Publications by authors named "Michelle D Sakala"

10 Publications

  • Page 1 of 1

Advances in MR Imaging of the Female Pelvis.

Magn Reson Imaging Clin N Am 2020 Aug 6;28(3):415-431. Epub 2020 Jun 6.

Department of Radiology, Division of Abdominal Imaging, University of Michigan-Michigan Medicine, University Hospital B1 D502D, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. Electronic address:

This article focuses on advanced MR imaging techniques of the female pelvis and clinical applications for benign and malignant disease. General and abbreviated protocols for female pelvic MR imaging are reviewed. Diffusion-weighted imaging, dynamic contrast-enhanced MR imaging, and susceptibility-weighted imaging are discussed in the context of adnexal mass characterization using the ADNEx-MR scoring system, evaluation of endometriosis, local staging of cervical and endometrial cancers, assessment of nodal and peritoneal metastasis, and potential detection of leiomyosarcoma. MR defecography is also discussed regarding evaluation of multicompartmental pelvic floor disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.mric.2020.03.007DOI Listing
August 2020

Impact of Clinical History on Maximum PI-RADS Version 2 Score: A Six-Reader 120-Case Sham History Retrospective Evaluation.

Radiology 2018 Jul 17;288(1):158-163. Epub 2018 Apr 17.

From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.).

Purpose To assess the impact of clinical history on the maximum Prostate Imaging Recording and Data System (PI-RADS) version 2 (v2) score assigned to multiparametric magnetic resonance (MR) imaging of the prostate. Materials and Methods This retrospective cohort study included 120 consecutively selected multiparametric prostate MR imaging studies performed between November 1, 2016, and December 31, 2016. Sham clinical data in four domains (digital rectal examination, prostate-specific antigen level, plan for biopsy, prior prostate cancer history) were randomly assigned to each case by using a balanced orthogonal design. Six fellowship-trained abdominal radiologists independently reviewed the sham data, actual patient age, and each examination while they were blinded to interreader scoring, true clinical data, and histologic findings. Readers were told the constant sham histories were true, believed the study to be primarily investigating interrater agreement, and were asked to assign a maximum PI-RADS v2 score to each case. Linear regression was performed to assess the association between clinical variables and maximum PI-RADS v2 score designation. Intraclass correlation coefficients (ICCs) were obtained to compare interreader scoring. Results Clinical information had no significant effect on maximum PI-RADS v2 scoring for any of the six readers (P = .09-.99, 42 reader-variable pairs). Distributions of maximum PI-RADS v2 scores in the research context were similar to the distribution of the scores assigned clinically and had fair-to-excellent pairwise interrater agreement (ICC range: 0.53-0.76). Overall interrater agreement was good (ICC: 0.64; 95% confidence interval: 0.57, 0.71). Conclusion Clinical history does not appear to be a substantial bias in maximum PI-RADS v2 score assignment. This is potentially important for clinical nomograms that plan to incorporate PI-RADS v2 score and clinical data into their algorithms (ie, PI-RADS v2 scoring is not confounded by clinical data).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1148/radiol.2018172619DOI Listing
July 2018

Improving Breast MR Wait Times: A Model for Transitioning Newly Implemented Diagnostic Imaging Procedures into Routine Clinical Operation.

J Am Coll Radiol 2018 Jun 4;15(6):859-864. Epub 2018 Apr 4.

Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan.

Purpose: The purpose of this quality improvement (QI) initiative was to increase patient access to breast MR while maintaining diagnostic image quality.

Methods: Institutional review board approval was waived for this HIPAA-compliant QI initiative, which was conducted from December 2014 through March 2016. Breast MR wait times, scheduling grids, and staffing models were reviewed to identify root causes of elevated wait times. Breast MR wait times were tracked on a biweekly basis as root causes were identified and action plans were implemented. Patient recall rates for repeat MR imaging were tracked. A retrospective analysis of image quality was performed in a randomly selected sample (20 per month; total: 320 examinations). Wait time and image quality data were analyzed with statistical process control charts and logistic regression.

Results: In all, 798 breast MR examinations were performed during the study period. Monthly volume increased from 23 in December 2014 to 50 in March 2016 (range: 23-64). Wait time for a routine breast MRI fell from 101 days before implementation to 5 days at study completion. The technical recall rate was 0.5% (4 of 798); no recall was performed for a technologist-related error or scan quality concern. The proportion of examinations with minor (31% [99 of 320]) or major (3% [9 of 320]) image quality impairments did not significantly change during the study period (P = .69-.70).

