Publications by authors named "Abdul Razik"

30 Publications

  • Page 1 of 1

Diffuse small bowel lipomatosis with intussusception.

BMJ Case Rep 2021 Jun 15;14(6). Epub 2021 Jun 15.

Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, Delhi, India

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http://dx.doi.org/10.1136/bcr-2021-242336DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207991PMC
June 2021

Utility of first order MRI-Texture analysis parameters in the prediction of histologic grade and muscle invasion in urinary bladder cancer: a preliminary study.

Br J Radiol 2021 Jun 29;94(1122):20201114. Epub 2021 Apr 29.

Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Objective: To explore the utility of first-order MRI-texture analysis (TA) parameters in predicting histologic grade and muscle invasion in urinary bladder cancer (UBC).

Methods: After ethical clearance, 40 patients with UBC, who were imaged on a 3.0-Tesla scanner, were retrospectively included. Using the TexRAD platform, two readers placed freehand ROI on the sections demonstrating the largest dimension of the tumor, evaluating only one tumor per patient. Interobserver reproducibility was assessed using the intraclass correlation coefficient (ICC). Mann-Whitney test and ROC curve analysis were used to identify statistical significance and select parameters with high class separation capacity (AUC >0.8), respectively. Pearson's test was used to identify redundancy in the results.

Results: All texture parameters showed excellent ICC. The best parameters in differentiating high and low-grade tumors were mean/ mean of positive pixels (MPP) at SSF 0 (AUC: 0.897) and kurtosis at SSF 5 (AUC: 0.828) on the ADC images. In differentiating muscle invasive from non-muscle invasive tumors, mean/ MPP at SSF 0 on the ADC images showed AUC >0.8; however, this finding resulted from the confounding effect of high-grade histology on the ADC values of muscle invasive tumors.

Conclusion: MRI-TA generated few parameters which were reproducible and useful in predicting histologic grade. No independent parameters predicted muscle invasion.

Advances In Knowledge: There is lacuna in the literature concerning the role of MRI-TA in the prediction of histologic grade and muscle invasion in UBC. Our study generated a few first-order parameters which were useful in predicting high-grade histology.
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http://dx.doi.org/10.1259/bjr.20201114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173695PMC
June 2021

Unveiling the confusion in renal fusion anomalies: role of imaging.

Abdom Radiol (NY) 2021 Apr 3. Epub 2021 Apr 3.

Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Renal fusion anomalies are common congenital anomalies of the urogenital tract and have their genesis in the early embryonic period. They are classified into partial fusion anomalies (e.g., crossed fused ectopia, and horseshoe kidney) and complete fusion anomalies (e.g., fused pelvic kidney). Horseshoe kidney is the most common renal fusion anomaly and is characterized by the presence of two distinct functioning kidneys on either side of the vertebral column, with fusion occurring at the inferior poles in majority of the cases. Crossed fused ectopia is characterized by the presence of an ectopic kidney that crosses the midline and fuses with the orthotopic contralateral kidney, whereas fused pelvic (pancake) kidney is a complete fusion anomaly characterized by extensive medial fusion of both kidneys in the pelvis. Fusion anomalies are often associated with abnormalities of renal rotation, migration, and vascular supply, which predispose the kidneys to a number of complications and create difficulty during retroperitoneal surgeries and interventions. They are also associated with other congenital abnormalities of the urogenital tract, gastrointestinal tract, cardiovascular system, and skeletal system. Hence, a thorough understanding of the etiopathogenesis and radiological features of fusion anomalies is important for directing patient management. This review summarizes the embryological basis, clinical presentation and imaging approach to renal fusion anomalies, followed by detailed anatomical and radiological description of the morphological types, and the complications associated with these anomalies.
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http://dx.doi.org/10.1007/s00261-021-03072-1DOI Listing
April 2021

Unusual Primary Neoplasms of the Adult Liver: Review of Imaging Appearances and Differential Diagnosis.

Curr Probl Diagn Radiol 2020 Nov 2. Epub 2020 Nov 2.

Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S), New Delhi, India.

