Displaying publications 1 - 20 of 35 in total

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  1. Bicchierai G, Nori J, De Benedetto D, Boeri C, Vanzi E, Bianchi S, et al.
    Tumori, 2019 Oct;105(5):378-387.
    PMID: 30558495 DOI: 10.1177/0300891618816212
    PURPOSE: To evaluate the role of contrast-enhanced spectral mammography (CESM) in the post biopsy management of breast lesions classified as lesions of uncertain malignant potential (B3) by core needle biopsy and vacuum-assisted biopsy (VAB).

    METHODS: The local ethics committee approved this retrospective study and for this type of study formal consent is not required. A total of 42 B3 lesions in 40 women aged 41-77 years were included in our study. All patients underwent CESM 2-3 weeks after the biopsy procedure and surgical excision was subsequently performed within 60 days of the CESM procedure. Three radiologists reviewed the images independently. The results were then compared with histologic findings.

    RESULTS: The sensitivity, specificity, and positive and negative predictive values for confirmed demonstration of malignancy at CESM were 33.3%, 87.2%, 16.7%, and 94.4% for reader 1; 66.7%, 76.9%, 18.2%, and 96.7% for reader 2; 66.7%, 74.4%, 16.7%, and 96.7% for reader 3. Overall agreement on detection of malignant lesions using CESM among readers ranged from moderate to substantial (κ = .451-.696), for categorization of BPE from moderate to substantial (κ = .562-.711), and for evaluation of lesion intensity enhancement from fair to moderate (κ = .346-.459).

    CONCLUSION: In cases of Breast Imaging Reporting and Data System (BI-RADS) 1, BI-RADS 2, or BI-RADS 3 results at CESM, follow-up or VAB rather than surgical biopsy might be performed.

    Matched MeSH terms: Radiologists
  2. Bohari A, Hashim S, Ghoshal SK, Mohd Mustafa SN
    Radiat Prot Dosimetry, 2019 Dec 31;186(4):462-468.
    PMID: 31329977 DOI: 10.1093/rpd/ncz051
    Long exposure to radiation from fluoroscopy-guided interventions (FGIs) can be detrimental to both patients and radiologists. The effective doses received by the interventional radiology staff after performing 230 FGIs in a year were assessed by using double dosimetry and five various algorithms. The Shapiro-Wilk test revealed normally-distributed data (p < 0.01), while the significant correlation coefficients between the effective doses ranged between 0.88 and 1.00. As for the Bland-Altman analysis, both Niklason and Boetticher algorithms strongly supported the absence of statistical significance between the estimated effective doses. This portrays that the occupational doses received by the interventional radiology staff during FGIs fall within the acceptable limit regardless of the varied algorithms applied. In short, the Niklason and Boetticher algorithms appeared to be the more interchangeable ones for effective evaluation of doses. This is in view of their strong mutual correlations and excellent agreement.
    Matched MeSH terms: Radiologists
  3. Che Jalil NA, Rama Chandran P, Samsudin AHZ, Yahya MM, Wan Abdul Rahman WF
    Malays J Pathol, 2021 Apr;43(1):69-73.
    PMID: 33903308
    Cancer metastasis to the thyroid gland from non-thyroid sites is a rare presentation in clinical practice. The most frequent primary cancers that metastasise to the thyroid are renal cell carcinoma, followed by colorectal, lung and breast. We report a case of a 64-year-old Malay lady who presented with anterior neck swelling 4 years after an initial diagnosis of uterine leiomyosarcoma. She had undergone a hysterectomy procedure four years ago. Fine needle aspiration cytology of the thyroid mass suggested undifferentiated thyroid carcinoma. After multi-disciplinary discussion, the patient underwent thyroidectomy and the final histopathological diagnosis was metastatic leiomyosarcoma of the thyroid. The diagnosis was aided by an immunohistochemistry panel of positive myogenic markers, negative epithelial markers as well as the previous medical history of uterine leiomyosarcoma. Metastatic leiomyosarcoma of the thyroid may mimic primary undifferentiated (anaplastic) thyroid carcinoma (UTC) with a sarcomatoid pattern, medullary thyroid carcinoma (MTC) with spindle cells morphology and spindle cell tumour with thymus-like differentiation (SETTLE). Hence, a multidisciplinary approach must be practised by pathologists, surgeons and radiologists to consider metastatic lesions of the thyroid gland, especially when a previous history of cancer exists or is suspected.
    Matched MeSH terms: Radiologists
  4. Che Mohamed SK, Abd Aziz A
    Malays J Med Sci, 2009 Oct;16(4):69-72.
    PMID: 22135515 MyJurnal
    When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury.
    Matched MeSH terms: Radiologists
  5. Chuah JS, Wong WL, Bakin S, Lim RZM, Lee EP, Tan JH
    Ann Med Surg (Lond), 2021 May;65:102294.
    PMID: 33948169 DOI: 10.1016/j.amsu.2021.102294
    Introduction and importance: A totally implantable venous access device (TIVAD), also referred to as 'chemoport', is frequently used for oncology patients. Chemoport insertion via the subclavian vein access may compress the catheter between the first rib and the clavicle, resulting in pinch-off syndrome (POS). The sequela includes catheter transection and subsequent embolization. It is a rare complication with incidence reported to be 1.1-5.0% and can lead to a devastating outcomes.

