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Trunz LM, Faro SH, Gorniak RJ. Osteoblastoma in the occipital bone: A case report of a rare tumor in the calvarium. Radiol Case Rep 2020; 15:610-614. [PMID: 32215163 PMCID: PMC7090311 DOI: 10.1016/j.radcr.2020.02.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/22/2020] [Accepted: 02/23/2020] [Indexed: 11/24/2022] Open
Abstract
Osteoblastomas infrequently occur in the calvarium, displaying a preference for temporal and frontal bones when it does. We present an unusual case of a large, expansile osteoblastoma in the occipital bone of a 23-year-old man who presented with a nontender lump at the back of his head. Initial computed tomography scan showed a large occipital bone mass, and after additional imaging, a gross total resection was performed. Histopathological examination revealed an osteoblastoma. Although these tumors are benign, overlapping imaging characteristics of lesions affecting the calvarium often present a diagnostic dilemma. This case emphasizes the importance of imaging in the management and work-up of these patients to decrease the risk of complications and assists surgeons in their preoperative planning.
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Affiliation(s)
- Lukas M Trunz
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Scott H Faro
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Richard J Gorniak
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
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Cai L, Hinkle JW, Arias D, Gorniak RJ, Lakhani PC, Flanders AE, Kuriyan AE. Applications of Artificial Intelligence for the Diagnosis, Prognosis, and Treatment of Age-related Macular Degeneration. Int Ophthalmol Clin 2020; 60:147-168. [PMID: 33093323 DOI: 10.1097/iio.0000000000000334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Kalavar M, Al-Khersan H, Sridhar J, Gorniak RJ, Lakhani PC, Flanders AE, Kuriyan AE. Applications of Artificial Intelligence for the Detection, Management, and Treatment of Diabetic Retinopathy. Int Ophthalmol Clin 2020; 60:127-145. [PMID: 33093322 PMCID: PMC8514105 DOI: 10.1097/iio.0000000000000333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 12/16/2022]
Abstract
Rates of diabetic retinopathy (DR) and diabetic macular edema (DME), a common ocular complication of diabetes mellitus, are increasing worldwide. There is a substantial burden concerning the detection and management of this condition, particularly in low-resource settings, due to limitations such as the time, cost, and labor associated with current screening and treatment methods. Artificial intelligence (AI) is a modality of pattern recognition that has the potential to combat these limitations in a reliable and cost-effective way. This review explores the various applications of AI on the screening, management, and treatment of DR and DME. AI applications for detecting referable DR and DME have been the most thoroughly researched applications for this condition. While some studies exist using AI to stratify DR patients based on the risk of progression, predict treatment outcomes to anti-VEGF therapy, and explore the utilization of AI for clinical trials to develop new treatments for DR, further validation studies on larger datasets are warranted.
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Affiliation(s)
- Meghana Kalavar
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Hasenin Al-Khersan
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Jayanth Sridhar
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | | | - Paras C. Lakhani
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA
| | - Adam E. Flanders
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA
| | - Ajay E. Kuriyan
- Mid Atlantic Retina, Philadelphia, PA
- The Retina Service, Wills Eye Hospital, Philadelphia, PA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
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Poplawski MM, Alizadeh M, Oleson CV, Fisher J, Marino RJ, Gorniak RJ, Leiby BE, Flanders AE. Application of Diffusion Tensor Imaging in Forecasting Neurological Injury and Recovery after Human Cervical Spinal Cord Injury. J Neurotrauma 2019; 36:3051-3061. [DOI: 10.1089/neu.2018.6092] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Michael M. Poplawski
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mahdi Alizadeh
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Christina V. Oleson
- Department of Physical Medicine and Rehabilitation, Case Western Reserve School of Medicine, Cleveland, Ohio
| | - Joshua Fisher
- Department of Radiology, Jefferson Integrated Magnetic Resonance Imaging Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ralph J. Marino
- Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Richard J. Gorniak
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Benjamin E. Leiby
- Department of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Adam E. Flanders
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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Gifford AM, Sperling MR, Sharan A, Gorniak RJ, Williams RB, Davis K, Kahana MJ, Cohen YE. Neuronal phase consistency tracks dynamic changes in acoustic spectral regularity. Eur J Neurosci 2018; 49:1268-1287. [PMID: 30402926 DOI: 10.1111/ejn.14263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 10/15/2018] [Accepted: 10/23/2018] [Indexed: 11/28/2022]
Abstract
The brain parses the auditory environment into distinct sounds by identifying those acoustic features in the environment that have common relationships (e.g., spectral regularities) with one another and then grouping together the neuronal representations of these features. Although there is a large literature that tests how the brain tracks spectral regularities that are predictable, it is not known how the auditory system tracks spectral regularities that are not predictable and that change dynamically over time. Furthermore, the contribution of brain regions downstream of the auditory cortex to the coding of spectral regularity is unknown. Here, we addressed these two issues by recording electrocorticographic activity, while human patients listened to tone-burst sequences with dynamically varying spectral regularities, and identified potential neuronal mechanisms of the analysis of spectral regularities throughout the brain. We found that the degree of oscillatory stimulus phase consistency (PC) in multiple neuronal-frequency bands tracked spectral regularity. In particular, PC in the delta-frequency band seemed to be the best indicator of spectral regularity. We also found that these regularity representations existed in multiple regions throughout cortex. This widespread reliable modulation in PC - both in neuronal-frequency space and in cortical space - suggests that phase-based modulations may be a general mechanism for tracking regularity in the auditory system specifically and other sensory systems more generally. Our findings also support a general role for the delta-frequency band in processing the regularity of auditory stimuli.