The radiological appearance of common primary hepatic tumors such as hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) is widely recognized. Hepatic masses with unusual histology are occasionally encountered, but seldom suspected on imaging. However, many possess characteristic imaging findings, which when assessed along with the clinical and demographic background and serum tumor markers, may enable a prospective diagnosis. This review attempts to familiarize the reader with the clinicopathological characteristics, imaging manifestations, and differential diagnosis of these unusual liver tumors in adults. Biphenotypic primary liver carcinoma is suspected in masses showing distinct areas of HCC and CCA-type enhancement pattern in cirrhotic livers. Fibrolamellar carcinoma occurs in young individuals without underlying chronic liver disease and shows a characteristic T2-hypointense scar frequently showing calcification. Perivascular epithelioid cell tumors are differentials for any arterial hyperenhancing mass in the noncirrhotic liver, particularly in patients with tuberous sclerosis. Multifocal subcapsular tumors showing target-like morphology, capsular retraction and "lollipop" sign are suspicious for epithelioid hemangioendothelioma. On the other hand, multiple hemorrhagic lesions showing patchy areas of bizarre-shaped arterial phase hyperenhancement are suspicious for angiosarcoma. Primary hepatic lymphoma (PHL) is suspected when patients with immunosuppression present with solitary or multifocal masses that insinuate around vessels and bile ducts without causing luminal narrowing. Intense diffusion restriction and low-level homogeneous or target-like enhancement are also ancillary features of PHL. Primary hepatic neuroendocrine tumor shows uptake on Ga-68 DOTANOC PET/CT. Although a straightforward diagnosis may be difficult in these cases, awareness of the characteristic imaging appearances is helpful in suspecting the diagnosis.
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http://dx.doi.org/10.1067/j.cpradiol.2020.10.001DOI Listing
November 2020

Male genital tract tuberculosis: A comprehensive review of imaging findings and differential diagnosis.

Abdom Radiol (NY) 2021 04 12;46(4):1677-1686. Epub 2020 Oct 12.

Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Urogenital tuberculosis is the most common form of extrapulmonary tuberculosis. Genital organ involvement occurs as a continuum of urinary tract tuberculosis and often presents a diagnostic challenge due to the non-specific nature of the symptoms. Delay in diagnosis may lead to complications such as infertility and perineoscrotal sinuses. Imaging plays an important role in raising timely suspicion of tuberculosis. In this article, we describe the imaging findings of male genital tuberculosis and the differential diagnosis. High-resolution ultrasonography (HRUS) is the best modality for assessing the epididymis, testis, scrotum and vas deferens, whereas MRI is optimal for evaluating the prostate, seminal vesicles and ejaculatory ducts. Epididymis is the most common site of genital tuberculosis, and presents as a nodular lesion limited to the tail or as diffuse enlargement. The proximal vas deferens is also frequently involved due to anatomical contiguity and shows diffuse or nodular thickening. Advanced cases may show pyocele formation and scrotal wall sinuses. Testicular involvement is almost always secondary to epididymal tuberculosis and presents as single or multiple nodules, diffuse enlargement, or the 'miliary' pattern. Isolated testicular involvement should raise suspicion of malignancy. Tuberculosis of the prostate is often asymptomatic. The most common imaging manifestations are nodules and the diffuse forms, which may later evolve into abscesses. Fibrosis and calcification occur with healing. Seminal vesicle and ejaculatory duct involvement with fibrosis may cause infertility. Awareness of the imaging findings would enable the radiologist to raise timely suspicion, so that prompt treatment is initiated and complications are prevented.
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http://dx.doi.org/10.1007/s00261-020-02811-0DOI Listing
April 2021

MRI-Targeted Prostate Biopsy: What Radiologists Should Know.

Korean J Radiol 2020 09;21(9):1087-1094

Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA.

Transrectal ultrasound (TRUS)-guided systematic biopsy, the current gold standard for the detection of prostate cancer, suffers from low sensitivity for clinically significant cancer. The use of diagnostic multiparametric MRI has increased the relevance of targeted biopsy techniques such as MRI-TRUS fusion biopsy and direct (in-bore) MRI-guided biopsy, which have higher detection rate for clinically significant cancer. Although primarily used in patients who remain at high clinical suspicion for prostate cancer despite a negative systematic biopsy, with the increasing use of upfront diagnostic MRI, these biopsies are expected to replace routine systematic biopsies. This pictorial essay aims to enhance our understanding of the concepts of these biopsy techniques so that they can be performed safely and provide maximum diagnostic yield.
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http://dx.doi.org/10.3348/kjr.2019.0817DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371617PMC
September 2020

MR texture analysis in differentiating renal cell carcinoma from lipid-poor angiomyolipoma and oncocytoma.

Br J Radiol 2020 Oct 26;93(1114):20200569. Epub 2020 Aug 26.

Institute of Nuclear Medicine, University College London Hospital NHS Trust, London, United Kingdom.

Objectives: To assess the utility of magnetic resonance texture analysis (MRTA) in differentiating renal cell carcinoma (RCC) from lipid-poor angiomyolipoma (lpAML) and oncocytoma.

