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At least 163 records · Page 9

Imaging the Breast in Pregnant or Lactating Women

Purpose of Review: To describe the imaging evaluation of common benign and malignant breast lesions encountered in pregnant or lactating women. Recent Findings: There is increasing prevalence of pregnancy-associated breast cancer as the age of women during pregnancy increases. Women in the first 10 years following pregnancy demonstrate an elevated risk for breast cancer compared to the average population. MRI has been shown to be more sensitive for evaluating the extent of disease in lactating patients than mammography or ultrasound. Summary: The hormonal effects of pregnancy and lactation on the breast lead to distinct physiologic changes and pathologic lesions, which can manifest in unique imaging appearances. Most patients will undergo ultrasound for primary diagnostic evaluation. While mammography is not routinely utilized, it is not contraindicated even in pregnancy given the negligible radiation dose to the fetus. While most detected lesions are benign, pregnancy-associated breast cancer (PABC) is a rare diagnosis that must always be excluded. Women with PABC have a worse prognosis than age-matched controls partly due to delay in diagnosis. Thus prompt and accurate work-up of PABC is critical to improve outcomes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-F-E-01: Pitfalls: Reliability and Performance of Diagnostic X-Sources

Purpose: Performance and reliability of medical X-ray tubes for imaging are crucial from an ethical, clinical and economic perspective. This lecture will deliver insight into the aspects to consider during the decision making process to invest in X-ray imaging equipment. Outdated metric still hampers realistic product comparison. It is time to change this and to comply with latest standards, which consider current technology. Failure modes and ways to avoid down-time of the equipment shall be discussed. In view of the increasing number of interventional procedures and the hazards associated with ionizing radiation, toxic contrast agents, and the combination thereof, the aspect of system reliability is of paramount importance. Methods: A comprehensive picture of trends for different modalities (CT, angiography, general radiology) has been drawn and led to the development of novel X-ray tube technology. Results: Recent X-ray tubes feature enhanced reliability and unprecedented performance. Relevant metrics for product comparison still have to be implemented in practice. Conclusion: The speed of scientific and industrial development of new diagnostic and therapeutic X-ray sources remains tremendous. Still, users suffer from gaps between desire and reality in day-to-day diagnostic routine. X-ray sources are still limiting cutting-edge medical procedures. Side-effects of wear and tear, limitations of the clinical work flow, costs, the characteristics of the X-ray spectrum and others topics need to be further addressed. New applications and modalities, like detection-based color-resolved X-ray and phase-contrast / dark-field imaging will impact the course of new developments of X-ray sources. The author is employee of Royal Philips.

60 APPLIED LIFE SCIENCES↗

WE-G-209-01: Digital Radiography

Digital radiography, CT, PET, and MR are complicated imaging modalities which are composed of many hardware and software components. These components work together in a highly coordinated chain of events with the intent to produce high quality images. Acquisition, processing and reconstruction of data must occur in a precise way for optimum image quality to be achieved. Any error or unexpected event in the entire process can produce unwanted pixel intensities in the final images which may contribute to visible image artifacts. The diagnostic imaging physicist is uniquely qualified to investigate and contribute to resolution of image artifacts. This course will teach the participant to identify common artifacts found clinically in digital radiography, CT, PET, and MR, to determine the causes of artifacts, and to make recommendations for how to resolve artifacts. Learning Objectives: Identify common artifacts found clinically in digital radiography, CT, PET and MR. Determine causes of various clinical artifacts from digital radiography, CT, PET and MR. Describe how to resolve various clinical artifacts from digital radiography, CT, PET and MR.

60 APPLIED LIFE SCIENCES↗

WE-G-209-02: CT

Digital radiography, CT, PET, and MR are complicated imaging modalities which are composed of many hardware and software components. These components work together in a highly coordinated chain of events with the intent to produce high quality images. Acquisition, processing and reconstruction of data must occur in a precise way for optimum image quality to be achieved. Any error or unexpected event in the entire process can produce unwanted pixel intensities in the final images which may contribute to visible image artifacts. The diagnostic imaging physicist is uniquely qualified to investigate and contribute to resolution of image artifacts. This course will teach the participant to identify common artifacts found clinically in digital radiography, CT, PET, and MR, to determine the causes of artifacts, and to make recommendations for how to resolve artifacts. Learning Objectives: Identify common artifacts found clinically in digital radiography, CT, PET and MR. Determine causes of various clinical artifacts from digital radiography, CT, PET and MR. Describe how to resolve various clinical artifacts from digital radiography, CT, PET and MR.

