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Article ; Online: Radiology Advocacy-The Time Has Come!

Slanetz, Priscilla J / Patel, Amy / Sun, Maryellen R M / Duszak, Richard

Journal of the American College of Radiology : JACR

2019 Volume 16, Issue 11, Page(s) 1595–1597

MeSH term(s)	Career Choice ; Consumer Advocacy/education ; Curriculum ; Education, Medical, Graduate/methods ; Humans ; Internship and Residency/methods ; Needs Assessment ; Patient Advocacy/education ; Radiology/education ; Time Factors ; United States
Language	English
Publishing date	2019-05-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2019.03.010
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Article ; Online: Imaging of Infections of the Urinary and Male Reproductive Tracts.

Steinkeler, Jennifer A / Sun, Maryellen R M

Seminars in roentgenology

2016 Volume 52, Issue 2, Page(s) 83–89

MeSH term(s)	Diagnostic Imaging/methods ; Female ; Genitalia, Male/diagnostic imaging ; Genitalia, Male/microbiology ; Humans ; Magnetic Resonance Imaging ; Male ; Male Urogenital Diseases/diagnostic imaging ; Male Urogenital Diseases/microbiology ; Tomography, X-Ray Computed ; Ultrasonography, Doppler ; Urinary Tract/diagnostic imaging ; Urinary Tract/microbiology ; Urinary Tract Infections/diagnostic imaging
Language	English
Publishing date	2016-05-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80310-8
ISSN	1558-4658 ; 0037-198X
ISSN (online)	1558-4658
ISSN	0037-198X
DOI	10.1053/j.ro.2016.05.010
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Article ; Online: The utility of magnetic resonance imaging for noninvasive evaluation of diabetic nephropathy.

Brown, Robert S / Sun, Maryellen R M / Stillman, Isaac E / Russell, Teresa L / Rosas, Sylvia E / Wei, Jesse L

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2019 Volume 35, Issue 6, Page(s) 970–978

Abstract: Background: Noninvasive quantitative measurement of fibrosis in chronic kidney disease (CKD) would be desirable diagnostically and therapeutically but standard radiologic imaging is too variable for clinical usage. By applying a vibratory force, tissue ... ...

Abstract	Background: Noninvasive quantitative measurement of fibrosis in chronic kidney disease (CKD) would be desirable diagnostically and therapeutically but standard radiologic imaging is too variable for clinical usage. By applying a vibratory force, tissue shear wave stiffness can be measured by magnetic resonance elastography (MRE) that may correlate with progression of kidney fibrosis. Since decreased kidney perfusion decreases tissue turgor and stiffness, we combined newly available three-dimensional MRE shear stiffness measurements with MR arterial spin labeling (ASL) kidney blood flow rates to evaluate fibrosis in diabetic nephropathy. Methods: Thirty individuals with diabetes and Stage 0-5 CKD and 13 control individuals without CKD underwent noncontrast MRE with concurrent ASL blood flow measurements. Results: MRE cortical shear stiffness at 90 Hz was decreased significantly below controls in all CKD stages of diabetic nephropathy. Likewise, ASL blood flow decreased progressively from 480 ± 136 mL/min/100 g of cortical tissue in controls to 302 ± 95, 229 ± 7 and 152 ± 32 mL/min/100 g in Stages 3, 4 and 5 CKD, respectively. A magnetic resonance imaging (MRI) surrogate for the measured glomerular filtration fraction [surrogate filtration fraction = estimated glomerular filtration rate (eGFR)/ASL] decreased progressively from 0.21 ± 0.07 in controls to 0.16 ± 0.04 in Stage 3 and 0.10 ± 0.02 in Stage 4-5 CKD. Conclusions: In this pilot study, MRI with ASL blood flow rates can noninvasively measure decreasing kidney cortical tissue perfusion and, with eGFR, a decreasing surrogate filtration fraction in worsening diabetic nephropathy that appears to correlate with increasing fibrosis. Differing from the liver, MRE shear stiffness surprisingly decreases with worsening CKD, likely related to decreased tissue turgor from lower blood flow rates.
MeSH term(s)	Case-Control Studies ; Diabetic Nephropathies/pathology ; Disease Progression ; Glomerular Filtration Rate ; Hemodynamics ; Humans ; Magnetic Resonance Imaging/methods ; Pilot Projects ; Renal Insufficiency, Chronic/physiopathology ; Spin Labels
Chemical Substances	Spin Labels
Language	English
Publishing date	2019-07-18
Publishing country	England
Document type	Evaluation Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfz066
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Article: Magnetic resonance imaging of renal masses.