Methods: After ethical approval, 42 patients with 54 masses (34 RCC, 14 lpAML and six oncocytomas) who underwent MRI on a 1.5 T scanner (Avanto, Siemens, Erlangen, Germany) between January 2011 and December 2012 were retrospectively included in the study. MRTA was performed on the TexRAD research software (Feedback Plc., Cambridge, UK) using free-hand polygonal region of interest (ROI) drawn on the maximum cross-sectional area of the tumor to generate six first-order statistical parameters. The Mann-Whitney U test was used to look for any statically significant difference. The receiver operating characteristic (ROC) curve analysis was done to select the parameter with the highest class separation capacity [area under the curve (AUC)] for each MRI sequence.

Results: Several texture parameters on MRI showed high-class separation capacity (AUC > 0.8) in differentiating RCC from lpAML and oncocytoma. The best performing parameter in differentiating RCC from lpAML was mean of positive pixels (MPP) at SSF 2 (AUC: 0.891) on DWI b500. In differentiating RCC from oncocytoma, the best parameter was mean at SSF 0 (AUC: 0.935) on DWI b1000.

Conclusions: MRTA could potentially serve as a useful non-invasive tool for differentiating RCC from lpAML and oncocytoma.

Advances In Knowledge: There is limited literature addressing the role of MRTA in differentiating RCC from lpAML and oncocytoma. Our study demonstrated several texture parameters which were useful in this regard.
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http://dx.doi.org/10.1259/bjr.20200569DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7548360PMC
October 2020

Hemodialysis in Infants: Challenges and New Paradigms.

J Vasc Interv Radiol 2020 05;31(5):787

Cardiovascular and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, India.

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http://dx.doi.org/10.1016/j.jvir.2020.02.011DOI Listing
May 2020

Prostate MRI-TRUS fusion biopsy: a review of the state of the art procedure.

Abdom Radiol (NY) 2020 07;45(7):2176-2183

Department of Radiology, University of Cincinnati Medical Center, ML 0761, 234 Goodman Street, Cincinnati, OH, 45267-0761, USA.

Prostate cancer is the fourth most common cancer and population-based screening programmes are being increasingly adopted worldwide. Screening-positive patients undergo routine transrectal ultrasound (TRUS)-guided systematic biopsy, which is the current diagnostic standard for prostate cancer. However, systematic biopsies suffer from poor sensitivity, especially for the tumors of the anterior prostate and apex as well as in large volume glands. In the past decade, MRI-guided targeted biopsies have come up, which utilize the multiparametric capability of MRI to target lesions for sampling. MRI/TRUS fusion biopsies combine the advantages of MRI-targeting with that of real-time guidance made possible by TRUS. MRI-TRUS fusion biopsies are being increasingly used in men with high clinical suspicion of prostate cancer who have had prior negative systematic biopsies. A large number of fusion biopsy platforms are currently available commercially. Although the basic workflow is similar, there are differences in the operational software, biopsy routes offered, TRUS acquisition technique, type of correction applied at the time of fusion and in the probe tracking hardware. The article describes the current role and indications of MRI-TRUS fusion biopsy followed by a discussion on the workflow, patient preparation, biopsy procedure and complications.
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http://dx.doi.org/10.1007/s00261-019-02391-8DOI Listing
July 2020

Urinary diversions: a primer of the surgical techniques and imaging findings.

Abdom Radiol (NY) 2019 12;44(12):3906-3918

Cincinnati Veterans Hospital, University of Cincinnati Medical Center, 234 Goodman Street, Cincinnati, OH, 45267, USA.

Objective: The article attempts to describe the indications, classification, and surgical anatomy of the commonly performed urinary diversion procedures, followed by the imaging protocol and radiological appearances of the normal postoperative anatomy and complications related to these procedures.

Contents: Diversion procedures are used to reroute urine after cystectomy and in patients with refractory neurogenic or outlet obstruction of the urinary bladder. Broadly, these can be classified as continent and incontinent diversions. Patients with urinary diversions frequently undergo radiological investigations for the detection of complications. Commonly, a loopogram or pouchogram is performed few weeks after the surgery to look for leak, whereas CT or MRI is used for long-term follow-up. Postoperative complications can be early (within 30 days of the surgery) or delayed and include leaks, collections, strictures, calculi, parastomal hernia, small bowel obstruction, and oncologic recurrence.

Conclusion: A variety of urinary diversion procedures are commonly performed and interpretation of the postsurgical anatomy can be overwhelming for the general radiologist. This article provides a basic understanding of the normal anatomy as well as a thorough discussion on the imaging protocol and radiological appearances of the potential complications associated with these procedures.
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http://dx.doi.org/10.1007/s00261-019-02179-wDOI Listing
December 2019

Role of MR texture analysis in histological subtyping and grading of renal cell carcinoma: a preliminary study.