60 APPLIED LIFE SCIENCES↗

WE-G-209-03: PET

Digital radiography, CT, PET, and MR are complicated imaging modalities which are composed of many hardware and software components. These components work together in a highly coordinated chain of events with the intent to produce high quality images. Acquisition, processing and reconstruction of data must occur in a precise way for optimum image quality to be achieved. Any error or unexpected event in the entire process can produce unwanted pixel intensities in the final images which may contribute to visible image artifacts. The diagnostic imaging physicist is uniquely qualified to investigate and contribute to resolution of image artifacts. This course will teach the participant to identify common artifacts found clinically in digital radiography, CT, PET, and MR, to determine the causes of artifacts, and to make recommendations for how to resolve artifacts. Learning Objectives: Identify common artifacts found clinically in digital radiography, CT, PET and MR. Determine causes of various clinical artifacts from digital radiography, CT, PET and MR. Describe how to resolve various clinical artifacts from digital radiography, CT, PET and MR.

60 APPLIED LIFE SCIENCES↗

WE-G-209-04: MRI

Digital radiography, CT, PET, and MR are complicated imaging modalities which are composed of many hardware and software components. These components work together in a highly coordinated chain of events with the intent to produce high quality images. Acquisition, processing and reconstruction of data must occur in a precise way for optimum image quality to be achieved. Any error or unexpected event in the entire process can produce unwanted pixel intensities in the final images which may contribute to visible image artifacts. The diagnostic imaging physicist is uniquely qualified to investigate and contribute to resolution of image artifacts. This course will teach the participant to identify common artifacts found clinically in digital radiography, CT, PET, and MR, to determine the causes of artifacts, and to make recommendations for how to resolve artifacts. Learning Objectives: Identify common artifacts found clinically in digital radiography, CT, PET and MR. Determine causes of various clinical artifacts from digital radiography, CT, PET and MR. Describe how to resolve various clinical artifacts from digital radiography, CT, PET and MR.

60 APPLIED LIFE SCIENCES↗

Coping with the diagnostic complexities of the compartment syndrome

This review recognizes that, given the various complexities associated with the condition, no pat answers can be given to fit every patient with the compartment syndrome. The authors first give a definition of the syndrome, together with a brief account of how this self-perpetuating pathologic cycle is triggered. Next, they delineate specific anatomical features of compartments that are likely to be involved, and follow this with an inventory of symptoms and signs to look for in suspected cases. After sorting out the entities that can mimic the compartment syndrome, the authors describe three essential techniques of measuring tissue pressure, which can prove invaluable in diagnosing the compartment syndrome.

NASA Program Biomedical Research↗

Physics-informed State-space Neural Networks for transport phenomena

This work introduces Physics -informed State -space neural network Models (PSMs), a novel solution to achieving real-time optimization, flexibility, and fault tolerance in autonomous systems, particularly in transportdominated systems such as chemical, biomedical, and power plants. Traditional data -driven methods fall short due to a lack of physical constraints like mass conservation; PSMs address this issue by training deep neural networks with sensor data and physics -informing using components' Partial Differential Equations (PDEs), resulting in a physics -constrained, end -to -end differentiable forward dynamics model. Further, through two in silico experiments - a heated channel and a cooling system loop - we demonstrate that PSMs offer a more accurate approach than a purely data -driven model. In the former experiment, PSMs demonstrated significantly lower average root -mean -square errors across test datasets compared to a purely data -driven neural network, with reductions of 44 %, 48 %, and 94 % in predicting pressure, velocity, and temperature, respectively. Beyond accuracy, PSMs demonstrate a compelling multitask capability, making them highly versatile. In this work, we showcase two: supervisory control of a nonlinear system through a sequentially updated state -space representation and the proposal of a diagnostic algorithm using residuals from each of the PDEs. The former demonstrates PSMs' ability to handle constant and time -dependent constraints, while the latter illustrates their value in system diagnostics and fault detection.