Sun, Maryellen R M / Pedrosa, Ivan

Seminars in ultrasound, CT, and MR

2009 Volume 30, Issue 4, Page(s) 326–351

Abstract: The increasing frequency of incidentally detected renal masses supports the need for accurate imaging characterization to avoid unnecessary surgery/interventional procedures. Furthermore, the need for accurate presurgical diagnosis of specific histologic ...

Abstract	The increasing frequency of incidentally detected renal masses supports the need for accurate imaging characterization to avoid unnecessary surgery/interventional procedures. Furthermore, the need for accurate presurgical diagnosis of specific histologic subtypes of renal malignancies is increasingly important as advances in understanding of tumor biology direct targeted courses of therapy. Magnetic resonance imaging is uniquely suited for the evaluation of renal masses because of its ability to provide excellent soft-tissue contrast and demonstration of enhancement, as well as its multiplanar capabilities. Although the spectrum of masses that may occur in the kidneys is broad, specific imaging features may assist in their accurate diagnosis. Examples of the imaging appearance of common and uncommon renal masses are provided along with a protocol for comprehensive magnetic resonance examination of the kidneys.
MeSH term(s)	Contrast Media ; Humans ; Image Enhancement/methods ; Kidney/pathology ; Kidney Diseases/pathology ; Kidney Neoplasms/pathology ; Magnetic Resonance Imaging/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2009-08-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1353113-x
ISSN	1558-5034 ; 0887-2171
ISSN (online)	1558-5034
ISSN	0887-2171
DOI	10.1053/j.sult.2009.04.001
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Article ; Online: Imaging of liver transplant and its complications.

Dani, Genta / Sun, Maryellen R M / Bennett, Andrew E

Seminars in ultrasound, CT, and MR

2013 Volume 34, Issue 4, Page(s) 365–377

Abstract: The role of diagnostic imaging in liver transplantation is reviewed with a focus on assessing for postoperative complications after adult orthotopic transplant. The normal postoperative appearance after liver transplant and imaging appearances of both ... ...

Abstract	The role of diagnostic imaging in liver transplantation is reviewed with a focus on assessing for postoperative complications after adult orthotopic transplant. The normal postoperative appearance after liver transplant and imaging appearances of both vascular and nonvascular complications are discussed. The key role of Doppler ultrasound as the first-line imaging modality is highlighted.
MeSH term(s)	End Stage Liver Disease/complications ; End Stage Liver Disease/diagnosis ; End Stage Liver Disease/surgery ; Graft Rejection/diagnosis ; Graft Rejection/etiology ; Humans ; Liver Transplantation/adverse effects ; Surgery, Computer-Assisted/methods ; Tomography, X-Ray Computed/methods ; Ultrasonography/methods
Language	English
Publishing date	2013-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1353113-x
ISSN	1558-5034 ; 0887-2171
ISSN (online)	1558-5034
ISSN	0887-2171
DOI	10.1053/j.sult.2013.04.002
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Article ; Online: US LI-RADS: ultrasound liver imaging reporting and data system for screening and surveillance of hepatocellular carcinoma.

Morgan, Tara A / Maturen, Katherine E / Dahiya, Nirvikar / Sun, Maryellen R M / Kamaya, Aya

Abdominal radiology (New York)

2017 Volume 43, Issue 1, Page(s) 41–55

Abstract: Ultrasound is the most widely used imaging tool for hepatocellular carcinoma (HCC) screening and surveillance. Until now, this method has lacked standardized guidelines for interpretation, reporting, and management recommendations [1-5]. To address this ... ...

