Publications by authors named "Vibhor Wadhwa"

82 Publications

Utilization and Outcomes of Cholecystostomy and Cholecystectomy in Patients Admitted With Acute Cholecystitis: A Nationwide Analysis.

AJR Am J Roentgenol 2021 Apr 21:1-8. Epub 2021 Apr 21.

Department of Radiology, Division of Interventional Radiology, Weill Cornell Medicine, 525 E 68th St, Payson 512, New York, NY 10065.

The purpose of this study was to report national utilization trends and outcomes after percutaneous cholecystostomy, cholecystectomy, or no intervention among patients admitted to hospitals with acute cholecystitis. The Nationwide Inpatient Sample was queried from 2005 to 2014. Admissions were identified and stratified into treatment groups of percutaneous cholecystostomy, cholecystectomy, and no intervention on the basis of International Classification of Diseases, 9th revision, codes. Outcomes, including length of stay, inpatient mortality, and complications including hemorrhage and bile peritonitis, were identified. Multivariate analysis was performed to identify mortality risk by treatment type after adjustment for baseline comorbidities and risk of mortality. Among 2,550,013 patients (58.6% women, 41.4% men; mean age, 55.9 years) admitted for acute cholecystitis over the study duration, 73,841 (2.9%) patients underwent percutaneous cholecystostomy, 2,005,728 (78.7%) underwent cholecystectomy, and 459,585 (18.0%) did not undergo either procedure. Use of percutaneous cholecystostomy increased from 2985 procedures in 2005 to 12,650 in 2014. The percutaneous cholecystostomy cohort had a higher mean age (70.6 years) than the other two groups (cholecystectomy, 53.8 years; no intervention, 62.5 years), a higher mean comorbidity index (cholecystostomy, 3.74; cholecystectomy, 1.77; no intervention, 2.65), and a higher mean risk of mortality index (cholecystostomy, 2.88; cholecystectomy, 1.45; no intervention, 2.07) ( < .05). Unadjusted inpatient all-cause mortality was 10.1% in the percutaneous cholecystostomy, 0.8% in the cholecystectomy, and 5.2% in the no intervention cohorts. After adjustment for baseline mortality risk, percutaneous cholecystostomy (odds ratio, 0.78; 95% CI, 0.76-0.81) and cholecystectomy (odds ratio, 0.42; 95% CI, 0.41-0.43) were associated with reduced mortality compared with no intervention. Use of percutaneous cholecystostomy is increasing among patients admitted with acute cholecystitis. After adjustment for baseline comorbidities, percutaneous cholecystostomy is associated with improved odds of survival compared with no intervention.
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http://dx.doi.org/10.2214/AJR.20.23156DOI Listing
April 2021

Temporal and geospatial variations among the interventional radiology physician workforce in the United States.

Clin Imaging 2021 Mar 19;78:105-109. Epub 2021 Mar 19.

Division of Interventional Radiology, NewYork-Presbyterian/Weill Cornell Medical Center, New York 10065, USA. Electronic address:

Objective: To analyze the temporal trends and state-wide geospatial variations in Vascular and Interventional Radiology (VIR) workforce in the United States.

Methods: The State Physician Workforce Data from the AAMC website was accessed for years 2015, 2017, and 2019. The variables collected for each state included total number of active physicians, total number of physicians per specialty and total number of female physicians in VIR. Comparative data was obtained for vascular surgery (VS), diagnostic radiology (DR), and radiation oncology (RO). The annual growth rate for total physicians and sub-analysis of female physicians in each state was computed for each specialty.

Results: From 2015 to 2019, the total number of active physicians in the United States grew by 1.8% per year. Growth of active physicians in VIR grew by 8.3%, DR 0.06%, VS 4.4%, and RO 1.9% per year. Colorado and Minnesota had the highest growth rate for VIR physicians (15%). VIR physicians per 100,000 people increased from 0.84 (2015) to 1.10 (2019) in the US. In comparison, VS physicians increased from 0.99 (2015) to 1.14 (2019), DR physicians decreased from 8.61 (2015) to 8.43 (2019), and RO physicians grew from 1.48 (2015) to 1.56 (2019). Women represented 6.8% of the VIR workforce in the US in 2019 and increased by a rate of 16% annually in the US from 2015 to 2019. In comparison, the number of women in VS has grown by 21%, DR by 2%, and RO by 2.4% during the same period. The state of Maryland has the highest proportion of women in VIR at 18%.

