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O’Shea A, Crotty RK, Randhawa MK, Oliveira G, Perugino CA, Stone JH, Harisinghani MG, Wallace ZS, Hedgire SS. Multimodality Imaging Features of Immunoglobulin G4-related Vessel Involvement. Radiol Cardiothorac Imaging 2024; 6:e230105. [PMID: 38483247 PMCID: PMC11056752 DOI: 10.1148/ryct.230105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/11/2023] [Accepted: 01/30/2024] [Indexed: 05/01/2024]
Abstract
Immunoglobulin 4 (IgG4)-related disease is a chronic immune-mediated fibroinflammatory disorder. Involvement of the vascular system, including large- and medium-sized vessels, is increasingly recognized. The varied appearances of vascular involvement reflect the sequela of chronic inflammation and fibrosis and can include aortitis and periaortitis with resultant complications such as aneurysm formation and dissection. A diagnosis of IgG4-related large vessel involvement should be considered when there is known or suspected IgG4-related disease elsewhere. Other organs that are typically affected in IgG4-related disease include the lacrimal and salivary glands, thyroid, pancreas, biliary tree, lungs, kidneys, and meninges. Diagnosis typically requires careful correlation with clinical, imaging, serum, and pathologic findings. Patients may be managed with corticosteroid therapy or the anti-CD20 monoclonal antibody, rituximab, if needed. The varied clinical presentations and imaging features of large vessel involvement are discussed herein. Keywords: Vascular, Inflammation, Aorta, IgG4-related Vessel Involvement © RSNA, 2024.
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Affiliation(s)
- Aileen O’Shea
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - Rory K. Crotty
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - Mangun Kaur Randhawa
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - George Oliveira
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - Cory A. Perugino
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - John H. Stone
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - Mukesh G. Harisinghani
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - Zachary S. Wallace
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
| | - Sandeep S. Hedgire
- From the Departments of Radiology (A.O., M.K.R., M.G.H., S.S.H.),
Pathology (R.K.C.), and Rheumatology (C.A.P., J.H.S., Z.S.W.), Massachusetts
General Hospital, 55 Fruit St, White 217, Boston, MA 02114; and Radiology
Associates of South Florida, Miami, Fla (G.O.)
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Lopez AR, Sohani AR, O’Shea A, Ng TS. Neurolymphomatosis in Recrudescent Diffuse Large B-cell Lymphoma. Asia Ocean J Nucl Med Biol 2023; 11:89-92. [PMID: 36619186 PMCID: PMC9803627 DOI: 10.22038/aojnmb.2022.66666.1464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 01/10/2023]
Abstract
Neurolymphomatosis is an uncommon manifestation of lymphoma, often presenting with painful polyneuropathy or polyradiculopathy and concomitant distal extremity weakness. Differentiation from other etiologies resulting in similar neuropathic symptoms such as compressive or inflammatory pathologies can be difficult and often results in delayed diagnosis. Here we describe a case of neurolymphomatosis affecting a 64-year-old man with a history of diffuse large B-cell lymphoma (DLBCL) in remission presenting with a right-sided foot drop following a gunshot wound. MRI at that time demonstrated thickening and enhancement of the cauda equina nerve roots. Over the course of the subsequent eight months, he developed left lower extremity sensory symptoms, left-sided foot drop and signs of upper motor neuron involvement, including left facial weakness, dysphonia, and dysphagia. 18F-FDG PET/CT revealed intensely avid left lumbosacral nerve roots, bilateral lower extremity and left upper extremity neurovascular bundles. Left sural nerve biopsies showed infiltration of DLBCL and confirmed neurolymphomatosis. We highlight the role of 18F-FDG PET/CT, with histological verification, for the diagnosis of an extended course of neurolymphomatosis occurring in the absence of typical painful neuropathy but with cranial and peripheral neuropathies.
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Affiliation(s)
| | - Aliyah R. Sohani
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Aileen O’Shea
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Thomas S.C. Ng
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA,Corresponding author: Thomas S.C. Ng. Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, White 4, 55 Fruit St, Boston MA 02114. Tel: (617) 732-5938; Fax: (617) 726 6165;
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O’Shea A, Foran AT, Murray TE, Thornton E, Dunne R, Lee MJ, Morrin MM. Quality of same-day CT colonography following incomplete optical colonoscopy. Eur Radiol 2020; 30:6508-6516. [DOI: 10.1007/s00330-020-06979-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/17/2020] [Accepted: 05/25/2020] [Indexed: 01/25/2023]
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Li MD, Arun NT, Gidwani M, Chang K, Deng F, Little BP, Mendoza DP, Lang M, Lee SI, O’Shea A, Parakh A, Singh P, Kalpathy-Cramer J. Automated Assessment and Tracking of COVID-19 Pulmonary Disease Severity on Chest Radiographs using Convolutional Siamese Neural Networks. Radiol Artif Intell 2020; 2:e200079. [PMID: 33928256 PMCID: PMC7392327 DOI: 10.1148/ryai.2020200079] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To develop an automated measure of COVID-19 pulmonary disease severity on chest radiographs (CXRs), for longitudinal disease tracking and outcome prediction. MATERIALS AND METHODS A convolutional Siamese neural network-based algorithm was trained to output a measure of pulmonary disease severity on CXRs (pulmonary x-ray severity (PXS) score), using weakly-supervised pretraining on ∼160,000 anterior-posterior images from CheXpert and transfer learning on 314 frontal CXRs from COVID-19 patients. The algorithm was evaluated on internal and external test sets from different hospitals (154 and 113 CXRs respectively). PXS scores were correlated with radiographic severity scores independently assigned by two thoracic radiologists and one in-training radiologist (Pearson r). For 92 internal test set patients with follow-up CXRs, PXS score change was compared to radiologist assessments of change (Spearman ρ). The association between PXS score and subsequent intubation or death was assessed. Bootstrap 95% confidence intervals (CI) were calculated. RESULTS PXS scores correlated with radiographic pulmonary disease severity scores assigned to CXRs in the internal and external test sets (r=0.86 (95%CI 0.80-0.90) and r=0.86 (95%CI 0.79-0.90) respectively). The direction of change in PXS score in follow-up CXRs agreed with radiologist assessment (ρ=0.74 (95%CI 0.63-0.81)). In patients not intubated on the admission CXR, the PXS score predicted subsequent intubation or death within three days of hospital admission (area under the receiver operating characteristic curve=0.80 (95%CI 0.75-0.85)). CONCLUSION A Siamese neural network-based severity score automatically measures radiographic COVID-19 pulmonary disease severity, which can be used to track disease change and predict subsequent intubation or death.
