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CT Colonography (Virtual Colonoscopy): Technique, Indications and Performance

Arye Blachar, Jacob Sosna
2007 Digestion  
CT Colonography, Background and Rationale Colorectal cancer is the second leading cause of cancer mortality in the United States accounting for approximately 10% of all cancer deaths in both men and women combined [1, 2] . The adenoma carcinoma sequence refers to the process of transformation of small adenomas into large adenomas, then into noninvasive carcinoma and finally into invasive carcinoma, through a series of genetic mutations. Colorectal cancer is a curable disease if detected early
more » ... d may be prevented if precursor adenomas are detected and removed. Regular colon cancer screening has been recommended by the medical community for all individuals over 50 years of age and for individuals over 40 years of age with a significant family history of colorectal cancer or other risk factors. Screening programs using fecal occult blood test, flexible sigmoidoscopy, conventional colonoscopy and double-contrast barium enema have reduced the mortality from colorectal cancer [3] . The goal of these programs is to interrupt the adenoma-carcinoma progression by identifying and removing small polyps before they become malignant as most carcinomas arise from pre-existing adenomas [3] . Mortality is reduced in screening populations thanks to early detection of malignant lesions and identification and removal of premalignant lesions. Screening for colorectal cancer is cost-effective, but a single optimal strategy has not yet been determined [4] .
doi:10.1159/000108392 pmid:17947817 fatcat:ultdyozyufdsbg3tcd6coih3f4

Enigma of primary aortoduodenal fistula

Miklosh Bala, Jacob Sosna, Liat Appelbaum, Eran Israeli, Avraham I Rivkind
2009 World Journal of Gastroenterology  
A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case
more » ... s unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm. P e e r re v i e w e r s : D r. L i m a s K u p c i n s k a s , P r o f e s s o r,
doi:10.3748/wjg.15.3191 pmid:19575502 pmcid:PMC2705745 fatcat:5zpntl4i4vcgpdlmrm2fo2rzki

Virtual nonenhanced abdominal dual-energy MDCT: Analysis of image characteristics

Jacob Sosna
2012 World Journal of Radiology  
Jacob Sosna, Professor is the principle investigator under a research agreement with Philips HealthCare. Dr. Liran Goshen and Dr. Galit Kafri are employees of Philips HealthCare.  ...  Inferior vena cava 12.2 ± 11.6 < 0.0001 Aorta 38.0 ± 9.3 < 0.0001 Iliac vein 8.3 ± 7.9 0.0225 Iliac artery 38.4 ± 15.0 < 0.0001 April 28, 2012|Volume 4|Issue 4| WJR|www.wjgnet.com Sosna  ... 
doi:10.4329/wjr.v4.i4.167 pmid:22590671 pmcid:PMC3351685 fatcat:7nbuig52mzfxvgqkhzlddwvmoq

Middle Ear Virtual Endoscopy in Malleus Fracture and Dislocation

Ophir Ilan, Phillip Berman, Jacob Sosna, Menachem Gross
2008 Open Otorhinolaryngology Journal  
Ossicular injury is a frequent complication of head trauma and temporal bone fractures. An isolated fracture of the malleus with lateral dislocation of the manubrium is extremely rare. High-resolution computed tomography is the method of choice for evaluation of ossicular trauma. Virtual endoscopy (VE) is a novel technique that provides a realistic surface rendering of various organs that can be applied for the use of three-dimensional (3D) reconstruction. We report a case of malleus handle
more » ... ture and dislocation after head trauma with confirmation of the diagnosis by VE of the middle ear.
doi:10.2174/1874428100802010023 fatcat:5czzauu4rjazta6qnlc7mzayky

Collective detection based on visual information in animal groups [article]

