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Biomedical subjects

E K Fishman

Publications and source records attributed to E K Fishman.

At least 55 records · Page 3Linked to original sources
PubMed2000

Local tumor recurrence following hepatic cryoablation: radiologic-histopathologic correlation in a rabbit model.

PURPOSE: To use radiologic-histopathologic correlation in an animal model to distinguish normal postoperative findings from evidence of residual tumor after cryoablation of malignant hepatic tumors. MATERIALS AND METHODS: Hepatic cryoablation was performed in 12 rabbits with VX2 tumors and in two healthy rabbits. Nonenhanced and dynamic contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging and power and color Doppler flow ultrasonography (US) were performed 7-8 days after cryoablation. Histopathologic findings were correlated with imaging findings. RESULTS: Twenty tumors of 5-20 mm (mean, 10 mm) and seven areas of normal liver were treated with cryolesions of 11-21 mm (mean, 15 mm). All cryolesions exhibited arterial phase rim enhancement at CT and MR imaging, and 13 (57%) of 23 lesions demonstrated peripheral flow at US because of granulation tissue. There was macroscopic recurrence in 15 (75%) of 20 treated tumors; 14 (93%) appeared as peripheral nodularity with low-grade enhancement. Necrotic tissue did not enhance. Intact vessels extended up to 6 mm inside cryolesion margins and caused focal internal enhancement and Doppler flow. Areas of high signal intensity on T2-weighted MR images correlated with liquefaction necrosis, granulation tissue, and tumor. CONCLUSION: In this animal model, recurrent tumor typically appeared as focal nodules at the cryolesion periphery. Rim and central foci of enhancement, Doppler flow, and increased signal intensity on T2-weighted MR images can be normal findings after hepatic cryoablation.

Animals↗
PubMed2000

Helical CT of skeletal muscle metastases from primary carcinomas.

OBJECTIVE: To determine the clinical and helical CT findings in patients with skeletal muscle metastases from carcinoma, we reviewed the cases of 15 consecutive patients who had muscle metastases diagnosed by contrast-enhanced helical CT. MATERIALS AND METHODS: Between February 1992 and August 1997, 15 patients (30 lesions) had metastatic disease to muscle from primary carcinoma diagnosed by helical CT in our institution. Patient data and imaging findings were retrospectively reviewed. RESULTS: Ten of 15 patients (67%) were known to have a malignancy at the time of CT. Patients complained of pain at the site of skeletal muscle metastases in five (17%) of 30 lesions, and in 11 (37%) of 30 lesions a mass was palpable. Lesion size averaged 3.2 cm (range, 0.7-7.8 cm). Thirteen of 15 patients had metastatic disease elsewhere at the time of skeletal muscle metastasis diagnosis. Muscles and other structures most commonly involved by metastatic disease included erector spinae (n = 9), psoas (n = 4), rotator cuff (n = 4), gluteal (n = 3), and abdominal (n = 3). The most common appearance of metastatic disease to muscle on contrast-enhanced helical CT was that of a rim-enhancing mass with central hypoattenuation in 25 (83%) of 30 lesions. CONCLUSION: Metastatic disease to skeletal muscle tends to be found in people with advanced-stage neoplasms. It may be an incidental finding on CT because pain is an uncommon feature; a minority of lesions were palpable in our series. The most common appearance on contrast-enhanced helical CT is a rim-enhancing intramuscular lesion with central hypoattenuation.

Adult↗
PubMed2000

1999 ARRS Executive Council Award. Contrast-enhanced CT of small hypovascular hepatic tumors: effect of lesion enhancement on conspicuity in rabbits. American Roentgen Ray Society.

