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Abdominal Radiology

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					   Abdominal Radiology
      Course 2007

                 Presented by

 The Society of Gastrointestinal Radiologists
                      and
        The Society of Uroradiology

              in conjuction with

The European Society of Urogenital Radiology




      The Thirty-Sixth Annual Meeting of
   The Society of Gastrointestinal Radiologists

    The Thirty-Second Scientific Assembly of
         The Society of Uroradiology

                     and the

         Fourteenth Annual Meeting of
  The European Society of Urogenital Radiology


               April 15 – 20, 2007

   Hyatt Regency Coconut Point Resort & Spa
            Bonita Springs, Florida
Program
Saturday, April 14, 2007
4:00 PM         6:00 PM    Registration

Sunday, April 15, 2007
6:30 AM    - 7:30 AM       Continental Breakfast
6:30 AM    - 1:00 PM       Registration and Viewing of Posters
7:30 AM    - 10:05 AM      SUR/ESUR Scientific Paper Session
                           Nancy S. Curry, MD and Bernd K. Hamm, MD, Coordinators
8:00 AM     -   10:05 AM   SGR Scientific Paper Session
                           Richard L. Baron, MD, Coordinator
10:05 AM    -   10:30 AM   Break
10:30 AM    -   12:45 PM   SGR and SUR/ESUR Scientific Paper Sessions (Continued)
1:00 PM     -   2:30 PM    SGR Business Meeting and Lunch
1:00 PM     -   2:30 PM    SUR Business Meeting and Lunch
5:00 PM     -   6:00 PM    In-Camera Session (SGR/ESGAR and SUR/ESUR Members Only)
                           How Can We Ensure High Quality CT Colonography?
                           Jay P. Heiken, MD, Moderator
                           What is at Stake?
                           Seth N. Glick, MD
                           Metrics for CT Colonography
                           C. Daniel Johnson, MD
                           The ACR Perspective
                           N. Reed Dunnick, MD
                           Discussion
6:30 PM     -   8:00 PM    SUR/ESUR Reception and Talent Show
                           "Uroradiology's Got Talent"
                           SUR/ESUR Members Only

Monday, April 16, 2007
6:30 AM     -   7:30 AM    Continental Breakfast
6:30 AM     -   1:00 PM    Registration, Viewing of Posters and Unknown Cases
6:55 AM     -   7:00 AM    Welcome and Announcements
7:00 AM     -   8:00 AM    New Horizons Lectures
                           Sameh K. Morcos, MD, Moderator
                           Molecular Imaging of Metastatic Ovarian Cancer
                           Peter L. Choyke, MD
                           National Cancer Institute
                           Bethesda, Maryland
                           Modern Imaging Techniques for Renal Parenchymal Diseases
                           Nicolas Grenier, MD
                           Hôpital Pellegrin-Tripode
                           Bordeaux, France
8:05 AM     -   10:10 AM   Characterizing and Treatment of Abdominal Tumors
                           Supported by Bayer Healthcare
                           N. Reed Dunnick, MD and Jay P. Heiken, MD, Moderators
8:05 AM     -   8:30 AM    Renal Masses: When and Why to Biopsy Them
                           Stuart G. Silverman, MD
8:30 AM     -   8:55 AM    Ablation of Renal Masses: RF and Cryoablation
                           Fred T. Lee, MD
8:55 AM     -   9:20 AM    Hepatic Masses: RFA
                           Gerald D. Dodd, III, MD
9:20 AM     -   9:45 AM    Stenting GI Tract Malignancies
                           Christoph L. Zollikofer, MD
9:45 AM     -   10:10 AM   Hepatic Masses: Distinguishing Benign from Malignant Lesions
                           Jay P. Heiken, MD
10:10 AM    -   10:30 AM   Break
10:30 AM    -   1:00 PM    Emergency Imaging of the Acute Abdomen
                           Mark E. Baker, MD and Carl M. Sandler, MD, Moderators
10:30 AM    -   10:55 AM   Scrotal Imaging
                           Jill E. Langer, MD
10:55 AM    -   11:20 AM   Imaging Evaluation of Pelvic Pain
                           Marcia C. Javitt, MD
11:20 AM    -   11:45 AM   Imaging and Interventions in Upper Urinary Tract Trauma
                           Parvati Ramchandani, MD, FACR
11:45 AM    -   12:10 PM   Appendicitis
                           Borut Marincek, MD
12:10 PM    -   12:35 PM   Bowel Obstruction
                           William M. Thompson, MD
12:35 PM    -   1:00 PM    Diverticulitis
                           Mark E. Baker, MD
1:00 PM     -   2:00 PM    Special Session: Nephrogenic Sclerosing Dermopathy
                           What is the True Current Status?
                           Michael A. Bettmann, MD and Arthur J. Segal, MD, Moderators
                           Richard H. Cohan, MD
                           Robert P. Hartman, MD
                           Zafar Jafri, MD
                           John R. Leyendecker, MD
                           Elizabeth Sadowski, MD
                           Henrik S. Thomsen, MD
6:30 PM     -   8:00 PM    Welcome Reception (Course Registrants and Guests)