Jacob D. Davidson, Matthew M. G. Sosna, Colin R. Twomey, Vivek H. Sridhar, Simon P. Leblanc, Iain D. Couzin
2021 bioRxiv   pre-print
AbstractThe spatio-temporal distribution of individuals within a group (i.e its internal structure) plays a defining role in how individuals interact with their environment, make decisions, and transmit information via social interactions. Group-living organisms across taxa, including many species of fish, birds, ungulates, and insects, use vision as the predominant modality to coordinate their collective behavior. Despite this importance, there have been few quantitative studies examining
more » ... l detection capabilities of individuals within groups. We investigate key principles underlying individual, and collective, visual detection of stimuli (which could include cryptic predators, potential food items, etc.) and how this relates to the internal structure of groups. While the individual and collective detection principles are generally applicable, we employ a model experimental system of schooling golden shiner fish (Notemigonus crysoleucas) to relate theory directly to empirical data, using computational reconstruction of the visual fields of all individuals to do so. Our integrative approach allows us to reveal how the external visual information available to each group member depends on the number of individuals in the group, the position within the group, and the location of the external visually-detectable stimulus. We find that in small groups, individuals have detection capability in nearly all directions, while in large groups, occlusion by neighbors causes detection capability to vary with position within the group. We then formulate a simple, and generally applicable, model that captures how visual detection properties emerge due to geometric scaling of the space occupied by the group and occlusion caused by neighbors. We employ these insights to discuss principles that extend beyond our specific system, such as how collective detection depends on individual body shape, and the size and structure of the group.
doi:10.1101/2021.02.18.431380 fatcat:sfoky7lucvdyhgxinebmv7yetq

Multiple myeloma involving the thyroid cartilage: case report

Jacob Sosna, B Simon Slasky, Ora Paltiel, Galina Pizov, Eugene Libson
2002 American Journal of Neuroradiology  
Multiple myeloma involving the thyroid cartilage is exceedingly rare. We describe a patient with progressive airway obstruction due to diffuse involvement of the thyroid cartilage with multiple myeloma. CT revealed a conglomerate of calcifications of the thyroid cartilage. Additional classic lytic lesions of multiple myeloma were subsequently found in the bones, without associated calcifications. Calcified matrix in multiple myeloma involving the thyroid cartilage should now be included as an
more » ... ditional manifestation of extraosseous multiple myeloma.
pmid:11847062 pmcid:PMC7975273 fatcat:ry3nwgtx4nd73o5w6rpx4lu5fq

Missed Lesions at Abdominal Oncologic CT: Lessons Learned from Quality Assurance

Bettina Siewert, Jacob Sosna, Ann McNamara, Vassilios Raptopoulos, Jonathan B. Kruskal
2008 Radiographics  
The evaluation of oncology patients represents a substantial volume of the workload in many radiology departments. Interpreting the results of oncologic examinations is often challenging and time-consuming because many abnormalities are identified in the same examination and must be compared with the findings in previous studies. However, errors in the interpretation of oncologic computed tomographic (CT) scans can have significant effects on patient care. These effects may range from
more » ... from a clinical trial or cessation of therapy to repeat CT examination because of a technically inadequate study, CTguided biopsy of newly identified lesions, or initiation of therapy for previously unrecognized lesions. A root cause analysis of reported errors in the interpretation of abdominal and pelvic CT scans led to the identification of potential pitfalls that may be encountered when interpreting oncologic CT scans and factors that contribute to these errors. Awareness of the spectrum of factors that contribute to misinterpretation of CT scans in oncology patients may improve the performance of the individual radiologist and ultimately translate into improved patient care. © RSNA, 2008 • Abbreviation: PACS = picture archiving and communication system RadioGraphics 2008; 28:623-638 • Published online 10.1148/rg.283075188 • Content Codes:
doi:10.1148/rg.283075188 pmid:18480475 fatcat:zehbj2iwczbnllhvtokv3rruja

A Bayesian Approach for Liver Analysis: Algorithm and Validation Study [chapter]

Moti Freiman, Ofer Eliassaf, Yoav Taieb, Leo Joskowicz, Jacob Sosna
2008 Lecture Notes in Computer Science  
We present a new method for the simultaneous, nearly automatic segmentation of liver contours, vessels, and metastatic lesions from abdominal CTA scans. The method repeatedly applies multi-resolution, multi-class smoothed Bayesian classification followed by morphological adjustment and active contours refinement. It uses multi-class and voxel neighborhood information to compute an accurate intensity distribution function for each class. The method requires only one or two user-defined voxel
more » ... s, with no manual adjustment of internal parameters. A retrospective study on two validated clinical datasets totaling 56 CTAs was performed. We obtained correlations of 0.98 and 0.99 with a manual ground truth liver volume estimation for the first and second databases, and a total score of 67.87 for the second database. These results suggest that our method is accurate, efficient, and robust to seed selection compared to manually generated ground truth segmentation and to other semi-automatic segmentation methods.
doi:10.1007/978-3-540-85988-8_11 fatcat:z6n6cabt4vhp5klmrtg7c2ykuu