OBJECTIVE: The purpose of this study was to evaluate the effect of lesion enhancement on the conspicuity of small hypovascular hepatic tumors in an animal model. MATERIALS AND METHODS: Seven VX2 hepatic tumors in five rabbits were imaged. Dynamic contrast-enhanced CT was performed at a single level centered over the lesions at 5-sec intervals for 119 sec after injection of 2 ml/kg i.v. contrast material at 2 ml/sec. Attenuation was measured over time within regions of interest in the tumor and normal liver, aorta, inferior vena cava, and portal vein. Lesion conspicuity, defined as the difference between the attenuation of the uninvolved liver and neoplasm, was calculated. RESULTS: The mean diameter of the tumors on CT was 10 mm (range, 6-15 mm). The tumors appeared as low-attenuation lesions with progressive enhancement during the arterial phase and early portal phase. Peak mean lesion attenuation was 60 +/- 27 H (enhancement, 23 H) at 64 sec. Peak mean lesion conspicuity was 80 +/- 18 H at 39 sec, occurring 10 sec before the peak mean hepatic attenuation of 135 +/- 15 H (enhancement, 67 H) at 49 sec. Relative lesion conspicuity paralleled relative enhancement of the liver throughout the imaging period. CONCLUSION: Although low-level tumor enhancement during the arterial phase and early portal phase reduced the conspicuity of small hypovascular tumors in this animal model, our results support the use of maximum liver enhancement as a marker for peak lesion conspicuity.

Animals↗
PubMed2000

CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment?

OBJECTIVE: The purpose of this study was to determine whether CT can be used to distinguish serous cystadenomas from mucinous cystadenomas or cystadenocarcinomas of the pancreas and play an enhanced role in patient triage and treatment. MATERIALS AND METHODS: A blinded retrospective analysis of CT scans from 50 patients with pathologically proven primary cystic pancreatic neoplasms was performed independently by three radiologists. Using classic CT criteria as reported in the literature, each tumor was categorized as definitely serous, mucinous, or indeterminate. Tumor location, size, presence of calcification, and size of largest cyst were recorded. Data for each reviewer were analyzed independently. Consensus data were then subjected to multivariate logistic regression analysis. RESULTS: The ability of our reviewers to diagnose serous neoplasms ranged from 23% to 41%. Eight mucinous neoplasms were mistaken for serous tumors by two of the three reviewers. When consensus between at least two of the three reviewers was used for diagnosis, 27% of serous neoplasms were correctly diagnosed and all of the mucinous tumors were correctly identified as uncertain or mucinous, yielding the same clinical end point. For multivariate logistic regression analysis, a cyst smaller than 2 cm had a statistically significant association (p = 0.005) with serous tumors, and the presence of peripheral tumoral calcification had a statistically significant association (p = 0.01) with mucinous tumors. CONCLUSION: There is significant variability in the CT appearance of serous and mucinous neoplasms of the pancreas, making CT an insensitive tool for differentiating these tumors. All tumors with peripheral calcifications were identified as mucinous neoplasms.

Adult↗
PubMed2000

Role of computer technology in medical illustration.

OBJECTIVE: Recent improvements of computer technology have resulted in a new approach to medical illustration and the scientific research process. The purpose of this manuscript is to define the current state of the art and to review paths of progress. CONCLUSION: Using examples, we compared the process of time-intensive hand-rendered art with current art created using new computer technology. Specific emphasis was made on the newest technologies and how high-quality lower cost medical art can now be created. These newly available tools and illustration methods have resulted in a new approach to research, creation, and reproduction of medical art.

Computer Graphics↗
PubMed2000

Musculoskeletal complications of Crohn's disease: the role of computed tomography in diagnosis and patient management.

The delayed diagnosis of musculoskeletal complications of Crohn's disease may produce major morbidity in patients. This study compared abdominal and pelvic computed tomography (CT) with conventional radiography in the diagnosis of musculoskeletal complications in 23 of 552 patients with Crohn's disease examined by CT over a 7-year period. Surgical confirmation was available in 15 of 21 patients. The clinical features of psoas/gluteal abscesses, abdominal wall fistulae, and sacral osteomyelitis are described. Because the clinical manifestations of these musculoskeletal complications are often nonspecific, CT is often useful in diagnosing and directing therapeutic interventions.

Abdominal Muscles↗