Seven centers enrolled 43 patie...
Article
The two most important challenges we face are the future of pediatric radiology in children's hospitals and developing leadership in pediatric imaging.
Article
Spinal cord compression secondary to metastases is an infrequent complication of childhood cancer. We describe an infant with hepatoblastoma in whom cord compression developed because of extensive epidural metastases during treatment. This is a hitherto undescribed metastatic site for hepatoblastoma.
Article
We must reload the pipeline of pediatric imagers, encourage subspecialization, and be creative in coordinating our professional needs with a reasonable lifestyle.
Article
We report two neonates with anemia, hemoperitoneum, and bilateral palpable abdominal masses. Both developed bleeding: a hemoperitoneum in one and visceral hemorrhages secondary to disseminated intravascular coagulation in the other. Each child was thought to have an unusual complication of adrenal hemorrhage, as the masses were of mixed echogenicit...

Citations

... Previous studies have shown that boys and children born preterm tend to spent more time on digital media. 4,19 Consistent with the previous findings, we found that boys spent more time playing video games In an additional attempt to correct for the smaller brain at baseline, we built a model (Models 4 and 5), accounting for the baseline brain measure as an additional covariate to the pre-existing covariates for the longitudinal analyses (as described in the methods). Absolute brain measure at two years of follow-up was used as the dependent variable. ...
... Decreased cerebellar volumes and delayed growth are associated with noxious perinatal and postnatal factors [16,17]. The cerebellar development of preterm infants and the crucial function of the cerebellum in terms of complex neurological abilities for cognitive and language development have gained more attention in recent years [18][19][20][21]. Impairments of complex functions have been associated with cerebellar injury, which then leads to deficits in language and cognitive skills, as well as altered social, emotional, and behavioral development of preterm infants [19,[22][23][24]. ...
... Abusive head trauma (AHT) is the leading cause of fatal head injuries in this age group, with an annual incidence of 33 to 38 per 100,000 infants [4,5] and high rates of mortality and long-term disability [6][7][8][9]. Diagnosing AHT is a clinical challenge that requires a combination of physical exam, detailed history and diagnostic studies including neuroimaging [10]. In recent years, magnetic resonance imaging (MRI) has been found to be a useful and sensitive modality for detecting parenchymal injuries, including contusions, diffuse axonal injury (DAI), hypoxic-ischemic injury (HII), and early cerebral edema in TBI. ...
... While some researchers have expressed concerns about excess adiposity among preterm infants [9,55], the cohort of preterm infants in this study at 3 years of age had a near normal distribution of BMI (Fig. 1), with the median BMI z-scores equal to −0.19, had slightly lighter BMIs than the WHO Multicentre Growth Reference Study participants [16]. A small percentage of the children was in the OWO category (2.4% had BMIs > +2 standard deviations), while the WHO Multicentre Growth Reference Study's selected healthy sample had 2.3% of their BMIs > +2 standard deviations, by the normal distribution definition. ...
... Both are based on relative risk models that depend on sex, age at exposure, and time since exposure, and inherently assume a linear extrapolation of risks from intermediate to low doses. [1996][1997][1998][1999] (bars left to right in each group) (McAlister WH, personal communication). Number of pediatric CT examinations almost doubled between 1996 and 1999. ...
... The important considerations to achieve the higher spatial resolution and signal to noise ratio include a 3T or higher magnetic field strength, a 32 or 64-channel head coil over an 8 or 12-channel head coil to increase peripheral resolution, along with combination of a precontrast and postcontrast T1-weighted anisotropic 2D and isotropic 3D sequences based on the specific clinical indication [26,27]. An important consideration in performing VWI, specifically in younger patients, in the evaluation and follow-up of CCV includes repetitive use of gadolinium-based contrast agent [28]. The role of dedicated MR sequences in the evaluation of CCV is summarized in Table 1. ...
... The 2016 Swedish Agency for Health Technology Assessment and Assessment of Social Services (Statens Beredning för medicinsk och social Utvärdering: SBU) report about 'traumatic shaking' [1] and the 2017 summarizing article in Acta Paediatrica [2] were heavily criticized, mostly because of concerns about methodological shortcomings [3][4][5][6][7][8][9][10][11]. ...