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Article ; Online: Expanding the Radiologist's Arsenal against Abdominal Aortic Aneurysms, a Versatile Adversary.

Mitsouras, Dimitrios / Leach, Joseph R

2020 Volume 295, Issue 3, Page(s) 730–732

MeSH term(s)	Aortic Aneurysm, Abdominal ; Disease Progression ; Humans ; Radiologists ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-03-31
Publishing country	United States
Document type	Editorial ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Comment
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2020200531
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Article ; Online: Multicomponent T2 relaxation studies of the avian egg.

Mitsouras, Dimitris / Mulkern, Robert V / Maier, Stephan E

Magnetic resonance in medicine

2016 Volume 75, Issue 5, Page(s) 2156–2164

Abstract: Purpose: To investigate the tissue-like multiexponential T2 signal decays in avian eggs.: Methods: Transverse relaxation studies of raw, soft-boiled and hard-boiled eggs were performed at 3 Tesla using a three-dimensional Carr-Purcell-Meiboom-Gill ... ...

Abstract	Purpose: To investigate the tissue-like multiexponential T2 signal decays in avian eggs. Methods: Transverse relaxation studies of raw, soft-boiled and hard-boiled eggs were performed at 3 Tesla using a three-dimensional Carr-Purcell-Meiboom-Gill imaging sequence. Signal decays over a TE range of 11 to 354 ms were fitted assuming single- and multicomponent signal decays with up to three separately decaying components. Fat saturation was used to facilitate spectral assignment of observed decay components. Results: Egg white, yolk and the centrally located latebra all demonstrate nonmonoexponential T2 decays. Specifically, egg white exhibits two-component decays with intermediate and long T2 times. Meanwhile, yolk and latebra are generally best characterized with triexponential decays, with short, intermediate and very long T2 decay times. Fat saturation revealed that the intermediate component of yolk could be attributed to lipids. Cooking of the egg profoundly altered the decay curves. Conclusion: Avian egg T2 decay curves cover a wide range of decay times. Observed T2 components in yolk and latebra as short as 10 ms, may prove valuable for testing clinical sequences designed to measure short T2 components, such as myelin-associated water in the brain. Thus we propose that the egg can be a versatile and widely available MR transverse relaxation phantom.
MeSH term(s)	Animals ; Biomarkers/metabolism ; Chickens ; Egg White/chemistry ; Egg Yolk/physiology ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Ovum/physiology ; Phantoms, Imaging ; Signal Processing, Computer-Assisted
Chemical Substances	Biomarkers
Language	English
Publishing date	2016-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	605774-3
ISSN	1522-2594 ; 0740-3194
ISSN (online)	1522-2594
ISSN	0740-3194
DOI	10.1002/mrm.25762
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Article ; Online: A Radiologist's Excursion in Four-dimensional Flow and the Bicuspid Aortic Valve: Vorticity, Helicity, Wall Shear Stress, and All That.

Mitsouras, Dimitrios / Hope, Michael D

Radiology

2019 Volume 293, Issue 3, Page(s) 551–553

MeSH term(s)	Aortic Valve/abnormalities ; Bicuspid Aortic Valve Disease ; Heart Valve Diseases ; Hemodynamics ; Humans ; Radiologists
Language	English
Publishing date	2019-10-08
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2019192076
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Article ; Online: Avian egg latebra as brain tissue water diffusion model.

Maier, Stephan E / Mitsouras, Dimitris / Mulkern, Robert V

Magnetic resonance in medicine

2013 Volume 72, Issue 2, Page(s) 501–509

Abstract: Purpose: Simplified models of non-monoexponential diffusion signal decay are of great interest to study the basic constituents of complex diffusion behavior in tissues. The latebra, a unique structure uniformly present in the yolk of avian eggs, ... ...

