Publications by authors named "Jeffrey Guenette"

Background: Observational studies suggest circulating tumor HPV DNA may facilitate early detection of recurrent HPV-positive oropharynx cancer (OPC). We prospectively investigated whether biomarker-guided surveillance detects recurrence sooner than standard-of-care.

Patients And Methods: We enrolled patients evaluated for HPV-positive OPC at a single center 11/2020-4/2023 undergoing curative-intent treatment in a single-arm cohort study.

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Objective: Although recommendations for additional imaging are common in radiology reports, completion of follow-up imaging does not always occur, which could reflect disagreement between radiologist and referring provider. We assessed how frequently referring providers agree with radiologists' follow-up recommendations, reasons for disagreement, and factors associated with radiologist-referring provider agreement.

Methods: This institutional review board-exempt, retrospective study was performed at a large academic center.

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Objective: Assess whether display of a patient photograph in the electronic health record (EHR) alongside head and neck CT or MRI radiology examinations is associated with recommendations for additional imaging (RAI) and whether self-reported race modifies that association.

Methods: This multi-institution health care system retrospective observational study from June 1, 2021 to May 31, 2022 included all patients with a head/neck CT or MRI report. We investigated association of photograph with RAIs using mixed-effects models adjusting for age, sex, complexity score, race, and area deprivation index while conditioning on patient and radiologist.

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Objectives: We aim to assess the pooled incidence of immune effector cell-associated neurotoxicity syndrome (ICANS) in clinical trials and real-world studies of chimeric antigen receptor (CAR) T-cell therapy for hematologic malignancy and compare the incidences among different agents.

Methods: The PubMed, Embase, and Web of Science databases were searched for clinical trials and real-world studies. An inverse-variance weighting model was used to calculate pooled incidences and subgroup analyses.

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Accurate and reliable registration of longitudinal spine images is essential for assessment of disease progression and surgical outcome. Implementing a fully automatic and robust registration is crucial for clinical use, however, it is challenging due to substantial change in shape and appearance due to lesions. In this paper we present a novel method to automatically align longitudinal spine CTs and accurately assess lesion progression.

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Objective: This study describes an innovative optic nerve MRI protocol for better delineating optic nerve anatomy from neighboring pathology.

Methods: Twenty-two patients undergoing MRI examination of the optic nerve with the dedicated protocol were identified and included for analysis of imaging, surgical strategy, and outcomes. T2-weighted and fat-suppressed T1-weighted gadolinium-enhanced images were acquired perpendicular and parallel to the long axis of the optic nerve to achieve en face and in-line views along the course of the nerve.

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MR imaging has become the routine technique for staging nasopharyngeal carcinoma, evaluating perineural tumor spread, and detecting cartilage invasion in laryngeal carcinoma. However, these protocols traditionally require in the range of 25 to 35 minutes of acquisition time. 3D sequences offer the potential advantage of time savings through the acquisition of 1-mm or submillimeter resolution isotropic data followed by multiplanar reformats that require no further imaging time.

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Importance: Image guidance is an important adjunct for endoscopic sinus and skull base surgery. However, current systems require bulky external tracking equipment, and their use can interrupt efficient surgical workflow.

Objective: To evaluate a trackerless surgical navigation system using 3-dimensional (3D) endoscopy and simultaneous localization and mapping (SLAM) algorithms in the anterior skull base.

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MR imaging has become the routine technique for staging nasopharyngeal carcinoma, evaluating perineural tumor spread, and detecting cartilage invasion in laryngeal carcinoma. However, these protocols traditionally require in the range of 25 to 35 minutes of acquisition time. 3D sequences offer the potential advantage of time savings through the acquisition of 1-mm or submillimeter resolution isotropic data followed by multiplanar reformats that require no further imaging time.

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A paucity of relevant guidelines may lead to pronounced variation among radiologists in issuing recommendations for additional imaging (RAI) for head and neck imaging. The purpose of this article was to explore associations of RAI for head and neck imaging examinations with examination, patient, and radiologist factors and to assess the role of individual radiologist-specific behavior in issuing such RAI. This retrospective study included 39,200 patients (median age, 58 years; 21,855 women, 17,315 men, 30 with missing sex information) who underwent 39,200 head and neck CT or MRI examinations, interpreted by 61 radiologists, from June 1, 2021, through May 31, 2022.

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Objective: To assess the rate of iatrogenic injury to the inner ear in vestibular schwannoma resections.