Conclusion: The number of VIR physicians is increasing at a higher rate than the national overall physician growth, and while female VIR physicians makeup a small fraction of the VIR workforce, their numbers have increased at a faster rate than overall VIR physicians.
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http://dx.doi.org/10.1016/j.clinimag.2021.03.013DOI Listing
March 2021

Pediatric interventional radiology workforce in North America: a descriptive analysis of demographics, educational backgrounds and scholarly activities.

Pediatr Radiol 2021 Mar 12. Epub 2021 Mar 12.

Department of Radiology, University of Arkansas for Medical Sciences & Arkansas Children's Hospital, 1 Children's Way, Slot #105, Little Rock, AR, 72202, USA.

Background: Pediatric interventional radiology has grown as an advanced subspecialty with increased demand, number and complexity of cases, and number of pediatric institutions offering a pediatric interventional radiology service. Despite the overall increase in the number of pediatric interventionalists over the past two decades, there is a heterogeneity in their academic backgrounds and a lack of uniform training pathways.

Objective: To analyze the demographics, academic backgrounds and scholarly activities of pediatric interventionalists across the United States (U.S.) and Canada.

Materials And Methods: A list of all members of the Society for Pediatric Interventional Radiology was obtained and pediatric interventionalists at academic and private practice institutions in the U.S. and Canada were included. Publicly available online sources were used to gather demographic and educational information about each pediatric interventionalist, which included the online curriculum vitae, the HealthGrades.com and Doximity.com websites, and Elsevier's Scopus database. Demographic and educational data including age, gender, educational background, additional degrees, academic rank, previous leadership positions, and metrics of scholarly activities were recorded. Fellowships in diagnostic pediatric radiology, adult interventional radiology and/or pediatric interventional radiology were recorded. Mann-Whitney U tests and Kruskal-Wallis tests were used to compare differences between groups.

Results: One hundred and twenty-five pediatric interventionalists were included, of whom 24 (19.2%) were female. The mean age was 48.6 years (standard deviation [SD]: 10.6, median: 45 years, range: 36-82 years). There was no statistical difference between median age for male versus female pediatric interventionalists (44.5 years vs. 45 years, P=0.89). A majority of pediatric interventionalists were American medical school graduates (96, 76.8%), while 29 (23.2%) were international medical graduates. Eighty-three percent (104) of the pediatric interventionalists completed diagnostic radiology residency training in the U.S., most commonly at the University of Cincinnati in Ohio (6.4%) and Washington University in St. Louis, MO (5.6%). Among fellowship training, pediatric interventionalists completed a pediatric radiology fellowship (61.6%), adult interventional radiology fellowship (40%) and/or a dedicated pediatric interventional radiology fellowship (57.6%). The mean±SD (median) publications, citations and Hirsch index (h-index) for pediatric interventionalists were 32±45 (12), 68±1,317 (120) and 9±10 (5), respectively. There was a statistically higher number of publications, citations and h-index with increasing academic rank at the assistant, associate and professor levels (P<0.001 for all groups). International medical graduate pediatric interventionalists had a higher, but not statistically significant, median publication count (26 vs. 11, P=0.0.25), citation count (236 vs. 93, P=0.36) and h-index (9.0 vs. 5, P=0.24) compared to pediatric interventional radiologists from American medical schools.

Conclusion: Pediatric interventionalists in North America are predominantly male, with about a quarter having graduated from international medical schools. Pediatric radiology fellowship, followed by pediatric interventional radiology fellowship, was the most frequently pursued training pathway.
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http://dx.doi.org/10.1007/s00247-021-05014-xDOI Listing
March 2021

Retrieval of Bard Simon Nitinol inferior vena cava filters: Approaches, technical successes, complications, and clinical outcomes.

Phlebology 2021 Jan 26:268355520925986. Epub 2021 Jan 26.

Department of Radiology, Division of Interventional Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Objective: The Simon Nitinol filter is a bi-level filtration device designed for permanent implantation that is no longer commercially available, but may result in similar complications to current commercially available long term indwelling temporary or permanent filters. Complications related to indwelling inferior vena cava filters include inferior vena cava thrombosis, inferior vena cava penetration, filter migration, and filter fracture. There is a paucity of reports describing the technical aspects related to retrieval of Simon Nitinol filters.

Materials And Methods: This study consisted of five patients with Simon Nitinol filters and describes the indication for retrieval, the retrieval techniques used to remove the filters, technical success, complications, and clinical course.

Results: The indications for retrieval included: abdominal pain ( = 2; 40%), iliocaval thrombosis ( = 1; 20%), identification of an intracardiac filter fragment ( = 1; 20%), and recurrent venous thromboembolic events ( = 1; 20%). Retrieval techniques included: biopsy forceps ( = 3; 60%), excimer laser extraction sheaths ( = 3; 60%), hangman modified loop snares ( = 3; 60%), rigid endobronchial forceps ( = 2; 40%), and balloon deflection ( = 2; 40%). All filters were successfully retrieved. One patient developed a post-procedural intramuscular hematoma near the site of right internal jugular sheath placement.

