Publications by authors named "Patricia T Acharya"

7 Publications

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Contrast-enhanced ultrasound of the kidneys and adrenals in children.

Pediatr Radiol 2021 May 12. Epub 2021 May 12.

Department of Radiology, Medical University of Gdansk, Gdansk, Poland.

Pediatric applications of contrast-enhanced ultrasound (CEUS) are growing. Evaluation of the kidneys and adrenal glands in children using intravenous administration of US contrast agents, however, is still an off-label indication. Pediatric CEUS applications for kidneys are similar to those in adults, including ischemic disorders, pseudo- versus real tumors, indeterminate lesions, complex cystic lesions, complicated pyelonephritis, and abscesses. CEUS applications for evaluation of adrenal glands in children are limited, mainly focusing on the assessment and follow-up of adrenal trauma and the differentiation between an adrenal hemorrhage and a mass. This review addresses the current experience in pediatric CEUS of the kidneys and adrenal glands. By extrapolating the established knowledge for US contrast evaluations in the adult kidney to the pediatric context we can note opportunities for CEUS clinical use in children.
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http://dx.doi.org/10.1007/s00247-020-04849-0DOI Listing
May 2021

Radiation in Pediatric Imaging: A Primer for Pediatricians.

Pediatr Ann 2020 Sep;49(9):e370-e373

Medical imaging in children makes up a considerable percentage of all imaging procedures performed in the United States. Although in recent years there has been a 15% to 20% reduction in the exposure to ionizing radiation from medical imaging in the US population, the total number of computed tomography (CT) scans has increased from 2006 to 2016, and about 85% of all medical ionizing radiation in children is due to CT. [Pediatr Ann. 2020;49(9):e370-e373.].
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http://dx.doi.org/10.3928/19382359-20200825-01DOI Listing
September 2020

Virtual Read-Out: Radiology Education for the 21st Century During the COVID-19 Pandemic.

Acad Radiol 2020 06 1;27(6):872-881. Epub 2020 May 1.

Department of Radiology, Keck School of Medicine of USC, 1520 San Pablo St. Lower Level, Rm1451, Los Angeles, CA 90033. Electronic address:

Technologic advances have resulted in the expansion of web-based conferencing and education. While historically video-conferencing has been used for didactic educational sessions, we present its novel use in virtual radiology read-outs in the face of the COVID-19 pandemic. Knowledge of key aspects of set-up, implementation, and possible pitfalls of video-conferencing technology in the application of virtual read-outs can help to improve the educational experience of radiology trainees and promote potential future distance learning and collaboration.
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http://dx.doi.org/10.1016/j.acra.2020.04.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252195PMC
June 2020

Pediatric Renal Neoplasms:: MR Imaging-Based Practical Diagnostic Approach.

Magn Reson Imaging Clin N Am 2019 May;27(2):279-290

Department of Radiology, Seattle Children's, University of Washington, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.

Pediatric renal tumors may be malignant or benign. Wilms tumor, the most common malignant pediatric renal tumor, arises sporadically or with various syndromes. Renal cell carcinoma typically presents in older children. Renal clear cell sarcoma and rhabdoid tumor are typically less common, more aggressive, and present in younger children. Benign renal tumors include mesoblastic nephroma, multilocular cystic renal tumor, angiomyolipoma, and metanephric adenoma. Lymphoma and leukemia may secondarily involve the kidney. Although there is overlap in the imaging appearance of several pediatric renal tumors, magnetic resonance characteristics and clinical data narrow the differential diagnosis and suggest a specific diagnosis. This article reviews current MR techniques, as well as the common MR imaging characteristics of malignant and benign pediatric renal neoplasms.
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http://dx.doi.org/10.1016/j.mric.2019.01.006DOI Listing
May 2019

Pediatric Mediastinal Masses:: Role of MR Imaging as a Problem-Solving Tool.