Study Design: Retrospective case review.

Setting: Multiple academic tertiary care hospitals.

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Purpose: The aims of this study were to measure the actionability of recommendations for additional imaging (RAIs) in head and neck CT and MRI, for which there is a near complete absence of best practices or guidelines; to identify the most common recommendations; and to assess radiologist factors associated with actionability.

Methods: All head and neck CT and MRI radiology reports across a multi-institution, multipractice health care system from June 1, 2021, to May 31, 2022, were retrospectively reviewed. The actionability of RAIs was scored using a validated taxonomy.

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Article Synopsis
  • * Researchers utilized various MRI data types to identify brain features that can distinguish PTSD from controls, revealing that classification accuracy decreases significantly when using multi-site data compared to single-site studies.
  • * The denoising variational autoencoder (DVAE) model showed improved generalization on new datasets, indicating its potential for better classification of PTSD, although overall performance still remained only slightly above chance levels.
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Sinonasal myxomas are rare benign tumors of the maxillary bone and sinus. There is published evidence that sinonasal myxomas occurring in children up to 3 years of age ("infantile sinonasal myxomas") are clinically distinctive and harbor Wnt signaling pathway alterations. Here, we characterized 16 infantile sinonasal myxomas and compared them to 19 maxillary myxomas and 11 mandibular myxomas in older patients.

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Purpose: Drilling injuries of the inner ear are an underreported complication of lateral skull base (LSB) surgery. Inner ear breaches can cause hearing loss, vestibular dysfunction, and third window phenomenon. This study aims to elucidate primary factors causing iatrogenic inner ear dehiscences (IED) in 9 patients who presented to a tertiary care center with postoperative symptoms of IED following LSB surgery for vestibular schwannoma, endolymphatic sac tumor, Meniere's disease, paraganglioma jugulare, and vagal schwannoma.

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Background: Pretreatment identification of pathological extranodal extension (ENE) would guide therapy de-escalation strategies for in human papillomavirus (HPV)-associated oropharyngeal carcinoma but is diagnostically challenging. ECOG-ACRIN Cancer Research Group E3311 was a multicentre trial wherein patients with HPV-associated oropharyngeal carcinoma were treated surgically and assigned to a pathological risk-based adjuvant strategy of observation, radiation, or concurrent chemoradiation. Despite protocol exclusion of patients with overt radiographic ENE, more than 30% had pathological ENE and required postoperative chemoradiation.

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Reported rates of recommendations for additional imaging (RAIs) in radiology reports are low. Bidirectional encoder representations from transformers (BERT), a deep learning model pretrained to understand language context and ambiguity, has potential for identifying RAIs and thereby assisting large-scale quality improvement efforts. The purpose of this study was to develop and externally validate an artificial intelligence (AI)-based model for identifying radiology reports containing RAIs.

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Article Synopsis
  • * Analysis included 526 patients with newly diagnosed GBM and 580 with recurrent GBM, revealing similar correlations in progression-free survival (PFS) and overall survival (OS) between RANO and mRANO.
  • * Findings indicate that confirmation scans within 12 weeks post-radiotherapy improve assessment accuracy, while the iRANO criteria did not provide additional benefits over RANO and mRANO.
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Background: More than 75% of patients with breast cancer treated with chemotherapy experience cognitive impairments (eg, memory and attention problems), commonly known as chemo-brain. Exercise, especially aerobic high-intensity interval training (HIIT), is associated with better cognitive function in healthy populations. However, clinical trials testing the impact of exercise interventions on chemotherapy-induced cognitive decline in patients with cancer are lacking, and the mechanisms through which exercise could improve cognitive function are unclear.

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Importance: It is challenging to ensure timely performance of radiologist-recommended additional imaging when radiologist recommendation language is incomplete or ambiguous.

Objective: To evaluate whether voluntary use of an information technology tool with forced structured entry of recommendation attributes was associated with improved completeness of recommendations for additional imaging over time.

Design, Setting, And Participants: This cohort study of imaging report data was performed at an academic quaternary care center in Boston, Massachusetts, and included consecutive adults with radiology examinations performed from September 12 to 13, 2019 (taxonomy validation), October 14 to 17, 2019 (before intervention), April 5 to 7, 2021 (1 week after intervention), and April 4 to 7, 2022 (1 year after intervention), with reports containing recommendations for additional imaging.

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