International Conference on Medical Imaging & Diagnosis October 20-21, 2016 Chicago, Illinois, USA

Biography:

Michael L Goris has a Medical degree from the University of Leuven in Belgium and a PhD degree in Medical Physics from UC Berkeley. He has been a Professor in the Stanford Medical School and is Emeritus since 2012 and served as a Chairman for University panel on Radiation safety during 2003-2010. He has more than 120 publications in peer reviewed journals. His research interests are radio-immunotherapy, medical imaging processing and quantification for diagnosis of clinical validations.

Abstract:

When new imaging is introduced in clinical settings, little is known about their potential to improve care. Acceptance is mostly based on how well structures can be seen on the images. True clinical validations are perceived as time expensive and difficult to fund. In this paper we look for alternatives. The defining diagnosis (e.g. by histology, microbiology) is a type of taxonomy, but is that taxonomy related to outcome? The validation of defining diagnostic technique is solipsistic. We will look at: Outcome analysis: Since imaging represents only a few steps in a chain of diagnostic and therapeutic interventions, it is difficult to ascribe the outcome to any specific link. The performance of an imaging test may be excellent, but there may still be adverse outcomes; outcomes evaluations of imaging are rare. Predictive power: A taxonomic exact diagnosis may not be predictive. If the median survival time is n years: 50% percent die earlier, 50% later. Staging refines the prognosis, or the expected response to a particular therapy. Imaging can predict if therapy will fail or succeed. Predicting taxonomy: The most relevant aspect of this approach is that at some point there has to be a defining test. Or that a ground truth is assumed to be known. The major problem is verification bias in the first case. There are ways to overcome is verification bias. Discriminating power: It is the ability to distinguish between closely related populations in all aspects except the actual disease. Equivalence: It is based on the (false) assumption that a gold standard reflects the ground truth. The result is the inability to show diagnostic superiority (no worse than). In conclusion, there are approaches to evaluate diagnostic imaging, which are both valid and not too expensive.

Biography:

Bin Zheng has experience in developing and evaluating computer-aided quantitative medical image analysis schemes for more than 20 years. Currently, his computer-aided diagnosis laboratory is working on the following research areas: (1) Identify quantitative image feature markers and develop machine learning classifiers or statistical models to help predict or assess cancer risk and prognosis (i.e., breast, lung and ovarian cancer); (2) develop interactive CAD schemes and workstation using content-based image retrieval (CBIR) approach to assist radiologists in cancer diagnosis (classify between malignant and benign lesions); (3) develop new electrical impedance spectroscopy (EIS) technology to assist cancer screening (e.g., breast) and/or lesion classification (e.g., thyroid nodules).   

Abstract:

The majority of ovarian cancer cases are diagnosed at late stage and it has the highest mortality rate among gynecologic malignancies. Thus, applying effective chemotherapy is important for reducing patients’ mortality rate. A principle challenge in treating ovarian cancer is that no biomarker exists to date to reliably select treatment options, predict clinical benefit, and determine drug resistance. In our group, we developed and tested several computer-aided detection (CAD) schemes, which aim to more accurately predict response of ovarian cancer patients to chemotherapy at an early stage using CT images acquired either pre-therapy, post-therapy or both. In this presentation, I will discuss 4 recent studies, which include (1) developing a B-spline based deformable image registration scheme to automatically detect more tumors that have significant volume and density changes depicting in pre- and post-therapy CT images, (2) segmenting targeted tumors and quantifying image feature change between the pre- and post-therapy CT images, (3) detecting non-tumor based quantitative image features and (4) testing the feasibility of using tumor image features computed from pre-therapy CT images only to predict progression-free survival (PFS). From our experimental results, we made following observations. First, using CAD schemes, we enabled to detect more clinically-relevant tumors that have impact on PFS. Second, it is feasible to predict PFS of patients who participated in the clinical trials at an early stage (i.e., 6 weeks after starting therapy). Third, quantifying some non-tumor (i.e., adiposity) features can play a useful role to predict patients’ PFS. Last, using tumor features computed from pre-therapy CT images only also provide discriminatory information to predict PFS.

