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Lawrence E Ginsberg

Publications and source records attributed to Lawrence E Ginsberg.

8 recordsLinked to original sources
PubMed2005

Multi-detector row CT artifacts that mimic disease.

PURPOSE: To determine retrospectively the frequency of two artifact patterns that mimic pathologic lesions on computed tomographic (CT) head images acquired in the axial scanning mode with two different multi-detector row CT systems at the same institution. MATERIALS AND METHODS: The institutional review board approved this Health Insurance Portability and Accountability Act-compliant study and waived informed consent. The study involved two groups of consecutive patients, a group of 22 (nine men, 13 women; mean age, 56 years; age range, 27-85 years) examined with one multi-detector row CT system with four detector rows, and another group of 13 (seven men, six women; mean age, 69 years; age range, 53-81 years) examined with a different four-detector row CT system. Examinations in each group took place in a 4-week period. CT images were retrospectively evaluated by a neuroradiologist and a physicist for presence, appearance, location (within the image set and on individual images), and size of artifacts. Elimination of artifacts was verified by scanning a water phantom after scanner service and repair. RESULTS: A pseudolesion, or artifact, was identified in scans of four of 22 patients examined with the first scanner and eight of 13 patients examined with the second scanner. The artifact on images obtained on the first scanner, an approximately 2-cm-diameter faintly hyperattenuating and nonenhancing area with hypoattenuating collar, was found at gantry isocenter on every fourth image. A different pattern was found on images obtained on the second scanner: a 1.1-cm-diameter circular area of hypoattenuation with a faintly attenuating rim, that mimicked a cyst. This artifact was observed also at the CT scanner gantry isocenter on every fourth image. Artifacts disappeared after recalibration (first scanner) or collimator cleaning (second scanner). CONCLUSION: CT scanning in the axial mode can produce a regularly repeating artifact when data from one detector row of a multi-detector row CT scanner are compromised. Because of the risk of misinterpreting such patterns, routine assessment of each detector element is recommended for multi-detector row CT scanners that are routinely used in the axial scanning mode.

Adult↗
PubMed2004

MR imaging of perineural tumor spread.

Perineural tumor spread (PNS) is a common and potentially devastating complication of head and neck cancer. Because perineural tumor spread may be asymptomatic, the radi-ologist plays a critical role in the evaluation of the head and neck cancer patient. Although PNS may be seen on CT, MR imaging is far more sensitive and is the imaging modality of choice in the evaluation of perineural tumor spread.

Journal Article↗
PubMed2004

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Audiovisual Aids↗
PubMed2003

Intraarterial cisplatin with intravenous paclitaxel and ifosfamide as an organ-preservation approach in patients with paranasal sinus carcinoma.

BACKGROUND: The objectives of this study were to determine the efficacy, organ-preservation rate, and safety of intraarterial (IA) cisplatin in combination with intravenous paclitaxel and ifosfamide in patients with locally advanced carcinoma of the paranasal sinuses who required orbital exenteration or major craniofacial resection for complete tumor resection. METHODS: Patients were treated with intravenous paclitaxel (135 mg/m(2)) on Day 1, ifosfamide (1000 mg/m(2)) on Days 1-3, sodium mercaptoethanesulfonate (600 mg/m(2)) on Days 1-3, and IA cisplatin (100 mg/m(2)) on Day 1 every 21 days. RESULTS: Of 24 study participants, 20 patients received at least 1 course of IA cisplatin, 1 patient had an early death, and 19 patients were evaluable for response. Five of those 19 patients (26%) achieved a complete response (CR), 6 patients (32%) achieved a partial response, and 8 patients (42%) had stable disease or developed progressive disease. Eye-sparing surgery followed by radiotherapy (RT) was feasible in 7 of 24 patients, RT was offered to only 7 patients, whereas 3 patients received chemotherapy and RT, 2 patients refused further therapy, 3 patients underwent craniofacial resection with orbitectomy, and 1 patient was treated systemically for metastatic disease. At the completion of treatment, 14 of 23 patients (61%) with locally advanced disease were disease free, and the orbit was preserved in 21 of 24 patients (88%). The overall survival, progression-free survival, and disease-free survival rates at 2 years were 60%, 50%, and 84%, respectively. Toxicity was substantial, with two patients experiencing cerebrovascular ischemia (one transient and one cerebrovascular accident) and three patients experiencing cranial neuropathy, which was reversible in two patients. CONCLUSIONS: Despite the encouraging organ-preservation rate, the approach studied resulted in substantial toxicity, and more effective adjunctive therapy is needed. Alternative approaches, including the integration of targeted therapy agents in induction chemotherapy regimens followed by concomitant chemotherapy and RT or eye-sparing surgery, need further exploration.