42 ENGINEERING↗

MRI-guided Wire Localization Surgical Biopsy in an Adolescent Patient with a Difficult to Diagnose Case of Lymphoma

A 17-year-old previously healthy female presented with a progressive soft tissue infiltrative process involving the neck and thorax. Extensive diagnostic evaluation including multiple imaging, laboratory, and biopsy studies was nondiagnostic. Due to an urgent need to establish a diagnosis and several previous nondiagnostic biopsies, she was referred to interventional radiology for MRI-guided wire localization immediately prior to open surgical biopsy. Under general anesthesia, wires were placed in the areas of increased T2 signal within the bilateral splenius capitis muscles using intermittent MRI-guidance followed by immediate surgical biopsy down to the wires. Pathology confirmed the diagnosis of diffuse large B-cell lymphoma.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Machine Learning-Enabled Wearable Piezoelectric Acoustic Sensor for Real-Time Breast Abnormality Detection

In contemporary society, breast health has become a significant public health concern, particularly among women. According to statistics from the World Health Organization, both the incidence and mortality rates of breast tumors have steadily increased in recent years. Therefore, effective early-stage screening and postoperative monitoring are essential for maintaining breast health. However, conventional clinical diagnostic modalities are typically bulky, operationally complex, and unsuitable for continuous real-time monitoring, which limits their use in portable and everyday health management applications. To address these limitations, this study proposes a machine learning-integrated wearable piezoelectric sensing platform as an auxiliary tool for breast health assessment. The device consists of a PDMS matching layer embedded with flexible silver nanowires, a P(VDF-TrFE) piezoelectric layer, and a multi-channel low-noise signal acquisition circuit. It is capable of acquiring acoustic echo signals from tissue-mimicking environments and automatically evaluating signal validity using a convolutional neural network (CNN). By integrating piezoelectric sensing with deep learning-based signal analysis, the proposed system achieves a signal-to-noise ratio exceeding 70 dB and a real-time classification accuracy above 96% under controlled conditions. These results demonstrate that the platform provides a compact, portable, and intelligent approach for wearable sensing of mechanical heterogeneity and highlight its potential for future development in continuous biomedical monitoring technologies.

He, Shuaitong↗

TH-E-201-00: Teaching Radiology Residents: What, How, and Expectation

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program. The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.

61 RADIATION PROTECTION AND DOSIMETRY↗

Periodontal Probe Improves Exams, Alleviates Pain

Dentists, comedian Bill Cosby memorably mused, tell you not to pick your teeth with any sharp metal object. Then you sit in their chair, and the first thing they grab is an iron hook!" Conventional periodontal probing is indeed invasive, uncomfortable for the patient, and the results can vary greatly between dentists and even for repeated measurements by the same dentist. It is a necessary procedure, though, as periodontal disease is the most common dental disease, involving the loss of teeth by the gradual destruction of ligaments that hold teeth in their sockets in the jawbone. The disease usually results from an increased concentration of bacteria in the pocket, or sulcus, between the gums and teeth. These bacteria produce acids and other byproducts, which enlarge the sulcus by eroding the gums and the periodontal ligaments. The sulcus normally has a depth of 1 to 2 millimeters, but in patients with early stages of periodontal disease, it has a depth of 3 to 5 millimeters. By measuring the depth of the sulcus, periodontists can have a good assessment of the disease s progress. Presently, there are no reliable clinical indicators of periodontal disease activity, and the best available diagnostic aid, periodontal probing, can only measure what has already been lost. A method for detecting small increments of periodontal ligament breakdown would permit earlier diagnosis and intervention with less costly and time-consuming therapy, while overcoming the problems associated with conventional probing. The painful, conventional method for probing may be destined for the archives of dental history, thanks to the development of ultrasound probing technologies. The roots of ultrasound probes are in an ultrasound-based time-of-flight technique routinely used to measure material thickness and length in the Nondestructive Evaluation Sciences Laboratory at Langley Research Center. The primary applications of that technology have been for corrosion detection and bolt tension measurements (Spinoff 2005). This ultrasound measurement system was adapted to the Periodontal Structures Mapping System, invented at Langley by John A. Companion, under the supervision of Dr. Joseph S. Heyman. Support of the research and development that led to this invention was provided by NASA s Technology Applications Engineering Program and by the Naval Institute for Dental and Biomedical Research, in Great Lakes, Illinois.