Abstract	Ultrasound is the most widely used imaging tool for hepatocellular carcinoma (HCC) screening and surveillance. Until now, this method has lacked standardized guidelines for interpretation, reporting, and management recommendations [1-5]. To address this need, the American College of Radiology (ACR) has developed the Ultrasound Liver Imaging Reporting and Data System (US LI-RADS) algorithm. The proposed algorithm has two components: detection scores and visualization scores. The detection score guides management and has three categories: US-1 Negative, US-2 Subthreshold, and US-3 Positive. The visualization score informs the expected sensitivity of the ultrasound examination and also has three categories: Visualization A: No or minimal limitations; Visualization B: Moderate limitations; and Visualization C: Severe limitations. Standardization in ultrasound utilization, reporting, and management in high-risk individuals has the capacity to improve communication with patients and referring physicians, unify screening and surveillance algorithms, impact outcomes, and supply quantitative data for future research.
MeSH term(s)	Algorithms ; Carcinoma, Hepatocellular/diagnostic imaging ; Humans ; Liver Neoplasms/diagnostic imaging ; Mass Screening ; Population Surveillance ; Sensitivity and Specificity ; Ultrasonography/methods
Language	English
Publishing date	2017-09-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2839786-1
ISSN	2366-0058 ; 2366-004X
ISSN (online)	2366-0058
ISSN	2366-004X
DOI	10.1007/s00261-017-1317-y
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Article ; Online: The Incidental Splenic Mass at CT: Does It Need Further Work-up? An Observational Study.

Siewert, Bettina / Millo, Noam Z / Sahi, Kamaldeep / Sheiman, Robert G / Brook, Olga R / Sun, Maryellen R M / Kane, Robert A

Radiology

2018 Volume 287, Issue 1, Page(s) 156–166

Abstract: Purpose To evaluate whether an incidentally noted splenic mass at abdominal computed tomography (CT) requires further imaging work-up. Materials and Methods In this institutional review board-approved HIPAA-compliant retrospective study, a search of a CT ...

Abstract	Purpose To evaluate whether an incidentally noted splenic mass at abdominal computed tomography (CT) requires further imaging work-up. Materials and Methods In this institutional review board-approved HIPAA-compliant retrospective study, a search of a CT database was performed for patients with splenic masses at CT examinations of the abdomen and chest from 2002 to 2008. Patients were divided into three groups: group 1, patients with a history of malignancy; group 2, patients with symptoms such as weight loss, fever, or pain related to the left upper quadrant and epigastrium; and group 3, patients with incidental findings. Patients' CT scans, follow-up examinations, and electronic medical records were reviewed. Final diagnoses of the causes of the masses were confirmed with imaging follow-up (83.9%), clinical follow-up (13.7%), and pathologic examination (2.4%). Results This study included 379 patients, 214 (56.5%) women and 165 (43.5%) men, with a mean age ± standard deviation of 59.3 years ± 15.3 (range, 21-97 years). There were 145 (38.3%) patients in the malignancy group, 29 (7.6%) patients in the symptomatic group, and 205 (54.1%) patients in the incidental group. The incidence of malignant splenic masses was 49 of 145 (33.8%) in the malignancy group, eight of 29 (27.6%) in the symptomatic group, and two of 205 (1.0%) in the incidental group (P < .0001). The incidental group consisted of new diagnoses of lymphoma in one (50%) patient and metastases from ovarian carcinoma in one (50%) patient. Malignant splenic masses in the incidental group were not indeterminate, because synchronous tumors in other organs were diagnostic of malignancy. Conclusion In an incidental splenic mass, the likelihood of malignancy is very low (1.0%). Therefore, follow-up of incidental splenic masses may not be indicated.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Incidental Findings ; Male ; Middle Aged ; Retrospective Studies ; Spleen/diagnostic imaging ; Splenic Neoplasms/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Young Adult
Language	English
Publishing date	2018
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2017170293
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Article ; Online: Arterial Spin Labeled Perfusion MRI for the Evaluation of Response to Tyrosine Kinase Inhibition Therapy in Metastatic Renal Cell Carcinoma.

