Publications by authors named "Gilkeson R"

Background: Evaluation of cardiothoracic pathologies is a common indication for computed tomography (CT) in infants. However, CT is fraught with challenges specific to the patient population, such as increased sensitivity to radiation and inability to remain stationary during imaging.

Objective: This study investigates potential advantages of a high-pitch helical CT protocol for infants with cardiothoracic pathologies.

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Although many advancements have been made in imaging modalities that can be used to diagnose pulmonary embolism (PE), computed tomography pulmonary angiography (CTPA) is still the preferred gold standard for promptly diagnosing pulmonary embolism by looking for filling defects caused by the embolus lodged within the main pulmonary artery or its respective branches. The diagnosis is made by the radiologists in emergency settings where quick detection of a PE on CTPA helps the Pulmonary Embolism Response Team (PERT) in quick management. Thus, utmost care is needed to follow standard image acquisition protocols and optimal contrast administration techniques to achieve a contrast opacification of at least 210 Hounsfield units for the radiologists to easily pinpoint an embolus within the pulmonary arteries.

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Article Synopsis
  • Researchers aimed to find a screening method using computed tomography calcium scoring (CTCS) to assess the risk of heart failure (HF) in patients, particularly focusing on those with type 2 diabetes.
  • They analyzed CTCS scans from nearly 2,000 patients and applied deep learning to create models that predict HF risk based on radiomic features of epicardial adipose tissue (EAT) and calcifications.
  • The study found that CTCS-based models, especially those using fat-omics for non-diabetic patients and calcium-omics for diabetic patients, significantly outperformed traditional clinical prediction methods in forecasting incident HF.
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Severe COVID-19 can lead to extensive lung disease causing lung architectural distortion. In this study we employed machine learning and statistical atlas-based approaches to explore possible changes in lung shape among COVID-19 patients and evaluated whether the extent of these changes was associated with COVID-19 severity. On a large multi-institutional dataset (N = 3443), three different populations were defined; a) healthy (no COVID-19), b) mild COVID-19 (no ventilator required), c) severe COVID-19 (ventilator required), and the presence of lung shape differences between them were explored using baseline chest CT.

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Whole-heart coronary calcium Agatston score is a well-established predictor of major adverse cardiovascular events (MACE), but it does not account for individual calcification features related to the pathophysiology of the disease (e.g., multiple-vessel disease, spread of the disease along the vessel, stable calcifications, numbers of lesions, and density).

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Purpose: This study aims to highlight presentations, acute findings and imaging phenotypes of patients presenting to the emergency department (ED) within 30 days of a transcatheter aortic valve replacement (TAVR).

Methods: A retrospective review of patients diagnosed with aortic valve disease who underwent a TAVR between Jan 2015 and Nov 2021 at a large academic medical center was completed. From an initial 1271 patients, 146 were included based on their presentation to the ED within 30 days post-TAVR procedure.

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Background: Coronary artery calcium (CAC) is a powerful predictor of major adverse cardiovascular events (MACE). Traditional Agatston score simply sums the calcium, albeit in a non-linear way, leaving room for improved calcification assessments that will more fully capture the extent of disease.

Objective: To determine if AI methods using detailed calcification features (i.

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In this report, we present a series involving critically ill patients with known coronavirus disease (COVID-19) infection where a portable X-ray machine equipped with artificial intelligence (AI) software aided in the urgent radiographic diagnosis of pneumothorax. These cases demonstrate how real-world clinical employment of AI tools capable of analyzing and prioritizing studies in the radiologist's worklist can potentially lead to earlier detection of emergent findings like pneumothorax. The use of AI tools in this manner has the potential to both improve radiology workflow and add significant clinical value in managing critically ill patient populations, such as those with severe COVID-19 infection.

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Objective: The disease COVID-19 has caused a widespread global pandemic with ~3. 93 million deaths worldwide. In this work, we present three models-radiomics (M), clinical (M), and combined clinical-radiomics (M) nomogram to predict COVID-19-positive patients who will end up needing invasive mechanical ventilation from the baseline CT scans.

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Background: Prior studies have suggested significant underutilization of statins in women and worse cardiovascular outcomes. Data examining the impact of real-world coronary artery calcium (CAC) scoring to improve utilization of preventive therapies and outcomes is limited.

Methods: In a prospective registry study of low cost or no-cost CAC scoring between 2014 and 19 (CLARIFY Study, Clinicaltrials.

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Objective: Low-dose cardiac-gated chest CTs allow for simultaneous evaluation of coronary artery calcification and aortic size. We sought to evaluate the prevalence of thoracic aortic dilation (TAD) and thoracic aortic aneurysm (TAA) in a large cohort of patients undergoing coronary artery calcium (CAC) screening.

Methods: We reviewed all patients from a large, prospective no-charge CAC screening program (CLARIFY, Clinicaltrials.

