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Article: Recurrent adamantinoma metastatic to the spine: Clinical and imaging considerations.

Marteslo, Jeffrey P / Bourekas, Eric C / Boulter, Daniel J / Tokhi, Yaquob

2021 Volume 16, Issue 8, Page(s) 1934–1940

Abstract: Metastatic adamantinoma involving the spine is an extremely rare occurrence. In this case report, we present a patient with recurrent adamantinoma of the tibia which was found to have metastasized to the spine. The metastatic involvement was diagnosed ... ...

Abstract	Metastatic adamantinoma involving the spine is an extremely rare occurrence. In this case report, we present a patient with recurrent adamantinoma of the tibia which was found to have metastasized to the spine. The metastatic involvement was diagnosed pathologically, status post CT guided percutaneous core needle biopsy, performed after the patient returned with concerning symptoms and imaging findings suggestive of metastasis. The patient was ultimately treated surgically with vertebrectomy and reconstruction. A thoughtful review of this disease process is explored, emphasizing the pathology, imaging characteristics, and pertinent differential diagnostic considerations. While uncommon, knowledge of this rare disease process and its presentation can improve future patient diagnosis and outcomes.
Language	English
Publishing date	2021-06-07
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2021.04.063
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Toward an artificial intelligence-assisted framework for reconstructing the digital twin of vertebra and predicting its fracture response.

Ahmadian, Hossein / Mageswaran, Prasath / Walter, Benjamin A / Blakaj, Dukagjin M / Bourekas, Eric C / Mendel, Ehud / Marras, William S / Soghrati, Soheil

International journal for numerical methods in biomedical engineering

2022 Volume 38, Issue 6, Page(s) e3601

Abstract: This article presents an effort toward building an artificial intelligence (AI) assisted framework, coined ReconGAN, for creating a realistic digital twin of the human vertebra and predicting the risk of vertebral fracture (VF). ReconGAN consists of a ... ...

Abstract	This article presents an effort toward building an artificial intelligence (AI) assisted framework, coined ReconGAN, for creating a realistic digital twin of the human vertebra and predicting the risk of vertebral fracture (VF). ReconGAN consists of a deep convolutional generative adversarial network (DCGAN), image-processing steps, and finite element (FE) based shape optimization to reconstruct the vertebra model. This DCGAN model is trained using a set of quantitative micro-computed tomography (micro-QCT) images of the trabecular bone obtained from cadaveric samples. The quality of synthetic trabecular models generated using DCGAN are verified by comparing a set of its statistical microstructural descriptors with those of the imaging data. The synthesized trabecular microstructure is then infused into the vertebra cortical shell extracted from the patient's diagnostic CT scans using an FE-based shape optimization approach to achieve a smooth transition between trabecular to cortical regions. The final geometrical model of the vertebra is converted into a high-fidelity FE model to simulate the VF response using a continuum damage model under compression and flexion loading conditions. A feasibility study is presented to demonstrate the applicability of digital twins generated using this AI-assisted framework to predict the risk of VF in a cancer patient with spinal metastasis.
MeSH term(s)	Artificial Intelligence ; Finite Element Analysis ; Humans ; Spinal Fractures/diagnostic imaging ; Spine/diagnostic imaging ; Spine/physiology ; X-Ray Microtomography
Language	English
Publishing date	2022-04-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2540968-2
ISSN	2040-7947 ; 2040-7939
ISSN (online)	2040-7947
ISSN	2040-7939
DOI	10.1002/cnm.3601
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Article ; Online: A digital twin for simulating the vertebroplasty procedure and its impact on mechanical stability of vertebra in cancer patients.

Ahmadian, Hossein / Mageswaran, Prasath / Walter, Benjamin A / Blakaj, Dukagjin M / Bourekas, Eric C / Mendel, Ehud / Marras, William S / Soghrati, Soheil

International journal for numerical methods in biomedical engineering

2022 Volume 38, Issue 6, Page(s) e3600

Abstract: We present the application of ReconGAN, introduced in a previous study, for simulating the vertebroplasty (VP) operation and its impact on the fracture response of a vertebral body. ReconGAN consists of a Deep Convolutional Generative Adversarial Network ...