Conclusions: Simon Nitinol filters may be retrieved safely and effectively using advanced inferior vena cava filter retrieval techniques.
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http://dx.doi.org/10.1177/0268355520925986DOI Listing
January 2021

A 15-Year Analysis of International Medical Graduates Matching Into Diagnostic Radiology Residency Programs in the United States.

Acad Radiol 2020 Nov 3. Epub 2020 Nov 3.

Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: https://twitter.com/DrRoopaRam.

Rationale And Objectives: To analyze the trends in international medical graduates (IMGs) matching into diagnostic radiology residency programs in the United States (US).

Materials And Methods: The National Resident Match Program data was accessed for years 2005-2020 and diagnostic radiology residency-specific data was extracted for US MD, osteopathic (DO), and IMG applicants. IMGs were categorized into US-citizen IMGs and non-US citizen IMGs per the National Residency Match Program. Variables collected for each year included the number of positions, number of applicants in each group, positions filled/unfilled, and fill rate of each group. Additional data for some years included USMLE Step 1 score, United States Medical Licensing Examination (USMLE) Step 2 clinical knowledge (CK) score, number of research experiences, number of abstracts/publications, and additional degrees obtained. Trends were analyzed using simple linear regression model and p value <0.05 was considered significant.

Results: The number of diagnostic radiology residency programs increased from 203 (2006) to 212 (2020). The total number of diagnostic radiology residency positions increased from 1011 (2006) to 1113 (2020), with the peak of 1145 in 2014. The overall "match rate," that is, proportion of positions filled to positions available, increased from 96.4% (2006) to 97.3% (2020), with a brief decline to 86.7% in 2015. Among the filled positions, the proportion filled by US medical school graduates significantly declined from 89.7% (2006) to 69.2% (2020) (p < 0.001), and the proportion of positions filled by osteopathic seniors and graduates significantly increased from 2.2% (2006) to 15.1% (2020; p < 0.001). The proportion of US IMGs increased from 3.2% (2006) to 5.4% (2020), while the proportion of non-US IMGs increased from 4.4% (2006) to 9.4% (2020), with overall IMG match rate increased significantly from 7.6% to 14.9% (p = 0.009). The mean Step 1 scores of US IMGs and non-US IMGs were 238 and 237.3, and the mean Step 2 CK scores were 241.67 and 241, respectively. Cumulatively over the study period, a total of 736 US IMGs and 1051 non-US IMGs have matched into diagnostic radiology residency.

Conclusion: There is an increasing proportion of IMGs, especially the non-US citizen IMGs, matching into US radiology residency programs in the last decade. Diagnostic radiology remains a competitive specialty evidenced by average USMLE scores higher than national average and research experiences of matched candidates.
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http://dx.doi.org/10.1016/j.acra.2020.09.018DOI Listing
November 2020

Critical Evaluation of Interventional Neuroradiology Fellowship Program Websites in North America.

World Neurosurg 2021 Feb 9;146:e48-e52. Epub 2020 Oct 9.

Division of Interventional Neuroradiology, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. Electronic address:

Objective: To investigate the accessibility and content of interventional neuroradiology (INR) fellowship program websites in North America.

Methods: We obtained a list of INR/endovascular surgical neuroradiology (ESN) fellowship programs from the Accreditation Council for Graduate Medical Education, the Committee on Advanced Subspecialty Training, the Society of NeuroInterventional Surgery, and the Neurosurgical Fellowship Training Program Directory websites. Individual program websites were evaluated for 27 different fellow recruitment and education criteria. U.S. programs were grouped based on census region and national ranking, and differences between these groups with regard to fellow recruitment and education characteristics were analyzed using nonparametric statistics.

Results: A total of 79 INR/ESN fellowship websites were evaluated for presence of fellow recruitment and education features. Approximately one third of all features pertinent to recruitment (32.11%) and approximately 1 in 5 features regarding education (19.11%) were described in these websites. Program description (69.6%), program coordinator/administrator contact e-mail (59.5%), program director's name (59.5%), program eligibility requirements (51.9%), research opportunities (40.5%), and faculty listing (39.2%) were among the most frequently described features, whereas details about parking (1.3%), interview day itinerary (1.3%), meal allowance (2.5%), retirement and benefits (3.8%), and call schedule (5.1%) were the least frequently described features. There was no significant difference between surveyed features and programs when stratified by U.S. census region, neurosurgery/neurology hospital rankings, or accreditation status.

