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  1. Article ; Online: Pediatric skeletal diffusion-weighted magnetic resonance imaging, part 2: current and emerging applications.

    Chaturvedi, Apeksha

    Pediatric radiology

    2021  Volume 51, Issue 9, Page(s) 1575–1588

    Abstract: Diffusion-weighted imaging (DWI) complements the more established T1, fluid-sensitive and gadolinium-enhanced magnetic resonance pulse sequences used to assess several pediatric skeletal pathologies. There is optimism that the technique might not just be ...

    Abstract Diffusion-weighted imaging (DWI) complements the more established T1, fluid-sensitive and gadolinium-enhanced magnetic resonance pulse sequences used to assess several pediatric skeletal pathologies. There is optimism that the technique might not just be complementary but could serve as an alternative to gadolinium and radiopharmaceuticals for several indications. As a non-contrast, free-breathing and noninvasive technique, DWI is especially valuable in children and is readily incorporated into existing MRI protocols. The indications for skeletal DWI in children include distinguishing between benign and malignant skeletal processes, initial assessment and treatment response assessment for osseous sarcomas, and assessment of inflammatory arthropathies and femoral head ischemia, among others. A notable challenge of diffusion MRI is the dynamic nature of the growing pediatric skeleton. It is important to consider the child's age when placing DWI findings in context with potential marrow pathology. This review article summarizes the current and evolving applications of DWI for assessing the pediatric skeleton, rounding off the discussion with evolving directions for further research in this realm.
    MeSH term(s) Bone Neoplasms/diagnostic imaging ; Child ; Contrast Media ; Diffusion Magnetic Resonance Imaging ; Gadolinium ; Humans ; Magnetic Resonance Imaging ; Musculoskeletal System ; Sensitivity and Specificity
    Chemical Substances Contrast Media ; Gadolinium (AU0V1LM3JT)
    Language English
    Publishing date 2021-05-21
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 124459-0
    ISSN 1432-1998 ; 0301-0449
    ISSN (online) 1432-1998
    ISSN 0301-0449
    DOI 10.1007/s00247-021-05028-5
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    Zs.A 927: Show issues Location:
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  2. Article ; Online: Pediatric skeletal diffusion-weighted magnetic resonance imaging: part 1 - technical considerations and optimization strategies.

    Chaturvedi, Apeksha

    Pediatric radiology

    2021  Volume 51, Issue 9, Page(s) 1562–1574

    Abstract: Diffusion-weighted MRI, or DWI, is a fast, quantitative technique that is easily integrated into a morphological MR acquisition. The ability of DWI to aid in detecting multifocal skeletal pathology and in characterizing tissue cellularity to a level ... ...

    Abstract Diffusion-weighted MRI, or DWI, is a fast, quantitative technique that is easily integrated into a morphological MR acquisition. The ability of DWI to aid in detecting multifocal skeletal pathology and in characterizing tissue cellularity to a level beyond that possible with other techniques makes it a niche component of multiparametric MR imaging of the skeleton. Besides its role in disease detection and establishing cellularity and character of osseous lesions, DWI continues to be examined as a surrogate biomarker for therapeutic response of several childhood bone tumors. There is increasing interest in harnessing DWI as a potential substitute to alternative modes of imaging evaluation that involve radiation or administration of intravenous contrast agent or radiopharmaceuticals, for example in early detection and diagnosis of capital femoral epiphyseal ischemia in cases of Legg-Calvé-Perthes disease, or diagnosis and staging of lymphoma. The expected evolution of skeletal diffusivity characteristics with maturation and the unique disease processes that affect the pediatric skeleton necessitate a pediatric-specific discussion. In this article, the author examines the developmentally appropriate normal appearances, technique, artifacts and pitfalls of pediatric skeletal DWI.
    MeSH term(s) Child ; Diffusion Magnetic Resonance Imaging ; Epiphyses ; Humans ; Legg-Calve-Perthes Disease ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy
    Language English
    Publishing date 2021-04-01
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 124459-0
    ISSN 1432-1998 ; 0301-0449
    ISSN (online) 1432-1998
    ISSN 0301-0449
    DOI 10.1007/s00247-021-04975-3
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  3. Article ; Online: Malignant Histiocytic Neoplasm of the Mediastinum with Pericardial Involvement in a Child.

