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Article ; Online: Screening Mammography: Guidelines versus Clinical Practice.

Oudsema, Rebecca / Hwang, Esther / Steinberger, Sharon / Yip, Rowena / Margolies, Laurie R

Journal of breast imaging

2024 Volume 2, Issue 3, Page(s) 217–224

Abstract: Objective: To understand physicians' comprehension of breast cancer screening guidelines and the existing literature on breast cancer screening, and whether this contributes to how patient screening is implemented in clinical practice.: Methods: A ... ...

Abstract	Objective: To understand physicians' comprehension of breast cancer screening guidelines and the existing literature on breast cancer screening, and whether this contributes to how patient screening is implemented in clinical practice. Methods: A survey of 18 questions was distributed across the United States via e-mail and social media resources to physicians and medical students of all disciplines and levels of training. Responses from 728 physicians and medical students were reviewed. Respondents were from over 200 different institutions and over 60 different medical specialties. Results: Our survey demonstrates that more than half of the participants felt uncomfortable in their knowledge of breast cancer screening recommendations (399/728, 54.8%) and existing literature on breast cancer screening (555/728, 76.2%). When stratified based on level of training, those at the attending level reported a greater level of comfort in their knowledge of breast cancer screening recommendations (168/238, 70.6%) and literature (95/238, 39.9%) compared with respondents at the trainee level. Attending physicians are also more likely to recommend screening for patients between the ages of 40-49 years old (209/238, 87.7%) compared to those at the trainee level. Responses on whether to screen based on age were most consistent for patients ages 50-74, with greater than 90% of the respondents endorsing screening mammogram for this age group in all levels of training. There were greater inconsistencies in the support to screen age groups 40-49 and 75+ . Conclusions: The results showed a disparity in screening practices by clinicians in all levels of training, particularly for patients ages 40-49 and 75+ , and for the interval of screening. Later initiation with less frequent intervals between screens may reduce the impact of screening on mortality reduction.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbaa003
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Article ; Online: The implantable loop recorder and its mammographic appearance: A case based approach.

Steinberger, Sharon / Margolies, Laurie R

Clinical imaging

2017 Volume 43, Page(s) 1–5

Abstract: The normal radiographic appearance of implantable loop recorders has been illustrated in the radiology literature; however, their mammographic appearance has not been described. Breast imagers should become familiar with the appearance of loop recorders ... ...

Abstract	The normal radiographic appearance of implantable loop recorders has been illustrated in the radiology literature; however, their mammographic appearance has not been described. Breast imagers should become familiar with the appearance of loop recorders in order to create an accurate report. In this paper we report 3 cases of patients with implantable loop recorders who underwent mammography. We describe the types and components of implantable loop recorders, indications for their placement, and their classic appearance on mammography.
Language	English
Publishing date	2017-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2017.01.006
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Article ; Online: Postoperative CT surveillance in the evaluation of local recurrence after sub-lobar resection of neoplastic lesions of the lung.

Xu, Dongming / de la Hoz, Rafael E / Steinberger, Sharon Roszler / Doucette, John / Pagano, Andrew Michael / Wolf, Andrea / Chung, Michael / Jacobi, Adam

Clinical imaging

2023 Volume 106, Page(s) 110030

Abstract: Objective: As indications for sub-lobar resections increase, it will become more important to identify risk factors for postsurgical recurrence. We investigated retrospectively the association between local recurrence after sub-lobar resection of ... ...