Conclusions: INR/ESN fellowship website content is variable across North America and there is room for improvement to develop and enhance comprehensiveness of program website content.
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http://dx.doi.org/10.1016/j.wneu.2020.09.164DOI Listing
February 2021

Trends in Neuroradiology Fellowship Match in the United States: Analysis of the 13-Year National Resident Matching Program Data.

Curr Probl Diagn Radiol 2020 Sep 24. Epub 2020 Sep 24.

Division of Neuroradiology, Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center, Houston, TX.

The neuroradiology fellowship match is conducted by the National Resident Matching Program (NRMP) every year. The purpose of this study is to report the trends in neuroradiology match results from 2008 to 2020 in the United States (US) using data available from the NRMP. The fellowship match data was obtained from the NRMP archives. Data specific to programs (number of programs and filled positions) were obtained. Using the NRMP's "Charting Outcomes in the Match: Specialty Matching Service'' report, a detailed analysis of applicant characteristics broken down for each specialty, was also obtained for neuroradiology for the year 2018. Neuroradiology programs in the NRMP Match increased from 71 to 77 and the number of positions increased from 158 to 270 between 2008 and 2020. The fill rate of fellowship spots has remained steady at 75.9% in 2008 and 74.4% in 2020. The proportion of US allopathic medical graduates (US MD) amongst the filled spots decreased from 79.2% (2008) to 64.2% (2020), while the proportion of international medical graduates (IMGs) increased from 11.7% to 25.4%. US MD and IMG fill trends did not reach statistical significance (P = 0.78 and P = 0.92, respectively). US MDs had a higher number of research experiences and publications (23.2 and 26, respectively) when compared to US IMGs (5 and 7) and non-US IMGs (6.8 and 14.2). To conclude, over the last 13 years, the neuroradiology fellowship programs in the US have increased in number and expanded in size, with an almost stable fill rate of around 75%.
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http://dx.doi.org/10.1067/j.cpradiol.2020.09.002DOI Listing
September 2020

Contemporary Interventional Radiology employment: analysis of the American College of Radiology and the Society of Interventional Radiology Occupational Portals.

Clin Imaging 2020 12 7;68:236-238. Epub 2020 Aug 7.

Division of Interventional Radiology, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, United States of America.

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http://dx.doi.org/10.1016/j.clinimag.2020.07.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7411508PMC
December 2020

Descriptive analysis of interventional radiology residency program directors in the United States.

Clin Imaging 2020 Dec 27;68:232-235. Epub 2020 Aug 27.

Division of Interventional Radiology, Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York City, NY, United States of America. Electronic address:

Purpose: To analyze the academic background, demographics and scholarly metrics of Interventional Radiology (IR) residency program directors (PDs) in the United States.

Methods: Online search of publicly available resources was performed from April 6-10, 2020. PDs and associate PDs of ACGME accredited integrated and independent IR residency programs were included in the study. The variables collected from publicly available sources included age, sex, academic background (including medical school, residency and fellowship), and scholarly activity (publications, citations and h-index). Nonparametric statistics including Mann-Whitney U and Kruskal-Wallis tests were applied to compare differences between groups.

Results: A total of 174 PDs and associate PDs from 110 unique integrated and independent IR residency programs were included in the study. One hundred fifty three (87.9%) were male and twenty one (12.1%) were female. The average age of PDs was 47.39 years (SD 8.99, median 45, range 34-74). Eighty six percent of the PDs were American medical school graduates, 97% received a MD degree or foreign equivalent, and 3% received a DO degree. There was no statistical difference between male and female PDs with regards to number of publications, average number of citations or mean h-index. Fellow of the Society of Interventional Radiology (FSIR) qualification was held by 21.3% and PDs with FSIR designation had significantly higher scholarly metrics.

Conclusion: IR Residency PDs are predominantly male and graduates of American medical schools. Women represent only 12% of the IR PD workforce with no significant difference in scholarly metrics of female PDs compared to male PDs. PDs with FSIR designation had significantly higher scholarly metrics.
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http://dx.doi.org/10.1016/j.clinimag.2020.08.012DOI Listing
December 2020

Differences in citation counts of radiology journals between citation databases.

Clin Imaging 2021 Jan 30;69:182-184. Epub 2020 Jul 30.

Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America.

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http://dx.doi.org/10.1016/j.clinimag.2020.07.015DOI Listing
January 2021

Evaluation of Pediatric IR Fellowship Program Websites in North America.

J Vasc Interv Radiol 2020 09 14;31(9):1514-1516. Epub 2020 Aug 14.

Department of Radiology, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, 1 Children's Way, Slot # 105, Little Rock, AR 72202.

