Publications by authors named "Ram Vaidhyanath"

Article Synopsis
  • This pilot study assesses the effectiveness of the Koios Decision Support™ AI tool in improving the accuracy of ultrasound evaluations for thyroid nodules, aiming to reduce the need for fine needle aspiration (FNA).
  • Conducted on 29 patients analyzed over a year, the study compared traditional FNA results with AI recommendations, using surgical histology as a standard reference.
  • The findings indicate that while the AI tool has a sensitivity of 85.7% and a positive predictive value of 63.2%, it also suggests that 53% of benign cases may not need FNA, highlighting the potential for AI to enhance diagnostic performance despite the sample size limitations.
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Article Synopsis
  • - The study aimed to compare the effectiveness of ultrasound (US) elastography-guided fine-needle aspiration cytology (FNAC) versus conventional US-guided FNAC in diagnosing thyroid nodules, focusing on reducing nondiagnostic results.
  • - Conducted across 18 hospitals in England, the trial involved 982 participants who were randomized to either the elastography (493 patients) or conventional method (489 patients), finding no significant differences in the nondiagnostic rates or time to diagnosis between the two methods.
  • - The results showed similar rates of malignancy and benign findings in both groups, indicating that US elastography-guided FNAC may not provide additional benefits compared to standard US-guided FNAC for thyroid nodules. *
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Introduction: ElaTION is a large multi-centre pragmatic randomised controlled trial, performed in 18 secondary/tertiary hospitals across England, comparing elastography ultrasound-guided fine needle aspiration cytology (EUS-FNAC) with ultrasound-guided FNAC (US-FNAC) alone in the diagnostic assessment of thyroid nodules. Secondary trial outcomes, reported here, assessed the accuracy of ultrasound-alone (US) compared with US-guided FNAC to inform and update current practice guidelines.

Methods: Adults with single or multiple thyroid nodules who had not undergone previous FNAC were eligible.

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Background: Extracapsular spread (ECS) is the extension of cancer cells beyond the lymph node capsule and is a significant prognostic factor in head and neck cancers. This meta-analysis compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers.

Methodology: The authors conducted a systematic review and meta-analysis of studies that compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers.

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Objective: The literature is divided with regards to contralateral tonsillectomy in a known/suspected case of ipsilateral tonsillar malignancy. In this study, we evaluate the incidence of indolent synchronous contralateral tonsillar malignancy (SCTC) in patients with known ipsilateral tonsillar malignancy.

Methods: All patients diagnosed with ipsilateral tonsillar carcinoma (TC) at a tertiary teaching center between January 2016 and December 2019 were screened.

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Article Synopsis
  • - The study aimed to evaluate how well combined CT and MRI detect metastases from oral cancers to lymph nodes in the neck compared to each method alone.
  • - 105 patients with untreated oral squamous cell carcinoma underwent both imaging techniques before surgery, with results showing a diagnostic accuracy of 87%.
  • - The findings suggest that using CT and MRI together may provide better detection of metastatic lymph nodes, which can assist in surgical planning and ongoing monitoring of superficial oral cancers.
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  • - This study assesses the effectiveness of FDG PET scans in staging and managing head and neck cancers by analyzing data from 99 treatment-naïve patients treated between 2017 and 2020 at a specialized medical center.
  • - The findings reveal that PET scans led to changes in management for 36.4% of patients, with significant staging adjustments noted in those with unknown primary cancers and advanced nodal disease.
  • - The research emphasizes the importance of PET-CT in providing accurate initial staging and informing treatment plans for patients with head and neck cancers.
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We present a very rare case of squamous cell carcinoma (SCC) ex pleomorphic adenoma of the lacrimal gland. Our patient presented with a 12 month history of painful proptosis of his left eye associated with severe headache. Imaging showed a left lacrimal gland lesion with extensive orbital disease extending into lateral and superior rectus muscles, cavernous sinus and the greater wing of the sphenoid.

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Temporal bone and ear structure inflammation is commonly due to infection. It can be associated with a variety of complications and postinflammatory sequelae. Where the ear is easily inspected, clinical evaluation suffices.

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Actinomycosis of the tongue is rare. It may be difficult to differentiate this infection clinically and radiologically from other tongue pathology especially neoplasia. We report a substantial tongue lesion which mimicked malignancy at presentation.

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Microcystic adnexal carcinoma (MAC) is a very rare and locally aggressive sweat gland tumour. MAC has been well reported presenting as a periocular cutaneous lesion, rarely with subsequent direct orbital invasion and only once as a primary orbital lesion. Local recurrence is frequent after primary surgical excision and the role of adjuvant radiotherapy is ill-defined.

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A 49-year-old male presented with a 4 month history of dysaesthesia in the left periorbital region. A CT scan showed a lacrimal gland mass with areas of dense calcification. Biopsies of the left lacrimal gland revealed a silver material with associated chronic granulomatous inflammation and secondary calcification.

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Intravascular papillary endothelial hyperplasia (IPEH) or Masson's tumor is an unusual variety of benign vascular tumor. Involvement of periorbital area is uncommon. We report 2 cases of periorbital IPEH and review relevant literature.

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Orbital manifestations in Wegener's granulomatosis develop in over 50% of patients. Ischemic vasculitis and optic nerve compression result in visual impairment. This case report highlights the importance of the yellow lid sign in the diagnosis of orbital granulomatosis as well as provides an explanation for the reversal of this phenomenon.

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Severe acute headache is a common presenting symptom to an accident and emergency department. Spontaneous intracranial hypotension (SIH) is an increasingly recognised cause of these symptoms and has characteristic clinical and imaging findings. SIH is characterised by headache worse on standing, low opening cerebrospinal fluid pressures at lumbar puncture and uniform pachymeningeal enhancement with gadolinium enhanced magnetic resonance imaging of the brain, all in the absence of dural trauma.

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Severe acute headache is a common presenting symptom to an accident and emergency department. Spontaneous intracranial hypotension (SIH) is an increasingly recognised cause of these symptoms and has characteristic clinical and imaging findings. SIH is characterised by headache worse on standing, low opening cerebrospinal fluid pressures at lumbar puncture and uniform pachymeningeal enhancement with gadolinium enhanced magnetic resonance imaging of the brain, all in the absence of dural trauma.

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