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Biomedical subjects

Sangeet Ghai

Publications and source records attributed to Sangeet Ghai.

9 recordsLinked to original sources
PubMed2026

Optimizing prostate biopsy decision making - (MUSIC-screen): A 1:1 randomized controlled trial comparing micro-ultrasound versus multiparametric magnetic resonance imaging for prostate cancer diagnosis.

BACKGROUND: Micro-ultrasound (microUS) represents a potential alternative to multiparametric magnetic resonance (mpMRI) in guiding prostate biopsy, with level 1 evidence demonstrating non-inferiority to detect Grade Group &#x2265;2 (GG&#xa0;&#x2265;&#xa0;2) prostate cancer in biopsy-na&#xef;ve men. However, a critical gap remains in the screening pathway, in which imaging is needed to identify men at risk and determine whether biopsy is warranted. METHODS: MUSIC-Screen is a phase 3, open-label, noninferiority 1:1 randomized controlled trial evaluating microUS as an alternative imaging compared to mpMRI for determining the need for prostate biopsy in biopsy- and imaging- na&#xef;ve men at risk for GG&#xa0;&#x2265;&#xa0;2. A total of 1284 men will be randomized to undergo either microUS or mpMRI. Men with PRI-MUS 3-5 or PI-RADS 3-5 lesion will undergo targeted and systematic biopsy. Men with negative imaging and PSA density&#xa0;&#x2265;&#xa0;0.15 will undergo systematic biopsy, while those with PSA density&#xa0;<&#xa0;0.15 will defer biopsy. RESULTS: The primary outcome is GG&#xa0;&#x2265;&#xa0;2 detection in each study arm. The primary hypothesis is that microUS is non-inferior to mpMRI for screening and detection of GG&#xa0;&#x2265;&#xa0;2. Secondary objectives include comparison of GG&#xa0;&#x2265;&#xa0;2 detection rates in targeted cores among patients with PRI-MUS or PI-RADS scores of 3-5, proportion of men who defer biopsy but are diagnosed with GG&#xa0;&#x2265;&#xa0;2 within 8&#xa0;years, assessment of the negative predictive value of each imaging modality, and health economic analyses. CONCLUSION: MUSIC-Screen will determine whether microUS can be used as an imaging modality to inform biopsy decision making that is non-inferior to mpMRI for GG&#xa0;&#x2265;&#xa0;2 prostate cancer detection. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06626022.

Humans↗
PubMed2006

Comparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules.

OBJECTIVE: Adrenal nodules having an attenuation of more than 10 H on unenhanced CT are considered indeterminate. The purpose of this study was to compare CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules. MATERIALS AND METHODS: Thirty-nine adrenal masses that were indeterminate on CT were identified in 37 patients. Histogram analysis was performed on unenhanced CT from a region of interest (ROI) that recorded mean attenuation, number of pixels, and percentage of negative pixels. MR signal intensity drop between the in- and opposed-phase images was measured for the masses. Analyses to determine whether correlations existed among the mean CT attenuation, percentage of negative pixels, and MR signal intensity drop were performed. A final diagnosis was obtained by pathology results, follow-up of more than 6 months, or adrenal washout CT findings. RESULTS: Negative pixels were present in 25 of 28 adenomas and nine of 11 nonadenomas. A threshold of more than 10% negative pixels for the diagnosis of adenoma provided a sensitivity of 46% and specificity of 100%. A threshold of more than 20% MR signal intensity drop yielded a sensitivity of 71% and specificity of 100%. An increase in the percentage of negative pixels was correlated with a decrease in mean CT attenuation. Using MRI, observers characterized seven additional nodules as adenomas compared with CT histogram analysis (McNemar test, chi2 = 5.1429; p = 0.023). CONCLUSION: CT histogram analysis with a threshold of a 10% negative pixel presence increases sensitivity for the characterization of adenomas compared with analysis of the mean CT attenuation alone. The use of chemical shift MRI with a threshold of 20% signal intensity drop results in a higher sensitivity than CT histogram analysis.

Adenoma↗
PubMed2004

Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses: does it still have a role?

PURPOSE: To evaluate chemical shift magnetic resonance (MR) imaging for the characterization of hyperattenuating adrenal masses. MATERIALS AND METHODS: Adrenal MR images obtained from January 1998 to February 2003 were reviewed. Patients were excluded if they did not undergo unenhanced computed tomography or did not have an adrenal mass with attenuation higher than 10 HU, adequate follow-up, or pathologic diagnosis for use as a reference standard. A diagnosis of adenoma required at least 24 weeks of stability on images. Thirty-eight masses in 36 patients were identified (27 adenomas, nine metastases, one adrenocortical oncocytoma, and one pheochromocytoma). Signal intensity (SI) decrease between in-phase and opposed-phase MR images was measured for the entire mass and normalized to the renal parenchymal SI. In 21 of 36 (58%) patients, dual-echo single-breath-hold MR imaging was used to eliminate misregistration. RESULTS: The attenuation of 61% (23 of 38) of all masses and 70% (19 of 27) of adenomas was 10-30 HU. With a threshold of 20% SI decrease, the sensitivity of chemical shift MR imaging for hyperattenuating adenoma was 67% (18 of 27 masses). When considering masses with attenuation of 10-30 HU, the sensitivity for adenoma was 89% (17 of 19 masses) and remained reasonable at 75% (six of eight masses) for adenomas with attenuation of 20-30 HU. Only one adenoma with attenuation higher than 30 HU had SI decrease of more than 20%. Specificity for diagnosis of adenoma was 100% (11 of 11). CONCLUSION: In certain circumstances, chemical shift MR imaging is a reasonable second imaging test for further characterization of a hyperattenuating adrenal mass.