Tuesday, April 17, 2007
6:30 AM     -   7:30 AM    Continental Breakfast
6:30 AM     -   1:00 PM    Registration, Viewing of Posters and Unknown Cases
6:55 AM     -   7:00 AM    Welcome and Announcements
7:00 AM   -   8:00 AM         Update on Contrast Media
                              Supported by Bracco Diagnostics, Inc.
                              James H. Ellis, MD and Henrik S. Thomsen, MD, Moderators
7:00 AM   -   7:40 AM         ESUR: Update on Safety Guidelines
                              Henrik S. Thomsen, MD
7:40 AM   -   8:00 AM         Contrast-Induced Nephrotoxicity: How Much Do We Know?
                              James H. Ellis, MD
8:15 AM   -   8:50 AM         Workshop Session I
                         1.   Anorectal Imaging in Fecal Incontinence: US and MRI (Beg/Int)
                              Joel G. Fletcher, MD
                              David M. Hough, MD
                         2.   Bowel Ischemia: The Essential Findings (Int)
                              R. Kristina Gedgaudas-McClees, MD
                              William E. Torres, MD
                         3.   Use of CT Fluoroscopy in Intervention (Int)
                              Erik K. Paulson, MD
                         4.   MRI of the Liver: Role of Liver Specific Contrast Agents (Int/Adv)
                              Kohkan Shamsi, MD
                         5.   Virtual Colonoscopy: Reporting and Reimbursement (Int)
                              Judy Yee, MD
                         6.   Intraoperative Ultrasound of the Liver (Adv)
                              Jonathan B. Kruskal, MD
                         7.   Renal Mass Evaluation (Int)
                              Nancy S. Curry, MD
                         8.   Prostate Cancer: Biopsy Strategies (Int)
                              Rosaleen B. Parsons, MD
                         9.   Ultrasound Examination of Pelvic Floor Disease (Int)
                              Catherine Roy, MD
                        10.   MR Imaging of Congenital Urogenital Anomalies (Int)
                              Hanan Sherif, MD
                        11.   Adrenal Imaging (Int)
                              Gertraud Heinz-Peer, MD
                              Philip J. Kenney, MD
                        12.   Renal Transplant Imaging (Int)
                              Barry D. Daly, MD
                              Jade J. Wong-You-Cheong, MB, ChB
                        13.   Quick and Dirty 3D Evaluation of the Abdomen: Fitting it into a Busy
                              Abdominal Service (Beg)
                              Neal C. Dalrymple, MD
9:00 AM   -   9:35 AM         Workshop Session II
                        14.   CT Enterography (Beg/Int)
                              Andres O'Brien, MD
                         15. 64 Slice CT Scanning: Technical Aspects You Need to Know (Adv)
                             Jonas Rydberg, MD
                             Kumaresan Sandrasegaran, MD
                         16. CT Colonography: Pitfalls in Interpretation (Int)
                             Abraham H. Dachman, MD
                             Philippe A. Lefere, MD
                         17. Ultrasound Evaluation of TIPS (Int)
                             Myron A. Pozniak, MD
                         18. Evaluation of Dysphagia (Int)
                             Rolf Olsson, MD, PhD
                         19. How to Perform a Quick but Comprehensive MR Exam of the
                             Abdomen (Beg)
                             Eduard E. de Lange, MD
                         20. Thermal Ablation of Renal Neoplasms: How, When and Why? (Int)
                             Ronald J. Zagoria, MD, FRCR
                         21. Retrograde Urethrography (Beg/Int)
                             Agnes M. Guthrie, MD
                         22. Hysterosalpingography: Unusual and Bizarre (Int/Adv)
                             Richard L. Clark, MD
                         23. MRI of Pelvic Floor Relaxation: How and Why We Do It (Int)
                             Marco A. Amendola, MD
                         24. Preoperative Radiological Planning to Optimize the Result of
                             Percutaneous Surgery of Complex Stones in the Renal Pelvis (Int)
                             Marianne Brehmer, MD
                             Anders Magnusson, MD
                             Eva Radecka, MD
                         25. Multisystem Abdominal Trauma Imaging (Int)
                             Philip J. Kenney, MD
                             Mark E. Lockhart, MD, MPH
9:45 AM   -   11:15 AM       Self Assessment Module (SAM) Registration Required in Advance
                             Using Contrast Media Wisely: Practical Aspects and Treatment of
                             Reactions
                             Richard H. Cohan, MD
                             James H. Ellis, MD
9:45 AM   -   10:20 AM       Workshop Session III
                         26. PET in Children (Int)
                             Martin Charron, MD
                         27. Biliary Tract: Optimizing Diagnoses (Int)
                             Richard L. Baron, MD
                         28. RF Ablation in the Liver: How to Achieve Good Results (Int)
                             Kedar N. Chintapalli, MD
                          29. GI Tract Manifestations of Hematologic Disorders (Beg/Int)
                              Douglas S. Katz, MD
                          30. Understanding Anal Fistula (Beg)
                              Clive I. Bartram, MD
                          31. Real Time Decision Support for Selecting and Ordering Abdominal
                              CT and MR Studies (Beg)
                              Steven E. Seltzer, MD
                          32. Imaging of Pelvic Pain-Endometriosis (U/S and MR) (Beg)
                              Rajeev Jyoti, MD
                          33. Traumatic and Non- Traumatic Diseases of the Penis - Part I (Int/Adv)
                              Michele Bertolotto, MD
                          34. PET/CT Imaging Applied to Gynecologic Oncology (Int)
                              Hubert Vesselle, MD
                          35. Genitourinary Lymphoma (Beg)
                              Manjiri K. Dighe, MD
                          36. Hematuria (Beg)
                              Henrik S. Thomsen, MD
                          37. Urothelial Tumors (Beg)
                              Carl M. Sandler, MD
                          38. The New Radiological Anatomy of Retroperitoneum and the Doors of
                              Intercommunication with Peritoneum (Adv)
                              Francesco M. Danza, MD
10:20 AM   -   10:50 AM       Break
10:50 AM   -   11:25 AM       Workshop Session IV
                          39. Nodules in Liver Cirrhosis: Detection and Differential Diagnosis (Int)
                              Hyun-Jung Jang, MD
                              Tae Kyoung Kim, MD
                          40. How to Build a CT Colonography Program (Int)
                              Perry J. Pickhardt, MD
                          41. CT Cholangiography: How and Why? (Int)
                              Benjamin M. Yeh, MD
                          42. Pitfalls and Atypical Appearances in CT and MRI of Pancreatic
                              Masses (Int)
                              Fergus V. Coakley, MD, MBBCh
                          43. CT of Spontaneous GI Tract Perforations: Ususal and Unusual (Int)
                              Michael C. Hill, MD
                          44. Defecography: Why and How? (Int)
                              Frederick M. Kelvin, MD
                              Frank J. Scholz, MD
                          45. Differential Diagnosis of Solid Renal Tumors (Adv)
                              Peter J. Hallscheidt, MD
                          46. Prostate Imaging (Int)
                              Stijn Heijmink, MD
                          47. Top Ten Indicators for Gynecologic MRI (Int)
                              Aliya Qayyum, MD
                              Antonio Westphalen, MD
                          48. Applications of Diffusion - Weighted MRI in Native and Transplanted
                              Kidneys (Int)
                              Harriet C. Thoeny, MD
                          49. ABR Update - 2007 (Beg)
                              Dennis M. Balfe, MD
                              N. Reed Dunnick, MD
                              Robert R. Hattery, MD
                          50. Imaging of the Bladder (Beg)
                              Jon Willatt, MD
11:35 AM   -   1:05 PM        Self Assessment Module (SAM) Registration Required in Advance
                              Imaging the Pancreas: Neoplastic and Inflammatory Disease
                              Isaac R. Francis, MD
                              Jay P. Heiken, MD
                              Desiree E. Morgan, MD
11:35 AM   -   12:10 PM       Workshop Session V
                          51. Sonographic Assessment of Intestinal Masses (Int)
                              Stefania Romano, MD
                          52. Pancreatic Transplantation (Int)
                              Barry D. Daly, MD
                              Jade J. Wong-You-Cheong, MB, ChB
                          53. Cross-Sectional Imager's Approach to PET-CT (Beg)
                              Rendon C. Nelson, MD
                          54. Imaging of Abdominal Infection (Int)
                              Peter F. Hahn, MD
                              Mukesh G. Harisinghani, MD
                          55. Diffusion-Weighted Imaging of the Abdomen (Int)
                              Bachir Taouli, MD
                          56. Imaging Evaluation of the Postoperative GI Tract (Int)
                              Ali Shirkhoda, MD, FACR
                              Ellen L. Wolf, MD, FACR
                          57. Detection and Characterization of Renal Masses at Ultrasound: A
                              Practical Guide (Int)
                              Mitchell E. Tublin, MD
                          58. Testicular Tumor and Microlithiasis (Int)
                              Bohyun Kim, MD
                              Bernard F. King, MD
                          59. MR Characterization of Uterine Leiomyomas with their
                              Histopathologic Findings (Int)
                              Teresa Margarida Cunha, MD
                          60. LN Imaging in Gynecologic Malignancy (Adv)
                              Hyuck Jae Choi, MD
                          61. Adreanl Imaging and Intervention (Int)
                              William W. Mayo-Smith, MD
                          62. Diagnosing Significant Renal Artery Stenosis: Critical Review of
                              Imaging and Functional Studies (Int)
                              Klemens H. Barth, MD
                          63. Advanced Course on Prostate MRI Techniques: Spectroscopy,
                              Dynamic Contrast Enhanced MRI and Imaging at 3T (Adv)
                              Jurgen J. Fütterer, MD, PhD
                              Geert M. Villeirs, MD, PhD
12:20 PM   -   12:55 PM       Workshop Session VI
                          64. CT Evaluation of Lower Abdominal Pain (Int)
                              Christine O. Menias, MD
                          65. Vascular Disorders of the Liver (Beg)
                              Richard M. Gore, MD
                          66. MR Enterography (Beg/Int)
                              Jeff L. Fidler, MD
                          67. The Postoperative Pharynx (Int)
                              Bronwyn Jones, MD
                          69. Imaging Evaluation after Laparoscopic Bariatric Surgery for Morbid
                              Obesity (Int)
                              Laura R. Carucci, MD
                              Mary Ann Turner, MD, FACR
                          70. Differentiating Surgical from Non-Surgical Renal Masses (Int)
                              Morton A. Bosniak, MD
                              Gary M. Israel, MD
                          71. Contrast-Enhanced TRUS and MRI Imaging of the Prostrate (Beg/Int)
                              François Cornud, MD
                              Jurgen J. Fütterer, MD, PhD
                          72. Adnexal Masses: Ultrasound and MRI Correlation (Int)
                              Brent J. Wagner, MD
                          73. MRI of Benign Uterine Tumors and Its Implications for
                              Therapy/Treatment by Uterine Artery Embolization (Int)
                              Bernd K. Hamm, MD
                              Thomas J. Kröncke, MD
                          74. Draining the Difficult to Reach Abscess: Let's Make it Easier (Int)
                              Ronald S. Arellano, MD
                              Brian C. Lucey, MD, MB, BCh, MRCPI
                          75. Review CIN (Adv)
                              Joshua A. Becker, MD
2:00 PM    -   4:30 PM        Tennis Tournament
Wednesday April 18, 2007
6:30 AM    -   7:30 AM     Continental Breakfast
6:30 AM    -   12:30 PM    Registration, Viewing of Posters and Unknown Cases
6:55 AM    -   7:00 AM     Welcome and Announcements
7:00 AM    -   8:00 AM     Walter B. Cannon Lecture
                           Evolution of Minimally Invasive Liver Cancer Program
                           David A. Geller, MD
                           University of Pittsburgh Medical Center
                           Pittsburgh, Pennsylvania
8:00 AM    -   9:15 AM     Luminal CT Conversation
                           Dean D.T. Maglinte, MD, Moderator
8:00 AM    -   8:20 AM     CT Enteroclysis
                           Dean D.T. Maglinte, MD
8:20 AM    -   8:40 AM     CT Enterography
                           Joel G. Fletcher, MD
8:40 AM    -   9:00 AM     Conventional SBFT
                           Frank J. Scholz, MD
9:00 AM    -   9:15 AM     Discussion
9:15 AM    -   9:45 AM     Break
9:45 AM    -   11:00 AM    CT Urography Panel: A Transatlantic Collaborative Conversation
                           Nigel C. Cowan, MD, Moderator
                           Elaine M. Caoili, MD
                           Richard H. Cohan, MD
                           François Cornud, MD
                           Nigel C. Cowan, MD
                           Ullrich G. Mueller-Lisse, MD
                           Claus Nolte-Ernsting, MD
                           Stuart G. Silverman, MD
                           F. Graham Sommer, MD
                           Aart J. van der Molen, MD
                           Terri J. Vrtiska, MD
10:45 AM   -   11:00 AM    Discussion
11:00 AM   -   12:30 PM    Unknown Film Panel
                           Lorenzo E. Derchi, MD, Vikram S. Dogra, MD and Alec J. Megibow, MD,
                           Moderators
                           Nigel C. Cowan, MD
                           Raymond B. Dyer, MD
                           Nicolas Grenier, MD
                           Mukesh G. Harisinghani, MD
                           Koenraad J. Mortele, MD
                           Dushyant V. Sahani, MD
                           Benjamin M. Yeh, MD
1:30 PM                    Golf Tournament
6:30 PM     -   7:15 PM       Annual Awards Banquet Reception
                              Supported by E-Z-EM, Inc.
7:30 PM     -   11:00 PM      Annual Awards Banquet