Source record↗

TH-E-201-01: Diagnostic Radiology Residents Physics Curriculum and Updates

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program. The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.

61 RADIATION PROTECTION AND DOSIMETRY↗

TH-E-201-02: Hands-On Physics Teaching of Residents in Diagnostic Radiology

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program. The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.

61 RADIATION PROTECTION AND DOSIMETRY↗

TH-E-201-03: A Radiology Resident’s Perspectives of Physics Teaching

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program. The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.

61 RADIATION PROTECTION AND DOSIMETRY↗

Balanced Expertise Distribution in Remote Ultrasound Imaging Aboard The International Space Station (ISS)

Astronaut training for ISS operations usually ensures independent performance. With small crew size same crews also conduct all science work onboard. With diverse backgrounds, a good "match" between the existing and required skills can only be anecdotal. Furthermore, full proficiency in most of the complex tasks can be attained only through long training and practice, which may not be justified and may be impossible given the scarcity of training time. To enable a number of operational and science advancements, authors have developed a new approach to expertise distribution in time and among the space and ground personnel. Methods: As part of NASA Operational Ultrasound Project (1998-2003) and the NASA-solicited experiment "Advanced Diagnostic Ultrasound in Microgravity-ADUM" (P.I. -S.D., ongoing), the authors have created a "Balanced Expertise Distribution" approach to perform complex ultrasound imaging tasks on ISS for both operational and science use. The four components of expertise are a) any pre-existing pertinent expertise; b) limited preflight training c) adaptive onboard proficiency enhancement tools; d) real-time ' guidance from the ground. Throughout the pre-flight training and flight time preceding the experiments, the four components are shaped in a dynamic fashion to meet in an optimum combination during the experiment sessions. Results: Procedure validation sessions and feasibility studies have given encouraging results. While several successful real-time remote guidance sessions have been conducted on ISS, Expedition 8 is the first to use an "on-orbit proficiency enhancement" tool. Conclusions: In spite of severely limited training time, daring peer-reviewed research and operational enhancements are feasible through a balanced distribution of expertise in time, as well as among the crewmembers and ground personnel. This approach shows great promise for biomedical research, but may be applicable for other areas of micro gravity-based science

Sargsyan, Ashot↗

Periprocedural Management in Transthoracic Needle Biopsy: Review of the Current Evidence

Purpose of Review: Transthoracic needle biopsy (TTNB) is a common diagnostic tool with expanding clinical indications. While most literature on this topic has focused on complications and techniques, this review will examine the evidence for periprocedural care specific to lung biopsy. Recent Findings: Review of the literature reveals great heterogeneity in clinical practice regarding periprocedural management of TTNB, for example, in terms of post-procedural monitoring as well as strategies for dealing with potential complications of TTNB. This is on the basis of a relative paucity of systematic clinical studies to guide management specific to the procedure. Summary: Further studies focused on periprocedural management in TTNB are needed to establish evidence-based guidelines that address the unique clinical aspects and complications of this procedure.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Research-Driven Radiation Oncology: A Narrative on the Ongoing Legacy of Henry S. Kaplan

In this rapidly evolving time of precision medicine and scientifically based cancer care, how radiation oncology became a strong research-based scientific discipline in the United States after its separation from diagnostic radiology might be lost. The importance of generational mentorship, “family trees,” and interpersonal relationships can be difficult or impossible to trace absent personal narrative recollections of those involved. Henry S. Kaplan is a central figure and the focal point for 3 generations of research-based academic department chairs. This report establishes a first draft of a living record of the radiation oncology history of the Kaplan legacy to serve as an example of how knowledge networks grow and flourish and as an impetus for others to trace the legacy of other radiation oncology academic “trees.”.

62 RADIOLOGY AND NUCLEAR MEDICINE↗