    Huang, Jessie / Lorca, Maria Clara / Chen, Irene Y / Chaturvedi, Apeksha

    Radiology. Imaging cancer

    2024  Volume 6, Issue 2, Page(s) e230133

    MeSH term(s) Child ; Humans ; Mediastinum/diagnostic imaging ; Mediastinum/pathology ; Pericardium/diagnostic imaging ; Pericardium/pathology ; Lung Neoplasms ; Thorax/pathology
    Language English
    Publishing date 2024-02-26
    Publishing country United States
    Document type Journal Article
    ISSN 2638-616X
    ISSN (online) 2638-616X
    DOI 10.1148/rycan.230133
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  4. Article ; Online: Teaching the Future Radiologist: TED-Inspired Radiology Didactics.

    Chaturvedi, Apeksha / Chaturvedi, Aadya / Ellika, Shehanaz / Lewis, Petra J

    Academic radiology

    2024  Volume 31, Issue 2, Page(s) 377–382

    Abstract: TED (acronym for technology, entertainment and design) conferences are an astonishingly successful modern-day platform for "ideas worth spreading". These continue to engage, enlighten and entertain an ever-expanding audience base. TED speakers highlight ... ...

    Abstract TED (acronym for technology, entertainment and design) conferences are an astonishingly successful modern-day platform for "ideas worth spreading". These continue to engage, enlighten and entertain an ever-expanding audience base. TED speakers highlight simple yet relevant ideas, often challenging entrenched perspectives and proposing hitherto unexplored solutions. In this perspective, the authors propose modeling some aspects of Radiology didactics along certain fundamental principles of TED and outline techniques to accomplish this. We overview how this shift can engage diverse learners and enhance retention of key information. We include evidence on such pedagogical techniques boosting learners' working memory and providing strategies for creative problem solving. Finally, we caution educators against criticisms of the TED format, including prioritizing style over content, "dumbing down" information to make it fit a prescribed format and sometimes offering insufficient scientific rigor.
    MeSH term(s) Humans ; Radiology ; Radiologists ; Teaching
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1355509-1
    ISSN 1878-4046 ; 1076-6332
    ISSN (online) 1878-4046
    ISSN 1076-6332
    DOI 10.1016/j.acra.2023.09.046
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  5. Article ; Online: Musculoskeletal MRI in Infants: Technical Considerations, Pitfalls and Optimization Strategies.

    York, Vincent / Sultan, Nadia / Thapa, Mahesh / Chaturvedi, Apeksha

    Seminars in roentgenology

    2021  Volume 56, Issue 3, Page(s) 277–287

    MeSH term(s) Humans ; Infant ; Magnetic Resonance Imaging ; Musculoskeletal Diseases/diagnostic imaging
    Language English
    Publishing date 2021-05-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80310-8
    ISSN 1558-4658 ; 0037-198X
    ISSN (online) 1558-4658
    ISSN 0037-198X
    DOI 10.1053/j.ro.2021.05.005
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  6. Article ; Online: Pediatric spine trauma: A comprehensive review.

    Mistry, Devanshi / Munjal, Havisha / Ellika, Shehanaz / Chaturvedi, Apeksha

    Clinical imaging

    2022  Volume 87, Page(s) 61–76

    Abstract: Trauma to the pediatric spine can manifest as osseous, disco-ligamentous, and/or neurological injuries. Associated mortality is significantly higher than in adults. Injury patterns in children are distinct from those encountered in adults. Although spine ...