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http://dx.doi.org/10.1016/j.jvir.2020.04.033DOI Listing
September 2020

Establishing an Online Educational Teaching File on Instagram for an Academic Radiology Department: Proof-of-Concept.

Acad Radiol 2021 May 7;28(5):711-717. Epub 2020 Aug 7.

Department of Radiology, University of Arkansas for Medical Sciences & Arkansas Children's Hospital, 1 Children's Way, Slot # 105, Little Rock, AR 72205. Electronic address:

Instagram is a powerful social media platform, which can serve as the ideal educational companion app for a visually rich discipline such as Radiology. Instagram facilitates easy content creation allowing for educators to utilize this resource for easy and rapid dissemination of educational content. The authors describe their experience of creating an online publicly available radiology teaching file on Instagram as a proof-of-concept, to help other individuals and institutions in leveraging social media to create and share quality educational content for current and future trainees.
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http://dx.doi.org/10.1016/j.acra.2020.06.031DOI Listing
May 2021

Diagnostic Radiology Residency Program Director Workforce in the United States: A Descriptive Analysis.

Acad Radiol 2021 04 4;28(4):579-584. Epub 2020 Jul 4.

Department of Radiology, University of Arkansas for Medical Sciences, 1 Children's Way, Slot #105, Little Rock, AR 72202. Electronic address:

Purpose: To investigate and describe the demographics, academic background, and scholarly activity of Diagnostic Radiology (DR) residency program directors in the United States.

Methods: A list of all DR residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and corresponding program directors (PD) was obtained from ACGME website. Information about each PD was obtained from publicly available sources including program websites, Healthgrades and Doximity. Demographic and academic data including age, sex, educational background, subspecialty, tenure, interval between residency completion and appointment as PD, terms served, additional degrees, academic rank, prior leadership positions and metrics of scholarly activity were recorded. Nonparametric statistics including Mann-Whitney U and Kruskal-Wallis tests were applied to compare differences between groups. Results are considered statistically significant at p < 0.05.

Results: A total of 197 PDs were included in the study of which 139 (70.6%) were male. Average age of PDs was 47.56 years (SD 8.29, median 45, range 35-77). There was no significant difference in median age of male vs female PDs (45 vs 44.5, p = 0.655). Majority of PDs attended American medical schools (181/197, 91.9%), and 16/197 attended international medical schools. Nine PDs received DO degrees (9/197, 4.6%). Academic rank was available for 137 PDs, of which 4 (2.9%) were instructors, 63 (46.0%) were assistant professors, 47 (34.3%) were associate professors and 23 (16.8%) were professors. Fellowship information was available for 183 PDs, of which the most common subspecialties were neuroradiology (24.5%), musculoskeletal radiology (15.8%), abdominal radiology (10.3%), and interventional radiology (9.8%). Female PDs had a significantly higher median publications (13.5 vs 6.0, p = 0.003), median citations (133 vs 37, p = 0.19) and median h-index compared to male PDs (6 ± 3, p = 0.005).

Conclusion: Radiology PDs are mostly males who graduated from US allopathic medical schools. Female PDs had significantly higher scholarly metrics compared to male PDs. Twenty three percent PDs were appointed in the last 1 year.
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http://dx.doi.org/10.1016/j.acra.2020.06.020DOI Listing
April 2021

Analysis of Demographic and Educational Backgrounds of Interventional Neuroradiology Fellowship Program Director Workforce in North America.

Curr Probl Diagn Radiol 2020 May 17. Epub 2020 May 17.

Division of Interventional Neuroradiology, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.. Electronic address:

Purpose: To analyse the demographics, academic background, and scholarly activity of Interventional Neuroradiology (INR)/Endovascular Surgical Neuroradiology (ESN) program directors (PDs) in the United States (US) and Canada.

Methods: A list of all INR/ESN fellowships was obtained from the Accreditation Council for Graduate Medical Education, the Committee on Advanced Subspecialty Training, maintained by Society of Neurological Surgeons, the NeuroInterventional Training list website maintained by the Society of NeuroInterventional Surgery, and the Neurosurgical Fellowship Training Program Directory website maintained by the American Association of Neurological Surgeons. Online search was performed to identify PDs for these programs. Publicly available sources used to gather information about each PD included the program websites, the HealthGrades and Doximity websites, and Elsevier's Scopus database. Demographic and educational data including age, gender, educational background, subspecialty, appointment age, interval between residency completion and appointment as PD, additional degrees, academic rank, prior leadership positions, and metrics of scholarly activity were recorded. One-way analysis of variance was used to determine differences between the means of different groups.