Abdom Radiol (NY) 2019 10;44(10):3336-3349

Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Purpose: The study evaluated the usefulness of magnetic resonance imaging (MRI) texture parameters in differentiating clear cell renal carcinoma (CC-RCC) from non-clear cell carcinoma (NC-RCC) and in the histological grading of CC-RCC.

Materials And Methods: After institutional ethical approval, this retrospective study analyzed 33 patients with 34 RCC masses (29 CC-RCC and five NC-RCC; 19 low-grade and 10 high-grade CC-RCC), who underwent MRI between January 2011 and December 2012 on a 1.5-T scanner (Avanto, Siemens, Erlangen, Germany). The MRI protocol included T2-weighted imaging (T2WI), diffusion-weighted imaging [DWI; at b 0, 500 and 1000 s/mm with apparent diffusion coefficient (ADC) maps] and T1-weighted pre and postcontrast [corticomedullary (CM) and nephrographic (NG) phase] acquisition. MR texture analysis (MRTA) was performed using the TexRAD research software (Feedback Medical Ltd., Cambridge, UK) by a single reader who placed free-hand polygonal region of interest (ROI) on the slice showing the maximum viable tumor. Filtration histogram-based texture analysis was used to generate six first-order statistical parameters [mean intensity, standard deviation (SD), mean of positive pixels (MPP), entropy, skewness and kurtosis] at five spatial scaling factors (SSF) as well as on the unfiltered image. Mann-Whitney test was used to compare the texture parameters of CC-RCC versus NC-RCC, and high-grade versus low-grade CC-RCC. P value < 0.05 was considered significant. A 3-step feature selection was used to obtain the best texture metrics for each MRI sequence and included the receiver-operating characteristic (ROC) curve analysis and Pearson's correlation test.

Results: The best performing texture parameters in differentiating CC-RCC from NC-RCC for each sequence included (area under the curve in parentheses): entropy at SSF 4 (0.807) on T2WI, SD at SSF 4 (0.814) on DWI b500, SD at SSF 6 (0.879) on DWI b1000, mean at SSF 0 (0.848) on ADC, skewness at SSF 2 (0.854) on T1WI and skewness at SSF 3 (0.908) on CM phase. In differentiating high from low-grade CC-RCC, the best parameters were: entropy at SSF 6 (0.823) on DWI b1000, mean at SSF 3 (0.889) on CM phase and MPP at SSF 5 (0.870) on NG phase.

Conclusion: Several MR texture parameters showed excellent diagnostic performance (AUC > 0.8) in differentiating CC-RCC from NC-RCC, and high-grade from low-grade CC-RCC. MRTA could serve as a useful non-invasive tool for this purpose.
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http://dx.doi.org/10.1007/s00261-019-02122-zDOI Listing
October 2019

Mesenteric Tuberculosis Masquerading as Carcinoid Tumor on Conventional Imaging and DOTANOC Positron Emission Tomography/Computed Tomography: Uncommon Presentation of a Common Disease.

Indian J Nucl Med 2019 Jul-Sep;34(3):216-219

Department of Radio-Diagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Carcinoid tumor of the mesentery has a classical imaging morphology. A specific diagnosis can often be provided on the basis of clinical history, elevated serum neuroendocrine markers, and uptake on somatostatin receptor-based radiotracer studies. Although a number of inflammatory and neoplastic conditions may mimic carcinoid tumor on many of these modalities, uptake on Ga-DOTANOC positron emission tomography/computed tomography (PET/CT) is considered specific. We report a case of a 28-year-old male presenting with a mesenteric mass along with elevated serum neuroendocrine markers and uptake on DOTANOC PET/CT, all suggestive of carcinoid tumor. However, the histopathologic examination after surgical resection revealed necrotizing granulomas consistent with tuberculosis (TB). This case highlights the great masquerader that TB can be and stresses the importance of keeping a high index of suspicion for TB, especially in endemic areas.
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http://dx.doi.org/10.4103/ijnm.IJNM_29_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6593933PMC
July 2019

Prospective analysis of factors predicting feasibility & success of longitudinal intussusception vasoepididymostomy in men with idiopathic obstructive azoospermia.

Indian J Med Res 2019 Jan;149(1):51-56

Department of Urology, All India Institute of Medical Sciences, New Delhi, India.

Background & Objectives: : Microsurgical reconstruction for idiopathic obstructive azoospermia is a challenging procedure, and selection of appropriate patients is important for successful outcomes. This prospective study was done to evaluate the ability of scrotal ultrasound measurements to predict the surgical feasibility and determine factors that could predict a patent anastomosis following vaso-epididymal anastomosis (VE) in men with idiopathic obstructive azoospermia.