Tsai, Leo L / Bhatt, Rupal S / Strob, Meaghan F / Jegede, Opeyemi A / Sun, Maryellen R M / Alsop, David C / Catalano, Paul / McDermott, David / Robson, Philip M / Atkins, Michael B / Pedrosa, Ivan

Radiology

2020 Volume 298, Issue 2, Page(s) 332–340

Abstract: Background Tumor perfusion may inform therapeutic response and resistance in metastatic renal cell carcinoma (RCC) treated with antiangiogenic therapy. Purpose To determine if arterial spin labeled (ASL) MRI perfusion changes are associated with tumor ... ...

Abstract	Background Tumor perfusion may inform therapeutic response and resistance in metastatic renal cell carcinoma (RCC) treated with antiangiogenic therapy. Purpose To determine if arterial spin labeled (ASL) MRI perfusion changes are associated with tumor response and disease progression in metastatic RCC treated with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). Materials and Methods In this prospective study (ClinicalTrials.gov identifier: NCT00749320), metastatic RCC perfusion was measured with ASL MRI before and during sunitinib or pazopanib therapy between October 2008 and March 2014. Objective response rate (ORR) and progression-free survival (PFS) were calculated. Perfusion was compared between responders and nonresponders at baseline, at week 2, after cycle 2 (12 weeks), after cycle 4 (24 weeks), and at disease progression and compared with the ORR by using the Wilcoxon rank sum test and with PFS by using the log-rank test. Results Seventeen participants received sunitinib (mean age, 59 years ± 7.0 [standard deviation]; 11 men); 11 participants received pazopanib (mean age, 63 years ± 6.6; eight men). Responders had higher baseline tumor perfusion than nonresponders (mean, 404 mL/100 g/min ± 213 vs 199 mL/100 g/min ± 136;
MeSH term(s)	Adult ; Aged ; Carcinoma, Renal Cell/drug therapy ; Carcinoma, Renal Cell/secondary ; Female ; Humans ; Indazoles ; Kidney Neoplasms/drug therapy ; Kidney Neoplasms/secondary ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Prospective Studies ; Protein Kinase Inhibitors/therapeutic use ; Protein-Tyrosine Kinases/antagonists & inhibitors ; Pyrimidines/therapeutic use ; Spin Labels ; Sulfonamides/therapeutic use ; Sunitinib/therapeutic use
Chemical Substances	Indazoles ; Protein Kinase Inhibitors ; Pyrimidines ; Spin Labels ; Sulfonamides ; pazopanib (7RN5DR86CK) ; Protein-Tyrosine Kinases (EC 2.7.10.1) ; Sunitinib (V99T50803M)
Language	English
Publishing date	2020-12-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2020201763
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Article ; Online: Utility of transabdominal ultrasound for surveillance of known pancreatic cystic lesions: prospective evaluation with MRI as reference standard.

Sun, Maryellen R M / Strickland, Corinne D / Tamjeedi, Bahar / Brook, Alexander / Mortele, Koenraad J / Brook, Olga R / Kane, Robert A / Siewert, Bettina

Abdominal radiology (New York)

2017 Volume 43, Issue 5, Page(s) 1180–1192

Abstract: Objectives: To prospectively assess the utility of transabdominal ultrasound in surveillance of known pancreatic cystic lesions (PCL) using same day MRI as reference standard.: Methods: In an IRB-approved study with written informed consent, patients ...