Between a Rock and a Hard Place: Clinical and Imaging Features of Vascular Compression Syndromes

Ruth Eliahou, Jacob Sosna, Allan I. Bloom
2012 Radiographics  
doi:10.1148/rg.321115011 pmid:22236908 fatcat:d67uyq6ixbd3tjto7omse4n5gq

Biochemical phosphates observed using hyperpolarized 31P in physiological aqueous solutions

Atara Nardi-Schreiber, Ayelet Gamliel, Talia Harris, Gal Sapir, Jacob Sosna, J. Moshe Gomori, Rachel Katz-Brull
2017 Nature Communications  
The dissolution-dynamic nuclear polarization technology had previously enabled nuclear magnetic resonance detection of various nuclei in a hyperpolarized state. Here, we show the hyperpolarization of 31 P nuclei in important biological phosphates (inorganic phosphate and phosphocreatine) in aqueous solutions. The hyperpolarized inorganic phosphate showed an enhancement factor >11,000 (at 5.8 T, 9.3% polarization) in D 2 O (T 1 29.4 s). Deuteration and the solution composition and pH all
more » ... the lifetime of the hyperpolarized state. This capability opens up avenues for real-time monitoring of phosphate metabolism, distribution, and pH sensing in the live body without ionizing radiation. Immediate changes in the microenvironment pH have been detected here in a cell-free system via the chemical shift of hyperpolarized inorganic phosphate. Because the 31 P nucleus is 100% naturally abundant, future studies on hyperpolarized phosphates will not require expensive isotope labeling as is usually required for hyperpolarization of other substrates.
doi:10.1038/s41467-017-00364-3 pmid:28839124 pmcid:PMC5570947 fatcat:v5i4n6pdwrerjdvcvuavh2ejki

The Occurrence, Recrudescence, and Worsening of Asthma in a Population of Young Adults

Ido Katz, Shlomo Moshe, Jacob Sosna, Gerald L. Baum, Gershon Fink, Joshua Shemer
1999 Chest  
Objective: To describe the rates of exacerbation of existing asthma and incidence of new disease in Israeli men during military service. Design: All 17-year-old Israeli nationals are obliged by law to appear at the Israel Defense Forces (IDF) recruiting office for medical examination. The medical history of army recruits was noted during the 30-month period after their induction into the IDF, and medical examinations were performed by pulmonary specialists in all suspected cases of asthma. The
more » ... uty status of the soldiers in combat units (CUs), maintenance units (MUs), and clerical tasks was related to their asthma status. Results: Of a total of 59,058 recruits, 1.0% developed asthma during the 30 months of this study; of those in CUs, 1.2% developed asthma; of those in MUs, 0.8% developed asthma; and of those performing clerical tasks, 0.6% developed asthma. The relative risk for developing or worsening of asthma was related to both the preexisting asthma status of the recruit and the environment in which he carried out his military service. The annual incidence of occupational-related asthma in MUs was found to be 800/million: five to six times the rates reported elsewhere. Conclusions: Service in CUs was associated with an increased frequency of exacerbation of asthma among recruits with previous disease and with the appearance of disease de novo. "Normal" conscripts with a history of childhood asthma are at a higher risk of developing overt asthma when compared to subjects with no such history. We found a 25% relative excess of incident cases of asthma in soldiers posted in MUs compared to those performing clerical tasks [(0.8 to 0.6%)/0.8%]. This difference is probably attributed to the difference in occupational hazards in these categories. Further studies are needed to determine if this represents the elicitation of underlying preexisting airway lability by new work demands or other environmental conditions, or if this represents a new development of airway lability because of specific immune or nonimmune factors. (CHEST 1999; 116:614 -618)
doi:10.1378/chest.116.3.614 pmid:10492261 fatcat:xmdptkg6dfdgfp2l5gcnn6zeei

Strategies for Establishing a Comprehensive Quality and Performance Improvement Program in a Radiology Department

Jonathan B. Kruskal, Stephan Anderson, Chun S. Yam, Jacob Sosna
2009 Radiographics  
doi:10.1148/rg.292085090 pmid:19168762 fatcat:qs6emknaxvck5l3fi5yntiy6zq

Quality Improvement in Radiology: Basic Principles and Tools Required to Achieve Success