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Affiliation(s)
- Matthew D. Li
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nishanth Thumbavanam Arun
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mishka Gidwani
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Chang
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Francis Deng
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Brent P. Little
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dexter P. Mendoza
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Min Lang
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susanna I. Lee
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aileen O’Shea
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anushri Parakh
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Praveer Singh
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jayashree Kalpathy-Cramer
- From the Athinoula A. Martinos Center for Biomedical Imaging (M.D.L., N.T.A., M.G., K.C., P.S., J.K.C.), Department of Radiology (F.D., M.L.), Division of Thoracic Imaging and Intervention (B.P.L, D.P.M.), Division of Abdominal Imaging (S.I.L., A.O., A.P.), and MGH and BWH Center for Clinical Data Science (J.K.) of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Abstract
Advances in MRI technologies have the potential to detect, characterize, and monitor a wide variety of diseases.
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Affiliation(s)
- Mukesh G. Harisinghani
- Department of Radiology, Massachusetts General Hospital, Fruit Street, Boston, MA 02114, USA
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge Street, CPZN 5206, Boston, MA 02114, USA
| | - Aileen O’Shea
- Department of Radiology, Massachusetts General Hospital, Fruit Street, Boston, MA 02114, USA
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge Street, CPZN 5206, Boston, MA 02114, USA
| | - Ralph Weissleder
- Department of Radiology, Massachusetts General Hospital, Fruit Street, Boston, MA 02114, USA
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge Street, CPZN 5206, Boston, MA 02114, USA
- Department of Systems Biology, Harvard Medical School, 200 Longwood Avenue, Boston, MA 02115, USA
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Babcock L, Riggs K, Rowe VD, Hunter JA, O’Shea A, Schell D, Varona M, Miller S, Barnett J, Kadia S. 0923 The Diagnosis and Treatment of Sleep Disordered Breathing in a Hypermobile Population. Sleep 2018. [DOI: 10.1093/sleep/zsy061.922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Babcock
- Rowe Neurology Institute, Lenexa, KS
| | - K Riggs
- Rowe Neurology Institute, Lenexa, KS
| | - V D Rowe
- Rowe Neurology Institute, Lenexa, KS
| | | | - A O’Shea
- Rowe Neurology Institute, Lenexa, KS
| | - D Schell
- Rowe Neurology Institute, Lenexa, KS
| | - M Varona
- Rowe Neurology Institute, Lenexa, KS
| | - S Miller
- Rowe Neurology Institute, Lenexa, KS
| | - J Barnett
- University Of Kansas Medical School, Kansas City, KS
| | - S Kadia
- University Of Kansas Medical School, Kansas City, KS
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Barnett J, Rowe V, Rowe E, Hunter J, Varona M, VanOwen K, O’Shea A, Schell D, Fisher S. 0518 TREATMENT OF SLEEP DISORDERED BREATHING IN HYPERMOBILE PATIENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Barnett J, Rowe V, Rowe E, Hunter J, Varona M, VanOwen K, O’Shea A, Schell D, Fisher S. 0449 EVALUATION OF SLEEP DISORDERED BREATHING IN HYPERMOBILE PATIENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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O’Shea A, Culleton S, Asadi H, Kok HK, O’Hare A, Thornton J, Brennan P, Looby S. A diagnosis of stroke-like migraine attacks after radiation therapy (SMART) as severe headache with stroke-like presentation. Iran J Neurol 2016; 15:237-239. [PMID: 28435635 PMCID: PMC5392200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Aileen O’Shea
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Sinead Culleton
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Hamed Asadi
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin, Ireland AND School of Health, Deakin University, Waurn Ponds, Australia
| | - Hong Kuan Kok
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Alan O’Hare
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - John Thornton
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Paul Brennan
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Seamus Looby
- Neuroradiology and Neurointerventional Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
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McDonald M, O’Shea A, Goodheart M, Bender D, Gonzalez Bosquet J, Button A, Stephan J. Abstract 8: The effects of obesity on oncologic outcomes in patients with ovarian cancer. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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