Publications by authors named "Alexander Norbash"

Article Synopsis
  • * AAR-RRA's task force studied how academic radiologists contribute beyond just high clinical volumes and RVU-generating work, highlighting the importance of these additional roles.
  • * Their findings are shared in a two-part report, with the first part addressing the current situation in radiology and the second part outlining future strategies for striking a better balance between clinical work and non-RVU activities.
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Article Synopsis
  • - This study systematically reviews brain MRI findings in COVID-19 patients with neurological symptoms, highlighting that over one-third experience such issues.
  • - After analyzing 25 publications and 3118 cases, significant MRI findings include acute/subacute infarction, olfactory bulb abnormalities, white matter abnormalities, and cerebral microbleeds.
  • - The research indicates a notable prevalence of detectable neurological abnormalities in COVID-19 patients, emphasizing the need for further exploration of these symptoms and their implications.
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Background phase errors in 4D Flow MRI may negatively impact blood flow quantification. In this study, we assessed their impact on cerebrovascular flow volume measurements, evaluated the benefit of manual image-based correction, and assessed the potential of a convolutional neural network (CNN), a form of deep learning, to directly infer the correction vector field. With IRB waiver of informed consent, we retrospectively identified 96 MRI exams from 48 patients who underwent cerebrovascular 4D Flow MRI from October 2015 to 2020.

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The use of artificial intelligence (AI) and robotics in endovascular neurosurgery promises to transform neurovascular care. We present a review of the recently published neurosurgical literature on artificial intelligence and robotics in endovascular neurosurgery to provide insights into the current advances and applications of this technology. The PubMed database was searched for "neurosurgery" OR "endovascular" OR "interventional" AND "robotics" OR "artificial intelligence" between January 2016 and August 2021.

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Background: Challenging arterial anatomy delays, or prevents timely endovascular treatment (EVT) of acute ischemic stroke (AIS). We introduce a new technique called 'Balloon Gliding Technique (BGT)' to overcome difficult arterial anatomy during EVT of AIS, utilizing flow-assistance to access challenging circulations.

Methods: Retrospective review of a prospectively collected database of all patients presenting to a single institution with AIS who underwent EVT was performed from January 2021 to June 2021.

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Catheters used for endovascular navigation in interventional procedures lack dexterity at the distal tip. Neurointerventionists, in particular, encounter challenges in up to 25% of aneurysm cases largely due to the inability to steer and navigate the tip of the microcatheters through tortuous vasculature to access aneurysms. We overcome this problem with submillimeter diameter, hydraulically actuated hyperelastic polymer devices at the distal tip of microcatheters to enable active steerability.

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The simultaneous growth of robotic-assisted surgery and telemedicine in recent years has only been accelerated by the recent coronavirus disease 2019 pandemic. Robotic assistance for neurovascular intervention has garnered significant interest due to opportunities for tele-stroke models of care for remote underserved areas. Lessons learned from medical robots in interventional cardiology and neurosurgery have contributed to incremental but vital advances in medical robotics despite important limitations.

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Venous variants and pathologic abnormalities are the most common causes of pulsatile tinnitus. These conditions include causes of turbulence within normally located veins and sinuses, and abnormally enlarged or abnormally located veins in close transmissive proximity to the conductive auditory pathway. Such disorders include pathologic abnormalities of the lateral sinus (transverse sinus stenosis and sigmoid sinus wall anomalies), abnormalities and variants of the emissary veins, and anomalies of the jugular bulb and jugular vein.

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Radiologists are facing an evolving dilemma of increased imaging examination volumes while maintaining the highest levels of diagnostic quality. This scenario places radiologists at risk for error, burnout, and loss of opportunities that add value beyond imaging interpretations. We propose a new framework categorizing radiology tests based on clinical intent, level of imaging technique, and appropriate level of reporting detail.

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Purpose: To evaluate gender distribution in radiology professional society leadership positions. Our study intends to assess and compare the gender distribution among leadership roles and professional society committee memberships of the radiology societies and seek an understanding of potential associations between gender, academic research metrics, institutional academic rank, and leadership roles.

Methods: We identified radiology professional society committee members to assess relative gender composition in 28 radiology societies in North America, Europe, and Australia/New Zealand.

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The speed at which coronavirus disease 2019 (COVID-19) spread quickly fractured the radiology practice model in ways that were never considered. In March 2020, most practices saw an unprecedented drop in their volume of greater than 50%. The profound changes that have interrupted the arc of the radiology narrative may substantially dictate how health care and radiology services are delivered in the future.

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Objective: The coronavirus disease 2019 (COVID-19) pandemic resulted in significant loss of radiologic volume as a result of shelter-at-home mandates and delay of non-time-sensitive imaging studies to preserve capacity for the pandemic. We analyze the volume-related impact of the COVID-19 pandemic on six academic medical systems (AMSs), three in high COVID-19 surge (high-surge) and three in low COVID-19 surge (low-surge) regions, and a large national private practice coalition. We sought to assess adaptations, risks of actions, and lessons learned.

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This article presents a current snapshot in time, describing how radiology departments around the country are planning recovery from the baseline of the coronavirus disease 2019 pandemic, with a focus on different domains of recovery such as managing appointment availability, patient safety and workflow changes, and operational data and analytics. An e-mail survey was sent through the Society of Chairs of Academic Radiology Departments list server to 114 academic radiology departments. On the basis of data reported by the 38 survey respondents, best practices and shared experience are described for three key areas: (1) planning for recovery, (2) creating a new normal, and (3) measuring and forecasting.

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Introduction This meta-analysis was conducted to assess the safety and efficacy of aspiration thrombectomy versus stent retriever thrombectomy for acute ischemic stroke (AIS). Methods We queried online databases for original studies comparing aspiration thrombectomy with stent retriever thrombectomy in patients with AIS. After article selection, data were extracted on multiple baseline characteristics and prespecified endpoints.

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Although there is an increasing understanding of the importance of diversity and inclusion in all aspects of radiology training and practice, many radiology practices have yet to invest into programs that raise awareness and assure that diversity and inclusion goals are met. In many instances, leadership fails to see the value of such investments. Here, we explore what can be learned from other industries in making the business case for diversity and inclusion.

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Background: Coil migration is a complication of endovascular coiling of cerebral aneurysms that has not been well studied.

Objective: To report the frequency, risk factors, management strategies, and outcomes of coil migration.

Methods: This was a retrospective analysis of the clinical and radiological data of patients who underwent cerebral aneurysm coiling complicated by coil migration at five neuroendovascular centers in the United States, Canada, and France between 2008 and 2018.

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Radiology has traditionally been a male-dominated medical specialty, and this is also reflected in the authorship of radiology publications and the composition of radiology journal editorial boards. The purpose of this study was to quantify the extent of the gender disparities reflected within the journal editorial boards of the largest international radiologic societies. Methods were crafted to generate a geographically based gender analysis of the editorial boards of the largest general radiologic societies globally.

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The anterior communicating artery is a common location for intracranial aneurysms. Compared to surgical clipping, endovascular coiling has been shown to improve outcomes for patients with ruptured aneurysms and we have seen a paradigm shift favoring this technique for treating aneurysms. Access to the anterior cerebral artery can be challenging, especially in patients with tortuous anatomy or subarachnoid hemorrhage or in patients presenting with vasospasm.

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