Abstract	Purpose: Simplified models of non-monoexponential diffusion signal decay are of great interest to study the basic constituents of complex diffusion behavior in tissues. The latebra, a unique structure uniformly present in the yolk of avian eggs, exhibits a non-monoexponential diffusion signal decay. This model is more complex than simple phantoms based on differences between water and lipid diffusion, but is also devoid of microscopic structures with preferential orientation or perfusion effects. Methods: Diffusion scans with multiple b-values were performed on a clinical 3 Tesla system in raw and boiled chicken eggs equilibrated to room temperature. Diffusion encoding was applied over the ranges 5-5,000 and 5-50,000 s/mm(2). A low read-out bandwidth and chemical shift was used for reliable lipid/water separation. Signal decays were fitted with exponential functions. Results: The latebra, when measured over the 5-5,000 s/mm(2) range, exhibited independent of preparation clearly biexponential diffusion, with diffusion parameters similar to those typically observed in in vivo human brain. For the range 5-50,000 s/mm(2), there was evidence of a small third, very slow diffusing water component. Conclusion: The latebra of the avian egg contains membrane structures, which may explain a deviation from a simple monoexponential diffusion signal decay, which is remarkably similar to the deviation observed in brain tissue.
MeSH term(s)	Animals ; Biomimetic Materials/chemistry ; Body Water/chemistry ; Brain Chemistry ; Chickens ; Diffusion ; Diffusion Magnetic Resonance Imaging/instrumentation ; Diffusion Magnetic Resonance Imaging/methods ; Egg Yolk/chemistry ; Equipment Design ; Equipment Failure Analysis ; Lipids/chemistry ; Models, Biological ; Models, Chemical ; Phantoms, Imaging ; Reproducibility of Results ; Sensitivity and Specificity
Chemical Substances	Lipids
Language	English
Publishing date	2013-09-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	605774-3
ISSN	1522-2594 ; 0740-3194
ISSN (online)	1522-2594
ISSN	0740-3194
DOI	10.1002/mrm.24941
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Article ; Online: Contrast-enhanced CT radiomics improves the prediction of abdominal aortic aneurysm progression.

Wang, Yan / Xiong, Fei / Leach, Joseph / Kao, Evan / Tian, Bing / Zhu, Chengcheng / Zhang, Yue / Hope, Michael / Saloner, David / Mitsouras, Dimitrios

European radiology

2023 Volume 33, Issue 5, Page(s) 3444–3454

Abstract: Objectives: To determine if three-dimensional (3D) radiomic features of contrast-enhanced CT (CECT) images improve prediction of rapid abdominal aortic aneurysm (AAA) growth.: Methods: This longitudinal cohort study retrospectively analyzed 195 ... ...

Abstract	Objectives: To determine if three-dimensional (3D) radiomic features of contrast-enhanced CT (CECT) images improve prediction of rapid abdominal aortic aneurysm (AAA) growth. Methods: This longitudinal cohort study retrospectively analyzed 195 consecutive patients (mean age, 72.4 years ± 9.1) with a baseline CECT and a subsequent CT or MR at least 6 months later. 3D radiomic features were measured for 3 regions of the AAA, viz. the vessel lumen only; the intraluminal thrombus (ILT) and aortic wall only; and the entire AAA sac (lumen, ILT, and wall). Multiple machine learning (ML) models to predict rapid growth, defined as the upper tercile of observed growth (> 0.25 cm/year), were developed using data from 60% of the patients. Diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve (AUC) in the remaining 40% of patients. Results: The median AAA maximum diameter was 3.9 cm (interquartile range [IQR], 3.3-4.4 cm) at baseline and 4.4 cm (IQR, 3.7-5.4 cm) at the mean follow-up time of 3.2 ± 2.4 years (range, 0.5-9 years). A logistic regression model using 7 radiomic features of the ILT and wall had the highest AUC (0.83; 95% confidence interval [CI], 0.73-0.88) in the development cohort. In the independent test cohort, this model had a statistically significantly higher AUC than a model including maximum diameter, AAA volume, and relevant clinical factors (AUC = 0.78, 95% CI, 0.67-0.87 vs AUC = 0.69, 95% CI, 0.57-0.79; p = 0.04). Conclusion: A radiomics-based method focused on the ILT and wall improved prediction of rapid AAA growth from CECT imaging. Key points: • Radiomic analysis of 195 abdominal CECT revealed that an ML-based model that included textural features of intraluminal thrombus (if present) and aortic wall improved prediction of rapid AAA progression compared to maximum diameter. • Predictive accuracy was higher when radiomic features were obtained from the thrombus and wall as opposed to the entire AAA sac (including lumen), or the lumen alone. • Logistic regression of selected radiomic features yielded similar accuracy to predict rapid AAA progression as random forests or support vector machines.
MeSH term(s)	Humans ; Aged ; Retrospective Studies ; Longitudinal Studies ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aorta, Abdominal ; Tomography, X-Ray Computed ; Thrombosis
Language	English
Publishing date	2023-03-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-09490-7
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Article ; Online: Computer-Based Vertebral Tumor Cryoablation Planning and Procedure Simulation Involving Two Cases Using MRI-Visible 3D Printing and Advanced Visualization.