Thursday, April 19, 2007
6:30 AM     -   7:30 AM        Continental Breakfast
6:30 AM     -   12:30 PM       Registration, Viewing of Posters and Unknown Cases
7:00 AM     -   7:35 AM        Workshop Session VII
                           76. MR Spectroscopic Applications in the Abdomen and Pelvis (Adv)
                               Bonnie N. Joe, MD, PhD
                               Aliya Qayyum, MD
                           77. Imaging Evaluation of Abdominal Hernias (Beg)
                               Sat Somers, MD
                           78. Technical Aspects of Imaging the Morbidly Obese (Beg/Int)
                               Myrosia M. Mitchell, MD
                           79. The Difficult Biopsy Made Easy (Int)
                               Brian C. Lucey, MD, MB, BCh, MRCPI
                           80. What About the Spleen? Differential Diagnosis for a Forgotten Organ
                               (Beg/Int/Adv)
                               David M. Warshauer, MD
                           81. Diagnostic and Interventional Radiology in Abdominal Trauma (Int)
                               Jamie Tisnado, MD, FACR, FACC, FSIR
                           82. RCC and Small Renal Neoplasms: Some Things Have Changed (Beg)
                               Raymond B. Dyer, MD
                           83. Imaging of Male Infertility (Beg/Int)
                               François Cornud, MD
                           84. Congenital Uterine Anomalies: Imaging Evaluation (Int)
                               Thomas M. Dykes, MD
                           85. MRI of the Pelvis: Extrauterine and Extraovarian Pathology (Int)
                               Paul Nikolaidis, MD
                           86. Abnormalities of the Boy's Urethra (Other than Posterior Urethral
                               Valves) (Int)
                               Robert L. Lebowitz, MD
                           87. Practical Approach to the Endometrium (Beg)
                               Deborah A. Baumgarten, MD, MPH
                           88. Urothelial Lesions: Imaging Strategies and Treatment Options (Int)
                               Nicholas Papanicolaou, MD
7:45 AM     -   8:20 AM        Workshop Session VIII
                           89. Abdominal Intervention in Children (Beg/Int/Adv)
                               Richard B. Towbin, MD
                           90. Updated Pancreatic Cancer Imaging: Making the Most of MDCT and
                               MPR (Beg)
                               Desiree E. Morgan, MD
                          91. Videofluoromanometry in Swallowing Disorders (Beg/Int)
                              Roberto Grassi, MD
                          92. What's New in Abdominal MRI? (Int)
                              John R. Leyendecker, MD
                          93. Focal Lesion in the Liver: Now What? (Beg)
                              Shailendra Chopra, MD
                          94. Colorectal Cancer: Diagnosis and Staging (Beg)
                              Abraham A. Ghiatas, MD
                          95. Interpreting Images after Renal and Hepatic Ablation (Int)
                              Erick M. Remer, MD
                          96. Problematic Scrotal Ultrasound Cases and the Role of MR (Int)
                              David D. Casalino, MD
                          98. CTU Optimization – Part I (Int)
                              Maka Kekelidze, MD, PhD
                              Aart J. van der Molen, MD
                          99. Functioning Adrenal Tumors (Int)
                              Isaac R. Francis, MD
                         100. The Current Consensus on Reducing the Rick of Contrast Induced
                              Nephrotoxicity (Int)
                              Sameh K. Morcos, MD
8:30 AM   -   10:00 AM        Self Assessment Module (SAM) Registration Required in Advance
                              Problematic Renal Mass
                              Peter L. Choyke, MD
                              David S. Hartman, MD
8:30 AM   -   9:05 AM         Workshop Session IX
                         101. Imaging Biliary Disorders in Infants and Children (Int)
                              Soroosh Mahboubi, MD
                         102. MDCT of Penetrating Trauma (Int)
                              William W. Mayo-Smith, MD
                         103. Marshak's 10 Principles of Crohn's Disease: Has Anything Changed
                              in 30 Years? (Int)
                              Stephen W. Trenkner, MD
                         104. MR Strategy for Hepatocellular Carcinoma Imaging (Int)
                              Claude B. Sirlin, MD
                         105. Achalasia and Other Motility Disorders of the Esophagus (Int)
                              Dina F. Caroline, MD
                         106. Molecular Biology and Cytogenetics of Pancreatic Neoplasms: An
                              Update for the Radiologist (Int)
                              Srinivasa R. Prasad, MD
                         107. Renal Cysts and Cystic Tumors (Int)
                              Morton A. Bosniak, MD
                              Gary M. Israel, MD
                         108. Imaging of Scrotal Diseases (Beg)
                              Boris Brkljacic, MD
                              Pietro Pavlica, MD
                         109. MR Imaging of Female Pelvis: Benign Disease (Int)
                              Frank H. Miller, MD
                         110. CTU Optimization – Part II (Int)
                              Maka Kekelidze, MD, PhD
                              Aart J. van der Molen, MD
                         111. Long-Term Urinary Diversion: Ureteric Stenting, Extra-Anatomic
                              Stent and Porges Stent (Adv)
                              Tze M. Wah, MD
                         112. Trauma to the GU Tract (Int)
                              Susan Hilton, MD
                         113. MRI of the Prostate - Dynamic Contrast Media Enhancement (Int)
                              Klaus Kubin, MD
9:05 AM   -   9:35 AM         Break
9:35 AM   -   10:10 AM        Workshop Session X
                         114. CT Evaluation of Acute Right Lower Quadrant Pain: Common and
                              Uncommon Mimics of Appendicitis (Int)
                              Mary Ann Turner, MD, FACR
                              Jinxing Yu, MD
                         115. Investigating the Small Bowel: Capsule Endoscopy vs. Radiology (Int)
                              Kumaresan Sandrasegaran, MD
                         116. PET/CT Guided Intervention (Int)
                              Ronald S. Arellano, MD
                              Michael Blake, FRCR, FFRRCSI
                         117. CT Colonography: Techniques and Pitfalls (Beg/Int)
                              Martina Morrin, MD
                              Pamela A. Nugent, MD
                         118. Barium Exposed: A Potpourri of Interesting Cases (Int)
                              Marc S. Levine, MD
                         119. MDCT of Intestinal Ischemia: Diagnosis and Criteria for Treatment
                              (Adv)
                              Stefania Romano, MD
                         120. Renal CTA (Int)
                              Myron A. Pozniak, MD
                         122. High-Resolution US/MR Imaging of the Female Urethra (Int)
                              Srinivasa R. Prasad, MD
                         123. First Trimester Ultrasound (Int)
                              Elizabeth Lazarus, MD
                         124. Non-Vascular Interventions in GU Tract: What, When, How (Int)
                              Mukesh G. Harlsinghani, MD
                              Peter R. Mueller, MD
                         125. Endometrial/Cervical/Carcinoma Staging (Int)
                              Rosaleen B. Parsons, MD
10:20 AM   -   10:55 AM          Workshop Session XI
                          126.   Small Bowel Ultrasound - Including Contrast Enhanced US and US
                                 Enteroclysis (Beg)
                                 Vlastimil A. Valek, MD, PhD
                          127.   3D Postprocessing for Pancreas and Biliary Tree (Int/Adv)
                                 Eric P. Tamm, MD
                          128.   Tropical Diseases of the Small Intestine (Int)
                                 Maurice M. Reeder, MD
                          129.   PET/CT of GI Neoplasms (Beg/Int)
                                 Leonard M. Freeman, MD
                                 Marc J. Gollub, MD
                          130.   Complications of Liver Transplantation (Int)
                                 Robert A. Halvorsen, Jr., MD
                          131.   Postoperative Pharynx (Adv)
                                 Cheri L. Canon, MD
                                 Robert E. Koehler, MD
                          132.   CT Angiography of the Renal Arteries (Int)
                                 Terri J. Vrtiska, MD
                          133.   Sonographic Evaluation of Benign Intrascrotal Lesions (Int/Adv)
                                 Shweta Bhatt, MD
                                 Vikram S. Dogra, MD
                          134.   Traumatic and Non-Traumatic Emergencies in Pregnancy (Beg/Int)
                                 Stanford M. Goldman, MD
                          135.   Adrenal Imaging 2007: PET/CT Experience (Adv)
                                 Giles W. Boland, MD
                          136.   Interesting/Challenging Case Review (Int)
                                 Parvati Ramchandani, MD, FACR
                          137.   The Collecting System & Ureter: Imaging and Pathological
                                 Correlation (Beg/Int/Adv)
                                 William H. Bush, MD
                          138.   MR Imaging of the Urinary Bladder (Int)
                                 Hanan Sherif, MD
11:05 AM   -   12:35 PM          Self Assessment Module (SAM) Registration Required in Advance
                                 Imaging the Peritoneal Cavity: Pearls and Pitfalls
                                 Dennis M. Balfe, MD
                                 James A. Brink, MD
                                 Michael P. Federle, MD
11:05 AM   -   11:40 AM          Workshop Session XII
                          139.   Pathogenesis and Radiology of GERD (Int)
                                 Giles W. Stevenson, MD
                          140.   Vascular Complications of Hepatic and Pancreatic Transplants (Beg)
                                 Beatrice Madrazo, MD, FACR
                          141.   Traumatic Injuries of the Gastrointestinal Tract (Beg)
                                 Francesco Lassandro, MD
                          142. Other Abdominal Hernias (Int)
                               Spencer B. Gay, MD
                          143. Understanding THADs and THIDs (Int)
                               Terry S. Desser, MD
                          144. Imaging Pancreatic and Biliary Trauma (Int)
                               Jorge A. Soto, MD
                          145. The Ultrasound of Renal Failure (Int)
                               John J. Cronan, MD
                          146. Traumatic and Non- Traumatic Diseases of the Penis - Part II
                               (Int/Adv)
                               Pietro Pavlica, MD
                          147. MRI of Benign Pelvic Masses: Pearls and Pitfalls (Int)
                               Keyanoosh Hosseinzadeh, MD
                          148. MR Imaging of the Ovary (Int)
                               Ahmed-Emad Mahfouz, MD
                          149. Contrast Reaction Review & What's New, Different, or JCAHO-
                               'Mandated' (Int)
                               Arthur J. Segal, MD
                          150. 3D Processing of Renal CT Data: Structure and Function (Int)
                               F. Graham Sommer, MD
11:50 AM   -   12:25 PM        Workshop Session XIII
                          151. Radiology of the Duodenum (Beg)
                               Kyunghee C. Cho, MD, FACR
                          152. Managing Incidental Findings on Abdominal MDCT (Beg)
                               Lincoln L. Berland, MD, FACR
                          153. Congenital Pancreatic and Biliary Anomalies (Beg)
                               Koenraad J. Mortele, MD
                               Andrew Taylor, MD
                          154. Cases for Aces (Int/Adv)
                               James L. Buck, MD
                               Neil H. Messinger, MD
                          155. Economic Issues and Billing Compliance in Abdominal Imaging (Int)
                               Robert K. Zeman, MD
                          156. Acute Gastrointestinal Bleeding: The Radiologist's Role in Diagnosis
                               and Treatment (Int)
                               Klemens H. Barth, MD
                          157. Radiofrequency Ablation of the Kidney (Int)
                               Peter R. Mueller, MD
                          158. Prostate Cancer Imaging, MRI and MRSI: What the Clinician Wants
                               to Know (Int)
                               Steven C. Eberhardt, MD
                          159. Hysterosalpingography: A to Z (Int)
                               Suresh K. Patel, MD
                           160. Magnetic Resonance Imaging (MRI) of Maternal Diseases in
                                Obstetrics Patients (Int)
                                Randy D. Ernst, MD
                                Aytekin Oto, MD
                           161. Renal Infections: From Pyelonephritis to AIDS (Beg)
                                Zafar Jafri, MD
                           162. Imaging Complications of Abdominal Transplantation (Int)
                                Emily Webb, MD
                                Benjamin M. Yeh, MD
Friday, April 20, 2007
6:30 AM     -   7:30 AM        Continental Breakfast
6:30 AM     -   1:00 PM        Registration, Viewing of Posters and Unknown Cases
7:20 AM     -   7:25 AM        Welcome and Announcements
7:25 AM     -   10:20 AM       Oncologic Imaging
                               Richard M. Gore, MD and Ulrike Mueller-Lisse, MD, Moderators
7:25 AM     -   7:50 AM        Adrenal Imaging
                               Gertraud Heinz-Peer, MD
7:50 AM     -   8:15 AM        Ovarian Cancer: Recent Imaging Developments
                               John A. Spencer, MD
8:15 AM     -   8:40 AM        Staging Renal Cell Carcinoma
                               Ullrich G. Mueller-Lisse, MD
8:40 AM     -   9:05 AM        GIST Tumors
                               Angela D. Levy, MD
9:05 AM     -   9:30 AM        Staging Pancreatic Cancer
                               Frank H. Miller, MD
9:30 AM     -   9:55 AM        Staging Upper GI Tumors
                               Ruedi F. Thoeni, MD
9:55 AM     -   10:20 AM       Staging Colorectal Cancer
                               Richard M. Gore, MD
10:20 AM    -   10:40 AM       Break
10:40 AM    -   1:00 PM        Interesting Topics
                               Michael P. Federle, MD, Moderator
10:40 AM    -   11:00 AM       Abdominal CTA: Techniques, Challenges, Pitfalls
                               Joel F. Platt, MD
11:00 AM    -   11:20 AM       State-of-the-Art MR Urography
                               Claus Nolte-Ernsting, MD
11:20 AM    -   11:40 AM       Radiation Safety During Pregnancy
                               Fergus V. Coakley, MD, MBBCh
11:40 AM    -   12:00 PM       MR of IBD
                               Gabriele Masselli, MD
12:00 PM    -   12:20 PM       CT Colonography
                               Michael Macari, MD
12:20 PM    -   12:40 PM       Cystic Pancreatic Neoplasms
                               Alec J. Megibow, MD
12:40 PM    -   1:00 PM        PET/CT GI Application
                               Michael P. Federle, MD
                               Adjourn
                    The Society of Gastrointestinal Radiologists
                                 Scientific Papers
                              Sunday, April 15, 2007
                              8:00 a.m. – 12:45 p.m.