Abstract	Objective: As indications for sub-lobar resections increase, it will become more important to identify risk factors for postsurgical recurrence. We investigated retrospectively the association between local recurrence after sub-lobar resection of neoplastic lung lesions and pre- and post-operative CT imaging and pathologic features. Materials and methods: We reviewed retrospectively neoplastic lung lesions with postoperative chest CT surveillance of sub-lobar resections in 2006-2016. We defined "suspicious" findings as nodularity ≥3 mm or soft tissue thickening ≥4 mm along the suture line and/or progression and explored their association with local recurrence. Primary lung cancer stage, tumoral invasion of lymphatics, visceral pleura or large vessels, bronchial and vascular margin distance were also assessed. Results: Our study group included 45 cases of sub-lobar resection took for either primary (n = 37) or metastatic (n = 8) lung tumors. Local recurrence was observed in 16 of those patients. New nodularity ≥3 mm or soft tissue thickening ≥4 mm along the suture line on surveillance CT was significantly associated with local recurrence (p = 0.037). Additionally, solid nodule (p = 0.005), age at surgery ≤60 years (p = 0.006), two or more sites of invasion (p < 0.0001) and poor histologic differentiation (p = 0.0001) were also significantly associated with local tumor recurrence. Of 16 patients with surveillance post-surgical PET-CT, 15 had elevated FDG uptake. Conclusion: The postoperative changes along the suture line should follow a predictable time course demonstrating a pattern of stability, thinning or resolution on CT surveillance. New or increasing postoperative nodularity ≥3 mm or soft tissue thickening ≥4 mm along the suture line requires close diagnostic work-up. Surgical pathology characteristics added prognostic value on postoperative recurrence surveillance.
MeSH term(s)	Humans ; Middle Aged ; Fluorodeoxyglucose F18 ; Lung/pathology ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/surgery ; Lung Neoplasms/pathology ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography ; Retrospective Studies ; Tomography, X-Ray Computed/methods
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2023-11-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2023.110030
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Article ; Online: Influence of coronary dominance on coronary artery calcification burden.

Azour, Lea / Steinberger, Sharon / Toussie, Danielle / Titano, Ruwanthi / Kukar, Nina / Babb, James / Jacobi, Adam

Clinical imaging

2021 Volume 77, Page(s) 283–286

Abstract: Objective: To evaluate the influence of coronary artery dominance on observed coronary artery calcification burden in outpatients presenting for coronary computed tomography angiography (CCTA).: Methods: A 12-month retrospective review was performed ... ...

Abstract	Objective: To evaluate the influence of coronary artery dominance on observed coronary artery calcification burden in outpatients presenting for coronary computed tomography angiography (CCTA). Methods: A 12-month retrospective review was performed of all CCTAs at a single institution. Coronary arterial dominance, Agatston score and presence or absence of cardiovascular risk factors including hypertension (HTN), hyperlipidemia (HLD), diabetes and smoking were recorded. Dominance groups were compared in terms of calcium score adjusted for covariates using analysis of covariance based on ranks. Only covariates observed to be significant independent predictors of the relevant outcome were included in each analysis. All statistical tests were conducted at the two-sided 5% significance level. Results: 1223 individuals, 618 women and 605 men were included, mean age 60 years (24-93 years). Right coronary dominance was observed in 91.7% (n = 1109), left dominance in 8% (n = 98), and codominance in 1.3% (n = 16). The distribution of patients among Agatston score severity categories significantly differed between codominant and left (p = 0.008), and codominant and right (p = 0.022) groups, with higher prevalence of either zero or severe CAC in the codominant patients. There was no significant difference in Agatston score between dominance groups. In the subset of individuals with coronary artery calcification, Agatston score was significantly higher in codominant versus left dominant patients (mean Agatston score 595 ± 520 vs. mean 289 ± 607, respectively; p = 0.049), with a trend towards higher scores in comparison to the right-dominant group (p = 0.093). Significance was not maintained upon adjustment for covariates. Conclusions: While the distribution of Agatston score severity categories differed in codominant versus right- or left-dominant patients, there was no significant difference in Agatston score based on coronary dominance pattern in our cohort. Reporting and inclusion of codominant subsets in larger investigations may elucidate whether codominant anatomy is associated with differing risk.
MeSH term(s)	Computed Tomography Angiography ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Coronary Vessels/diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Vascular Calcification/diagnostic imaging ; Vascular Calcification/epidemiology
Language	English
Publishing date	2021-06-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2021.06.008
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Article ; Online: How Does Pruning Impact Long-Tailed Multi-Label Medical Image Classifiers?