Guenette, Jeffrey P / Himes, Nathan / Giannopoulos, Andreas A / Kelil, Tatiana / Mitsouras, Dimitris / Lee, Thomas C

AJR. American journal of roentgenology

2016 Volume 207, Issue 5, Page(s) 1128–1131

Abstract: Objective: We report the development and use of MRI-compatible and MRI-visible 3D printed models in conjunction with advanced visualization software models to plan and simulate safe access routes to achieve a theoretic zone of cryoablation for ... ...

Abstract	Objective: We report the development and use of MRI-compatible and MRI-visible 3D printed models in conjunction with advanced visualization software models to plan and simulate safe access routes to achieve a theoretic zone of cryoablation for percutaneous image-guided treatment of a C7 pedicle osteoid osteoma and an L1 lamina osteoblastoma. Both models altered procedural planning and patient care. Conclusion: Patient-specific MRI-visible models can be helpful in planning complex percutaneous image-guided cryoablation procedures.
MeSH term(s)	Adolescent ; Cryosurgery/methods ; Humans ; Magnetic Resonance Imaging ; Male ; Osteoblastoma/surgery ; Osteoma, Osteoid/surgery ; Printing, Three-Dimensional ; Software ; Spinal Neoplasms/surgery ; Surgery, Computer-Assisted ; Young Adult
Language	English
Publishing date	2016-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.16.16059
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Article: Height and body surface area versus wall stress for stratification of mid-term outcomes in ascending aortic aneurysm.

Zamirpour, Siavash / Xuan, Yue / Wang, Zhongjie / Gomez, Axel / Leach, Joseph R / Mitsouras, Dimitrios / Saloner, David A / Guccione, Julius M / Ge, Liang / Tseng, Elaine E

International journal of cardiology. Heart & vasculature

2024 Volume 51, Page(s) 101375

Abstract: Objectives: Current diameter-based guidelines for ascending thoracic aortic aneurysms (aTAA) do not consistently predict risk of dissection/rupture. ATAA wall stresses may enhance risk stratification independent of diameter. The relation of wall ... ...

Abstract	Objectives: Current diameter-based guidelines for ascending thoracic aortic aneurysms (aTAA) do not consistently predict risk of dissection/rupture. ATAA wall stresses may enhance risk stratification independent of diameter. The relation of wall stresses and diameter indexed to height and body surface area (BSA) is unknown. Our objective was to compare aTAA wall stresses with indexed diameters in relation to all-cause mortality at 3.75 years follow-up. Methods: Finite element analyses were performed in a veteran population with aortas ≥ 4.0 cm. Three-dimensional geometries were reconstructed from computed tomography with models accounting for pre-stress geometries. A fiber-embedded hyperelastic material model was applied to obtain wall stress distributions under systolic pressure. Peak wall stresses were compared across guideline thresholds for diameter/BSA and diameter/height. Hazard ratios for all-cause mortality and surgical aneurysm repair were estimated using cause-specific Cox proportional hazards models. Results: Of 253 veterans, 54 (21 %) had aneurysm repair at 3.75 years. Indexed diameter alone would have prompted repair at baseline in 17/253 (6.7 %) patients, including only 4/230 (1.7 %) with diameter < 5.5 cm. Peak wall stresses did not significantly differ across guideline thresholds for diameter/BSA (circumferential: Conclusions: Diameter/height improved stratification of peak wall stresses compared to diameter/BSA. Peak longitudinal stresses predicted all-cause mortality independent of age and indexed diameter and may aid risk stratification for aTAA adverse events.
Language	English
Publishing date	2024-02-28
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	2818464-6
ISSN	2352-9067
ISSN	2352-9067
DOI	10.1016/j.ijcha.2024.101375
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Article ; Online: RadioGraphics

Mitsouras, Dimitrios / Liacouras, Peter C / Wake, Nicole / Rybicki, Frank J

Radiographics : a review publication of the Radiological Society of North America, Inc

2020 Volume 40, Issue 4, Page(s) E21–E23

Abstract: Editor's Note. ...

Abstract	Editor's Note.
MeSH term(s)	Diagnostic Imaging ; Humans ; Printing, Three-Dimensional ; Radiologists
Keywords	covid19
Language	English
Publishing date	2020-07-21
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	603172-9
ISSN	1527-1323 ; 0271-5333
ISSN (online)	1527-1323
ISSN	0271-5333
DOI	10.1148/rg.2020190217
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Article: Abdominal aortic aneurysm measurement at CT/MRI: potential clinical ramifications of non-standardized measurement technique and importance of multiplanar reformation.