Abstract	Objectives: To prospectively assess the utility of transabdominal ultrasound in surveillance of known pancreatic cystic lesions (PCL) using same day MRI as reference standard. Methods: In an IRB-approved study with written informed consent, patients with known PCL underwent pancreas US on same day as surveillance MRI. US was performed blinded to same date MRI results. Transverse (TR), antero-posterior (AP), cranio-caudal (CC), and longest any plane diameter, were measured for each PCL at US and MRI. Visualization was correlated with patient (weight, abdominal diameter, thickness of abdominal fat, sex) and cyst (location, size, internal complexity) factors. Results: 252 PCLs evaluated in 57 subjects (39 females; mean age 67 (range 39-86) yrs). Mean maximum PCL diameter 8.5 (range 2-92) mm. US identified 100% (5/5) of cysts ≥3 cm; 92% (12/13) ≥2 and <3 cm; 78% (43/55) ≥1 and <2 cm; 35% (27/78) ≥5 mm and <1 cm; and 16% (16/101) <5 mm. US visualization correlated with PCL location (<0.0001), size (p < 0.0001), patient gender (p = 0.005), participation of attending radiologist (p = 0.03); inversely with patient weight (p = 0.012) and AP abdominal diameter (p = 0.01). Conclusion: Many PCLs are visualized and accurately measured at follow-up with transabdominal ultrasound. Visualization correlates with lesion size, location, patient sex, weight, and abdominal diameter.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreas/diagnostic imaging ; Pancreatic Cyst/diagnostic imaging ; Prospective Studies ; Reproducibility of Results ; Ultrasonography/methods
Language	English
Publishing date	2017-08-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2839786-1
ISSN	2366-0058 ; 2366-004X
ISSN (online)	2366-0058
ISSN	2366-004X
DOI	10.1007/s00261-017-1269-2
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Article ; Online: Pemberton's sign: explained nearly 70 years later.

De Filippis, Elena A / Sabet, Amin / Sun, Maryellen R M / Garber, Jeffrey R

The Journal of clinical endocrinology and metabolism

2014 Volume 99, Issue 6, Page(s) 1949–1954

Abstract: Context: Pemberton's sign is used to evaluate venous obstruction in patients with goiters. The sign is positive when bilateral arm elevation causes facial plethora. It has been attributed to a "cork effect" resulting from the thyroid obstructing the ... ...

Abstract	Context: Pemberton's sign is used to evaluate venous obstruction in patients with goiters. The sign is positive when bilateral arm elevation causes facial plethora. It has been attributed to a "cork effect" resulting from the thyroid obstructing the thoracic inlet, thereby increasing pressure on the venous system. According to some, the "cork effect" is caused by the thyroid descending into the thoracic inlet during arm elevation. According to others, the obstruction is due to elevation of the thoracic inlet against the thyroid. Objective: We studied a 36-year-old man with a positive Pemberton's sign secondary to a goiter extending to the substernal region. Design and intervention: Clinical, biochemical, and radiological assessments were done. Magnetic resonance angiography of the neck was performed while the patient's arms were elevated and at his sides. After the imaging studies were completed, the patient underwent thyroidectomy. Results: Magnetic resonance angiography demonstrated that there was no craniocaudal movement of the goiter relative to the thoracic inlet. However, the lateral aspect of the clavicle moved medially and inferiorly, obstructing the right external jugular vein and subclavian vein confluence. Conclusions: In the present case, we demonstrated that when eliciting Pemberton's sign, facial plethora and venous engorgement were due to the clavicles moving and compressing venous vasculature against the enlarged thyroid and not to a "cork effect." Rather, the clavicular motion observed during arm elevation could be compared to the movement of a "nutcracker" compressing major venous structures within a narrowed thoracic inlet against a relatively fixed and enlarged thyroid.
MeSH term(s)	Adult ; Constriction, Pathologic/diagnosis ; Constriction, Pathologic/surgery ; Goiter, Substernal/complications ; Goiter, Substernal/diagnosis ; Goiter, Substernal/surgery ; Humans ; Jugular Veins/pathology ; Jugular Veins/surgery ; Male ; Thyroidectomy ; Vascular Diseases/diagnosis ; Vascular Diseases/etiology ; Vascular Diseases/surgery
Language	English
Publishing date	2014-06
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/jc.2013-4240
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