Magn Reson Imaging Clin N Am 2019 May;27(2):227-242

Division of Thoracic Imaging, Department of Radiology, Boston Children's Hospital, Harvard Medical School, 330 Longwood Avenue, Boston, MA 02115, USA. Electronic address:

Computed tomography (CT) is the imaging modality of choice for evaluating mediastinal masses detected by radiography or clinical presentation. However, CT results can often be indeterminate. Thoracic magnetic resonance (MR) imaging is a noninvasive way to characterize mediastinal lesions, site of origin, and involvement of adjacent structures by providing higher soft tissue contrast than CT, with superior tissue characterization and higher diagnostic specificity. Thoracic MR imaging of mediastinal masses can increase diagnostic certainty, reduce the number of surgical interventions, and improve clinical decision making. In this review article, current imaging techniques and clinical applications of MR imaging as a problem-solving tool for assessing mediastinal masses in pediatric patients are discussed.
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http://dx.doi.org/10.1016/j.mric.2019.01.003DOI Listing
May 2019

Pediatric contrast-enhanced ultrasound in the United States: a survey by the Contrast-Enhanced Ultrasound Task Force of the Society for Pediatric Radiology.

Pediatr Radiol 2018 06 13;48(6):852-857. Epub 2018 Feb 13.

Division of Pediatric Radiology, Department of Radiology, Georgetown University, Washington, DC, USA.

Background: The United States Food and Drug Administration (FDA) recently approved an ultrasound (US) contrast agent for intravenous and intravesical administration in children.

Objective: Survey the usage, interest in and barriers for contrast-enhanced US among pediatric radiologists.

Materials And Methods: The Contrast-Enhanced Ultrasound Task Force of the Society for Pediatric Radiology (SPR) surveyed the membership of the SPR in January 2017 regarding their current use and opinions about contrast-enhanced US in pediatrics.

Results: The majority (51.1%, 166) of the 325 respondents (26.7% of 1,218) practice in either a university- or academic affiliated group. The most widely used US contrast agent was Lumason® 52.3% (23/44). While lack of expertise and training were reported barriers, all respondents who are not currently using US contrast agents are considering future use.

Conclusion: Interest in pediatric contrast US is very high. Education and training are needed to support members who plan to adopt contrast US into practice.
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http://dx.doi.org/10.1007/s00247-018-4088-xDOI Listing
June 2018

Response Evaluation Criteria in Solid Tumors (RECIST) following neoadjuvant chemotherapy in osteosarcoma.

Pediatr Blood Cancer 2018 04 18;65(4). Epub 2017 Dec 18.

Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.

Background: In osteosarcoma, patient survival has not changed in over 30 years. Multiple phase II trials have been conducted in osteosarcoma using the Response Evaluation Criteria in Solid Tumors (RECIST) as a primary endpoint; however, none of these have revealed new treatment strategies. We investigated RECIST in newly diagnosed patients who received neoadjuvant chemotherapy proven to be beneficial.

Methods: Patients treated from 1986 to 2011 for newly diagnosed osteosarcoma with paired tumor imaging before and after adequate neoadjuvant chemotherapy were included in this retrospective study. Two radiologists performed independent, blinded (to image timing) RECIST measurements of primary tumor and lung metastases at diagnosis and post-neoadjuvant chemotherapy. Association between RECIST and histological necrosis and outcome were assessed.

Results: Seventy-four patients met inclusion criteria. Five-year overall survival and progression-free survival (PFS) were 77 ± 7% and 61 ± 8%, respectively. No patients had RECIST partial or complete response in the primary tumor. Sixty-four patients (86%) had stable disease, and 10 (14%) had progressive disease (PD). PD in the primary tumor was associated with significantly worse PFS in localized disease patients (P = 0.02). There was no association between RECIST in the primary tumor and necrosis. There were an insufficient number of patients with lung nodules ≥1 cm at diagnosis to evaluate RECIST in pulmonary metastases.

Conclusions: PD by RECIST predicts poor outcome in localized disease patients. In bone lesions, chemotherapy proven to improve overall survival does not result in radiographic responses as measured by RECIST. Further investigation of RECIST in pulmonary metastatic disease in osteosarcoma is needed.
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http://dx.doi.org/10.1002/pbc.26896DOI Listing
April 2018
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