Publications by authors named "Etan Dayan"

10 Publications

  • Page 1 of 1

MRI Evaluation of Various Elbow, Forearm, and Wrist Neuropathies: A Pictorial Review.

Semin Musculoskelet Radiol 2021 Aug 27;25(4):617-627. Epub 2021 Oct 27.

Department of Radiology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York.

Upper extremity entrapment neuropathies are common and can cause pain, sensory loss, and muscle weakness leading to functional disability. We conducted a retrospective review from January 2007 until March 2020 of the magnetic resonance imaging (MRI) features of intrinsic and extrinsic causes of wrist, forearm, and elbow neuropathies of 637 patients who received a diagnosis of neuropathy by means of clinical and electrodiagnostic testing. We discuss cases with varying intrinsic and extrinsic nerve pathologies, including postoperative examples, affecting the median, radial, and ulnar nerve.Our collection of cases demonstrates a diversity of intrinsic and extrinsic causative factors. Intrinsic pathologies include neuritis as well as tumors arising from the nerve. Extrinsic causes resulting in nerve entrapment include masses, acute and chronic posttraumatic cases, anatomical variants, inflammatory and crystal deposition, calcium pyrophosphate deposition disease, and dialysis-related amyloidosis. Finally, we review postsurgical cases, such as carpal tunnel release and ulnar nerve transposition.Although upper extremity neuropathies tend to have a typical clinical presentation, imaging, particularly MRI, plays a vital role in evaluating the etiology and severity of each neuropathy and ultimately helps guide clinical management.
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http://dx.doi.org/10.1055/s-0041-1729961DOI Listing
August 2021

Narrative Review of Ligamentous Wrist Injuries.

J Hand Microsurg 2021 Apr 28;13(2):55-64. Epub 2021 Feb 28.

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.

Ligamentous wrist injuries are common occurrences that require complex anatomical mastery and extensive understanding of diagnostic and treatment modalities. The purpose of this educational review article is to delve into the most clinically relevant wrist ligaments in an organized manner to provide the reader with an overview of relevant anatomy, function, clinical examination findings, imaging modalities, and options for management. Emphasis is placed on elucidating reported diagnostic accuracies and treatment outcomes to encourage evidence-based practice.
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http://dx.doi.org/10.1055/s-0041-1724224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041499PMC
April 2021

Epiphyseal Ewing Sarcoma in a skeletally mature patient: A case report and review of the literature.

Radiol Case Rep 2021 May 19;16(5):1191-1197. Epub 2021 Mar 19.

Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, 1468 Madison Ave, New York, NY, 10029, USA.

While Ewing sarcoma of bone is the second most common primary osseous malignancy in childhood where it typically involves the diaphysis or metadiaphyses of long bones of skeletally immature patients, primary epiphyseal involvement of the long bone in skeletally mature patients is rare with no cases reported in the literature to our knowledge, rendering this case the first of its kind. We present the first case of primary Ewing Sarcoma of the epiphyses of the long bones in a skeletally mature 20-year-old male patient. The patient initially presented with left knee stiffness and pain that was empirically treated with non-steroidal anti-inflammatory medications. His pain progressed despite treatment. An x-ray of the left knee was obtained 5 months later demonstrating an irregular lucent lesion in the medial femoral condyle. A subsequent MRI revealed an enhancing lesion in the medial femoral condyle, and when biopsied it was consistent with Ewing sarcoma (positive for gene rearrangement by fluorescence in situ hybridization). The lesion was resected surgically, and the patient underwent neoadjuvant chemotherapy with a good clinical outcome.
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http://dx.doi.org/10.1016/j.radcr.2021.02.049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010574PMC
May 2021

Impact of COVID-19 social distancing regulations on outpatient diagnostic imaging volumes and no-show rates.

Clin Imaging 2021 Aug 30;76:65-69. Epub 2021 Jan 30.

Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA.

Background: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted outpatient radiology practices, necessitating change in practice infrastructure and workflow.

Objective: The purpose of this study was to assess the consequences of social distancing regulations on 1) outpatient imaging volume and 2) no-show rates per imaging modality.

Methods: Volume and no-show rates of a large, multicenter metropolitan healthcare system outpatient practice were retrospectively stratified by modality including radiography, CT, MRI, ultrasonography, PET, DEXA, and mammography from January 2 to July 21, 2020. Trends were assessed relative to timepoints of significant state and local social distancing regulatory changes.