    Case presentation: 50-year-old male had his chemoport inserted for adjuvant chemotherapy 3 years ago. During the removal, remaining half of the distal catheter was not found. There was no difficulties during the removal. Chest xray revealed that the fractured catheter had embolized to the right ventricle. Further history taking, he did experienced occasional palpitation and chest discomfort for the past six months. Electrocardiogram and cardiac enzymes were normal. Urgent removal of the fractured catheter via the percutaneous endovascular approach, under fluoroscopic guidance by an experience interventional radiologist was done. The procedure was successful without any complication. Patient made an uneventful recovery. He was discharged the following day, and was well during his 3rd month follow up.

    Conclusion: Early detection and preventive measures can be done to prevent pinch-off syndrome. Unrecognized POS can result in fatal complications such as cardiac arrhythmia and septic embolization. Retrieval via the percutaneous endovascular approach provide excellent outcome in the case of embolized fractured catheter.

    Matched MeSH terms: Radiologists
  6. Gupta H, Batta NS, Kataria H, Batra V, Upadhyay AD, Jain V, et al.
    Malays Orthop J, 2020 Mar;14(1):34-41.
    PMID: 32296480 DOI: 10.5704/MOJ.2003.006
    Introduction: An increased tibial tuberosity-trochlear groove (TTTG) distance is used for deciding a treatment plan in patello-femoral instability (PFI). The centre of the patellar tendon and the chondral trochlear groove can be directly visualised on MRI, and measured, giving the patellar tendon-trochlear groove (PTTG) distance. A study was designed to compare the inter-rater and the test-retest reliabilities of PTTG and TTTG measurements in MRI of patients without PFI and in a group with PFI.

    Materials and Methods: This cross-sectional reliability study was done on archival MRI films of 50 patients without patellar instability and 20 patients with patellar instability. TTTG and PTTG distances were independently measured by two orthopaedic surgeons and two radiologists. A hybrid PTTG measurement with bony landmarks on the femoral side and the patellar tendon landmark on the tibial side, was used to estimate the influence of the differences in the femoral and tibial landmarks on the difference in reliabilities. The intra-class correlation coefficient (ICC) was calculated for all four raters, as well as separately for each rater.

    Results: The PTTG distance had a higher inter-rater reliability (ICC=0.86, 95% CI=0.79-0.92) compared to the TTTG distance (ICC=0.70, 95% CI=0.59-0.80) in patients without PFI. Similar trends were seen in patients with PFI (0.83 vs 0.66). The inter-rater reliability for the hybrid PTTG distance was found to lie in between the TTTG and PTTG.