Methods: : In this prospective study, men diagnosed with idiopathic obstructive azoospermia, scheduled for a longitudinal intussusception VE, underwent a scrotal ultrasound measurement of testicular and epididymal dimensions. During surgery, site and type of anastomosis, presence of sperms in the epididymal fluid and technical satisfaction with the anastomosis were recorded. All men where VE could be performed were followed up for appearance of sperms in the ejaculate. Ultrasound parameters were compared between men who had a VE versus those with negative exploration. Predictive factors were compared between men with or without a patent anastomosis.

Results: : Thirty four patients were included in the study conducted between September 2014 and August 2016 and a VE was possible in only 19 (55%) patients. Of these 19 patients, six had a patent anastomosis with one pregnancy. Preoperative ultrasound measurements could not identify patients where a VE could not be performed. Motile sperm in the epididymal fluid was the only significant predictor of a successful anastomosis.

Interpretation & Conclusion: : Forty five per cent of men planned for a VE for idiopathic obstructive azoospermia could not undergo a reconstruction. Ultrasound assessment of testicular and epididymal dimensions could not predict the feasibility of performing a VE. The presence of motile sperms in the epididymal fluid was the only significant predictor of a patent VE in our study.
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http://dx.doi.org/10.4103/ijmr.IJMR_1192_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507538PMC
January 2019

Infectious versus non-infectious causes of oligoarticular inflammatory arthritis: A prospective study from a tertiary care hospital in north India.

Drug Discov Ther 2019 ;13(2):96-100

Department of Medicine, All India Institute of Medical Sciences.

Oligoarticular arthritis (inflammation of upto 4 joints) has a wide range of infectious and non-infectious etiologies. The aim of our study was to identify the features which could help in the differentiation of infectious from non-infectious arthritis. The study was prospective and observational, and included 100 patients with oligoarticular inflammatory arthritis. The final diagnosis was made using standard diagnostic criteria and the patients were categorized into infectious and non-infectious groups. Among the 100 patients who were recruited, the following final diagnosis were made: peripheral spondyloarthritis (n = 37), axial spondyloarthritis (n = 11), tuberculosis (n = 19), brucellosis (n = 6), septic arthritis (n = 6), gouty arthritis (n = 5), early rheumatoid arthritis (n = 5), non-tubercular mycobacteria (n = 2), SLE (n = 2), post-chikungunya arthritis (n = 2), acute lymphocytic leukaemia (n = 1), pachydermoperiostosis (n = 1), sarcoidosis (n = 1) and juvenile idiopathoic arthritis (n = 1). The patients were categorized into two groups: infectious (33) and non-infectious (60). The presence of monoarthritis, clinically-significant weight loss, hepatomegaly, splenomegaly and erosive arthritis were significantly more common in the infectious group as compared to the non-infectious group.
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http://dx.doi.org/10.5582/ddt.2019.01019DOI Listing
September 2019

Demystifying the mesenteric root lesions.

Abdom Radiol (NY) 2019 08 11;44(8):2708-2720. Epub 2019 May 11.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India.

Objective: The aim of this article is to describe the normal anatomy of the root of the small bowel mesentery (RSBM) as well as the multidetector computed tomography (MDCT) features of the various primary and secondary lesions that affect the RSBM.

Results: The small bowel mesentery attaches the jejunum and ileum to the posterior abdominal wall, the line of attachment forming the RSBM. Several primary as well as secondary lesions involve the RSBM. The RSBM has anatomical contiguity with the mesocolon and other peritoneal ligaments, which forms a route for the spread of infection, neoplasms as well as several other abdominal pathologies. MDCT plays an important role in the evaluation of mesenteric root lesions.

Conclusion: Familiarity with the lesions involving the RSBM and their characteristic appearances on MDCT is important in giving thoughtful differential diagnosis and guiding the treating physician in further management.
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http://dx.doi.org/10.1007/s00261-019-02053-9DOI Listing
August 2019

Macrodystrophia lipomatosa of the foot.

BMJ Case Rep 2019 May 6;12(5). Epub 2019 May 6.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India.

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http://dx.doi.org/10.1136/bcr-2019-229464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510147PMC
May 2019

Cutaneous metastasis in adenocarcinoma rectum.

BMJ Case Rep 2019 Apr 8;12(4). Epub 2019 Apr 8.

Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India.

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http://dx.doi.org/10.1136/bcr-2019-229652DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506098PMC
April 2019

Comparison of F18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Dynamic Contrast-Enhanced Magnetic Resonance Imaging as Markers of Graft Viability in Anterior Cruciate Ligament Reconstruction.