Results: The decline in imaging volume and rise in no-show rates was first noted on March 10, 2020 following the declaration of a state of emergency in New York State (NYS). Total outpatient imaging volume declined 85% from baseline over the following 5 days. Decreases varied by modality: 88% for radiography, 75% for CT, 73% for MR, 61% for PET, 80% for ultrasonography, 90% for DEXA, and 85% for mammography. Imaging volume and no-show rate recovery preceded the mask mandate of April 15, 2020, and further trended along with New York City's reopening phases. No-show rates recovered within 2 months of the height of the pandemic, however, outpatient imaging volume has yet to recover to baseline after 3 months.

Conclusion: The total outpatient imaging volume declined alongside an increase in the no-show rate following the declaration of a state of emergency in NYS. No-show rates recovered within 2 months of the height of the pandemic with imaging volume yet to recover after 3 months.

Clinical Impact: Understanding the impact of social distancing regulations on outpatient imaging volume and no-show rates can potentially aid other outpatient radiology practices and healthcare systems in anticipating upcoming changes as the COVID-19 pandemic evolves.
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http://dx.doi.org/10.1016/j.clinimag.2021.01.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846884PMC
August 2021

Sources of Revenue Loss and Recovery in Radiology Practices During the Coronavirus Disease 2019 (COVID-19) Pandemic.

Acad Radiol 2021 04 18;28(4):447-456. Epub 2021 Jan 18.

Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029.

Rationale And Objectives: This study seeks to quantify the financial impact of COVID-19 on radiology departments, and to describe the structure of both volume and revenue recovery.

Materials And Methods: Radiology studies from a large academic health system were retrospectively studied from the first 33 weeks of 2020. Volume and work relative value unit (wRVU) data were aggregated on a weekly basis for three periods: Presurge (weeks 1-9), surge (10-19), and recovery (20-33), and analyzed compared to the pre-COVID baseline stratified by modality, specialty, patient service location, and facility type. Mean and median wRVU per study were used as a surrogate for case complexity.

Results: During the pandemic surge, case volumes fell 57%, while wRVUs fell by 69% relative to the pre-COVID-19 baseline. Mean wRVU per study was 1.13 in the presurge period, 1.03 during the surge, and 1.19 in the recovery. Categories with the greatest mean complexity declines were radiography (-14.7%), cardiothoracic imaging (-16.2%), and community hospitals overall (-15.9%). Breast imaging (+6.5%), interventional (+5.5%), and outpatient (+12.1%) complexity increased. During the recovery, significant increases in complexity were seen in cardiothoracic (0.46 to 0.49), abdominal (1.80 to 1.91), and neuroradiology (2.46 to 2.56) at stand-alone outpatient centers with similar changes at community hospitals. At academic hospitals, only breast imaging complexity remained elevated (1.32 from 1.17) during the recovery.

Conclusion: Reliance on volume alone underestimates the financial impact of the COVID-19 pandemic as there was a disproportionate loss in high-RVU studies. However, increased complexity of outpatient cases has stabilized overall losses during the recovery.
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http://dx.doi.org/10.1016/j.acra.2021.01.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813500PMC
April 2021

MRI features of pyoderma gangrenosum in a diabetic patient with ulcerative colitis: A case report and review of the literature.

Radiol Case Rep 2020 Dec 6;15(12):2540-2546. Epub 2020 Oct 6.

Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, 1468 Madison Ave, New York, NY 10029, USA.

Pyoderma gangrenosum (PG) is a rare noninfectious skin condition which clinical picture can overlap with that of the diabetic foot. Meticulous physical examination along with biopsy and magnetic resonance imaging (MRI) can make the distinction easier, saving the patients from undergoing a debilitating intervention. We report a case of pathologically proven PG in the right ankle region of a 55-year old male with known uncontrolled diabetes mellitus and inflammatory bowel disease. Radiographs revealed increased soft tissue density overlying the lateral melleolus of the right ankle. MRI showed a well-defined soft tissue mass with heterogeneously intrinsically high signal intensity on T1- and on T2-weighted images, and heterogeneous peripheral enhancement on fat-suppressed, contrast-enhanced T1-weighted images. Histologically, diffuse neutrophilic infiltrate throughout the dermis was present without micro-organisms. This is the first report of MRI findings of PG in the ankle. We also summarize the findings of previously reported cases of PG.
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http://dx.doi.org/10.1016/j.radcr.2020.09.038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7548426PMC
December 2020

Rhabdomyolysis as a manifestation of a severe case of COVID-19: A case report.

Radiol Case Rep 2020 Sep 7;15(9):1633-1637. Epub 2020 Jul 7.

Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, 1468 Madison Ave, 10029, New York, NY, USA.