Adenoma↗
PubMed2003

Efficacy of embolization in traumatic uterine vascular malformations.

PURPOSE: To evaluate the efficacy of embolotherapy in patients with bleeding traumatic uterine arteriovenous malformations (AVMs). MATERIALS AND METHODS: A retrospective review of all patients who underwent pelvic arterial embolization at our institution between July 1992 and September 2002 was performed. Fifteen patients were diagnosed with a uterine vascular malformation on duplex ultrasonography and correlative MR imaging. Serial beta-human chorionic gonadotropin levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of the uterine arteries. Embolizations were performed with use of standard 4-5-F catheters and microcatheters when necessary. Embolic agents in the 25 procedures included glue only (n = 13), polyvinyl alcohol (PVA) particles and glue (n = 4), PVA particles (n = 2), Gelfoam (n = 2), coils (n = 1), PVA particles and coils (n = 1), glue and Gelfoam (n = 1), and glue and coils (n = 1). PVA particle size ranged from 350 to 1,000 micro m. Outcomes assessed were cessation of bleeding, persistence or resolution of the AVM, complications, and pregnancy after embolization. These were assessed by chart, laboratory, and imaging reviews. RESULTS: A total of 25 embolization procedures were performed in 15 patients. Six patients required repeat embolization (one patient underwent embolization on six occasions; five patients had two embolization procedures each) for recurrence of bleeding. Sixteen procedures were performed on an elective basis and nine were performed on an emergent basis. The technical success rate of embolization was 100%. The clinical success rate was 93%: bleeding was controlled in 14 of 15 patients and one patient underwent a hysterectomy. Four of the 15 patients subsequently had a total of five uneventful intrauterine pregnancies carried to term. The 14 patients who underwent successful embolization had no recurrence of bleeding at a median follow-up of 53 months (range, 3-124 months) after treatment. Three patients were eventually lost to follow-up. One minor complication (0.4%) of non-flow-limiting dissection of the internal iliac artery occurred. CONCLUSION: Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. This procedure allows for preservation of uterine function with the possibility of future pregnancy and should be considered as a primary treatment option.

Adult↗
PubMedDate not supplied

Mixed sclerosing bone dysplasia--a case report with literature review.

We report a case of mixed sclerosing bone dysplasia in a 26-year-old man. This is a very rare disorder characterized by a variable combination of melorheostosis, osteopoikilosis and osteopathia striata. The disease may be generalized or may show unilateral involvement.

Adult↗
PubMedDate not supplied

Helical CT evaluation of aortic aneurysms and dissection: a pictorial essay.

The relative noninvasive nature, easy accessibility, convenience and accuracy of helical CT in the rapid evaluation of not only the aorta and its branches, but the entire thorax/abdomen, makes it the best suited imaging modality for use in evaluation of aortic aneurysms and dissection. Excellent vascular opacification, the advantage of reconstructing overlapping scans without respiratory misregistration, multiplanar reconstruction and 3D rendering of the vessels highlight the benefits of helical CT. Helical CT evaluation combines the advantages of conventional CT, giving true information about the exact transverse and longitudinal extent of the aneurysm, the vessel wall, luminal thrombus and structures around the aorta, and those of aortography in the form 3D volumetric information display. The purpose of this essay is to present a spectrum of aortic aneurysms and dissection to highlight the role of helical CT in their evaluation.

Aortic Dissection↗
PubMedDate not supplied

Uterine artery embolization for leiomyomas: pre- and postprocedural evaluation with US.

Transabdominal and transvaginal ultrasonography (US) are commonly used to assess the uterus and pelvis prior to and following uterine artery embolization (UAE) for symptomatic leiomyomas (fibroids). Preprocedural US may help identify relative contraindications for UAE, whereas postprocedural US can help determine the quality and quantity of fibroid involution and help identify any complications associated with the procedure. The consulting radiologist should be familiar with certain typical postprocedural US findings, which might otherwise be improperly interpreted, leading to unnecessary intervention. Magnetic resonance (MR) imaging or computed tomography will frequently provide the most accurate information in UAE patients with certain pathologic conditions, and early study results suggest that MR imaging may be helpful in predicting treatment response. Nevertheless, US is a readily available first-line imaging modality and a well-accepted method for both pre- and postprocedural evaluation of patients who undergo UAE. A proper understanding of the US findings in this patient population allows objective determination of treatment response and detection of most of the commonly recognized complications that are associated with UAE.

Adult↗