    Conclusions: The MRI-based PTTG distance had better inter-rater reliability compared with the MRI-based TTTG distance.

    Matched MeSH terms: Radiologists
  7. Halmi Shamsudin, Norman Nordin, Sa’don Samian, Hafiz Salahudin, Azrul, A.B., Nik Azuan, N.I., et al.
    Jurnal Inovasi Malaysia, 2018;2(1):31-50.
    MyJurnal
    Angiography procedures is one of the diagnostic imaging procedures for studying blood vessels in the arteries and veins. This angiography examination is performed by injecting a viscous liquid called contrast media into the blood vessels to clearly identify the blocked blood vessels. This procedure involves the exposure of X-Ray in certain blood vessels and is performed by the Interventionist Radiologist. There are several types of angiography examinations which include cerebral angiography, coronary angiography, pulmonary angiography, peripheral angiography and renal angiography. The main problem that occurs during the Lower Limb Angiography examination involving elderly patients aged 60 years and above who suffer from critical diabetes stage in both blood vessels. The problem arise when there is no special immobilize device to support the foot and the patients were in an uncomfortable state for a period of 2-3 hours during the examination. Hence specialists had difficulty to interpret accurately the blood vessel clot in the foot due to less optimum radiograph. IMMOLIMBTM is an innovative invention created from used waste to overcome the foot movements, providing comfort and enhancing optimum diagnostic images.
    Matched MeSH terms: Radiologists
  8. Hashim H, Muda AS, Abdul Aziz A, Abdul Hamid Z
    Malays J Med Sci, 2016 Jul;23(4):59-64.
    PMID: 27660546 MyJurnal DOI: 10.21315/mjms2016.23.4.8
    Embolisation has long been used as an adjunct to surgical resection in the treatment of brain arteriovenous malformation (bAVM). The most commonly used embolic material, n-butylcyanoacrylate glue, requires experience and skill to handle its quick and unpredictable flow and polymerisation. A new liquid embolic agent, ethylene vinyl alcohol copolymer (Onyx), is less adhesive and polymerises slowly, which provides better control for radiologists performing embolisation.
    Matched MeSH terms: Radiologists
  9. Hassan R, Abd Aziz A
    Malays J Med Sci, 2010 Apr;17(2):29-39.
    PMID: 22135535 MyJurnal
    Blunt abdominal trauma can cause multiple internal injuries. However, these injuries are often difficult to accurately evaluate, particularly in the presence of more obvious external injuries. Computed tomography (CT) imaging is currently used to assess clinically stable patients with blunt abdominal trauma. CT can provide a rapid and accurate appraisal of the abdominal viscera, retroperitoneum and abdominal wall, as well as a limited assessment of the lower thoracic region and bony pelvis. This paper presents examples of various injuries in trauma patients depicted in abdominal CT images. We hope these images provide a resource for radiologists, surgeons and medical officers, as well as a learning tool for medical students.
    Matched MeSH terms: Radiologists
  10. Hassan R, Abd Aziz A, Md Ralib AR, Saat A
    Malays J Med Sci, 2011 Jan;18(1):60-7.
    PMID: 22135575 MyJurnal
    The spleen is one of the organs most frequently injured in blunt abdominal trauma. Computed tomography (CT) scanning can accurately detect splenic injury and is currently the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. The CT features of spleen injury include lacerations, subcapsular or parenchymal haematomas, active haemorrhage, and vascular injuries. We present a pictorial review of the spectrum of CT findings for blunt splenic injuries. This article will be a useful reference for radiologists and surgeons as CT scan is widely used for the assessment of splenic injuries and contributes to the current trend towards nonsurgical management of this injury.
    Matched MeSH terms: Radiologists
  11. Hassan R, Aziz AA, Mohamed SK
    Malays J Med Sci, 2011 Oct;18(4):84-7.
    PMID: 22589677
    Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.
    Matched MeSH terms: Radiologists
  12. Hussain IZ, Mohd Zaki F, Mukari SA, Md Pauzi SH, Loh CK, Alias H
    Indian J Radiol Imaging, 2020 03 30;30(1):46-51.
    PMID: 32476749 DOI: 10.4103/ijri.IJRI_209_19
    Objectives: The objective of this study is to describe the imaging features of medulloblastoma (MB) and correlate the MR characteristics with the different histological subtype of MB with 2-year survival.