8:00 a.m.    Welcome and Announcements

Session I:   Colon, Biliary Tract, and Liver
             Fred Lee, MD and Benjamin Yeh, MD, Moderators

8:05 a.m.    The Impact of Additional Polyps Detected at Optical Colonoscopy in
             Patients Referred from Positive CT Colonography
             David H. Kim, MD

8:15 a.m.    CT Colonography Without Bowel Cleansing Compared to CTC and
             Optical Colonoscopy after Bowel Cleansing
             Ke Lin, MD

8:25 a.m.    Detection of Colorectal Cancer on Standard Nontargeted CT Evaluation
             Bora Ozel, MD

8:35 a.m.    64MDCT: Use in the Detection of Biliary Strictures and
             Choledocholithiasis
             Stephan Anderson, MD

8:45 a.m.    Low Tube Voltage, High Tube Current 64-Slice MDCT for Detection of
             Hypervascular Liver Tumors: A Phantom Study
             Sebastian Tobias Schindera, MD

8:55 a.m.    Imaging Accuracy of Hepatocellular Carcinoma (HCC) Staging in
             Cirrhotic Patients Undergoing Liver Transplantation
             Alessandro Furlan

9:05 a.m.    Apparent Diffusion Coefficient Measurements in Chemoembolized
             Hepatocellular Carcinomas
             Charan Singh, MD

9:15 a.m.    Tumor Response of Hepatocellular Carcinoma (HCC) Following Intra-
             arterial Treatment with Yttrium-90 (90Y) Microspheres: Use of Criteria
             besides RECIST
             Frank H. Miller, MD

9:25 a.m.    Liver Lesion Detection and Characterization in Patients with Colorectal
             Cancer: Is Non-enhanced PET/CT or Contrast-enhanced PET/CT or
             Liver MRI Better?
             Colin Patrick Cantwell, MD
9:35 a.m.     Automated RECIST and WHO Criteria Measurements and Volumetric
              Segmentation of Liver Lesions on Multi-slice CT
              Bassel Atassi, MD

9:45 a.m.     Quantification of Liver Iron Deposition with Opposed-phase Imaging
              and T2* Sequence with Explant Correlation
              Ruth Lim

9:55 a.m.     Quantification of Liver Volume, Liver Fat Fraction and Subcutaneous-
              visceral Fat Changes with 3T MRI after Hypocaloric Diet in Morbidly
              Obese Patients
              Abe Shaikh

10:05 a.m.    Break

10:30 a.m.    SGR Research Award Reports

                      SGR 2005 Phillip H. Meyers, MD Research Grant Report
                        Thermal Ablation of the Liver: Design of Effective Composite
                        Ablations for the Treatment of Large Liver Tumors
                        Hayden Head, MD
                        University of Texas, Health Science Center at San Antonio


                      SGR 2005 Wylie J. Dodds Research Grant Report
                        Role of PET/CT in the Characterization of Intraductal
                        Papillary Mucinous Neoplasms (IPMN) of the Pancreas
                        Dushyant Sahani, MD
                        Massachusetts General Hospital

Session II:   Pancreas, GI Tract, Mesentery and Others
              Angela Levy, MD and Jonas Rydberg, MD, Moderators

10:45 a.m.    Autoimmune Pancreatitis : Evolution of Disease with MDCT Features
              that Predict Response to Steroid Treatment
              Nisha Sainani, MD

10:55 a.m.    Correlation of FDG-PET and MDCT Features in Mucinous Lesions of
              Pancreas for Lesion Characterization and Prediction of Malignancy
              Dushyant Sahani, MD

11:05 a.m.    Is Secondary Bowel Thickening a Reliable Sign in Differentiating
              Perforated from Non-perforated Appendicitis?
              Monica Jain, MD

11:15 a.m.    Practice Patterns in Imaging of the Pregnant Patient with Abdominal
              Pain– A Survey of Academic Centers
              Tracy A. Jaffe, MD
11:25 a.m.   Efficacy of Specific MR Sequences in Distinguishing Peritoneal
             Carcinomatosis
             Nancy Hammond, MD

11:35 a.m.   Posterior Deep Peritoneal Pelvic Endometriosis with Rectosigmoïd
             Involvement. What does Endocavitary MRI add to Diagnosis?
             Preoperative Prospective Study with Surgical Correlation.
             Catherine Roy, MD

11:45 a.m.   Abdominal Lymph Nodes Seen on Coronal Reformations from Isotropic
             Voxels using 16-Slice MDCT: Do we Really See them Better than on the
             Axial Scan?
             Sebastian J. Chlebek, MD

11:55 a.m.   Multidetector CT Detection of a Small Amount of Isolated Pelvic Free
             Fluid in Male Blunt Trauma Patients: Incidence and Significance
             Jinxing Yu, MD

12:05 p.m.   Automated Volumetric, RECIST and WHO Measurements of Intra-
             abdominal Lymph Nodes on MSCT: Preliminary Results
             Vahid Yaghmai, MD

12:15 p.m.   Multi-slice CT of the Stomach: Comparison of VoLumen and Water in
             the Same Patient Population
             Paul Nikolaidis, MD

12:25 p.m.   Comparison of the Utility of CT Enterography and Capsule Endoscopy
             in Patients with Abdominal Pain or Anemia
             Marina Giursecu, MD

12:35 p.m.   Comparison of CT Enterography (CTE) Using 64 Row Detector MDCT
             with Wireless Video Capsule Endoscopy (VCE) in the Investigation of
             Small Bowel Disease
             Brian C. Lucey, MD
8:05 a.m.
The Impact of Additional Polyps Detected at Optical Colonoscopy in Patients Referred
from Positive CT Colonography
David H. Kim, MD, University of Wisconsin Medical School; Perry J. Pickhardt; Andrew J.
Taylor; J. L. Hinshaw
Purpose: The purpose of this study was to assess the frequency and characteristics of
additional polyps seen at optical colonoscopy (OC) beyond those called at preceding CT
colonography (CTC).
Materials and Methods: Retrospective review of a single institution CTC screening
program was performed (n=2,695 patients). Of the positive CTC examinations (n=329), 194
underwent subsequent OC. Diminutive lesions were not reported at CTC.
Results: A total of 179 additional lesions were found at OC in 75 (38.6%) of 194 patients. Of
these, 76 % (n=136) were diminutive, 19% (n=34) were small (6-9mm), and 5% (n=9) were
large (≥ 10mm). 27.2% (37/136) of diminutive lesions were adenomas. Of CTC false-
negative lesions (≥ 6mm), 30.2% (13/43) were adenomas, 65.1% (28/43) were nonneoplastic,
and 4.6% (2/43) were not retrieved. None of the 179 additional polyps demonstrated high-
grade dysplasia or invasive carcinoma; 7 (3.9%) qualified as advanced adenomas due to size
≥ 10mm or villous component. All patients with an additional advanced adenoma also had at
least one true-positive CTC-detected advanced adenoma.
Conclusion: Additional polyps seen at OC following CTC are typically diminutive lesions
rather than CTC false negatives. The vast majority are nonneoplastic or non-advanced
adenomas. These observations support current CTC screening practices, including
nonreporting of diminutive lesions.