However, using the features difference computed pre- and post-therapy CT still yielded higher prediction accuracy. In conclusion, we demonstrated that applying CAD schemes has potential to assist developing more effective personalized cancer treatment strategy in the future.

Biography:

David A Gutman received his MD/PhD from Emory University, and then completed a Psychiatry residency. He has published over 75 papers, and has a broad range of interests in the digital imaging (radiology and pathology), and clinical informatics. He is currently an Assistant Professor of Neurology, Psychiatry & Biomedical Informatics and is also a staff Physician at the Atlanta, VA. 

Abstract:

The Cancer Genome Atlas (TCGA) is an NCI funded project integrating clinical, histopathological, molecular (mRNA/miRNA, protein, copy number, etc.), and metadata for over 25 different cancer types. The overall goal is to harness large data sets to discover insights in cancer progression. Several recent TCGA studies have illustrated important relationships between morphology observed in whole-slide images, clinical data, and genetic events and therefore the ability to link these data sources over hundreds of patients could potentially lead to a greater insight in cancer progression. However, the integration and visualization is a common challenge in biomedical informatics and better tools are needed to combine the vast and disparate data types. Our group has developed a number of web-based tools to support the federation, visualization, and analysis of both pathology and radiology imaging data. The CDSA houses over 25,000 digital pathology images, as well as integrated tools to view related metadata, as well as for image markup and data analysis. A brief overview of some of the capabilities and data available in this public resource will be discussed. In addition, we will review some of the open-source tools used to power this archive. Finally, some of the science that this technology has enabled will be reviewed.

Biography:

Limin Yang has completed her MD from Peking University Health Science Center, PhD and Post-doctoral training from The University of Texas Health Science Center at San Antonio. She completed her Radiology Residency and Breast Imaging Fellowship from The University of Iowa. She is a Clinical Associate Professor in the Department of Radiology, The University of Iowa and the Medical Director of Breast Imaging at The University of Iowa Hospitals and Clinics. She has published more than 20 papers in reputed journals and has been serving as an Editorial Board Member of Journal of Medical Diagnostic Methods and is reviewer for several reputed journals. 

Abstract:

The purpose of this study is to characterize sternal lesions detected on breast MRI, compare MRI detection of sternal lesions with other imaging modalities (bone scan, PET/CT and chest CT), and ascertain how often patient management is altered by discovery of sternal lesions. Retrospective review of 1143 breast MRIs between 2007 and 2012 identified 17 patients with sternal lesions including 15 patients with newly diagnosed breast cancer and 2 patients with remote history of breast cancer. Tumor size, histopathology, receptor status, nodal and distant metastasis, and images of breast MRI and other modalities were reviewed. Sternal lesions in 9 of the 17 patients were determined to be malignant (metastasis) either by biopsy or presence of widespread metastases. Sternal lesions in 8 of the 17 were benign, confirmed by biopsy or presumed benign as not detected by other modalities. The malignant group had statistically significant larger breast cancer size (malignant: 6.4 cm; benign: 2.3 cm), a higher percentage of diffuse sternal lesions (malignant: 56%; benign: 0%), and more frequently showed rapid initial enhancing (malignant: 100%; benign: 63%) and delayed washout curves (malignant: 67%; benign: 13%). Although not statistically significant, the malignant group had a higher frequency of invasive lobular carcinoma (malignant: 44%; benign: 13%) and more lymph node involvement (malignant: 78%; benign: 50%). Breast MRI detected more sternal lesions than did bone scan, PET/CT and chest CT. Four of the 17 (24%) patients were upgraded to stage 4 due to unsuspected metastatic sternal lesions on breast MRI. In conclusion, breast MRI is more sensitive than other modalities in detecting sternal lesions. Sternal metastases occur more frequently in aggressive breast cancer and exhibit malignant-type dynamics on breast MRI. Detection of unsuspected sternal metastasis alters staging and improves patient management with more appropriate treatment.