    Materials and Methods: This is a retrospective descriptive study. A total of 29 patients diagnosed with MB from January 2005 to December 2015 were included in this study. The MRI brain and spine studies of these patients were retrieved and reviewed by a pediatric radiologist and a neuroradiologist independently, both blinded from the histological type of the MB. The HPE slides were also retrieved and reviewed by a pathologist.

    Results: 80% of desmoplastic MB showed the presence of intracranial leptomeningeal seeding and 57.1% of anaplastic MB showed the presence of necrosis. The presence of intracranial leptomeningeal seeding (P = 0.002) and necrosis (P = 0.019) was predictive of the histological subtypes. There is a significant correlation between the enhancement pattern and the 2-year outcome (P = 0.03) with 6 out of 8 patients whose tumors showed minimal enhancement having disease progression within 2 years. A significant correlation was also seen between the presence of necrosis with a poorer outcome (P = 0.03) and between the HPE subtype and 2-year outcome (P = 0.03) with anaplastic MB having the poorest prognosis.

    Conclusion: MR imaging features of intracranial leptomeningeal seeding and the presence of necrosis were correlated with a specific histologic subtype of MB. The enhancement pattern as well as necrosis correlated with 2-year poorer outcome of the disease.

    Matched MeSH terms: Radiologists
  13. Jalalian A, Mashohor S, Mahmud R, Karasfi B, Saripan MIB, Ramli ARB
    EXCLI J, 2017;16:113-137.
    PMID: 28435432 DOI: 10.17179/excli2016-701
    Breast cancer is the most prevalent cancer that affects women all over the world. Early detection and treatment of breast cancer could decline the mortality rate. Some issues such as technical reasons, which related to imaging quality and human error, increase misdiagnosis of breast cancer by radiologists. Computer-aided detection systems (CADs) are developed to overcome these restrictions and have been studied in many imaging modalities for breast cancer detection in recent years. The CAD systems improve radiologists' performance in finding and discriminating between the normal and abnormal tissues. These procedures are performed only as a double reader but the absolute decisions are still made by the radiologist. In this study, the recent CAD systems for breast cancer detection on different modalities such as mammography, ultrasound, MRI, and biopsy histopathological images are introduced. The foundation of CAD systems generally consist of four stages: Pre-processing, Segmentation, Feature extraction, and Classification. The approaches which applied to design different stages of CAD system are summarised. Advantages and disadvantages of different segmentation, feature extraction and classification techniques are listed. In addition, the impact of imbalanced datasets in classification outcomes and appropriate methods to solve these issues are discussed. As well as, performance evaluation metrics for various stages of breast cancer detection CAD systems are reviewed.
    Matched MeSH terms: Radiologists
  14. Letchumanan M, Anour AA, Ganapathy SS, Harry S, Nik Lah NSH, Arsad N, et al.
    Med J Malaysia, 2021 03;76(2):131-137.
    PMID: 33742618
    OBJECTIVES: To recognize the radiographic patterns of coronavirus disease 2019 (COVID-19) in Malaysia.

    MATERIALS AND METHODS: Chest radiographs of patients confirmed with COVID-19 in Hospital Tawau, Sabah, Malaysia were retrospectively analyzed by two radiologists. The radiographic pattern, distribution among subgroups and evolution of the disease over time were determined.