    Abstract Trauma to the pediatric spine can manifest as osseous, disco-ligamentous, and/or neurological injuries. Associated mortality is significantly higher than in adults. Injury patterns in children are distinct from those encountered in adults. Although spine radiographs are the first line of diagnosis, they may be challenging to interpret in children due to the difficulty of applying recognized radiographic landmarks to the partially ossified spine. Ligamentous laxity and developmental phenomena also lead to imaging pitfalls. Much of the recent literature on this subject focuses on region-specific injuries or individual entities, and may not be tailored specifically to the radiologist, thereby not stressing key aspects pertinent to the effective performance and successful interpretation of imaging exams. We aim to address this void. We provide a comprehensive review of pediatric spine trauma, outlining the clinical decision tools, imaging protocols including the current American College of Radiology (ACR) appropriateness guidelines, interpretive pitfalls and tips to navigate these pitfalls, and management implications of the spectrum of these injuries. Throughout the text, extensive tables, illustrations and imaging examples reinforce key concepts.
    MeSH term(s) Adult ; Cervical Vertebrae ; Child ; Diagnostic Imaging ; Humans ; Magnetic Resonance Imaging ; Radiography ; Spinal Injuries/diagnostic imaging
    Language English
    Publishing date 2022-04-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1028123-x
    ISSN 1873-4499 ; 0899-7071
    ISSN (online) 1873-4499
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2022.04.012
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    Zs.A 1469: Show issues Location:
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  7. Article ; Online: Pediatric Musculoskeletal Infections: Imaging Guidelines and Recommendations.

    Butt, Frederick E / Lee, Edward Y / Chaturvedi, Apeksha

    Radiologic clinics of North America

    2021  Volume 60, Issue 1, Page(s) 165–177

    Abstract: Pediatric musculoskeletal infections often pose a diagnostic challenge due to their frequently vague and nonspecific clinical presentation. Imaging evaluation is a crucial component to diagnostic workup of these entities. Changed epidemiology of these ... ...

    Abstract Pediatric musculoskeletal infections often pose a diagnostic challenge due to their frequently vague and nonspecific clinical presentation. Imaging evaluation is a crucial component to diagnostic workup of these entities. Changed epidemiology of these infections over the past 2 decades has resulted in increases in both disease incidence and severity in the pediatric population. Prompt and accurate diagnosis is essential in order to reduce the risk of morbid sequelae, and to optimize patient management. In this article, the unique pathophysiology of musculoskeletal infections and characteristic imaging findings in children compared with adults are reviewed.
    MeSH term(s) Child ; Child, Preschool ; Diagnostic Imaging/methods ; Female ; Humans ; Infant ; Infant, Newborn ; Infections/diagnostic imaging ; Male ; Musculoskeletal Diseases/diagnostic imaging ; Musculoskeletal System ; Practice Guidelines as Topic
    Language English
    Publishing date 2021-11-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 215712-3
    ISSN 1557-8275 ; 0033-8389
    ISSN (online) 1557-8275
    ISSN 0033-8389
    DOI 10.1016/j.rcl.2021.08.012
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  8. Article ; Online: Physiological fetal vascular shunts and failure to regress: what the radiologist needs to know.

    Leshen, Michael A / Devanagondi, Rajiv / Saul, David / Chaturvedi, Apeksha

    Pediatric radiology

    2022  Volume 52, Issue 7, Page(s) 1207–1223

    Abstract: The fetal circulation is characterized by the presence of three physiological vascular shunts - the ductus arteriosus, the foramen ovale and the ductus venosus. Acting in concert, these shunts preferentially stream blood flow in a pattern that maximizes ... ...