Results: A total of 78 PDs from 72 programs were included, of which 72 (92.3%) were male with the mean age of 49.59 years (SD 7.25). Specialty division of PDs was neurosurgery (40, 51.3%), radiology (26, 33.3%), and neurology (10, 12.8%), whereas 2 PDs were dual board-certified in neurology and radiology. Twenty-five (32.1%) PDs attended an international medical school. All PDs received an MD degree or foreign equivalent, with no PD holding a DO degree. Eleven PDs received a PhD degree and 16 PDs received fellowship from a professional medical society. The mean ± SD publications, citations, and h-indexes of PDs were 111.32 ± 121.18, 2985.0 ± 1459.0 and 22.27 ± 15.45, respectively. There was no statistical difference in scholarly activity among PDs when stratified on the basis of specialty, gender, and US region.

Conclusion: INR/ESN PDs are predominantly male, with a majority from neurosurgery background, and thirty percent having graduated from international medical schools.
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http://dx.doi.org/10.1067/j.cpradiol.2020.05.001DOI Listing
May 2020

Disparities in Citation Metrics Amongst Web of Science, Scopus, and Google Scholar for Interventional Radiology Journals.

Cardiovasc Intervent Radiol 2020 10 3;43(10):1583-1586. Epub 2020 Jun 3.

Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, WA, USA.

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http://dx.doi.org/10.1007/s00270-020-02535-0DOI Listing
October 2020

Continued decrease in utilization of IVC filters: update from 2016 Nationwide Inpatient Sample.

Clin Imaging 2020 09 22;65:94-95. Epub 2020 Apr 22.

Division of Interventional Radiology, University of Colorado Medical Center, Aurora, CO, United States of America. Electronic address: https://twitter.com/radtrivedi.

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http://dx.doi.org/10.1016/j.clinimag.2020.04.009DOI Listing
September 2020

Increasing Volume of Bone Marrow Biopsies by Radiology Providers: Evaluation of Trends by Physician Specialty and Practice Setting.

J Am Coll Radiol 2020 Jul 3;17(7):933-937. Epub 2020 Mar 3.

Division of Interventional Radiology, Kenosha Medical Center, Kenosha, Illinois.

Purpose: The aim of this study was to evaluate trends in bone marrow biopsies performed in the United States by physician specialty and practice setting.

Methods: The CMS Medicare Physician Supplier Procedure Summary database was queried from 2005 to 2016 for bone marrow biopsies and aspirations (BMBs). Data were categorized according to the largest subspecialty groups (medicine, surgery, radiology, pathology, and other) and encounter setting (office, inpatient hospital, and outpatient hospital). Trends in procedure volume by specialty and practice setting were evaluated.

Results: Between 2005 and 2016, an annual average of 11,417 BMBs were performed (range, 10,380-14,204), with no significant year-over-year change in volume. Medicine was the largest provider of BMBs by specialty, although their market share over this time period declined from 60.2% to 36.6%. Radiology saw the greatest growth in BMB market share from 4.1% to 16.2%. The compound annual growth rate (CAGR) of BMBs performed by medicine subspecialists demonstrated a decrease in year-over-year procedural volume at -5.16% (P < .001). Both surgery and radiology demonstrated positive trends in the number of BMBs performed, with CAGRs of 6.20% (P < .001) and 12.43% (P < .001), respectively. Independent of physician specialty, there was a decrease in the number of biopsies performed in the office setting, decreasing by a CAGR of -5.59% (P < .001).

Conclusions: From 2005 to 2016, medicine has remained the primary provider of BMBs, although their market share has declined. Radiology has experienced the greatest rate of growth in this time period and now represents the third largest individual specialty providing this service.
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http://dx.doi.org/10.1016/j.jacr.2020.02.004DOI Listing
July 2020

Scholarly Activities and Indices Among Academic Endovascular Specialists: A Comparative Analysis Between Interventional Radiologists and Vascular Surgeons.

Curr Probl Diagn Radiol 2021 Mar-Apr;50(2):132-136. Epub 2019 Oct 31.

Department of Radiology, Division of Interventional Radiology, University of Washington, Seattle, WA. Electronic address:

Purpose: To report scholarly metrics amongst academic endovascular specialists.

Material And Methods: Faculty pages identified interventional radiologists and vascular surgeons at academic institutions. Members were classified as assistant, associate, or full professors. Scopus was used to extract publication and citation records. Data extracted included: number of publications, number of citations, h-index, i-10 index, hc-index, m-quotient, e-index, and g-index.