Am J Sports Med 2019 01 27;47(1):88-95. Epub 2018 Nov 27.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background: F18-fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT) can be used to assess changes in the metabolism of an anterior cruciate ligament (ACL) graft as it is undergoing "ligamentization." Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is the preferred modality for noninvasive assessment of graft structure and graft vascularity.

Purpose: To compare the use of F18-FDG PET/CT and DCE-MRI to assess ligamentization within the ACL graft and correlate the results with clinical tests.

Study Design: Case series; Level of evidence, 4.

Methods: Among 30 recruited patients, 27 patients (3 females and 24 males) completed 2 follow-up assessments at a mean of 125 ± 22 days and 259 ± 38 days after arthroscopic ACL reconstruction. At both assessments, anterior drawer test, Lachman test, and Lysholm scoring (LS) were conducted. Images from F18-FDG PET/CT and MRI were analyzed qualitatively and quantitatively (maximum standardized uptake value [SUVmax], SUVmax ratio to the contralateral side [SUVmax CL], normalized enhancement [NE]) in 3 zones: femoral, intra-articular (IA), and tibial. Of the 27 recruited patients, 1 patient had reinjury due to a fall. Therefore, 26 patients were considered for the final analysis.

Results: A significant improvement ( P = .0001) was found in median LS, from 78.5 (range, 62-90) to 94.5 (range, 84-100), at the second follow-up. All grafts were found to be viable on PET/CT and vascularized on MRI. All grafts were seen as continuous on MRI, with exception of 1 graft at the second follow-up. Dynamic MRI identified single-vessel supply to all of the grafts at the first follow-up and multiple-vessel supply in 10 patients at the second follow-up. Reduction in the median SUVmax, SUVmax CL, and NE at second follow-up was seen in all 3 zones. Only SUVmax CL in the IA zone showed a significant reduction ( P = .032); patients with excellent LS at the second follow-up showed significantly higher reduction ( P = .005) than patients with good LS. NE in the IA zone was correlated (0.39; P = .048) with LS only at the first follow-up, whereas SUVmax CL (-0.52; P = .006) and SUVmax (-0.49, P = .010) in the IA zone negatively correlated with LS at the second follow-up only. No correlation was observed between PET/CT and MRI parameters.

Conclusion: Glucose metabolism and vascularity in the graft tissue can be used to assess ligamentization of ACL graft. A viable and vascularized graft at first follow-up is associated with good to excellent final outcome, regardless of LS at this stage. Since no correlation was observed between PET/CT and MRI parameters, they may be assessing different domains of the same process. Higher NE in the IA zone at the first follow-up and lower SUVmax CL in the same region at second follow-up are associated with better outcome.
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http://dx.doi.org/10.1177/0363546518805092DOI Listing
January 2019

Atypical cases of filariasis from a non-endemic area.

Drug Discov Ther 2018;12(4):254-258

Department of Medicine, All India Institute of Medical Sciences.

Filariasis can present in many different ways and pose significant dilemma to the clinician. We report four atypical cases of filariasis which presented as abdominal mass, cervical lymph node enlargement, fever in pregnancy and nosocomial febrile illness respectively. All the four cases were treated successfully with oral antifilarial agents. It is essential to be aware of such atypical presentations of filariasis so that prompt therapy can be initiated.
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http://dx.doi.org/10.5582/ddt.2018.01026DOI Listing
August 2019

Staring at the stars: a case of gastrointestinal basidiobolomycosis from the Indian subcontinent.

BMJ Case Rep 2018 Sep 5;2018. Epub 2018 Sep 5.

Medicine, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.1136/bcr-2018-226693DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129062PMC
September 2018

Positron emission tomography in prostate cancer: An update on state of the art.

Indian J Urol 2018 Jul-Sep;34(3):172-179

Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi, India.

Prostate cancer (PCa), one of the most common cancers in males, is a topic of active interest in imaging research. Positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance imaging (PET/MRI) have enabled the combination of morphologic and functional imaging with the promise of providing better information in guiding therapy. F-fluorodeoxyglucose, the workhorse radiopharmaceutical in PET imaging, has not found preference in PCa since these tumors show poor glucose uptake and can be obscured by the normal urinary excretion of the radiotracer. Hence, the last two decades have seen the development of multiple newer radiotracers and better optimization of the technical aspects of PET imaging. The combination of functional imaging and MRI holds great promise. We searched PubMed, Scopus, and Google Scholar for peer-reviewed literature concerning the advances and newer developments in the imaging of PCa between the years 2005 and 2017. This review aims at summarizing current evidence on the role of PET imaging in PCa and its impact on the diagnosis, staging, prognostication, response assessment, and restaging of this malignancy.
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http://dx.doi.org/10.4103/iju.IJU_320_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034413PMC
July 2018

Magnetic Resonance Imaging-Transrectal Ultrasound Fusion Biopsy of the Prostate-An Update.