8:15 a.m.
CT Colonography Without Bowel Cleansing Compared to CTC and Optical
Colonoscopy after Bowel Cleansing
Ke Lin, MD, NYU School of Medicine; Michael Macari; Edmond Bini; Jean Reid
Purpose: To evaluate CTC data interpretation obtained with fecal tagging but without bowel
cleansing.
Methods: 57 patients underwent fecal tagging using barium sulfate without colon catharsis.
Patients underwent CTC with CO2 insufflation. All polyps measuring ≥ 6 mm were recorded
independently by two radiologists. One week later, subjects underwent same day CTC and
colonoscopy after bowel cleansing. Segmental unblinding was used as a reference standard.
Patient preferences were assessed.
Results: 50 patients had no polyps ≥ 6 mm. One reader had a single false positive at CTC
with fecal tagging (7 mm). There was one (9 mm) and zero false positives for CTC and OC
after bowel cleansing. 7 patients had 8 polyps. 6 were 6-9 mm and two were ≥ 10 mm. Both
readers detected 3/6 polyps 6-9 mm and 2/2 polyps ≥ 10 mm with fecal tagging. CTC after
bowel cleansing detected 5/6 polyps 6-9 mm and 2/2 polyps ≥ 10 mm. OC detected 6/6
polyps 6-9 mm and 1/2 polyps ≥ 10 mm. 50 patients preferred prepless CTC, one CTC after
preparation, and five preferred OC.
Conclusion: CTC with fecal tagging and without bowel cleansing can detect significant
lesions. Patients overwhelmingly preferred CTC without bowel preparation.
8:25 a.m.
Detection of Colorectal Cancer on Standard Nontargeted CT Evaluation
Bora Ozel, MD, University of Wisconsin Medical School; Perry J. Pickhardt; David H.
Kim; Neil Bharghava; Clark W. Schumacher; Rajat Mukherjee; Patrick R. Pfau
Purpose: To assess the accuracy of routine IV contrast-enhanced CT for the detection of
invasive colorectal carcinoma.
Materials and Methods: Routine CT studies were reviewed by 3 independent readers in 100
adults (mean age, 54.2 years; 48 men/52 women). CT technique consisted of oral and IV
contrast utilizing a standard abdomen/pelvis protocol. All patients had undergone optical
colonoscopy within 6 months of CT; 29 had invasive colorectal cancer, 71 did not. Each
colonic segment was evaluated for colorectal cancer at CT utilizing a 5-point scale
(1=definitely not cancer, 2=probably not; 3=possibly; 4=probably; 5=definitely cancer). ROC
analysis was performed to derive threshold-independent results. For threshold analysis,
scores of 1-2 were considered negative and 3-5 positive.
Results: By-patient sensitivity for the 3 readers was 69.0%, 65.5%, and 82.8% (pooled
sensitivity = 72.4%). By-patient specificity was 88.7%, 84.5%, and 77.5% (pooled specificity
= 83.6%). The area under the ROC curve (AUC±SE) for the 3 readers was 0.826±0.050,
0.775±0.055, and 0.857±0.040 (p=0.372).
Conclusion: Routine contrast-enhanced CT is reasonably effective for colorectal cancer
detection, even without dedicated colonic preparation or distention. These results may have
implications for CT colonography when the goal is cancer detection rather than prevention
(e.g. a non-cathartic approach in elderly patients).


8:35 a.m.
64MDCT: Use in the Detection of Biliary Strictures and Choledocholithiasis
Stephan Anderson, MD, Boston University Medical Center; Eunjin Rho; Jorge Soto
Purpose: To evaluate the accuracy of 64MDCT in evaluating biliary pathology.
Materials and Methods: This study included adult patients receiving abdominal CT with
64MDCT as well as MRCP and/or ERCP. This included 75 (33 males, 42 females) patients.
Scans were completed with intravenous contrast using a slice thickness of 1.25 mm. Two
reviewers independently evaluated the CT datasets using axial images as well as MPR and
MinIP reformations. Reviewers were asked to determine whether a biliary stricture was
present and indicate its cause. Reviewers also evaluated for evidence of choledocholithiasis.
MRCP and/or ERCP reports were used as gold standard.
Results: In evaluating biliary strictures, diagnostic accuracies were as follows: Reviewer 1:
sensitivity, 70%; specificity, 94%; PPV, 84%; NPV, 88%; Reviewer 2: sensitivity, 72%;
specificity, 98%; PPV, 94%; NPV, 90%. Diagnostic accuracies in distinguishing benign from
malignant etiologies revealed decreased sensitivities; specificity remained high.
In detecting choledocholithiasis, the diagnostic accuracies were as follows: Reviewer 1:
sensitivity, 72%; specificity, 95%; PPV, 81%; NPV, 92%; Reviewer 2: sensitivity, 67%,
specificity, 95%, PPV, 80%; NPV, 90%.
Conclusions: Given increasing use of 64 MDCT in abdominal imaging, it is important for
radiologists to recognize strengths and limitations of this modality in evaluating biliary
disease.
8:45 a.m.
Low Tube Voltage, High Tube Current 64-Slice MDCT for Detection of Hypervascular
Liver Tumors: a Phantom Study
Sebastian Tobias Schindera, MD, Duke University Medical Center; Rendon Nelson; Erik
Paulson; Tracy Jaffe; Chad Miller; David DeLong; Keigo Kawaji; Terry Yoshizumi;
Srinivasan Mukundan
Purpose: To investigate the effect of low kVp / high mAs MDCT for detection of
hypervascular liver tumors on CNR, lesion conspicuity, and radiation dose.
Materials and Methods: A custom liver phantom containing 16 cylindrical cavities (3, 5, 8
and 15mm) filled with various iodinated solutions and an anthropomorphic phantom were
scanned with a 64-slice MDCT scanner at 140, 120, 100 and 80kVp with corresponding mAs
settings at 225, 275, 420, and 675mAs, respectively. The CNRs for eight lesions filled with
different iodinated solutions were calculated. Three radiologists graded the conspicuity of 16
lesions.
Results: As the tube voltage decreased from 140 to 80kVp, the CNR increased linearly. The
CNR increase of the lesions ranged from 147% to 5,100% comparing the 140-kVp with the
80-kVp protocol (P < 0.001). The lower the CNR of a lesion at 140kVp, the higher the
percentage increased at 80kVp. At 80kVp, the highest lesion conspicuity was seen. The
effective dose decreased by 57% comparing the 140-kVp (11.1 ± 0.6mSv)with the 80-kVp
protocol (4.8 ± 0.3mSv) (P < 0.001).
Conclusions: The data support the use of 80 kVp with high mAs setting for 64-slice MDCT
during the late arterial phase to detect hypervascular liver tumors.


8:55 a.m.
Imaging Accuracy of Hepatocellular Carcinoma (HCC) Staging in Cirrhotic Patients
Undergoing Liver Transplantation
Alessandro Furlan, UPMC Radiology; Omar Almusa; James Wallis Marsh; Michael
Federle
Purpose: To assess the imaging accuracy for pre-transplant staging of HCC in cirrhotic
patients with respect to the Milan and UCSF criteria.
Materials and Methods: 1029 consecutive cirrhotic patients who underwent liver
transplantation in the last 5 years were evaluated. The report of the last radiological study
prior to transplantation (970 CT; 59 MRI) was compared to the final explant pathologic
report. Note was made of the number and dimensions of lesions reported as HCC and signs
of macro-vascular invasion. Patients were classified according to the Milan (solitary nodule
≤ 5 cm or 2 or 3 nodules, none >3 cm, no vascular invasion) and UCSF (solitary nodule ≤6.5
cm or 2 or 3 nodules, none >4.5 cm and total diameter ≤ 8 cm, no vascular invasion) criteria.
Results: Concordance between the radiological and pathologic staging was demonstrated in
993 (96.50%) and 1003 (97.47%) patients according to the Milan and UCSF criteria,
respectively. Under-staging by imaging was noted in 28 patients (2.72%) and 19 patients
(1.85%) and over-staging in 8 patients (0.78%) and 7 patients (0.68%), according to the
Milan and UCSF criteria respectively.
Conclusions: CT and MRI are highly accurate at staging HCC with respect to the Milan and
UCSF criteria.
9:05 a.m.
Apparent Diffusion Coefficient Measurements in Chemoembolized Hepatocellular
Carcinomas
Charan Singh, MD, NYU Medical Center; Bachir Taouli; Sooah Kim; Alec Goldenberg;
Hearns Charles; Timothy Clark; Theresa Aquino
Purpose: To compare apparent diffusion coefficient (ADC) obtained with diffusion-
weighted MRI (DWI) in viable and nonviable areas of hepatocellular carcinoma (HCC)
following transarterial chemoembolization (TACE).
Methods: A preliminary series of 16 patients who underwent TACE of 17 HCCs was
analyzed. MRI was obtained with a mean interval of 2.2 months following TACE. The % of
necrosis was assessed using post-contrast subtracted images by consensus of 2 radiologists.
ADC values were measured within areas of 100% necrosis and areas of incomplete necrosis,
and within the regions of maximal enhancement.
Results: A total of 17 HCC nodules (mean size 5 cm) were analyzed. Median % necrosis on
post-contrast images of all nodules was 80 %. 6 (35%) HCCs with 100% necrosis had a mean
ADC of 2.01 x 10-3 mm2/sec; whereas 11 (65%) HCCs with incomplete necrosis had mean
ADC of 1.69 x 10-3 mm2/sec measured throughout the entire tumor (P =0.38). Within
incompletely necrotic HCCs, ADC of viable tumor was 1.26x10-3 mm2/sec, compared to
1.86 x 10-3 mm2/sec within areas of necrosis (P
Conclusions: In our preliminary experience, ADC differs significantly between areas of
viable and nonviable tumor following TACE of HCC.