Holste, Gregory / Jiang, Ziyu / Jaiswal, Ajay / Hanna, Maria / Minkowitz, Shlomo / Legasto, Alan C / Escalon, Joanna G / Steinberger, Sharon / Bittman, Mark / Shen, Thomas C / Ding, Ying / Summers, Ronald M / Shih, George / Peng, Yifan / Wang, Zhangyang

ArXiv

2023

Abstract: Pruning has emerged as a powerful technique for compressing deep neural networks, reducing memory usage and inference time without significantly affecting overall performance. However, the nuanced ways in which pruning impacts model behavior are not well ...

Abstract	Pruning has emerged as a powerful technique for compressing deep neural networks, reducing memory usage and inference time without significantly affecting overall performance. However, the nuanced ways in which pruning impacts model behavior are not well understood, particularly for
Language	English
Publishing date	2023-08-17
Publishing country	United States
Document type	Preprint
ISSN	2331-8422
ISSN (online)	2331-8422
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Article: How Does Pruning Impact Long-Tailed Multi-label Medical Image Classifiers?

Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention

2023 Volume 14224, Page(s) 663–673

Abstract	Pruning has emerged as a powerful technique for compressing deep neural networks, reducing memory usage and inference time without significantly affecting overall performance. However, the nuanced ways in which pruning impacts model behavior are not well understood, particularly for
Language	English
Publishing date	2023-10-01
Publishing country	Germany
Document type	Journal Article
DOI	10.1007/978-3-031-43904-9_64
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Article ; Online: Malignant and Benign Tracheobronchial Neoplasms: Comprehensive Review with Radiologic, Bronchoscopic, and Pathologic Correlation.

Girvin, Francis / Phan, Alexander / Steinberger, Sharon / Shostak, Eugene / Bessich, Jamie / Zhou, Fang / Borczuk, Alain / Brusca-Augello, Geraldine / Goldberg, Margaret / Escalon, Joanna

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

2023 Volume 43, Issue 9, Page(s) e230045

Abstract: Tracheobronchial neoplasms are much less common than lung parenchymal neoplasms but can be associated with significant morbidity and mortality. They include a broad differential of both malignant and benign entities, extending far beyond more commonly ... ...

Abstract	Tracheobronchial neoplasms are much less common than lung parenchymal neoplasms but can be associated with significant morbidity and mortality. They include a broad differential of both malignant and benign entities, extending far beyond more commonly known pathologic conditions such as squamous cell carcinoma and carcinoid tumor. Airway lesions may be incidental findings at imaging or manifest with symptoms related to airway narrowing or mucosal irritation, invasion of adjacent structures, or distant metastatic disease. While there is considerable overlap in clinical manifestation, imaging features, and bronchoscopic appearances, an awareness of potential distinguishing factors may help narrow the differential diagnosis. The authors review the epidemiology, imaging characteristics, typical anatomic distributions, bronchoscopic appearances, and histopathologic findings of a wide range of neoplastic entities involving the tracheobronchial tree. Malignant neoplasms discussed include squamous cell carcinoma, malignant salivary gland tumors (adenoid cystic carcinoma and mucoepidermoid carcinoma), carcinoid tumor, sarcomas, primary tracheobronchial lymphoma, and inflammatory myofibroblastic tumor. Benign neoplasms discussed include hamartoma, chondroma, lipoma, papilloma, amyloidoma, leiomyoma, neurogenic lesions, and benign salivary gland tumors (pleomorphic adenoma and mucous gland adenoma). Familiarity with the range of potential entities and any distinguishing features should prove valuable to thoracic radiologists, pulmonologists, and cardiothoracic surgeons when encountering the myriad of tracheobronchial neoplasms in clinical practice. Attention is paid to any features that may help render a more specific diagnosis before pathologic confirmation.
MeSH term(s)	Humans ; Salivary Gland Neoplasms/diagnosis ; Salivary Gland Neoplasms/pathology ; Carcinoma, Adenoid Cystic/diagnosis ; Carcinoma, Adenoid Cystic/pathology ; Carcinoma, Mucoepidermoid/diagnosis ; Carcinoma, Mucoepidermoid/pathology ; Lung Neoplasms ; Carcinoma, Squamous Cell ; Carcinoid Tumor/diagnostic imaging ; Brain Neoplasms
Language	English
Publishing date	2023-08-10
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	603172-9
ISSN	1527-1323 ; 0271-5333
ISSN (online)	1527-1323
ISSN	0271-5333
DOI	10.1148/rg.230045
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Article ; Online: Practice patterns in reporting interstitial lung abnormality at a tertiary academic medical center.