Semin Roentgenol 2018 Jul 5;53(3):219-226. Epub 2018 Apr 5.

Department of Radiology, All India Institute of Medical Sciences (A.I.I.M.S), Ansari Nagar, New Delhi 110029, India.

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http://dx.doi.org/10.1053/j.ro.2018.04.003DOI Listing
July 2018

Angiomyolipoma of the Kidneys: Current Perspectives and Challenges in Diagnostic Imaging and Image-Guided Therapy.

Curr Probl Diagn Radiol 2019 May - Jun;48(3):251-261. Epub 2018 Mar 20.

Department of Radiology, All India Institute of Medical Sciences (A.I.I.M.S), New Delhi, India.

Angiomyolipomas (AML) are benign tumors of the kidneys frequently encountered in radiologic practice in large tertiary centers. In comparison to renal cell carcinomas (RCC), AML are seldom treated unless they are large, undergo malignant transformation or develop complications like acute hemorrhage. The common garden triphasic (classic) AML is an easy diagnosis, however, some variants lack macroscopic fat in which case the radiologic differentiation from RCC becomes challenging. Several imaging features, both qualitative and quantitative, have been described in differentiating the 2 entities. Although minimal fat AML is not entirely a radiologic diagnosis, the suspicion raised on imaging necessitates sampling and potentially avoids an unwanted surgery. Recently a new variant, epitheloid AML has been described which often has atypical imaging features and is at a higher risk for malignant transformation. Apart from the diagnosis, the radiologist also needs to convey information regarding nephrometric scores which help in surgical decision-making. Recently, more and more AMLs are managed with selective arterial embolization and percutaneous ablation, both of which are associated with less morbidity when compared to surgery. The purpose of this article is to review the imaging and pathologic features of classic AML as well as the differentiation of minimal fat AML from RCC. In addition, an overview of nephrometric scoring and image-guided interventions is also provided.
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http://dx.doi.org/10.1067/j.cpradiol.2018.03.006DOI Listing
August 2019

Mucinous adenocarcinoma arising from chronic perianal fistula mimicking horseshoe abscess.

BMJ Case Rep 2018 Apr 5;2018. Epub 2018 Apr 5.

Department of Radiodiagnosis, SGPGIMS, Lucknow, Uttar Pradesh, India.

Perianal fistulae are commonly seen clinical entity. Development of malignancy within a perianal fistula is rare. Even rarer is the development of mucinous adenocarcinoma in a chronic fistula-in-ano. Only a handful of such cases have been reported in the past. A case of mucinous adenocarcinoma arising in chronic perianal fistula in a 34-year-old woman is being described. She presented with complaints of perineal fullness, pain and recurrent pus discharge from perianal fistula for 4 years. On radiological workup, a large solid-cystic pelvic mass was seen in relation to the fistula. On MRI, the lesion was mimicking a large horseshoe abscess. Transrectal ultrasound-guided biopsy and subsequent histopathological examination confirmed the presence of mucinous adenocarcinoma with tumour cells immunopositive for CK7 and CK20.
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http://dx.doi.org/10.1136/bcr-2017-223063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5893951PMC
April 2018

Intratesticular varicocele: a rare cause of male factor infertility.

BMJ Case Rep 2018 Mar 15;2018. Epub 2018 Mar 15.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.1136/bcr-2018-224547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878263PMC
March 2018

Diagnostic performance of diffusion-weighted MR imaging at 3.0 T in predicting muscle invasion in urinary bladder cancer: utility of evaluating the morphology of the reactive tumor stalk.

Abdom Radiol (NY) 2018 09;43(9):2431-2441

Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Purpose: To evaluate the diagnostic performance of stalk morphology on diffusion-weighted imaging (DWI) in comparison with conventional MRI in predicting muscle invasion in urinary bladder cancer.

Methods: The study was prospective and approved by the institutional ethics committee. A written informed consent was obtained from all the patients. The study included 56 patients who presented with bladder mass between January 2014 and November 2015. After excluding 16 patients, 40 patients with 92 tumors were assessed. All the 40 patients underwent MRI at 3.0 Tesla (Achieva, Philips) inclusive of DWI (b0, 500, 1000 and 1500). Two radiologists evaluated the images independently, and disparities were resolved through consensus. For predicting muscle invasion on T2-weighted images, tumor morphology (papillary versus non-papillary), distensibility of the underlying bladder wall, and perivesical fat infiltration were evaluated. On DWI, the criterion used in a previous study (Takeuchi et al.) was used along with tumor stalk morphology. Findings were compared with histopathology using Pearson's χ test, and diagnostic performance indices were calculated.