Leach, Joseph R / Zhu, Chengcheng / Mitsouras, Dimitrios / Saloner, David / Hope, Michael D

Quantitative imaging in medicine and surgery

2021 Volume 11, Issue 2, Page(s) 823–830

Abstract: Accurate and reproducible measurement of abdominal aortic aneurysm (AAA) size is an essential component of patient management, and most reliably performed at CT using a multiplanar reformat (MPR) strategy. This approach is not universal, however. This ... ...

Abstract	Accurate and reproducible measurement of abdominal aortic aneurysm (AAA) size is an essential component of patient management, and most reliably performed at CT using a multiplanar reformat (MPR) strategy. This approach is not universal, however. This study aims to characterize the measurement error present in routine clinical assessment of AAAs and the potential clinical ramifications. Patients were included if they had AAA assessed by CT and/or MRI at two time points at least 6 months apart. Clinical maximal AAA diameter, assessed by non-standardized methods, was abstracted from the radiology report at each time point and compared to the reference aneurysm diameter measured using a MPR strategy. Discrepancies between clinical and reference diameters, and associated aneurysm enlargement rates were analyzed. Two hundred thirty patients were included, with average follow-up 3.3±2.5 years. When compared to MPR-derived diameters, clinical aneurysm measurement inaccuracy was, on average, 3.3 mm. Broad limits of agreement were found for both clinical diameters [-6.7 to +6.5 mm] and aneurysm enlargement rates [-4.6 to +4.2 mm/year] when compared to MPR-based measures. Of 78 AAAs measuring 5-6 cm by the MPR method, 21 (26.9%) were misclassified by the clinical measurement with respect to a common repair threshold (5.5 cm), of which 5 were misclassified as below, and 16 were misclassified as above the threshold. The clinical use of non-standardized AAA measurement strategies can lead to incorrect classification of AAAs as larger or smaller than the commonly accepted repair threshold of 5.5 cm and can induce large errors in quantification of aneurysm enlargement rate.
Language	English
Publishing date	2021-01-16
Publishing country	China
Document type	Journal Article
ZDB-ID	2653586-5
ISSN	2223-4306 ; 2223-4292
ISSN (online)	2223-4306
ISSN	2223-4292
DOI	10.21037/qims-20-888
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Article ; Online: Three-dimensional printing of MRI-visible phantoms and MR image-guided therapy simulation.

Mitsouras, Dimitris / Lee, Thomas C / Liacouras, Peter / Ionita, Ciprian N / Pietilla, Todd / Maier, Stephan E / Mulkern, Robert V

Magnetic resonance in medicine

2017 Volume 77, Issue 2, Page(s) 613–622

Abstract: Purpose: To demonstrate the use of anatomic MRI-visible three-dimensional (3D)-printed phantoms and to assess process accuracy and material MR signal properties.: Methods: A cervical spine model was generated from computed tomography (CT) data and 3D- ...

Abstract	Purpose: To demonstrate the use of anatomic MRI-visible three-dimensional (3D)-printed phantoms and to assess process accuracy and material MR signal properties. Methods: A cervical spine model was generated from computed tomography (CT) data and 3D-printed using an MR signal-generating material. Printed phantom accuracy and signal characteristics were assessed using 120 kVp CT and 3 Tesla (T) MR imaging. The MR relaxation rates and diffusion coefficient of the fabricated phantom were measured and Results: The printed model produced a CT signal of 102 ± 8 Hounsfield unit, and an MR signal roughly 1/3 Conclusion: Current 3D printing technology can be used to print anatomically accurate phantoms that can be imaged by both CT and MRI. Such models can be used to simulate MRI-guided interventions such as cryosurgeries. Future development of the proposed technique can potentially lead to printed models that depict different tissues and anatomical structures with different MR signal characteristics. Magn Reson Med 77:613-622, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
MeSH term(s)	Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Cryosurgery/instrumentation ; Equipment Design ; Equipment Failure Analysis ; Humans ; Magnetic Resonance Imaging/instrumentation ; Phantoms, Imaging ; Printing, Three-Dimensional/instrumentation ; Reproducibility of Results ; Sensitivity and Specificity ; Surgery, Computer-Assisted/instrumentation
Language	English
Publishing date	2017
Publishing country	United States
Document type	Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	605774-3
ISSN	1522-2594 ; 0740-3194
ISSN (online)	1522-2594
ISSN	0740-3194
DOI	10.1002/mrm.26136
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