Results: Two hundred seventy six interventional radiologists and 266 vascular surgeons were included. Mean publications for interventional radiology assistant, associate, and full professors were 17.81, 48.77, and 131.65 and the citation counts were 311.45, 1051.08, and 3981.71, respectively. Mean publications for vascular surgeon assistant, associate, and full professors were 24.00, 48.7, and 161.37 and the citation counts were 414.33, 1147.89, and 5747.00, respectively. Multivariable proportional odds model for interventional radiologists showed a positive correlation between the academic rank and publication count (c = 0.028), h-index (c = 0.090), i10-index (c = 0.014), hc-index (c = 0.052), e-index (c = 0.016), and g-index (0.037). There was a negative correlation between m-quotient (c = -1.745) and citations (c = -0.001) and academic rank. Multivariable proportional odds model for vascular surgeons showed a positive correlation between the academic rank and publication count (c = 0.037) and g-index (c = 0.083). There was a negative correlation between m-quotient (c = -2.232) and hc-index (c = -0.065) and academic rank.

Conclusion: Citation count and h-index are positively correlated while m-quotient is negatively correlated with academic performance for endovascular specialists.
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http://dx.doi.org/10.1067/j.cpradiol.2019.10.010DOI Listing
October 2019

Self-citations in musculoskeletal radiology: frequency and pattern analysis.

Acta Radiol 2019 Nov 7;60(11):1490-1495. Epub 2019 Mar 7.

Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

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http://dx.doi.org/10.1177/0284185119836215DOI Listing
November 2019

Endovascular Therapy for Lower Extremity Chronic Deep Venous Occlusive Disease: State of Practice.

Semin Intervent Radiol 2018 Oct 5;35(4):333-341. Epub 2018 Nov 5.

Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan.

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http://dx.doi.org/10.1055/s-0038-1669963DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218266PMC
October 2018

Regarding "Double prepuncture as a valuable adjunctive technique for complex endovenous ablation".

J Vasc Surg Venous Lymphat Disord 2018 11;6(6):805

Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich; Cardiovascular and Interventional Radiology, Inova Alexandria Hospital, Alexandria, Va.

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http://dx.doi.org/10.1016/j.jvsv.2018.06.011DOI Listing
November 2018

MR Neurographic Evaluation of Facial and Neck Pain: Normal and Abnormal Craniospinal Nerves below the Skull Base.

Radiographics 2018 Sep-Oct;38(5):1498-1513

From the Departments of Radiology (A.C., R.S.Q., J.W.), Orthopaedic Surgery (A.C.), Neurological Surgery (J.W.), Otolaryngology (L.L.M.), Plastic Surgery (B.A.), Surgery (J.R.Z.), and Neurology and Neurotherapeutics (J.R.Z.), University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9178; and Department of Diagnostic Radiology, University of Arkansas for Medical Sciences, Little Rock, Ark (G.B., V.W.).

Cranial nerve disease outside the skull base is a common cause of facial and/or neck pain, which causes significant disability for patients and frustration for clinicians. Neuropathy in this region can be traumatic, idiopathic, or iatrogenic secondary to dental and surgical procedures. MR neurography is a modification of conventional MRI techniques dedicated to evaluation of peripheral nerves and is being increasingly used for imaging of peripheral neuropathies at various sites in the body. MR neurography facilitates assessment of different causes of craniofacial pain and cranial nerves and allows elegant depiction of a multitude of regional neuropathies. This article discusses the anatomy, pathologic conditions, and imaging findings of the commonly implicated but difficult to image infratentorial nerves, such as the peripheral trigeminal nerve and its branches, facial nerve, glossopharyngeal nerve, vagus nerve, hypoglossal nerve, and greater and lesser occipital nerves. RSNA, 2018.
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http://dx.doi.org/10.1148/rg.2018170194DOI Listing
December 2018

Current perspectives in conventional and advanced imaging of the distal radioulnar joint dysfunction: review for the musculoskeletal radiologist.

Skeletal Radiol 2019 Mar 1;48(3):331-348. Epub 2018 Sep 1.

Radiology, UT Southwestern Medical Center, Dallas, TX, USA.

Distal radioulnar joint (DRUJ) dysfunction is a common cause of ulnar sided wrist pain. Physical examination yields only subtle clues towards the underlying etiology. Thus, imaging is commonly obtained towards an improved characterization of DRUJ pathology, especially multimodality imaging, which is frequently resorted to arrive at an accurate diagnosis. With increasing use of advanced MRI and CT techniques, DRUJ imaging has become an important part of a musculoskeletal radiologist's practice. This article discusses the normal anatomy and biomechanics of the DRUJ, illustrates common clinical abnormalities, and provides a comprehensive overview of the imaging evaluation with an insight into the role of advanced cross-sectional modalities in this domain.
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http://dx.doi.org/10.1007/s00256-018-3042-1DOI Listing
March 2019

In-Hospital Mortality Benefit of Inferior Vena Cava Filters in Patients With Pulmonary Embolism and Congestive Heart Failure.