Escalon, Joanna G / Podolanczuk, Anna J / Aronson, Kerri I / Legasto, Alan C / Gruden, James F / Lynch, David A / Rachid, Leena / Rabkova, Yana / Steinberger, Sharon

Clinical imaging

2023 Volume 104, Page(s) 109996

Abstract: Purpose: Interstitial lung abnormality (ILA) is a common finding on chest CTs and is associated with higher all-cause mortality. The 2020 Fleischner Society position paper standardized the terminology and definition of ILA. Despite these published ... ...

Abstract	Purpose: Interstitial lung abnormality (ILA) is a common finding on chest CTs and is associated with higher all-cause mortality. The 2020 Fleischner Society position paper standardized the terminology and definition of ILA. Despite these published guidelines, the extent to which radiologists use this term is unknown. We evaluated practice patterns for identification of ILAs among radiologists at a tertiary academic medical center. Methods: In this retrospective review, we identified 157 radiology reports between January 1, 2010 through December 31, 2021 containing the phrase "interstitial lung abnormality" or "interstitial abnormality". After exclusions, 125 CT scans were reviewed by thoracic-trained radiologists using the sequential reading method. Results: Seventy-seven (62%) patients were found to have ILA (69% subpleural fibrotic, 19% subpleural non-fibrotic, and 6% non-subpleural), nine (7%) were equivocal for ILA and 39 (31%) had no ILA. The term ILA was used exclusively by thoracic-trained radiologists except for two cases. Use of the term ILA has rapidly increased since the position paper publication (none from 2010-2017, one case in 2018, 20 cases in 2019, 41 cases in 2020, and 73 cases in 2021), and cases were typically very mild (1-25% of the lung). Conclusion: While there has been increased use of the term ILA among thoracic-trained radiologists, non-thoracic radiologists have essentially not begun to use the term. Almost one-third of cases labeled ILA on clinical reads were re-classified as not having ILA on research reads.
MeSH term(s)	Humans ; Lung Diseases, Interstitial/diagnostic imaging ; Lung Diseases, Interstitial/complications ; Lung/diagnostic imaging ; Lung Neoplasms ; Retrospective Studies ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2023-10-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2023.109996
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Article ; Online: Radiology Implementation Considerations for Artificial Intelligence (AI) Applied to COVID-19, From the

Li, Matthew D / Chang, Ken / Mei, Xueyan / Bernheim, Adam / Chung, Michael / Steinberger, Sharon / Kalpathy-Cramer, Jayashree / Little, Brent P

AJR. American journal of roentgenology

2021 Volume 219, Issue 1, Page(s) 15–23

Abstract: Hundreds of imaging-based artificial intelligence (AI) models have been developed in response to the COVID-19 pandemic. AI systems that incorporate imaging have shown promise in primary detection, severity grading, and prognostication of outcomes in ... ...