Biography:

Tamara Feygin is an Associate Professor of Clinical Radiology in University of Pennsylvania, Perelman School of Medicine, and Staff Neuroradiologist in The Children's Hospital of Philadelphia. She led the development and implementation of magnetic resonance fluoroscopy in clinical practice for assessment of cerebral and spinal CSF flow dynamic in children and fetuses; for assessment of fetal swallowing; for evaluation of phonation in children with velopharyngeal incompetence. She is a dedicated educator and mentor of undergraduate and medical students, radiology residents, and radiology and neuroradiology fellows. She has been invited to present her work nationally and internationally. She is a member of the European Society of Neuroradiology, the Radiological Society of North America, the Society for Pediatric Radiology, and a senior member of the American Society of Neuroradiology.

Abstract:

Dynamic Cine Magnetic Resonance imaging (MR “fluoroscopy”) is a rapidly developing technique, which evolves from research and works in progress into routine imaging sequences. This technique is designed to demonstrate some of the physiologic and pathologic processes of the human body in almost real time. MR “fluoroscopy” offers many advantages over other dynamic imaging modalities (such as x-ray based fluoroscopy, nuclear medicine examinations or ultrasonography) due to its lack of ionized radiation and short acquisition time. These features are particularly important in pediatric and prenatal medicine.  The dynamic sequences are based on fast acquisition and organization of images in a sequential-loop, resulting in an impression of observing a real-time movie. The sequences vary slightly in different manufactures but almost any sequence sensitive to flow may be employed.  They are easily obtainable from a technical standpoint, and are easily tolerated by patients. These dynamic sequences prove to be valuable tools in functional assessment of intracranial/intraspinal CSF flow dynamics, evaluation of effectiveness of endoscopic procedures, esophageal or bowel motility (and almost any other type of dynamic motion in the human body); evaluation of cardiac contractility and blood flow patterns and joint mobility. Dynamic Cine MR Imaging improves our knowledge of fetal physiology, demonstrates functional impairment of fetal fluids flow dynamics; provides clinically significant prognostic information for pre and postnatal planning and contributes in very careful selection of patients eligible for fetal intervention.

Biography:

Dr. Zweit is a professor of Radiology, Radiation Oncology, Molecular Pathology, Biochemistry & Molecular Biology and Chemistry. He is the Director of the Center for Molecular Imaging and a senior member of the Massey Cancer Center at Virginia Commonwealth University Medical Center. He leads an inter-disciplinary and inter-collaborative molecular imaging and nanomedicine research program that emphasizes multi-modality molecular imaging approaches to study biochemical and biological pathways in vivo. Professor Zweit’s research interests include the development of paradigms for molecular imaging and nanotechnology strategies for preclinical and clinical translational research in cancer, neuroscience and immunotherapy   Dr. Zweit is internationally recognized for his work in molecular imaging of cancer drug development, and conducted the “world’s first” Molecular PET Imaging clinical trial of Anti-angiogenic therapy in cancer patients (Journal National Cancer Institute 2002 & 2006). 

Abstract:

Precision medicine is an advanced procedure for disease treatment, prevention, diagnosis and, formulated around each individual’s variability in genes, environment and life style, including nutrition. Precision medicine has made advances in diseases such as cancer, but the ultimate goal is to apply the approach to other diseases. With genomics, proteomics and molecular diagnostics, molecular imaging is well positioned to be a major driver of the precision medicine initiative. As a non-invasive tool, multi-modality molecular imaging excels at revealing quantitative information on the cellular and molecular pathways underpinning diseases on an individualized patient basis. Advancements in molecular imaging also provide new and specific ways to detect disease at early and potentially curable stages of disease. Molecular imaging can also identify which patients are likely to respond to certain therapies, from those less likely to respond. In this paradigm, molecular imaging has a huge role to play in accelerating and advancing the field of precision medicine towards more cost-effective healthcare.  Our multi-modality molecular imaging research addresses targeted imaging of both the tumor and the tumor microenvironment (TME) and its associated stroma. In this context, we are studying mechanisms of therapeutic intervention within a heterogeneous tumor and TME. A theranostic approach to cancer therapy, where live monitoring of treatment, is visualized by molecular PET imaging of anticancer drugs. Such imaging data is used to guide location-dependent proteomic analysis within a heterogeneous tumor volume. This combined approach reveals information on individual drug resistance driven by alterations in the proteome of cancerous legions. The concept of imaging both tumors and the associated immune cell environment will also be highlighted.