9:15 a.m.
Tumor Response of Hepatocellular Carcinoma (HCC) Following Intra-arterial
Treatment with Yttrium-90 (90Y) Microspheres: Use of Criteria besides RECIST
Frank H. Miller, MD, Northwestern University Feinberg School of Medicin; Ana L.
Keppke; Denise H. Reddy; Jie Huang; Jianhua Jin; Andrew Larson; Riad Salem
Purpose: 90Y radioembolization is an emerging therapy for unresectable HCC. Although
multiple studies have evaluated therapeutic response based on size, only a few have used
necrosis as criteria for response. The purpose was to describe imaging features following 90Y
using various criteria for response.
Materials and Methods: CT of 42 patients with 76 90Y treated lesions were analyzed using 4
criteria: size (WHO and RECIST), necrosis, and combined criteria (RECIST and necrosis).
Imaging features of treated lesions included both nodular and peripheral rim enhancements.
Survival was assessed using Kaplan-Meier.
Results: Response rate was 23% by RECIST, 26% by WHO, 57% by necrosis, and 59% by
combined criteria. Response by necrosis and combined criteria detected response earlier than
size criteria alone. Ten responding lesions initially increased in size. Enhancing peripheral
nodules increased in size in 10, decreased in two and disappeared in two following therapy.
Twenty-one of 25 lesions with thin rim enhancement following 90Y responded to treatment.
The median survival was 660 and 236 days for Okuda I and II patients, respectively.
Conclusions: Combined size and necrosis criteria may provide more accurate assessment of
response to 90Y than size criteria alone.
9:25 a.m.
Liver Lesion Detection and Characterization in Patients with Colorectal Cancer: Is
Non-enhanced PET/CT or Contrast-enhanced PET/CT or Liver MRI Better?
Colin Patrick Cantwell, MD, Massachusetts General Hospital; Bindu Setty; Nagaraj
Holalkere; Duyshant Sahani; Peter Hahn; Alan Fischman; Michael Blake
Purpose: To compare non-enhanced PET/CT, contrast-enhanced PET/CT and MRI for
detection and characterization of liver lesions in colorectal cancer.
Methods and Materials: A retrospective search of imaging database of 2004-2005 was
performed for colorectal cancer patients with suspected liver metastases evaluated with both
PET/CT and MRI. Thirty three patients met our selection criteria and had liver metastases
proven either by biopsy or on follow up imaging. All patients had a gadolinium enhanced
liver MR on 1.5 T (GE Medical system) within 6 weeks of PET/CT. The liver lesions seen on
NE-PET/CT and CE-PET/CT and MR images were characterized on an ordinal scale of 0-5.
Receiver operating characteristic (ROC) analysis was performed.
Results: A total of 112 lesions were present on follow up. Accurate detection rate on NE-
PET/CT, CE-PET/CT and MRI was 73.6% (81/110), 90.9% (100/110) and 95.4% (105/110)
respectively. The sensitivity, specificity and accuracy for characterization of liver lesions
present on NE-PET/CT were 95.3%, 80%, and 94.2%, on CE-PET/CT were 95.2%, 87.5%,
and 94.6% and on MRI were 98.9%, 100% and 99% respectively.
Conclusions: The accuracy in the detection and characterization of liver lesions in patients
with CRC was highest on MRI followed by contrast enhanced and non-enhanced PET/CT.


9:35 a.m.
Automated RECIST and WHO Criteria Measurements and Volumetric Segmentation
of Liver Lesions on Multi-slice CT
Bassel Atassi, MD, Northwestern University; Vahid Yaghmai; Maryam Rezvani; Paul
Nikolaidis; Riad Salem; Haytham Soud
Purpose: To assess the feasibility of automatically segmenting and measuring liver lesions
utilizing RECIST and WHO criteria.
Materials and Methods: twenty-two liver lesions on contrast-enhanced abdominal CT scans
of twelve patients were selected. For the purposes of this preliminary feasibility study,
confluent liver lesions were excluded. All scans had been acquired using multi-slice CT with
5mm slice thickness. Prototype software program (Siemens Medical Solutions, Forchheim,
GER) was utilized to measure the maximal diameter (RECIST criteria) and cross-product of
diameters (WHO criteria) both manually and automatically. Pearson product moment
correlation coefficient (r) was calculated. The quality of automated volumetric segmentation
for each liver lesion was evaluated using a five-point scale (1: poor, 5: excellent).
Results: The prototype software successfully segmented all liver lesions. Nine lesions (41%)
had a segmentation score of 5; Nine (41%) a score of 4 and the remaining four (18%) a score
of 3. The average score was 4.23 (SD = 0.75). The correlation coefficient between manual
and automated measurements using RECIST and WHO criteria was 0.99 (p
Conclusion: Our preliminary data suggests that automated segmentation as well as RECIST
and WHO measurements of the liver lesions may be performed rapidly and accurately.
9:45 a.m.
Quantification of Liver Iron Deposition with Opposed-phase Imaging and T2*
Sequence with Explant Correlation
Ruth Lim, NYU Medical Center; Bachir Taouli; Keren Tuvia; Tejas Parikh; Mariela Losada
Purpose: Quantify liver iron deposition with opposed-phase imaging (OPI) and T2*
sequence.
Materials and Methods: A review of liver MR images of 36 patients who underwent liver
transplantation was performed. OPI was used in all patients, T2* in 26 patients. ROIs were
drawn on the liver and muscle to measure SI (signal intensity). The following ratios were
calculated, Ropi = (SIout - SIin)/SIoutx100 and for T2*, liver/muscle ratio, LM
T2*=SIliver/SImuscle x 100.
Results: 16 patients had hepatic iron deposition. Ropi was significantly higher in patients
with iron deposition than in patients without iron (mean Ropi 14.3 ± 14.9 vs. 5.2 ± 6.3; p <
0.01). LM T2* was significantly lower in patients with iron deposition vs. patients without
iron (mean LM T2* 47.9 ± 19.5 vs. 74.1 ± 20.5; p < 0.008). There was a significant positive
correlation between Ropi and histologic iron grade (r 0.58, p < 0.0001), and a significant
negative correlation between LM T2* and histologic iron grade (r -0.71, p < 0.001).
Conclusions: Liver SI changes on OPI and T2* imaging can be used to quantify hepatic iron
deposition, T2* showing a better correlation than OPI.


9:55 a.m.
Quantification of Liver Volume, Liver Fat Fraction and Subcutaneous-visceral Fat
Changes with 3T MRI after Hypocaloric Diet in Morbidly Obese Patients
Abe Shaikh, NYU Medical Center; Bachir Taouli; Ting Song; Heekoung Youn; George
Fielding; Christine Ren
Purpose: To investigate the impact of a short period of hypocaloric diet on liver volume
(LV), liver fat fraction (LFF) and subcutaneous-visceral fat measured with 3T MRI in
morbidly obese patients before laparoscopic adjustable gastric banding (LAGB).
Materials and Methods: Nine morbidly obese patients (mean baseline weight and BMI,
140.5 kg and 47.8) were prospectively enrolled on a 2 week hypocaloric diet before LAGB.
3T MRI was obtained at baseline and at the end of the diet. The following parameters were
obtained: Liver volume (LV), liver fat fraction (LFF) calculated with in- and out-of phase
imaging, subcutaneous and mesenteric fat surface at the level of L2.
Results: All patients experienced weight loss after diet (mean weight loss 6.6 kg). Baseline
and follow-up LV were 3.73 and 3.08 l, LFF 27.1-20.9%, subcutaneous-mesenteric fat
surfaces 80.8-75.9 mm2. There was a significant correlation between weight loss and LV
change (r 0.76, p < 0.02), and between LV and LFF changes (r 0.81, p < 0.008); and a weak
correlation between weight loss and LFF change (r 0.50, p=0.17).
Conclusions: These preliminary results demonstrate that MRI can document rapid changes
in LV, LFF and subcutaneous-visceral after hypocaloric diet in morbidly obese patients.
10:45 a.m.
Autoimmune Pancreatitis: Evolution of Disease with MDCT Features that Predict
Response to Steroid Treatment
Nisha Sainani, MD, DMRE, Massachusetts General Hospital; Mehrine Shaikh; Zarine
Shah; Dimitry Frinkelberg; Carlos Fernandes-Del-Castillo; Dushyant Sahani
Purpose: Evaluate natural evolution of autoimmune pancreatitis (AIP) on MDCT and
identify features that may predict outcome following steroids.
Materials and Methods: 15/61 patients with AIP, treated with steroids, with or without
surgery and imaged, pre and post-therapy were included in this study. Baseline and serial
follow-up MDCT images were reviewed for pancreatic, peri-pancreatic and ductal changes
and correlated with clinical and laboratory outcome.
Results: MDCT features noted were, diffuse swelling (13/15), loss of lobularity (15/15),
‘halo’ (12/15), focal pancreatic mass lesion (6/12), tail cut off (12/15), PD and CBD
narrowing (8/15). Following steroid therapy, there was complete resolution of findings in 5/9,
partial resolution in 3/9 and no change in 1/9. 2/15 underwent surgery followed by steroids
and revealed partial improvement. Imaging features correlated with clinical outcome.
Conclusion: The evolution of disease is in the form of swelling, heterogeneity and ‘halo’
with subsequent retraction of the tail of pancreas, decrease in swelling and strictures
involving the PD and CBD. Diffuse enlargement of the pancreatic parenchyma and ‘halo’ are
predictors of good response to therapy. Presence of duct strictures, atrophy and focal mass in
the pancreatic head were poor predictors.



10:55 a.m.
Correlation of FDG-PET and MDCT Features in Mucinous Lesions of Pancreas for
Lesion Characterization and Prediction of Malignancy
Dushyant Sahani, MD, Massachusetts General Hospital; Nisha Sainani; Bindu Setty;
Micheal Blake; Carlos Fernandes-Del-Castillo; Alan Fischman
Purpose: MDCT features in characterization and differentiating benign from malignant
cystic lesions
If FDG-PET can predict malignancy and correlate areas of increased FDG activity with
morphologic features on MDCT
Materials and Methods: In this ongoing study, 12 suspected mucinous lesions of pancreas,
underwent a dedicated dual-phase 16-MDCT scan of abdomen and whole body FDG-PET.
Axial/2D/3D images were evaluated for lesion morphology, diagnosis and characterization
into benign or malignant on MDCT. FDG uptake on PET was evaluated and SVU values
were calculated. CT and PET images were fused, areas of increased uptake were correlated
with morphological features on CT.
Results: 5/12 lesions were main-duct IPMN’s, 5/12 side-branch IPMN’s, 2/12 unclassified
cysts, 10/12 were benign, 2/12 were malignant. The PPV of MDCT and FDG-PET for
malignancy was 50% and 66.6%, while the NPV for benignity was 100% for both. Gross
main ductal dilatation, thick-septation, mural-nodule and lymphadenopathy favored
malignancy on MDCT. Areas with increased FDG uptake correlated with regions of thick-
septae, mural-nodule and thick wall on MDCT. Higher values of SVU suggested higher
grade of malignancy.
Conclusions: MDCT is reliable for diagnosing the mucinous lesions of pancreas and
predicting malignancy. FDG-PET is complementary to CT and can increase the diagnostic
confidence.