Since the outbreak of the ongoing pandemic of the novel coronavirus disease (COVID-19) in Wuhan, China, from December 2019, we have learned that multiple organs can be affected with the potential for various complications. Although myalgia is a frequent symptom in COVID-19 patients, no imaging findings of rhabdomyolysis have been featured in the literature. We report a case of presumed rhabdomyolysis in a 38-year-old male with COVID-19 based on the clinical presentation, laboratory results and radiological findings. By discussing the diagnostic rationale and reviewing the relevant literature we hope to advance the existing understanding of this disease and its effects on the musculoskeletal system.
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http://dx.doi.org/10.1016/j.radcr.2020.07.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340044PMC
September 2020

Gastrointestinal stromal tumor presenting as a right adnexal mass with histopathologic correlation.

Clin Imaging 2017 Jul - Aug;44:97-100. Epub 2017 May 5.

Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, United States.

The authors report and discuss a rare case of a gastrointestinal stromal tumor (GIST) in a 35-year-old female, which was pre-procedurally characterized as a right ovarian mass by magnetic resonance imaging (MRI) features. This manuscript reviews the imaging and clinical features of GISTs with pathologic correlation, and emphasizes how this entity may present a diagnostic challenge in certain anatomic regions owing in large part to its exophytic nature. This case is unique among similarly reported cases in that there was a "claw sign" with the right ovary, which provided convincing evidence of its point of origin.
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http://dx.doi.org/10.1016/j.clinimag.2017.05.006DOI Listing
December 2017

Radiation Segmentectomy versus TACE Combined with Microwave Ablation for Unresectable Solitary Hepatocellular Carcinoma Up to 3 cm: A Propensity Score Matching Study.

Radiology 2017 06 7;283(3):895-905. Epub 2016 Dec 7.

From the Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1184 Fifth Ave, MC Level, New York, NY 10029-6574.

Purpose To compare the outcomes of radiation segmentectomy (RS) and transarterial chemoembolization (TACE) combined with microwave ablation (MWA) in the treatment of unresectable solitary hepatocellular carcinoma (HCC) up to 3 cm. Materials and Methods This retrospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. From January 2010 to June 2015, a total of 417 and 235 consecutive patients with HCC underwent RS and TACE MWA, respectively. A cohort of 121 patients who had not previously undergone local-regional therapy (RS, 41; TACE MWA, 80; mean age, 65.4 years; 84 men [69.4%]) and who had solitary HCC up to 3 cm without vascular invasion or metastasis was retrospectively identified. Outcomes analyzed included procedure-related complications, laboratory toxicity levels, imaging response, time to progression (TTP), 90-day mortality, and survival. Propensity score matching was conducted by using a nearest-neighbor algorithm (1:1) to account for pretreatment clinical, laboratory, and imaging covariates. Postmatching statistical analysis was performed with conditional logistic regression for binary outcomes and the stratified log-rank test for time-dependent outcomes. Results Before matching, the complication rate was 8.9% and 4.9% in the TACE MWA and RS groups, respectively (P = .46). The overall complete response (CR) rate was 82.9% for RS and 82.5% for TACE MWA (odds ratio, 1.0; 95% confidence interval [CI]: 0.4, 2.8; P = .95). There were 41 (RS, 11; TACE MWA, 30) instances of progression occurring after an initial CR, of which 10 (24%) were classified as target progression (RS, one; TACE MWA, nine). Median overall TTP was 11.1 months (95% CI: 8.8 months, 25.6 months) in the RS group and 12.1 months (95% CI: 7.7 months, 19.1 months) in the TACE MWA group (P > .99). After matching, the overall CR rate (P = .94), TTP (P = .83), and overall survival (P > .99) were not significantly different between the two groups. The 90-day postoperative mortality rate was 0% in both groups. Conclusion Imaging response and progression outcomes of patients with solitary HCC up to 3 cm treated with RS were not significantly different when compared with those of patients treated with TACE MWA. RSNA, 2016 Online supplemental material is available for this article.
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http://dx.doi.org/10.1148/radiol.2016160718DOI Listing
June 2017

Magnetic Resonance Imaging of Complications of Anterior Cruciate Ligament Reconstruction.

Am J Orthop (Belle Mead NJ) 2015 Dec;44(12):569-71

Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.

The incidence of anterior cruciate ligament reconstruction (ACL-R) has increased in recent years. ACL-R plays an important role in the prevention of secondary osteoarthritis from resultant joint instability. Magnetic resonance imaging is the preferred modality in the evaluation of ACL-R complications. Complications after ACL-R may be broadly characterized as those resulting in decreased range of motion (arthrofibrosis, impingement) and resulting in increased laxity (graft disruption). Other miscellaneous complications that do not fall into these categories will also be discussed in this article.
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December 2015
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