Results: All the evaluated features were present with significantly higher frequency in muscle-invasive tumors (p < 0.001). The finding of absent or distorted stalk on DWI had the highest sensitivity (87.5%) and specificity (97.6%). Conventional imaging features of non-papillary stalk morphology, restricted distension of underlying bladder wall, perivesical fat infiltration, as well as the previous DWI criterion were less sensitive (56.3%, 68.8%, 56.3% and 56.3%, respectively) in predicting muscle invasion.

Conclusions: Assessment of the morphology of the reactive tumor stalk on DWI has better diagnostic performance in predicting muscle invasion than conventional MRI.
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http://dx.doi.org/10.1007/s00261-018-1458-7DOI Listing
September 2018

PET-CT and PET-MR in urological cancers other than prostate cancer: An update on state of the art.

Indian J Urol 2018 Jan-Mar;34(1):20-27

Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.

Hybrid positron emission tomography with computed tomography (PET/CT) and magnetic resonance imaging (PET/MRI) have enabled the combination of morphologic and functional imaging with the promise of providing better information in guiding therapy. Further advance has been made in the past decade with the development of newer radiotracers and optimization of the technical aspects. We performed a search in PubMed, Scopus, and Google Scholar for peer-reviewed literature concerning the advances and newer developments in the imaging of nonprostate urologic cancers between 2005 and 2017. This review aims at summarizing the current evidence on PET imaging in nonprostate urologic cancers and their impact on the diagnosis, staging, prognostication, response assessment, and restaging of these malignancies. However, much of the evidence is still in infancy and has not been incorporated into routine management or the practice guidelines of National Comprehensive Cancer Network or European Society for Medical Oncology (ESMO).
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http://dx.doi.org/10.4103/iju.IJU_321_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769244PMC
January 2018

Gastrointestinal Stromal Tumor of the Jejunum With Active Bleeding Demonstrated on Dual-Energy MDCT Angiography: A Case Report.

Curr Probl Diagn Radiol 2019 May - Jun;48(3):298-301. Epub 2017 Oct 31.

Department of Radio-diagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract and may occasionally present with acute gastrointestinal bleed (GIB). Multidetector computed tomography (MDCT) angiography is extremely useful in demonstrating the tumor as well as the presence of active hemorrhage, thereby guiding subsequent interventional or surgical management. We report a case of a 38-year-old man who presented with acute-onset melena and compensated shock, whose source of bleed remained elusive on endoscopy. MDCT angiography performed on a dual-energy scanner showed a jejunal tumor with active intraluminal contrast extravasation. The tumor was subsequently resected and the patient did well on follow-up. This was one of the few instances when MDCT angiography demonstrated active bleeding in a GIST and the first such case demonstrated on a dual-energy scanner.
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http://dx.doi.org/10.1067/j.cpradiol.2017.10.008DOI Listing
August 2019

Dural calcification and calvarial hyperostosis: a rare cause of obstructive hydrocephalus in 'malignant' osteopetrosis.

BMJ Case Rep 2015 Sep 3;2015. Epub 2015 Sep 3.

Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), New Delhi, India.

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http://dx.doi.org/10.1136/bcr-2015-212283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4567710PMC
September 2015

Psychiatric morbidity among housemaids in Kuwait. III: Vulnerability factors.

Int J Soc Psychiatry 2003 Jun;49(2):87-96

Faculty of Medicine, Kuwait University, Safat.

Background: Housemaids are a relatively homogenous immigrant subgroup in terms of their gender; ethnic origin; and socio-cultural, educational and occupational background. Psychiatric morbidity among housemaids is two to five times higher than the native female population.

Aims: To determine the possible pre-immigration risk factors for prospective psychiatric breakdown among the housemaids.

Methods: The sample consisted of all the housemaids (N = 197) hospitalised during the two-year study period. The controls comprised all the newly arrived housemaids (N = 502). The measures obtained included demographic characteristics and previous history of physical illness, psychiatric illness, hospitalisation and family history of psychiatric disorder.

Results: More than a quarter of the hospitalised group broke down within one month of their arrival. The hospitalised group had a significant excess of Sri Lankan housemaids; non-Muslims; those with less than four years of education and those with a previous history of physical illness, psychiatric illness or hospitalisation.

Conclusions: A number of potential risk factors results in premature repatriation of housemaids on mental health grounds. Preventive measures involving recruitment procedures and pre-departure orientation courses are needed to minimise the expatriate failure among the housemaids.
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http://dx.doi.org/10.1177/0020764003049002002DOI Listing
June 2003
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