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Tumoral calcinosis is a rare syndrome that affects mostly soft tissues. It is characterized by calcium salt deposition in the periarticular soft tissue surrounding bony structures forming slow-growing, seldom asymptomatic masses. This case report describes a 41-year-old male with end-stage renal disease on home hemodialysis, who presented with an unusual rapidly progressive mass overlying the manubrium and suprasternal notch, following recent cardiothoracic surgery, which was initially felt to be a hematoma.

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Lung transplant patients often suffer from posttransplant airway pathologies that require placement of endobronchial stents. In addition to surveillance bronchoscopy, patients often undergo radiographic stent evaluations. Chest x-rays are extremely limited in their ability to diagnose stent complications, so many patients require chest computed tomography (CT) scans for stent evaluation.

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Purpose: Preimplantation cardiac computed tomography (CT) for assessment of the left atrial appendage (LAA) enables correct sizing of the device and the detection of contraindications, such as thrombi. In the arterial phase, distinction between false filling defects and true thrombi can be hampered by insufficient contrast medium distribution. A delayed scan can be used to further differentiate both conditions, but contrast in these acquisitions is relatively lower.

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Article Synopsis
  • The study aimed to develop a quantitative imaging method using CT scans to distinguish between different types of adenocarcinoma, specifically adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (INV).
  • By analyzing 268 patients with small semisolid lung lesions and extracting 248 radiomic texture features from the scans, researchers tested a machine learning classifier to determine the lesions' invasiveness.
  • The results showed the model effectively differentiated INV from MIA/AIS with high accuracy, suggesting that integrating advanced radiomic analysis with traditional imaging methods could improve clinical decision-making for cancer treatment.
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Coronary artery calcium (CAC) scores obtained from CT scans have been shown to be prognostic in assessment of the risk for development of cardiovascular diseases, facilitating the prediction of outcome in asymptomatic individuals. Currently, several methods to calculate the CAC score exist, and each has its own set of advantages and disadvantages. Agatston CAC scoring is the most extensively used method.

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Prevention of cardiovascular disease is currently guided by probabilistic risk scores that may misclassify individual risk and commit many middle-aged patients to prolonged pharmacotherapy. The coronary artery calcium (CAC) score, although endorsed for intermediate-risk patients, is not widely adopted because of barriers in reimbursement. The impact of removing cost barrier on cardiovascular outcomes in real-world settings is not known.

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Background: CardioMEMS heart failure (HF) system is an implantable wireless pressure sensor that is placed in a branch of the pulmonary artery (PA) for remote monitoring of PA pressures in patients with HF. Pulmonary artery injury/haemoptysis can occur during the sensor placement.

Case Summary: An 80-year-old male patient with HF with reduced ejection fraction (20%) underwent CardioMEMS HF system implantation for recurrent shortness of breath.

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Although interest in artificial intelligence (AI) has exploded in recent years and led to the development of numerous commercial and noncommercial algorithms, the process of implementing such tools into day-to-day clinical practice is rarely described in the burgeoning AI literature. In this report, we describe our experience with the successful integration of an AI-enabled mobile x-ray scanner with an FDA-approved algorithm for detecting pneumothoraces into an end-to-end solution capable of extracting, delivering, and prioritizing positive studies within our thoracic radiology clinical workflow. We also detail several sample cases from our AI algorithm and associated PACS workflow in action to highlight key insights from our experience.

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For more than 1 year, COVID-19 pandemic has impacted every aspect of our lives. This paper reviews the major challenges that the radiology community faced over the past year and the impact the pandemic had on the radiology practice, radiologist-in-training education, and radiology research. The lessons learned from COVID-19 pandemic can help the radiology community to be prepared for future outbreaks and new pandemics, preserve good habits, enhance cancer screening programs, and adapt to the changes in radiology education and scientific meetings.

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Almost 25% of COVID-19 patients end up in ICU needing critical mechanical ventilation support. There is currently no validated objective way to predict which patients will end up needing ventilator support, when the disease is mild and not progressed. N = 869 patients from two sites (D: N = 822, D: N = 47) with baseline clinical characteristics and chest CT scans were considered for this study.

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The aim of this study is to evaluate whether NIS radiomics can distinguish lung adenocarcinomas from granulomas on non-contrast CT scans, and also to improve the performance of Lung-RADS by reclassifying benign nodules that were initially assessed as suspicious. The screening or standard diagnostic non-contrast CT scans of 362 patients was divided into training (S, = 145), validation (S, = 145), and independent validation (S, = 62) sets from different institutions. Nodules were identified and manually segmented on CT images by a radiologist.

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Clinicians should be aware of the potential for cardiovascular involvement in COVID-19 infection. Coronavirus disease-2019 (COVID-19) is a viral illness caused by severe acute respiratory syndrome-coronavirus-2. While it primarily causes a respiratory illness, a number of important cardiovascular implications have been reported.

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Objective: To identify stable and discriminating radiomic features on non-contrast CT scans to develop more generalisable radiomic classifiers for distinguishing granulomas from adenocarcinomas.

Methods: In total, 412 patients with adenocarcinomas and granulomas from three institutions were retrospectively included. Segmentations of the lung nodules were performed manually by an expert radiologist in a 2D axial view.

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