Biography:

Manohar Roda is a Board Certified Radiologist currently working as an Assistant Professor- Body Imaging with University of Mississippi Medical Center in Jackson, MS. He has immense expertise in whole body MRI with special interest in body, MSK, cardiac and fetal MRI. He is passionate about evaluation of complex fetal congenital abnormalities on MRI to help clinicians and families in planning further management during these complex situations to improve fetal and maternal well-being. He has interpreted more than 500 cases of fetal MRI while working in University of MS over last five years. He teaches radiology residents, fellows, maternal-fetal medicine fellows, radiology technicians to design protocol, perform and interpret fetal MRI’s with focus on patient safety and diagnostic accuracy. He is one of the key imaging personnel at UMC in carrying forwards the fetal imaging program which is a well-coordinated multi-disciplinary team effort between MFM Department, Neuroradiology, Body Imaging Division and other relevant departments. He has completed Body MRI Fellowship in Radiology Department of Tufts Medical Center at Boston in 2009. He also completed Thoracic Fellowship in Radiology Department of M D Anderson Cancer Center at Houston in 2008. He has completed his Radiology Residency Program in 2002 from Ram Manohar Lohia Hospital, University of Delhi, India.  During his Post-residency Tenure of five years, he worked with the best multimodality radiology centers. He completed his Medical Schooling in 1999 form Maulana Azad Medical College, University of Delhi, India.

Abstract:

USG is the primary technique for fetal imaging due to its proven utility, availability and low cost. Technical and therapeutic advances have driven the development of fetal MRI which now plays an increasingly important role in the evaluation of sonographically complex or occult anomalies of the fetal body. MRI during pregnancy was initially being used for maternal and placental abnormalities. Modern fetal MRI began with the availability of   T2W- ultrafast sequences which provides an excellent contrast declination between the fluid (CSF) and tissues (developing brain). Fetal MRI was initially primarily utilized for evaluation of the fetal brain-neurological abnormalities. Development of more ultrafast breath hold sequences like T1, diffusion, echo planar, led to the MRI evaluation of the fetal organs. Continued progressive works of various  groups has added signifcantly to the further development of this technique. Fetal MRI now offers an unrivaled method for advanced detailed anatomic imaging with a high degree of flexibility in the image contrasts. All the fetal cavities are fluid filled and appear T1 hypointense, T2 hyperintense; mouth, nose, ear, GI tract including stomach, kidneys, UB, GB, trachea, lungs, ventricles, CSF spaces and amniotic cavity. The bowel meconium, pituitary, thyroid and liver appears T1 hyperintense. Robust use of bright blood imaging and dark blood imaging sequences also helps in fast imaging as vessels and heart can appear bright/dark based on different imaging sequences. Fast MRI sequences have overcome fetal motion, hence scanning with adequate slice thickness, resolution, quality and SNR is now feasible. Parallel imaging is a general method for reducing the time of data processing required to produce images by simultaneous data collection on multiple separate channels with total imaging time ~30-45 minutes. Standard MRI screening and consent is obtained and scan is performed without any IV contrast administered. Main fetal safety concerns are first trimester teratogenesis and acoustic damage. Although safety has not been positively established, hazards appear negligible and outweighed by diagnostic benefit. Hence, pregnant women in the second and third trimester can be reassured that MRI poses no known risk to the fetus. My presentation will elaborate on common indications, ultrafast MRI technique, normal fetal anatomy and major congenital anomalies. All radiologists involved in prenatal imaging should be aware of the applications, safety concerns and limitations of this evolving modality.