Adult↗
PubMed2002

Imaging pitfalls in the postoperative head and neck.

It may well be that imaging of the post-treatment head and neck is among the most difficult tasks faced by the radiologist. Pitfalls are everywhere, and opportunities for error endless. In this manuscript, an attempt is made to categorize many of the various types of pitfalls that exist in imaging the operated head and neck patient. The radiologist can avoid error by remembering certain common postoperative appearances and not misinterpreting them as abnormal, by having available baseline postoperative studies, and by gaining experience in this very challenging aspect of head and neck radiology.

Cicatrix↗
PubMed2002

MR imaging of perineural tumor spread.

Perineural tumor spread (PNS) is a common and potentially devastating complication of head and neck cancer. Because perineural tumor spread may be asymptomatic, the radiologist plays a critical role in the evaluation of the head and neck cancer patient. Although PNS may be seen on CT, MR imaging is far more sensitive and is the imaging modality of choice in the evaluation of perineural tumor spread.

Cranial Nerves↗
PubMed2002

MR imaging of leptomeningeal metastases: comparison of three sequences.

BACKGROUND AND PURPOSE: Recent work has shown that fluid-attenuated inversion recovery (FLAIR) imaging with contrast enhancement is highly sensitive for detecting subarachnoid space disease. We hypothesized that contrast-enhanced FLAIR imaging has superior sensitivity to contrast-enhanced T1-weighted MR imaging in detecting leptomeningeal metastases. METHODS: Sixty-eight patients referred for suspected leptomeningeal metastases underwent 74 MR imaging studies. The patients had either temporally related cytologic proof of leptomeningeal metastases or negative results of clinical follow-up confirming absence of leptomeningeal metastases. The MR imaging examinations included unenhanced and contrast-enhanced FLAIR images and contrast-enhanced T1-weighted MR images that were independently reviewed by two neuroradiologists blinded to the results of cytology. Each of the three sequences was reviewed individually and separately and was assigned a score of positive or negative for leptomeningeal metastases. Discrepancies were settled by consensus. RESULTS: Of the 17 studies of patients with cytology-proven leptomeningeal metastases, two were positive based on unenhanced FLAIR images, seven were positive based on contrast-enhanced FLAIR images, and 10 were positive based on contrast-enhanced T1-weighted MR images. Of the 57 studies of patients without leptomeningeal metastases, 53 were negative based on unenhanced FLAIR images, 50 were negative based on contrast-enhanced FLAIR images, and 53 were negative based on contrast-enhanced T1-weighted MR images. The sensitivity and specificity of unenhanced FLAIR images for detecting leptomeningeal metastases were 12% (two of 17) and 93% (53 of 57), respectively. The sensitivity and specificity for contrast-enhanced FLAIR images for detecting leptomeningeal metastases were 41% (seven of 17) and 88% (50 of 57), respectively. The sensitivity and specificity of contrast-enhanced T1-weighted MR images for detecting leptomeningeal metastases were 59% (10 of 17) and 93% (53 of 57), respectively. CONCLUSION: Contrast-enhanced fast FLAIR sequences are less sensitive than standard contrast-enhanced T1-weighted MR sequences in detecting intracranial neoplastic leptomeningeal disease.

Adolescent↗