Jonathan B. Kruskal, Ronald Eisenberg, Jacob Sosna, Chun Sham Yam, Joshua D. Kruskal, Phillip M. Boiselle
2011 Radiographics  
All imaging departments are expected to establish and maintain effective quality, safety, and performance improvement programs. Essential components of such programs include adherence to the basic principles of quality management and appropriate utilization of quality tools. The initial step is the gathering of relevant information, followed by the collection and analysis of quality and performance data; analysis and ranking of causes that likely contributed to a process failure, error, or
more » ... se event; and prioritization and local implementation of solutions, with careful monitoring of newly implemented processes and wider dissemination of the tools when a process proves to be successful. Quality improvement requires a careful, dedicated, and continuously planned effort by a number of skilled and committed team members, with the goal being to do the right thing in a timely fashion in every case. This process can be sustained by offering rewards and celebrating successes, with all lessons learned disseminated throughout the department or organization. © RSNA,
doi:10.1148/rg.316115501 pmid:21997978 fatcat:qmbrqfbfffebbmnnww5wsoi3zq

Blind spots at oncological CT: lessons learned from PET/CT

Jacob Sosna, Steven J. Esses, Nikolay Yeframov, Hanna Bernstine, Tamar Sella, Shifra Fraifeld, Jonathan B. Kruskal, David Groshar
2012 Cancer Imaging  
Improved accuracy in oncological computed tomography (CT) could lead to a decrease in morbidity and improved survival for oncology patients. Visualization of metabolic activity using the glucose analogue [ 18 F]fluorodeoxyglucose (FDG) in combination with the high anatomic resolution of CT in an integrated positron emission tomography (PET)/CT examination has the highest sensitivity and specificity for the detection of primary and metastatic lesions. However, PET/CT costs are high and patient
more » ... cess is limited; thus CT remains the primary imaging modality in oncology patients. We have noted that subtle lesions are more easily detected on CT by radiologists with PET/CT experience. We aimed to provide a brief review of the literature with comparisons of multi-detector computed tomography (MDCT) and PET/CT in primary and metastatic disease with an emphasis on findings that may be overlooked on MDCT in cancer of the breast, lung, colon, and ovaries, and in melanoma, as well as thrombosis in oncology patients. We further reviewed our experience for illustrative comparisons of PET/CT and MDCT studies. Experience in interpreting conventional CT scans alongside PET/CT can help the reader develop an appreciation for the subtle appearance of some lesions on CT that might otherwise be missed. This could improve detection rates, reduce errors, and improve patient management.
doi:10.1102/1470-7330.2012.0030 pmid:22935164 pmcid:PMC3458785 fatcat:6un25evkfjf3tdevquvlkdkgba

Differentiation of Heterogeneous Mouse Liver from HCC by Hyperpolarized 13C Magnetic Resonance

Naama Lev-Cohain, Gal Sapir, Sivaranjan Uppala, Atara Nardi-Schreiber, Shraga Goldberg, Yael Adler-Levy, Jacob Sosna, J. Gomori, Rachel Katz-Brull
2021 Sci  
The clinical characterization of small hepatocellular carcinoma (HCC) lesions in the liver and differentiation from heterogeneous inflammatory or fibrotic background is important for early detection and treatment. Metabolic monitoring of hyperpolarized 13C-labeled substrates has been suggested as a new avenue for diagnostic magnetic resonance. The metabolism of hyperpolarized [1-13C]pyruvate was monitored in mouse precision-cut liver slices (PCLS) of aged MDR2-KO mice, which served as a model
more » ... r heterogeneous liver and HCC that develops similarly to the human disease. The relative in-cell activities of lactate dehydrogenase (LDH) to alanine transaminase (ALT) were found to be 0.40 ± 0.06 (n = 3) in healthy livers (from healthy mice), 0.90 ± 0.27 (n = 3) in heterogeneously inflamed liver, and 1.84 ± 0.46 (n = 3) in HCC. Thus, the in-cell LDH/ALT activities ratio was found to correlate with the progression of the disease. The results suggest that the LDH/ALT activities ratio may be useful in the assessment of liver disease. Because the technology used here is translational to both small liver samples that may be obtained from image-guided biopsy (i.e., ex vivo investigation) and to the intact liver (i.e., in a noninvasive MRI scan), these results may provide a path for differentiating heterogeneous liver from HCC in human subjects.
doi:10.3390/sci3010008 fatcat:r2t6dc4urzaxbltnrujtf3u3ru
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