Abstract	We present the application of ReconGAN, introduced in a previous study, for simulating the vertebroplasty (VP) operation and its impact on the fracture response of a vertebral body. ReconGAN consists of a Deep Convolutional Generative Adversarial Network (DCGAN) and a finite element based shape optimization algorithm to virtually reconstruct the trabecular bone microstructure. The VP procedure involves injecting shear-thinning liquid bone cement through a needle in the trabecular region to reinforce a diseased or fractured vertebra. To simulate this treatment modality, computational fluid dynamics (CFD) is employed to predict the morphology of the injected cement within the bone microstructure. A power-law equation is utilized to characterize the non-Newtonian shear-thinning behavior of the polymethyl methacrylate (PMMA) bone cement during injection simulations. The CFD model is coupled with the level-set method to simulate the motion of the interface separating bone cement and bone marrow. After predicting the cement morphology, a data co-registration algorithm is employed to transform the CFD model to a high-fidelity continuum damage mechanics (CDM) finite element model of the augmented vertebra for predicting the fracture response. A feasibility study is presented to demonstrate the ability of this CFD-CDM framework to investigate the effect of VP on the mechanical integrity of the vertebral body in a cancer patient with a lytic metastatic tumor.
MeSH term(s)	Bone Cements/therapeutic use ; Humans ; Neoplasms ; Spinal Fractures/surgery ; Spine ; Vertebroplasty/methods
Chemical Substances	Bone Cements
Language	English
Publishing date	2022-04-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2540968-2
ISSN	2040-7947 ; 2040-7939
ISSN (online)	2040-7947
ISSN	2040-7939
DOI	10.1002/cnm.3600
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Article ; Online: Clinical Deterioration and Early Imaging Changes after Intravenous Tissue Plasminogen Activator Administration in Acute Ischemic Stroke Patients.

Chou, Claudia / Bourekas, Eric C / Slivka, Andrew

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2016 Volume 25, Issue 7, Page(s) 1823–1827

Abstract: Background and purpose: Clinical worsening is a known complication following acute ischemic stroke. This study attempted to determine the mechanism of deterioration by correlating clinical findings with changes on computed tomography or magnetic ... ...

Abstract	Background and purpose: Clinical worsening is a known complication following acute ischemic stroke. This study attempted to determine the mechanism of deterioration by correlating clinical findings with changes on computed tomography or magnetic resonance. Methods: From a single university medical center, 30 consecutive acute ischemic stroke patients who received intravenous tissue plasminogen activator within 3 hours of symptom onset during a 3-year period were identified from a quality database that included all hospitalized patients either admitted with strokes or with in-hospital strokes. Images were reviewed by a single neuroradiologist for changes including edema, extension of infarct, hemorrhage, herniation, and midline shift and were correlated to National Institutes of Health Stroke Scale (NIHSS) scores obtained from data in the medical chart. Results: Ten patients had documented clinical deterioration with a corresponding increase in the NIHSS score. Of these, 4 patients had follow-up scans that showed worsening changes concurrent with deterioration. In the 20 patients who remained clinically stable, 3 patients had worsening changes on follow-up scans. Patients who deteriorated were no more likely to have imaging changes than those who had a stable clinical course. Appearance of herniation, both subfalcine and uncal, was the only specific imaging change associated with clinical deterioration. Conclusions: This study demonstrates that processes besides hemorrhage, including edema, midline shift, herniation, extension of infarct, and new infarct, are neither frequent nor specific for predicting clinical course. Other factors associated with these processes that may or may not be quantifiable on imaging are likely involved. Furthermore, in over half of the cases of worsening, deterioration occurs without associated imaging, metabolic, or infectious etiologies.
MeSH term(s)	Academic Medical Centers ; Aged ; Aged, 80 and over ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/drug therapy ; Brain Ischemia/physiopathology ; Disability Evaluation ; Disease Progression ; Female ; Fibrinolytic Agents/administration & dosage ; Fibrinolytic Agents/adverse effects ; Humans ; Infusions, Intravenous ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Ohio ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; Stroke/diagnostic imaging ; Stroke/drug therapy ; Stroke/physiopathology ; Thrombolytic Therapy/adverse effects ; Time Factors ; Tissue Plasminogen Activator/administration & dosage ; Tissue Plasminogen Activator/adverse effects ; Tomography, X-Ray Computed ; Treatment Outcome
Chemical Substances	Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2016.03.016
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Zs.A 3519: Show issues

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Article ; Online: Combined Stroke and Spinal Cord Infarction in Hybrid Type I Aortic Arch Debranching and TEVAR and the Dual Role of the Left Subclavian Artery.

Awad, Hamdy / Raza, Arwa / Saklayen, Samiya / Bhandary, Sujatha / Kelani, Hesham / Powers, Ciaran / Bourekas, Eric / Essandoh, Michael

Journal of cardiothoracic and vascular anesthesia

2022

Language	English
Publishing date	2022-02-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2022.02.012
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Zs.A 2203: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging.

Nguyen, Xuan V / Tahir, Sana / Bresnahan, Brian W / Andre, Jalal B / Lang, Elvira V / Mossa-Basha, Mahmud / Mayr, Nina A / Bourekas, Eric C

Topics in magnetic resonance imaging : TMRI

2020 Volume 29, Issue 3, Page(s) 125–130

Abstract: Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, ...