Biography:

Daniel Pastore has completed his PhD from University of Sao Paulo, SP, Brazil in 2009 and research fellow in Musculoskeletal Imaging, Department of Radiology from University of California, San Diego, USA in 2007. He is a member of the Radiology Society of North America (RSNA), Musculoskeletal Radiologist at University of Sao Paulo and Fleury Medicine and Health. He has published as author and co-author in reputed journals and has been serving as a reviewer for Skeletal Radiology and American Journal of Roentgenology. 

Abstract:

Anterior cruciate ligament (ACL) lesion is the most frequently observed lesion among athletes. Cruciate ligaments are the center of knee kinematics and responsible for the primary restraints to anterior and posterior stability of the knee. These ligaments also maintain articular bone surfaces in contact and are capable to resist multiple combined forces and movements. One third of the cases in patients with ACL lesions will present osteoarthrosis in the future. Thus, it is extremely necessary to develop a more individualized treatment, considering some variables related to surgical intervention, such as ligament rupture grade, meniscal tears and lifestyle. The objective of this study is to demonstrate ligament anatomy, surgical principles and graft classification (structure constitution, fixation method and rehabilitation). It is also our aim to discuss imaging methods (radiographic studies, magnetic resonance, CT-arthrography and MR-arthrography) by illustrating clinical cases and post surgical complications. A correct interpretation of imaging aspects along with clinical evaluation are keys to a successful treatment. 

Biography:

Sanjay Gandhi is a Senior Attending Radiologist at one of the largest teaching hospitals and Regional Trauma Units in the UK. For the past 17 years, he has been teaching at the University of Bristol and University of West of England. As a Professor, he also teaches at Sri Devaraj Urs University, India. He has won multiple academic awards and has been involved in numerous research projects and collaborative trials. He has published widely on use of cutting-edge technology and co-authored and edited eight medical textbooks. He is an internationally recognized leader in Healthcare IT and development of Smart Apps.

Abstract:

The focus of the talk would be to develop a greater understanding of benign and malignant splenic pathologies and increase confidence in dealing with lesions encountered in everyday practice. This presentation will be on a practical approach to focal and diffuse splenic pathologies, normal imaging appearances and clinically important variants, congenital anomalies such as cardiosplenic syndromes. Imaging features of common and some rare lesions including benign and malignant neoplasms such as hemangioma, hamartoma, lymphoma and infections and infarction will be discussed. Different imaging modalities including ultrasound, CT, MRI, nuclear medicine (Technetium sulfur colloid) and PET will be included along with the relative merits and limitations of each technique. A practical approach to splenic calcification, and solitary and multiple focal cystic and solid lesions will be discussed. 

Biography:

Mafalda Gomes has completed her degree in Basic Health Sciences in the Faculty of Medicine at the University of Porto, the best medical school in Portugal, in 2012. She is engaged in one of the biggest hospitals in the country and gained clinical experience in Hospital S Joao, with internships in Hospital Pedro Hispano and Povoa de Varzim-Vila do Conde Hospital Center. In 2015, she finished her Master’s degree in Medicine in the same Faculty of Medicine. Her thesis was recently published in an international journal with an impact factor of 1.6.

Abstract:

The use of radiation in diagnostic exams during pregnancy raises a lot of questions among clinicians and patients. Being a matter of great impact in our clinical practice, in this review we task the risks of radiation to the fetus, the doses in which this occurs, the most sensitive periods for radiation exposure and how should a medical professional behave in this situation. Between the 8^th and 15^th weeks of gestation there is a higher risk for most deleterious effects. The deterministic effects require a dose above 100-200 mGy in order to occur, being the risk consider negligible at 50 mGy. It is important to highlight that no diagnostic exam exceeds this dose. However, measures to diminish dosage should be kept and nonionizing measuresought to be preferred whenever possible. Every radiology center should have its own data onfetal radiation exposure. This systematic review poses as a guideline for every doctor dealing with possibly pregnant patients that require a diagnostic exam with radiation.