    Abstract The fetal circulation is characterized by the presence of three physiological vascular shunts - the ductus arteriosus, the foramen ovale and the ductus venosus. Acting in concert, these shunts preferentially stream blood flow in a pattern that maximizes efficiency of blood oxygenation by the maternofetal unit. Shortly following the transition to extrauterine life, a quick and predetermined succession of events results in closure of these embryological structures with consequent establishment of postnatal vascular flow patterns. While this transition is often seamless, the physiological shunts of the fetus occasionally fail to regress. Such failure to regress can occur in isolation or in association with other congenital malformations. This failed regression challenges the circulatory physiology of the neonate and might have implications for the optimum functioning of several organ systems. When symptomatic, these shunts are treated. Interventions, when undertaken, might be medical, endovascular or surgical. The radiologist's role continues to expand in the assessment of these shunts, in providing a roadmap for treatment and in prompt identification of treatment-related complications. This review is to familiarize radiologists with the embryology, pre- and post-treatment imaging appearances, and associated complications of persistent fetal vascular shunts.
    MeSH term(s) Ductus Arteriosus/physiology ; Ductus Arteriosus, Patent ; Hemodynamics/physiology ; Humans ; Infant, Newborn ; Radiologists
    Language English
    Publishing date 2022-02-15
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 124459-0
    ISSN 1432-1998 ; 0301-0449
    ISSN (online) 1432-1998
    ISSN 0301-0449
    DOI 10.1007/s00247-022-05302-0
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  9. Article: Optimizing low contrast volume thoracic CT angiography: From the basics to the advanced.

    Kaproth-Joslin, Katherine / Hobbs, Susan / Rajiah, Prabhakar / Chaturvedi, Apeksha / Chaturvedi, Abhishek

    Journal of clinical imaging science

    2022  Volume 12, Page(s) 41

    Abstract: Contrast-enhanced CT angiography (CTA) is a widely used, noninvasive imaging technique for evaluating cardiovascular structures. Contrast-induced nephrotoxicity is a concern in renal disease; however, the true nephrotoxic potential of iodinated contrast ... ...

    Abstract Contrast-enhanced CT angiography (CTA) is a widely used, noninvasive imaging technique for evaluating cardiovascular structures. Contrast-induced nephrotoxicity is a concern in renal disease; however, the true nephrotoxic potential of iodinated contrast media (CM) is unknown. If a renal impaired patient requires CTA, it is important to protect the kidneys from further harm by reducing total iodinated CM volume while still obtaining diagnostic quality imaging. These same reduced volume CM techniques can also be applied to nonrenal impaired patients in times of CM shortage. This educational review discusses several modifications to CTA that can be adapted to both conventional 64-slice and the newer generation CT scanners which enable subsecond acquisition with a reduced CM volume technique. Such modifications include hardware and software adjustments and changes to both the volume and flow rate of administered CM, with the goal to reduce the dose of CM without compromising diagnostic yield.
    Language English
    Publishing date 2022-07-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2601233-9
    ISSN 2156-5597 ; 2156-7514
    ISSN (online) 2156-5597
    ISSN 2156-7514
    DOI 10.25259/JCIS_51_2022
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  10. Article ; Online: Acutely presenting congenital chest lesions: a primer for the radiologist.

    Chaturvedi, Apeksha / Klionsky, Nina / Biyyam, Deepa / Chess, Mitchell A / Sultan, Nadia

    Emergency radiology

    2022  Volume 29, Issue 3, Page(s) 557–570

    Abstract: Congenital chest lesions encompass several important entities. Without prompt intervention, many of these can culminate in serious complications. Timely and accurate radiologic interpretation of these entities is integral to patient management. Imaging ... ...

    Abstract Congenital chest lesions encompass several important entities. Without prompt intervention, many of these can culminate in serious complications. Timely and accurate radiologic interpretation of these entities is integral to patient management. Imaging can help characterize and prognosticate several of these entities, and may both suggest the need for and guide therapy. We overview the clinical presentation, associated complications, imaging characteristics, and prognostic indicators-both postnatal and antenatal-of the spectrum of emergently presenting congenital chest lesions. We also outline current and evolving management strategies, whether fetal, peripartum, or postnatal. The ultimate goal is to help radiologists formulate timely and effective diagnoses of these entities and boost the relevance of their input towards clinical decision-making.
    MeSH term(s) Cystic Adenomatoid Malformation of Lung, Congenital/diagnosis ; Cystic Adenomatoid Malformation of Lung, Congenital/therapy ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis ; Radiologists ; Thorax ; Ultrasonography, Prenatal
    Language English
    Publishing date 2022-03-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1425144-9
    ISSN 1438-1435 ; 1070-3004
    ISSN (online) 1438-1435
    ISSN 1070-3004
    DOI 10.1007/s10140-022-02035-3
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