Abstract	Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.
MeSH term(s)	Anxiety/epidemiology ; Anxiety/psychology ; Humans ; Magnetic Resonance Imaging/economics ; Magnetic Resonance Imaging/psychology ; Magnetic Resonance Imaging/statistics & numerical data ; Movement ; Phobic Disorders/epidemiology ; Phobic Disorders/psychology ; Prevalence ; Treatment Refusal/psychology
Language	English
Publishing date	2020-07-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1112716-8
ISSN	1536-1004 ; 0899-3459
ISSN (online)	1536-1004
ISSN	0899-3459
DOI	10.1097/RMR.0000000000000243
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Zs.A 3430: Show issues

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Article ; Online: Recurrent adamantinoma metastatic to the spine

Jeffrey P. Marteslo, MD / Eric C. Bourekas, MD, MBA, FACR / Daniel J. Boulter, MD / Yaquob Tokhi, DO

Radiology Case Reports, Vol 16, Iss 8, Pp 1934-

Clinical and imaging considerations

2021 Volume 1940

Abstract	Metastatic adamantinoma involving the spine is an extremely rare occurrence. In this case report, we present a patient with recurrent adamantinoma of the tibia which was found to have metastasized to the spine. The metastatic involvement was diagnosed pathologically, status post CT guided percutaneous core needle biopsy, performed after the patient returned with concerning symptoms and imaging findings suggestive of metastasis. The patient was ultimately treated surgically with vertebrectomy and reconstruction. A thoughtful review of this disease process is explored, emphasizing the pathology, imaging characteristics, and pertinent differential diagnostic considerations. While uncommon, knowledge of this rare disease process and its presentation can improve future patient diagnosis and outcomes.
Keywords	Adamantinoma ; Metastatic ; Recurrent ; Spine ; Tibia ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: MRI in neurosciences.

Kangarlu, Alayar / Parsey, Ramin V / Bourekas, Eric C

International journal of biomedical imaging

2012 Volume 2012, Page(s) 579192

Language	English
Publishing date	2012-05-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2196721-0
ISSN	1687-4196 ; 1687-4188
ISSN (online)	1687-4196
ISSN	1687-4188
DOI	10.1155/2012/579192
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Article: Dual-energy CT cisternography in the evaluation of CSF leaks: A novel approach.

Foust, Alexandra M / Nguyen, Xuan V / Prevedello, Luciano / Bourekas, Eric C / Boulter, Daniel J

Radiology case reports

2017 Volume 13, Issue 1, Page(s) 237–240

Abstract: Cerebrospinal fluid leaks pose a serious threat to patients as they represent an unchecked communication between the subarachnoid space and the extracranial environment. Accurate localization of the leakage site is essential for treatment planning. We ... ...

Abstract	Cerebrospinal fluid leaks pose a serious threat to patients as they represent an unchecked communication between the subarachnoid space and the extracranial environment. Accurate localization of the leakage site is essential for treatment planning. We describe the novel utilization of dual-energy computed tomography technology in cisternography in the evaluation of a patient with a cerebrospinal fluid leak.
Language	English
Publishing date	2017-10-13
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2017.09.005
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Article ; Online: Postoperative cement augmentation after 360-degree fixation for highly unstable vertebral fractures in patients with multiple myeloma: a technical note on delayed trans-instrumentation vertebroplasty.

Mattei, Tobias A / Mendel, Ehud / Bourekas, Eric C

World neurosurgery

2014 Volume 82, Issue 3-4, Page(s) 537.e1–8

Abstract: Background: Although surgical fixation is usually not part of the first-line treatment of spinal lesions in patients with multiple myeloma, there are some unique clinical situations (such as the presence of acute onset of neurological deficits) in which ...

Abstract	Background: Although surgical fixation is usually not part of the first-line treatment of spinal lesions in patients with multiple myeloma, there are some unique clinical situations (such as the presence of acute onset of neurological deficits) in which spinal decompression and instrumentation may be required. In such scenario, because of the presence of poor bone quality, the strength of the spinal construct is of paramount importance. Although several studies have demonstrated the benefits of cement augmentation in increasing the pullout strength of pedicle screw fixation, the injection of cement during placement of pedicle screws may hamper the possibility of additional circumferential screw fixation. In addition, cement injection into vertebral bodies full of tumor and in the presence of adjacent epidural disease may incur in higher risks of tumor extravasation and worsening of neurological deficits than cement injection after initiation of adjuvant therapies. Case description: The advantages of delayed trans-instrumentation vertebroplasty after 360-degree fixation are discussed in this technical note with an illustrative case of a patient with multiple myeloma presenting with cauda equina syndrome after a T12 compression fracture. Conclusions: In spite of the associated challenges of such an interventional procedure due to the presence of extensive hardware, carrying out delayed trans-instrumentation vertebroplasty after 360-degree circumferential fixations is not only feasible, but in our opinion, may constitute the best strategy to optimize the strength of spinal instrumentation in challenging scenarios involving poor bone quality, such as in patients with multiple myeloma.
MeSH term(s)	Bone Cements ; Bone Screws ; Brain Neoplasms/complications ; Female ; Fracture Fixation, Internal/methods ; Humans ; Middle Aged ; Multiple Myeloma/complications ; Postoperative Care ; Spinal Cord Compression/surgery ; Spinal Fractures/surgery ; Vertebroplasty/methods
Chemical Substances	Bone Cements
Language	English
Publishing date	2014-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2014.03.044
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Zs.A 1159: Show issues

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