Abstract	Hundreds of imaging-based artificial intelligence (AI) models have been developed in response to the COVID-19 pandemic. AI systems that incorporate imaging have shown promise in primary detection, severity grading, and prognostication of outcomes in COVID-19, and have enabled integration of imaging with a broad range of additional clinical and epidemiologic data. However, systematic reviews of AI models applied to COVID-19 medical imaging have highlighted problems in the field, including methodologic issues and problems in real-world deployment. Clinical use of such models should be informed by both the promise and potential pitfalls of implementation. How does a practicing radiologist make sense of this complex topic, and what factors should be considered in the implementation of AI tools for imaging of COVID-19? This critical review aims to help the radiologist understand the nuances that impact the clinical deployment of AI for imaging of COVID-19. We review imaging use cases for AI models in COVID-19 (e.g., diagnosis, severity assessment, and prognostication) and explore considerations for AI model development and testing, deployment infrastructure, clinical user interfaces, quality control, and institutional review board and regulatory approvals, with a practical focus on what a radiologist should consider when implementing an AI tool for COVID-19.
MeSH term(s)	Artificial Intelligence ; COVID-19 ; Humans ; Pandemics ; Radiography ; Radiology
Language	English
Publishing date	2021-10-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.21.26717
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Article ; Online: Barotrauma in COVID 19: Incidence, pathophysiology, and effect on prognosis.

Steinberger, Sharon / Finkelstein, Mark / Pagano, Andrew / Manna, Sayan / Toussie, Danielle / Chung, Michael / Bernheim, Adam / Concepcion, Jose / Gupta, Sean / Eber, Corey / Dua, Sakshi / Jacobi, Adam H

Clinical imaging

2022 Volume 90, Page(s) 71–77

Abstract: Objectives: To investigate the incidence, risk factors, and outcomes of barotrauma (pneumomediastinum and subcutaneous emphysema) in mechanically ventilated COVID-19 patients. To describe the chest radiography patterns of barotrauma and understand the ... ...

Abstract	Objectives: To investigate the incidence, risk factors, and outcomes of barotrauma (pneumomediastinum and subcutaneous emphysema) in mechanically ventilated COVID-19 patients. To describe the chest radiography patterns of barotrauma and understand the development in relation to mechanical ventilation and patient mortality. Methods: We performed a retrospective study of 363 patients with COVID-19 from March 1 to April 8, 2020. Primary outcomes were pneumomediastinum or subcutaneous emphysema with or without pneumothorax, pneumoperitoneum, or pneumoretroperitoneum. The secondary outcomes were length of intubation and death. In patients with pneumomediastinum and/or subcutaneous emphysema, we conducted an imaging review to determine the timeline of barotrauma development. Results: Forty three out of 363 (12%) patients developed barotrauma radiographically. The median time to development of either pneumomediastinum or subcutaneous emphysema was 2 days (IQR 1.0-4.5) after intubation and the median time to pneumothorax was 7 days (IQR 2.0-10.0). The overall incidence of pneumothorax was 28/363 (8%) with an incidence of 17/43 (40%) in the barotrauma cohort and 11/320 (3%) in those without barotrauma (p ≤ 0.001). In total, 257/363 (71%) patients died with an increase in mortality in those with barotrauma 33/43 (77%) vs. 224/320 (70%). When adjusting for covariates, barotrauma was associated with increased odds of death (OR 2.99, 95% CI 1.25-7.17). Conclusion: Barotrauma is a frequent complication of mechanically ventilated COVID-19 patients. In comparison to intubated COVID-19 patients without barotrauma, there is a higher rate of pneumothorax and an increased risk of death.
MeSH term(s)	Barotrauma/complications ; Barotrauma/etiology ; COVID-19/epidemiology ; Humans ; Incidence ; Mediastinal Emphysema/diagnostic imaging ; Mediastinal Emphysema/epidemiology ; Mediastinal Emphysema/etiology ; Pneumothorax/diagnostic imaging ; Pneumothorax/epidemiology ; Pneumothorax/etiology ; Prognosis ; Retrospective Studies ; Subcutaneous Emphysema/diagnostic imaging ; Subcutaneous Emphysema/epidemiology ; Subcutaneous Emphysema/etiology
Language	English
Publishing date	2022-06-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2022.06.014
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