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Affiliation(s)
- Adam M Gifford
- Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael R Sperling
- Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ashwini Sharan
- Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Richard J Gorniak
- Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ryan B Williams
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kathryn Davis
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael J Kahana
- Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Yale E Cohen
- Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, Pennsylvania.,Departments of Otorhinolaryngology, Neuroscience, and Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
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Gorniak RJ, Sevenster M, Flanders AE, Deshmukh SP, Ford RW, Katzman GL, Lo R, Mankovich G, Tellis R, Chang PJ. A PACS-Integrated Tool to Automatically Extract Patient History From Prior Radiology Reports. J Am Coll Radiol 2016; 13:1249-1252. [PMID: 27451115 DOI: 10.1016/j.jacr.2016.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | - Robert W Ford
- Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Ryan Lo
- Yale New Haven Hospital, New Haven, Connecticut
| | - Gabe Mankovich
- Philips Research North America, Cambridge, Massachusetts
| | - Ranjith Tellis
- Philips Research North America, Cambridge, Massachusetts
| | - Paul J Chang
- University of Chicago School of Medicine, Chicago, Illinois
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Wu C, Boorman DW, Gorniak RJ, Farrell CJ, Evans JJ, Sharan AD. The effects of anatomic variations on stereotactic laser amygdalohippocampectomy and a proposed protocol for trajectory planning. Neurosurgery 2015; 11 Suppl 2:345-56; discussion 356-7. [PMID: 25850599 DOI: 10.1227/neu.0000000000000767] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stereotactic laser amygdalohippocampectomy (SLAH) is a promising minimally invasive alternative for mesial temporal lobe epilepsy. As seizure outcome has been associated with the extent of amygdalar and hippocampal ablation, it is important to select a safe trajectory optimizing involvement of both structures; however, variations in temporal anatomy significantly affect the overall complexity of planning. OBJECTIVE To quantify anatomic variables of SLAH and facilitate stereotactic planning by developing a protocol for optimally targeting the amygdalohippocampal complex (AHC). METHODS We performed a retrospective analysis of 19 SLAHs. Anatomic measurements from preoperative magnetic resonance imaging and laser trajectory measurements from coregistered postoperative magnetic resonance imaging were taken in 11 patients. Simple linear regression analysis was performed to identify significant predictor variables determining ablation extent. Based on these data, a protocol for optimal trajectory planning was developed and subsequently implemented in 8 patients. RESULTS The medial angle of the laser trajectory correlated with the medial angle of the AHC. The length of amygdalar cannulation was predictive of its ablation volume. All trajectories passed through a posteroinferior corridor formed by the lateral ventricle superiorly and collateral sulcus inferiorly. Our protocol facilitated planning and increased the volume of AHC ablation. CONCLUSION The medial AHC angle dictates the medial trajectory angle and a path from the posteroinferior corridor through the hippocampus and the center of the amygdala dictates the caudal angle. These observations led to a protocol for long-axis AHC cannulation that maintains an extraventricular trajectory to minimize hemorrhage risk and targets the center of the amygdala to optimize ablation volumes.
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Affiliation(s)
- Chengyuan Wu
- Departments of *Neurosurgery and ‡Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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Gorniak RJ, Kramer EL, McMeeking AA, Zagzag D. Thallium-201 uptake in cytomegalovirus encephalitis. J Nucl Med 1997; 38:1386-8. [PMID: 9293794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A 36-yr-old man with AIDS exhibited intense 201Tl uptake (lesion-to-brain uptake ratio 5.38) in a brain lesion previously detected by MRI and CT. The lesion was biopsied and found to contain cells with viral inclusions diagnostic of cytomegalovirus infection, not tumor as the thallium SPECT results suggested. Thallium-201 SPECT may be less specific than previously reported for differentiating neoplastic disease from opportunistic infections in AIDS patients.
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Affiliation(s)
- R J Gorniak
- Department of Radiology, New York University School of Medicine, New York, USA
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Abstract
We present a graphical three-dimensional method that facilitates image registration and fusion, and provides quantitative geometric and volume information. In particular it enhances the use of functional (radiopharmaceutical) imaging (SPECT, PET) which, though a powerful clinical tool, has the disadvantage of low spatial resolution and ill-defined boundaries. Registration between functional images and structural images (MRI, CT) can augment the anatomical context of these functional images.
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Affiliation(s)
- E J Farrell
- IBM Research Center, Yorktown Heights, New York 10598, USA
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Abstract
The authors demonstrate a method for constructing three-dimensional (3D) images of the prostate based on standard two-dimensional ultrasonic (US) images. Transverse US images of the prostate in six patients (aged 61-83 years) and 10 water-filled balloon phantoms were recorded at video rates by manually withdrawing a biplane transrectal probe at a constant speed. Data acquisition time of the images was less than a minute. Typically, 50-70 scans of 0.2-0.5-mm-thick cross sections were acquired. Postprocessing of these data enabled lifelike 3D visualization of the gland and accurate measurement of its volume.
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Affiliation(s)
- C M Sehgal
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104
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