AJR Am J Roentgenol 2018 09 17;211(3):672-676. Epub 2018 Jul 17.

6 Division of Interventional Radiology, University of Texas Southwestern Medical Center, Dallas, TX.

Objective: Pulmonary embolism (PE) is associated with a higher mortality rate in patients with congestive heart failure (CHF) than in those without heart failure. The purpose of this study was to evaluate if inferior vena cava (IVC) filter placement provides any mortality benefit in patients admitted with CHF and PE.

Materials And Methods: The 2005-2014 Nationwide Inpatient Sample (NIS) was used for this study. Adults (≥ 18 years old) with PE were identified using International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) diagnosis codes. Patients with CHF were identified using the Elixhauser comorbidity variable (CM_CHF) in the NIS database. IVC filter placement was identified using the ICD-9-CM procedure code 38.7 (interruption of the vena cava). A multivariate logistic regression model was used to determine the association of IVC filter placement with in-hospital mortality. The model was adjusted for demographics, hospital characteristics, comorbidities, and PE severity indexes (pressor dependence, mechanical ventilation, nonseptic shock, and use of thrombolytic therapy).

Results: During the study years, 425,877 patients with a comorbidity of CHF were hospitalized with PE (44% male; mean age, 71.5 years old). Of them, 67,237 patients (15.8%) received an IVC filter during the admission, and 50,338 (11.8%) died during the hospital stay. The all-cause in-hospital mortality rate among patients who received an IVC filter was 9.7% (6541 of 67,237 patients) compared with 12.2% (43,796 of 358,638 patients) among those without an IVC filter (p < 0.001), with an absolute risk reduction of 2.5%. The multivariate adjusted hazard ratio of in-hospital mortality associated with IVC filter placement was 0.535 (95% CI, 0.518-0.551; p < 0.001).

Conclusion: A lower all-cause mortality rate was observed in patients with CHF and PE who received an IVC filter while hospitalized. In the absence of data from randomized controlled trials, this study suggests that IVC filters could help prevent in-hospital death among patients admitted with PE and CHF.
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http://dx.doi.org/10.2214/AJR.17.19332DOI Listing
September 2018

Factors Increasing Tweet Engagement Rate for the Journal of Vascular and Interventional Radiology Twitter Feed.

J Vasc Interv Radiol 2018 07;29(7):1057-1059

Division of Interventional Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450m Chicago, IL 60612.

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http://dx.doi.org/10.1016/j.jvir.2018.03.004DOI Listing
July 2018

Series of rare lung diseases mimicking imaging patterns of common diffuse parenchymal lung diseases.

Lung India 2018 May-Jun;35(3):231-236

Department of Pulmonology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Diffuse parenchymal lung diseases (DPLDs) encompass a variety of restrictive and obstructive lung pathologies. In this article, the authors discuss a series of rare pulmonary entities and their high-resolution computed tomography imaging appearances, which can mimic more commonly encountered patterns of DPLDs. These cases highlight the importance of surgical lung biopsies in patients with imaging findings that do not show typical imaging features of usual interstitial pneumonia.
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http://dx.doi.org/10.4103/lungindia.lungindia_291_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946556PMC
April 2018

Medial meniscal extrusion: Detection, evaluation and clinical implications.

Eur J Radiol 2018 May 6;102:115-124. Epub 2018 Mar 6.

Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States. Electronic address:

The menisci play an important role in knee kinematics. Their unique anatomy allows them to channel forces generated during knee movements through the larger tibio-femoral condylar surfaces while simultaneously resisting deleterious hoop stresses. Although physiologic meniscal extrusion occurs with every knee joint movement, pathologic meniscal extrusion subjects the knee to persistent and excessive load transmission. This renders the knee structures susceptible to injury or exacerbates worsening of existing knee joint internal derangement. Detection and quantification of meniscus extrusion is important given its association with underlying pathological processes and internal derangements such as cartilage loss, osteoarthritis and meniscal tears. The medial and lateral menisci vary in size, attachments and load transmission, and the medial meniscus is more susceptible to injury. In this article, the authors illustrate the role of meniscus kinematics, and the identification and quantification of medial meniscal extrusion. Multimodality imaging appearances and implications of presence of medial meniscal extrusion in different knee joint pathologies are discussed with review of the relevant literature.
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http://dx.doi.org/10.1016/j.ejrad.2018.03.007DOI Listing
May 2018