11:05 a.m.
Is Secondary Bowel Thickening a Reliable Sign in Differentiating Perforated from Non-
perforated Appendicitis?
Monica Jain, MD, NYU School of Medicine; Michael Macari; James Babb; Cristina Hajdu
Purpose: To assess several CT findings in differentiating perforated from non-perforated
appendicitis.
Methods: 102 patients with perforated and 65 with non-perforated appendicitis were
identified from a pathology database. Without knowledge of the pathological findings the
diameter of the appendix, presence of abscess, phlegmon, free air, gas within the appendix,
and secondary thickening of the terminal ileum (>4 mm) were assessed in patients in whom
preoperative CECT was available. Fisher’s exact test was used to asses for the association of
perforation and the above CT findings.
Results: CECT was performed in 87/167 patients of which 50 (57.5%) had perforation at
pathology. Patients with perforation had significantly larger diameters (1.37cm ± 0.37cm)
than those without (1.05cm ± 0.39cm) (p
Conclusion: Secondary bowel thickening is an important CT finding that may be used to
help predict perforated appendicitis.


11:15 a.m.
Practice Patterns in Imaging of the Pregnant Patient with Abdominal Pain– A Survey
of Academic Centers
Tracy A. Jaffe, MD, Duke University Medical Center; Chad M. Miller; Erik K. Paulson;
Elmar M. Merkle; Tracy A. Jaffe
Purpose: To evaluate current practice patterns in imaging pregnant women with abdominal
pain.
Method and Materials: A survey was sent to the abdominal imaging division of 183
radiology residency programs in the United States. The survey asked for information
regarding CT and MRI imaging of abdominal pain in pregnant patients.
Results: 77 surveys were returned (42%). 73/77 (95%) of respondents perform CT in
pregnant women when benefits outweigh risks. All 77 perform MRI in pregnant women.
53/77 (69%) of respondents do not give gadolinium in pregnancy. In the setting of trauma,
respondents chose CT over MR in all three trimesters (73% vs. 5%, 83% vs. 4%, and 87% vs.
3%). In the second / third trimester, more respondents prefer CT to MRI for maternal renal
calculus (38%/49% vs. 16%/18%), appendicitis (47%/57% vs. 39%/30%), and abscess
(47%/56% vs. 43%/36%). However, MRI is preferred for imaging of appendicitis and
abscesses in the first trimester (42% and 48% vs. 30% and 30%, respectively).
Conclusion: Both CT and MRI are performed in pregnant women on a regular basis with
gadolinium administered infrequently. Academic radiologists prefer CT to MRI in imaging
abdominal complaints in pregnant women, especially in the second and third trimester.
11:25 a.m.
Efficacy of Specific MR Sequences in Distinguishing Peritoneal Carcinomatosis
Nancy Hammond, MD, Northwestern University, Feinberg School of Medici; Paul
Nikolaidis; Lee Myers; Vahid Yaghmai; Helena Gabriel; Frank H. Miller
Purpose: To assess the efficacy of specific MR sequences in distinguishing
peritoneal/retroperitoneal enhancement secondary to carcinomatosis.
Materials and Methods: MRI studies of 24 patients with known peritoneal carcinomatosis
and 21 with peritoneal/retroperitoneal enhancement secondary to advanced portal
hypertension were pre-selected and randomized by a fellowship-trained body imager. Images
were reviewed on PACS by three other fellowship-trained body imagers. Sequences reviewed
included T1-SE, HASTE, and multiphase post-gadolinium T1-FS-GRE. Specific
characteristics evaluated included degree, thickness, and extent of enhancement. Separate
confidence levels for arterial and delayed phases assessing the likelihood of neoplastic
disease were assigned (range 1-5; 5-highest malignant likelihood).
Results: 17 of 24 (71%) on arterial phase and 22 of 24 (92%) on delayed phase were
correctly identified (confidence level 4/5) as having peritoneal carcinomatosis. In seven
cases, the delayed phase increased confidence that findings were based on malignancy rather
than portal hypertension. In control cases, 19 of 21 (90 %) on arterial phase and 17 of 21
(81%) on delayed phase were correctly identified as enhancement secondary to portal
hypertension.
Conclusion: The distinction of peritoneal enhancement from malignancy versus portal
hypertension can be reliably made by MRI. The use of delayed phase imaging increases
confidence in making this distinction.


11:35 a.m.
Posterior Deep Peritoneal Pelvic Endometriosis with Rectosigmoïd Involvement. What
does Endocavitary MRI add to Diagnosis? Preoperative Prospective Study with
Surgical Correlation.
Catherine Roy, MD, Radiology B Department; Veronique Thoma; Amelie Bibloque; Arnaud
Wattiez; Joel Leroy
Purpose: US and MRI are able to detect rectosigmoid infiltration but their usefulness is still
debated.
To assess additional value of TVUS and MRI obtained by both phased-array body (bMRI)
and endovaginal (evMRI) coils for predicting intestinal involvement.
Material and Methods: 47 women underwent before endometriosis nodule resection TVUS
and ev-bMRI. MRI performed using T2w FSE, pre-postinjected T1w GE.
Images were retrospectively reviewed and correlated with surgery and pathological findings.
Results: At pathology, 43 women presented a deep muscle layer invasion, 2 an isolated
serosal involvement and 2 had no intestinal extension. All nodules had well-defined borders,
low signal intensity with small hyperintense spots on T2w (18). They were homogeneous and
hypoechoic on TVUS. Spiculated strandings were most often seen on MR T2w (44) than on
TVUS (35). Deep extension was diagnosed as hypoechoic or hypointense homogeneous
thickening of muscle layer in 32 TVUS and 41 MR. A hyperintense layer of submucosa
surrounding the nodule was found on MR for all cases. EvMRI was better to diagnose
intestinal involvement for lesions inferior to 2 cm localized inside Douglas pouch.
Conclusion: ev-bMRI gives additional informations over TVUS for diagnosis of rectal
involvement before surgery.


11:45 a.m.
Abdominal Lymph Nodes Seen on Coronal Reformations from Isotropic Voxels using
16-Slice MDCT: Do we Really See them Better than on the Axial Scan?
Sebastian J. Chlebek, MD, Duke University Medical Center; Tracy A. Jaffe; Lisa M. Ho;
Erik K. Paulson; Tracy A. Jaffe
Purpose: To test the hypothesis that abdominal lymph node enlargement identified on
coronal reformations obtained with isotropic MDCT data sets is equal to the axial data sets of
the abdomen and pelvis.
Methods and Materials: 105 consecutive patients with unexplained abdominal pain
underwent 16-slice MDCT with coronal reformations. Two independent blinded readers
reviewed a randomized set of scans (axials and coronals) and identified lymph nodes in four
intraabdominal locations: root of the mesentery, right lower quadrant, upper retroperitoneum
(diaphragm to iliac bifurcation), and lower retroperitoneum (below iliac bifurcation). One
month later readers reviewed the scan obtained in the other imaging plane for the same
findings. P values from the signed rank test of differences in the rates of positive calls
between the two scans were obtained.
Results: P values for the signed rank test of differences are as follows: root of mesentery,
0.11; right lower quadrant mesentery, 0.28; upper retroperitoneum, 0.006; and lower
retroperitoneum, 0.20.
Conclusion: With the exception of the upper retroperitoneum, there is no statistically
significant difference in identification of abdominal lymph nodes between the axial and
coronal planes. Readers are more likely to identify upper retroperitoneal lymph nodes in the
axial plane.


11:55 a.m.
Multidetector CT Detection of a Small Amount of Isolated Pelvic Free Fluid in Male
Blunt Trauma Patients: Incidence and Significance
Jinxing Yu, MD, MCV Hospitals / VCU Medical Center; Ann S. Fulcher; Dengbin Wang;
Jonathan D. Ha; Madison McCulloch; Ajai K. Malhtra; Robert A. Halvorsen; Mary Ann
Turner
Purpose: To determine incidence and significance of a small amount of isolated pelvic free
fluid in male blunt trauma patients without solid organ injury.
Methods and Materials: Male blunt trauma patients with abdominal/pelvic multidetector
CT (MDCT) from January 2005 to July 2006 were identified from the trauma registry at a
level 1 trauma center. 750 MDCT scans were performed within 6 hours of admission. Two
abdominal radiologists independently reviewed the CT scans. CT scan assessment included
attenuation and volume measurements of isolated pelvic free fluid. Interpretations were
correlated with the final clinical diagnoses.
Results: Isolated pelvic free fluid without solid organ injury was found in 5.2% (37 of 750)
of patients by reader 1 and 5.3% (40 of 750) by reader 2 (k value, 0.79). The mean volume
was 2.4 ± 2.1 ml (reader 1) and 2.7 ± 1.8 ml (reader 2). The mean Hounsfield unit of free
fluid was 5.7 ± 4.1 (reader 1) and 4.8 ± 3.7 (reader 2). No patients in this group had a missed
bowel injury.
Conclusions: A small amount of isolated pelvic free fluid measuring less than 10 HU in male
blunt trauma patients likely represents physiological fluid rather than a sign of bowel injury.