Conclusion: A specialized MR examination was transitioned into routine clinical operation while maintaining image quality. This model may be useful for transitioning other specialized diagnostic imaging examinations into routine clinical practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jacr.2018.02.004DOI Listing
June 2018

Understanding Patient Preference in Female Pelvic Imaging: Transvaginal Ultrasound and MRI.

Acad Radiol 2018 04 11;25(4):439-444. Epub 2017 Dec 11.

Department of Radiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109; Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109. Electronic address:

Rationale And Objectives: Women with pelvic pain or abnormal uterine bleeding may undergo diagnostic imaging. This study evaluates patient experience in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) and explores correlations between preference and symptom severity.

Materials And Methods: Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant prospective study. Fifty premenopausal women with pelvic symptoms evaluated by recent TVUS and MRI and without history of gynecologic cancer or hysterectomy were included. A phone questionnaire used validated survey instruments including Uterine Fibroid Symptoms Quality of Life index, Testing Morbidities Index, and Wait Trade Off for TVUS and MRI examinations.

Results: Using Wait Trade Off, patients preferred TVUS over MRI (3.58 vs 2.80 weeks, 95% confidence interval [CI] -1.63, 0.12; P = .08). Summary test utility of Testing Morbidities Index for MRI was worse than for TVUS (81.64 vs 87.42, 95%CI 0.41, 11.15; P = .03). Patients reported greater embarrassment during TVUS than during MRI (P <.0001), but greater fear and anxiety both before (P <.0001) and during (P <.001) MRI, and greater mental (P = .02) and physical (P = .02) problems after MRI versus TVUS. Subscale correlations showed physically inactive women rated TVUS more negatively (R = -0.32, P = .03), whereas women with more severe symptoms of loss of control of health (R = -0.28, P = .04) and sexual dysfunction (R = -0.30, P = .03) rated MRI more negatively.

Conclusion: Women with pelvic symptoms had a slight but significant preference for TVUS over MRI. Identifying specific distressing aspects of each test and patient factors contributing to negative perceptions can direct improvement in both test environment and patient preparation. Improved patient experience may increase imaging value.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.acra.2017.10.011DOI Listing
April 2018

The "erased charcoal" sign.

Abdom Radiol (NY) 2017 Mar;42(3):981-982

Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00261-016-0938-xDOI Listing
March 2017

Bright Red Rectal Bleeding: The Bottom Line from Neonates to Older Adults: Gastrointestinal Imaging.

Radiographics 2016 Sep-Oct;36(5):1600-1

From the Department of Radiology, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC 27157.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1148/rg.2016160063DOI Listing
September 2017

Mimics of hepatic neoplasms.

Semin Roentgenol 2015 Oct 19;50(4):305-19. Epub 2015 Aug 19.

Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.ro.2015.08.003DOI Listing
October 2015

Endometrial Ablation: Normal Imaging Appearance and Delayed Complications.

AJR Am J Roentgenol 2015 Oct;205(4):W451-60

1 Department of Radiology, Wake Forest Baptist Medical Center, One Medical Center Blvd, 3rd Fl MRI, Winston-Salem, NC 27157.

Objective: Nonresectoscopic endometrial ablation techniques are being used as an alternative first-line management for menorrhagia. With these techniques, patients are at risk of developing delayed complications including painful obstructed menses, such as central hematometra and cornual hematometra, and postablation tubal sterilization syndrome. Pregnancy and the detection of endometrial cancer after ablation pose challenges in management.

Conclusion: Radiologists should recognize the normal imaging findings in patients who have undergone endometrial ablation, be aware of the causes of treatment failure, and accurately identify delayed complications associated with these procedures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2214/AJR.14.13960DOI Listing
October 2015

The horseshoe kidney.

Abdom Imaging 2015 Oct;40(7):2910-1

Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00261-015-0454-4DOI Listing
October 2015

MR enterography of ileocolovesicular fistula in pediatric Crohn disease.

Pediatr Radiol 2011 May 13;41(5):663-7. Epub 2010 Nov 13.

Wayne State University School of Medicine, Detroit, MI, USA.

Crohn disease, a form of chronic inflammatory bowel disease is characterized by discontinuous inflammatory lesions of the gastrointestinal tract, has a variety of behavioral patterns, including penetrating or fistulous disease. While magnetic resonance enterography (MRE) excellently depicts inflamed bowel segments, it can also be used to assess for a variety of Crohn-disease-related extraintestinal complications, including fistulae. We present the MRE findings of a complex ileocolovesicular fistula in a 14-year-old boy with Crohn disease, where the fistulous tract to the urinary bladder was best delineated on precontrast T1-W imaging because of the presence of fecal material.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00247-010-1896-zDOI Listing
May 2011