Tyler M. Coupal

Artifacts in Dual-Energy CT Gout Protocol: A Review of 50 Suspected Cases With an Artifact Identification Guide

OBJECTIVE The objective of our study was to discover the types and incidence of artifacts in dual-energy CT (DECT) using datasets of 50 consecutive patients who underwent a four-limb DECT protocol for the evaluation of suspected gout. Identification of artifacts and techniques for artifact reduction are discussed. CONCLUSION Artifacts commonly occur in DECT performed for gout assessment but are usually readily recognizable. For 90% of the patients in our study who underwent imaging for suspected gout, DECT showed some type of artifact, with nail bed and skin artifacts being the most common.

Peering through the glare: using dual-energy CT to overcome the problem of metal artefacts in bone radiology.

ObjectiveImaging of patients with large metal implants remains one of the most difficult endeavours for radiologists. This article reviews the theory of dual-energy CT (DECT) and its ability to reduce metal artefact, thus enhancing the diagnostic value of musculoskeletal imaging. The strengths, weaknesses, and alternative applications of DECT, as well as areas requiring further research, will also be reviewed.ConclusionCurrently, DECT stands as the frontier for metal artefact reduction in musculoskeletal imaging. DECT requires no additional radiation and provides significantly enhanced image acquisition. When considered along with its other capabilities, DECT is a promising new tool for musculoskeletal and trauma radiologists.

CT-Guided Percutaneous Cryoablation for Osteoid Osteoma: Initial Experience in Adults

OBJECTIVE The purpose of this study was to investigate the safety and efficacy of CT-guided percutaneous cryoablation for the treatment of osteoid osteoma in adults. MATERIALS AND METHODS A retrospective case series over a 30-month period involved 10 consecutive adult patients (nine male and one female patients; mean age, 27.9 years; age range, 16-49 years) who underwent CT-guided percutaneous cryoablation for management of osteoid osteoma. Clinical and technical success was evaluated with postprocedure MRI at 4-5 weeks and with digital numeric pain scores taken before and immediately after the procedure, as well as at primary follow-up (4-10 weeks; average, 5 weeks) and secondary follow-up (23-29 weeks; average, 24 weeks). RESULTS Clinical and technical success rates were 100%. Average digital numeric pain scores were 7.4 before the procedure, 1.5 after procedure, 0.5 at the primary follow-up, and 0.3 at secondary follow-up. No minor or major complications were noted during the procedure, recovery period, primary follow-up, or secondary follow-up. CONCLUSION CT-guided percutaneous cryoablation is safe and effective in the treatment of osteoid osteoma in adults.

Getting the Most From Your Dual-Energy Scanner: Recognizing, Reducing, and Eliminating Artifacts

OBJECTIVE Dual-energy CT (DECT) is an innovative imaging modality that allows superior detection of pulmonary embolism, enhanced detection of urate in gout, and improved assessment of metal prostheses when compared with conventional CT. CONCLUSION The primary aim of this review is to describe these DECT protocols and compare each to its respective diagnostic reference standards. Moreover, this review will describe how to recognize, reduce, and eliminate DECT artifacts, thereby maximizing its diagnostic capabilities.

Imagine IR symposium: an approach to increasing IR awareness and understanding among medical students.

treatment methods are determined on a case-by-case basis. A 2013 literature review by Saeki et al (1) identified 13 cases, from 11 reports, of bleeding ectopic varices at the sites of previous choledochojejunostomies. In that series, interventional radiologic techniques were employed in eight patients, including dilation and stent implantation of the portal vein (n 1⁄4 5) and embolization of varices (n 1⁄4 3). None of these cases involved percutaneous creation of an extraanatomic shunt as performed in the present case. Decompression of splenic outflow with an extraanatomic shunt was effectively established in the patient described

Osteosarcoma Arising from a Haemangioma: Case Report and Review of the Literature

Abstract To create awareness of the benign lesions from which osteosarcoma may arise. Osteosarcoma is a rare tumour of bone the etiology of which is poorly understood, but it may arise from benign lesions. Malignant transformation in hemangiomas, in the absence of prior radiation, is exceedingly rare and the resulting neoplasm is usually an angiosarcoma. We report the case of a 30-year-old woman where investigation for thigh pain revealed a distal femoral hemangioma. She represented with pain and mass 18 years later, leading to a confirmed diagnosis of osteosarcoma at the same site. Osteosarcomas may arise from a variety of benign lesions. In this article we report the case of a histologically confirmed hemangioma which subsequently underwent malignant change into an osteosarcoma. ÖZ Benign bir lezyondan osteosarkom gelişebileceğine dikkat çekmek. Kemiğin nadir bir tümörü olarak osteosarkom etyolojisi anlaşılamamış bir tümör olup, iyi huylu lezyonlardan da gelişebilir. Hemanjiomun öncesinde radyoterapi hikayesi olmaksızın malign transformasyonu ileri derecede nadir olup, bu genellikle anjiyosarkom yönündedir. Bu yazıda sağ uyluk ağrısı nedeni ile incelenen 30 yaşında bir kadın hastada saptanan distal femoral kemik yerleşimli hemanjiom olgusunu sunmak istedik. Hastanın özelliği bu tanıdan 18 yıl sonra aynı bölgede osteosarkomla uyumlu kitle ile tekrar baş vurmuş olmasıdır. Osteosarkomlar değişik benign lezyonlardan çıkabilir. Bu yazıda histolojik olarak tanısı doğrulanmış intraosseöz bir hemanjiom zemininde osteosarkom yönünde malign transformasyon gösteren bir olguyu sunmaktayız.

A shift in scholarly publishing practices and the growing menace of predatory journals

149 T been the result of the advent of the internet and its growing influence on our lives. In an effort to adapt to this new age of technology, many journals have developed online editions and some journals have even switched over entirely to online editions. A step beyond this has been the implementation of open access journal publication, which continues to become more commonplace within current publishing practices.

Radiologic Findings in Gabapentin-Induced Myositis

Throughout recent years, Gabapentin has become increasingly used for the treatment of neuropathic pain. We report on a case of a 31 year old female who presented to the emergency department with unilateral leg pain, weakness, and swelling after increasingly titrating her Gabapentin dosage over three weeks. Magnetic resonance imaging confirmed the presence of myositis confined to the left thigh and the patients symptoms and laboratory abnormalities resolved following Gabapentin cessation. While Gabapentin-induced myositis and rhabdomyolysis is a rare entity, it should be a diagnostic consideration for radiologists, particularly in the absence of infection or trauma.

Sacral stress fractures in a sprint and throw athlete--a case report.

Introduction Sacral stress fractures in athletes are rare clinical diagnoses that are found most commonly in female long distance or marathon runners (5,6). Previous literature also has described these fractures in athletes involved in repetitive high-impact sports such as tennis, basketball, gymnastics, volleyball, and military training (5Y7). To the authors’ knowledge, however, sacral stress fractures have yet to be determined in the sprinting and throwing athlete. Given the scarce literature describing sacral stress fractures, the primary objective of this report was to outline their clinical and radiological characteristics to aid diagnosis. The secondary objective was to provide continued awareness surrounding the incidence of sacral stress fractures in high-performance athletes.

Book Review: MRI Made Easy (for Beginners), 2nd ed.

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