    RESULTS: Among the 82 patients studied, 65 (79.3%) were males. Mean age of our cohorts was 37 ± 15 years. Baseline chest radiographs were abnormal in 37 patients (45.1%). Over half (52.9%) of the symptomatic patients had abnormal baseline radiograph. Among the children, patients with comorbidities, and patients 60 years of age and above, the abnormal radiographs were 14.3%, 71.4% and 69.3% respectively. Ground glass opacities were the commonest abnormal radiographic feature (35.4%), were peripherally located (35.4%) with predilection for the lower zones (29.3%). Most radiographic abnormalities were multifocal (20.7%) and frequently located in the left lung (19.5%). Radiographic recovery was observed in 15 of 18 patients (83%). Computed tomography (CT) scan demonstrated greater extent of the disease than observed in radiographs of the same patient.

    CONCLUSIONS: COVID-19 pneumonia presented with a specific radiographic pattern in our cohort of patients, comprising of ground glass opacities in peripheral and basilar distribution, affecting a single lung field and was observed in both symptomatic and asymptomatic patients. Chest radiograph is a useful adjunct screening tool, and in combination with clinical and epidemiological assessment may facilitate in early diagnosis of COVID-19 pneumonia.

    Matched MeSH terms: Radiologists
  15. Md Ralib AR, Han NT, Hin HS, Muda AS
    Malays J Med Sci, 2010 Jul;17(3):55-60.
    PMID: 22135550 MyJurnal
    Massive haemoptysis is the most dreaded of all respiratory emergencies. Bronchial artery embolisation is known to be a safe and effective procedure in massive haemoptysis. Bronchial artery of anomalous origin presents a diagnostic challenge to interventional radiologists searching for the source of haemorrhage. Here, we report a case of massive haemoptysis secondary to a lung carcinoma with the bronchial artery originating directly from the right subclavian artery. This artery was not evident during the initial flush thoracic aortogram. The anomalous-origin bronchial artery was then embolised using 15% diluted glue with good results. An anomalous-origin bronchial artery should be suspected if the source of haemorrhage is not visualised in the normally expected bronchial artery location.
    Matched MeSH terms: Radiologists
  16. Moghbel M, Mashohor S, Mahmud R, Saripan MI
    EXCLI J, 2016;15:406-23.
    PMID: 27540353 DOI: 10.17179/excli2016-402
    Segmentation of liver tumors from Computed Tomography (CT) and tumor burden analysis play an important role in the choice of therapeutic strategies for liver diseases and treatment monitoring. In this paper, a new segmentation method for liver tumors from contrast-enhanced CT imaging is proposed. As manual segmentation of tumors for liver treatment planning is both labor intensive and time-consuming, a highly accurate automatic tumor segmentation is desired. The proposed framework is fully automatic requiring no user interaction. The proposed segmentation evaluated on real-world clinical data from patients is based on a hybrid method integrating cuckoo optimization and fuzzy c-means algorithm with random walkers algorithm. The accuracy of the proposed method was validated using a clinical liver dataset containing one of the highest numbers of tumors utilized for liver tumor segmentation containing 127 tumors in total with further validation of the results by a consultant radiologist. The proposed method was able to achieve one of the highest accuracies reported in the literature for liver tumor segmentation compared to other segmentation methods with a mean overlap error of 22.78 % and dice similarity coefficient of 0.75 in 3Dircadb dataset and a mean overlap error of 15.61 % and dice similarity coefficient of 0.81 in MIDAS dataset. The proposed method was able to outperform most other tumor segmentation methods reported in the literature while representing an overlap error improvement of 6 % compared to one of the best performing automatic methods in the literature. The proposed framework was able to provide consistently accurate results considering the number of tumors and the variations in tumor contrast enhancements and tumor appearances while the tumor burden was estimated with a mean error of 0.84 % in 3Dircadb dataset.
    Matched MeSH terms: Radiologists
  17. Mohd Norsuddin N, Mello-Thoms C, Reed W, Lewis S
    Asian Pac J Cancer Prev, 2019 Feb 26;20(2):537-543.
    PMID: 30803217
    Rationale and objectives: Target recall rates are often used as a performance indicator in mammography screening
    programs with the intention of reducing false positive decisions, over diagnosis and anxiety for participants. However,
    the relationship between target recall rates and cancer detection is unclear, especially when readers are directed to
    adhere to a predetermined rate. The purpose of this study was to explore the effect of setting different recall rates on
    radiologist’s performance. Materials and Methods: Institutional ethics approval was granted and informed consent
    was obtained from each participating radiologist. Five experienced breast imaging radiologists read a single test set
    of 200 mammographic cases (20 abnormal and 180 normal). The radiologists were asked to identify each case that
    they required to be recalled in three different recall conditions; free recall, 15% and 10% and mark the location of any
    suspicious lesions. Results: Wide variability in recall rates was observed when reading at free recall, ranging from
    18.5% to 34.0%. Readers demonstrated significantly reduced performance when reading at prescribed recall rates,
    with lower sensitivity (H=12.891, P=0.002), case location sensitivity (H=12.512, P=0.002) and ROC AUC (H=11.601,
    P=0.003) albeit with an increased specificity (H=12.704, P=0.002). However, no significant changes were evident in
    lesion location sensitivity (H=1.982, P=0.371) and JAFROC FOM (H=1.820, P=0.403). Conclusion: In this laboratory
    study, reducing the number of recalled cases to 10% significantly reduced radiologists’ performance with lower detection
    sensitivity, although a significant improvement in specificity was observed.
    Matched MeSH terms: Radiologists/standards*
  18. Nayak SB, Kodimajalu Vasudeva S
    Heliyon, 2020 Sep;6(9):e05014.
    PMID: 32995649 DOI: 10.1016/j.heliyon.2020.e05014
    Testicular veins are known to show many variations in their origin, course and termination. Some of their variations can lead to male sterility. We report a unique variation of right testicular vein here. Pampiniform plexus reduced to three testicular veins (medial, middle and lateral) at the deep inguinal ring on the right side. The medial vein terminated into the right renal vein, the middle vein terminated into the inferior vena cava above the level of right renal vein (close to the suprarenal gland) and the lateral vein terminated partly into the veins in the capsules of the kidney and partly into the veins under the diaphragm. The medial and middle testicular veins were connected through an oblique communicating vein. The middle and lateral testicular veins were also connected to each other through another oblique communicating vein. Knowledge of this case could be useful to radiologists, nephrologists and surgeons in general.
    Matched MeSH terms: Radiologists
  19. Nayak SB, Shetty SD, Packirisamy V, Vasudeva SK
    Morphologie, 2021 May 05.
    PMID: 33965324 DOI: 10.1016/j.morpho.2021.04.003
    Jejunum is drained into superior mesenteric vein through a series of jejunal veins. The way in which the first jejunal vein terminates is of great importance in upper abdominal surgery and radiological procedures. Knowledge of its variations is particularly important in surgical procedures like orthotropic hepatic transplantation, hepatic vein reconstruction, pancreatic surgery and surgical procedures of duodenojejunal junction. We saw a first jejunal vein opening directly into the portal vein. Further, the inferior mesenteric vein drained into the first jejunal vein. This case could be useful to gastroenterologists, general surgeons and radiologists.
    Matched MeSH terms: Radiologists
  20. Nayak SB, Soumya KV
    Anat Cell Biol, 2020 Mar;53(1):114-116.
    PMID: 32274257 DOI: 10.5115/acb.19.186
    Nerve to mylohyoid is a branch of inferior alveolar nerve. It arises in the infratemporal fossa and runs in the mylohyoid groove of mandible to reach the submandibular region, where it supplies the anterior belly of digastric and mylohyoid muscles. Though sensory distribution of this nerve have been described, it is predominantly a motor nerve. Here, a rare intra-mandibular origin of nerve to mylohyoid has been presented. This nerve arose from the inferior alveolar nerve inside the mandible and came out to the submandibular region by passing through a small foramen present on the medial surface of the body of the mandible. It ended by supplying the anterior belly of digastric and mylohyoid muscles. The knowledge of this variation could be of importance to maxillofacial surgeons and radiologists.
    Matched MeSH terms: Radiologists
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