12:05 p.m.
Automated Volumetric, RECIST and WHO Measurements of Intra-abdominal Lymph
Nodes on MSCT: Preliminary Results
Vahid Yaghmai, MD, Northwestern University; Maryam Rezvani; Haytham Soud; Bassel
Atassi; Paul Nikolaidis; Frank Miller
Purpose: To assess the feasibility of automatically segmenting and measuring lymph nodes
volumetrically and by RECIST as well as WHO criteria.
Materials and Methods: Thirty lymph nodes on contrast-enhanced abdominal and pelvic
multi-slice CT scans of eleven patients with history of lymphoma were selected (para-
aortic/para-caval N=10; mesenteric N=10; iliac chain N=6; inguinal N=4). Prototype
software program (Siemens Medical Solutions, Forchheim, GER) was utilized to obtain
RECIST and WHO measurements both manually and automatically. Two board-certified
radiologists performed the manual measurements. The software automatically calculated the
volume of each lymph node. The quality of automated segmentation for each lymph node
was evaluated in consensus by the radiologists on a five point scale (1:poor-5:excellent).
Results: The software successfully segmented all the lymph nodes ( Score 5: 18 lymph
nodes; Score 4: 10 lymph nodes; Score 3: 2 lymph nodes). The average quality of
segmentation was 4.53 (SD = 0.63). The correlation coefficient between manual and
automated measurements using RECIST and WHO criteria was 0.98 (p
Conclusion: Our preliminary data suggests that automated segmentation as well as
volumetric, RECIST and WHO measurements of the intra-abdominal lymph nodes is feasible
and accurate. This may affect follow-up of oncology patients.


12:15 p.m.
Multi-slice CT of the Stomach: Comparison of VoLumen and Water in the Same
Patient Population
Paul Nikolaidis, MD, Northwestern University, Feinberg School of Medici; Warren
Brandwein; Vahid Yaghmai; Nancy Hammond; Richard M. Gore; Frank H. Miller; Aheed
Siddiqi; Ayis T. Pyrros
Purpose: To compare the degree of gastric distension and visualization of gastric wall detail
when using water versus a commercially available neutral oral contrast agent (VoLumen) on
multislice CT, utilizing the same patient population.
Materials and Methods: 82 multislice CT scans of 41 patients (average age: 58) imaged
repeatedly for pancreatic pathology were reviewed by two fellowship trained abdominal
imagers. Readers were blinded to the type of oral contrast agent used. Each patient was
imaged once with water, once with VoLumen, on different dates. Studies were randomized.
Each patient received either 1200 mL of water or 1300 mL of VoLumen. Using a subjective
grading scale (1: none-5: excellent) gastric distension and visualization of gastric wall detail
were scored.
Results: Mean scores for VoLumen and water, respectively, when assessing gastric
distension were: 3.98 vs 2.54, p=0.00001. Mean scores for visualization of gastric wall detail
for VoLumen and water, were: 3.56 vs. 2.22, p=0.00005.
Conclusions: VoLumen results in far superior evaluation of the stomach on multislice CT.
VoLumen significantly improved distention of the stomach as well as visualization of gastric
wall detail. The results of this study imply that VoLumen may be utilized whenever gastric or
perigastric pathology is suspected.


12:25 p.m.
Comparison of the Utility of CT Enterography and Capsule Endoscopy in Patients with
Abdominal Pain or Anemia
Marina Giursecu, MD, Mayo Clinic Arizona; Marina Giurescu; Amy Hara; Brie Noble
Purpose: To compare CT Enterography (CTE) and capsule endoscopy (CE) in patients
presenting with abdominal pain (AP) or anemia.
Materials and Methods: A retrospective review of the electronic database from Mar 2004-
Mar 2006 identified 88 pts (52F/36M, 61 yrs + 17) who had undergone both CTE and CE for
AP or anemia. The average time between CTE and CE exams was 27 days (range 1-176
days). Pathology results when available were also recorded.
Results: 36 pts underwent CTE and CE for AP. More pts had positive CE results (12/36,
33%) than CTE (6/36, 17%). Positive pathologic correlation was proven in 11/27 pts.
52 pts underwent CTE and CE for anemia. Almost half had positive CE exams (24/52, 46%)
while CTE was positive in only 10/52 (19%). Positive pathologic correlation was proven in
16/34 pts.
CE detected more inflammation (17 vs 7), masses (10 vs 4) AVMs (9 vs 2) compared to
CTE. No proven abnormalities were seen at CTE and not CE. Of 10 masses at CE, 3 were
also seen at CTE and proven surgically (lymphoma, hemangioma, adenoma), the remainder
had negative or no follow-up.
Conclusion:CE detects more small bowel disease than CTE in pts with AP and anemia.


12:35 p.m.
Comparison of CT Enterography (CTE) Using 64 Row Detector MDCT with Wireless
Video Capsule Endoscopy (VCE) in the Investigation of Small Bowel Disease
Brian C. Lucey, MD, Boston University Medical Center; Daniel Mishkin; Jorge A. Soto
Purpose: To evaluate the capability of CTE in the identification of small bowel disease using
video capsule endoscopy (VCE) as the gold standard and to identify the role of CTE in the
work up of patients with suspected small bowel pathology.
Materials and Methods: We prospectively evaluated 55 patients that were referred for
investigation of suspected small bowel pathology who were scheduled for VCE. CTE prior to
VCE was performed in all cases. CT was performed on a 64MDCT. Neutral oral contrast,
VoLumen ® 1350mL was given to all patients. VCE was used as the gold standard. The CTE
findings were compared to VCE findings.
Results: 5 patients avoided a VCE as a direct result of the CTE findings. In patients with
suspected Crohn disease, the sensitivity and specificity of CTE was 100% (55-100%) and
85% (58-98%) respectively. In patients with obscure GI bleeding, the sensitivity and
specificity of CTE was 8% (8-25%) and 100% (59-100%) respectively.
Conclusion: CTE is a valuable imaging modality in the investigation of Crohn disease. CTE
is also valuable as a pre capsule examination and helps determine which patients should not
undergo VCE. CTE is of limited value but still has a role in the investigation of obscure GI
bleeding.
                              Society of Uroradiology
                              Scientific Paper Session
                              Sunday, April 15, 2007
                               7:30 a.m. – 12:35 p.m.

7:30 a.m.     Welcome and Announcements

7:35 a.m.     SUR Research Award Reports

                     In-Vivo Renal Blood Flow Quantification Using Contrast
                     Enhanced Sonography
                     Mitchell E. Tublin, MD
                     University of Pittsburgh

                     Urinary Oxygen Tension Measurement in Normal Renal
                     Transplants Using MRI
                     Zhen Jane Wang, MD
                     University of California, San Francisco

Session I:    MR of Renal Tumors
              Erick Remer, MD, Moderator

7:45 a.m.     Characterization of T1 Hyperintense Renal Lesions with Diffusion-
              weighted MRI: Preliminary Experience
              Sooah Kim, MD

7:55 a.m.     Papillary and Clear Cell Renal Cell Carcinomas: MRI Features
              Correlated with Histopathology
              M. Raquel B. Oliva, MD

8:05 a.m.     Lymphotrophic Magnetic Nanoparticle Enhanced MRI (LNMRI) – A
              Novel Approach for Noninvasive Assessment of Lymph Node Assessment
              in Renal Cell Cancer – Pilot study
              Alexander R. Guimaraes, MD

Session II:   Renal Tumor Ablation
              Stuart Silverman, MD, Moderator

8:15 a.m.     Oncologic Efficacy and Factors Influencing the Success of Computerized
              Tomography Guided Percutaneous Radiofrequency Ablation of Renal
              Cell Carcinomas
              Ronald J. Zagoria, MD

8:25 a.m.     Comparison of Cost Effectiveness and Outcome of Percutaneous and
              Laparoscopic Renal Cryoablation
              Tony Shadid, MD
8:35 a.m.      Stereotactic Radiosurgical Ablation of Renal Tumors: Initial Experience
               with CT Evaluation
               Shetal N. Shah, MD

Session III:   Prostate Carcinoma
               Part 1: MR Evaluation
               Philip Kenney, MD, Moderator

8:45 a.m.      Standardized Threshold Approach using Three-Dimensional Proton MR
               Spectroscopic Imaging in Prostate Cancer Localization of the Entire
               Prostate
               Jurgen J. Futterer, MD

8:55 a.m.      Value of Endorectal Coil T2-Weighted MRI Combined with 3D-CSI
               Spectroscopy in the Diagnosis of Prostate Cancer in Patients with
               Elevated PSA (≥ 4 NG/ML)
               Gert O. De Meerleer, MD

9:05 a.m.      The Usefulness of Diffusion-weighted Imaging for the Prediction of
               Prostate Cancer Localization at 3T
               Chan Kyo Kim, MD

9:15 a.m.      Feasibility of MR Imaging Guided Biopsy of the Prostate Using a 32-
               channel Phased-array Coil at 3 Tesla
               Thomas Hambrock, MD

               Part 2: PET/CT and Post-Prostatectomy Cystography
               Bernard King, MD, Moderator

9:25 a.m.      Focal Hypermetabolism in the Prostate Gland on FDG-PET/CT:
               Frequency of Prostate Cancer and Correlation with PSA
               Mark Alan Nathan, MD

9:35 a.m.      Diagnostic Performance of Conventional Cystography on Vesicourethral
               Leaks Following Radical Prostatectomy: as Compared with MDCT
               Cystography
               Hak Jong Lee, MD

9:45 a.m.      Cystography after Robotic Assisted Laparoscopic Prostatectomy:
               Predictor of Foley Catheter Duration?
               Isabel Rudolf, MD

10:05 a.m.     Break

Session IV:    Contrast Media and Adverse Reactions
               Sam Morcos, MD and Bill Bush, MD, Moderators

10:30 a.m.     Frequency of Iodinated and Gadolinium Contrast Reactions: A
               Retrospective Review of 407,589 Doses
               Christopher Harker Hunt, MD
10:40 a.m.    Contrast Induced Nephrotoxicity vs. "Hospital Nephrotoxicity" – What
              is the Relative Risk with Intravenous Injection?
              Richard J. Bruce, MD

10:50 a.m.    Nephrogenic Systemic Fibrosis - A Very Late Severe and Serious
              Adverse Reaction to Gadodiamide
              Henrik S. Thomsen, MD

11:00 a.m.    Nephrogenic Systemic Fibrosis: A Preliminary Report from One
              Institution
              Richard H. Cohan, MD

Session V:    Renal Function; CT Urography
              F. Graham Sommer, MD, Moderator

11:25 a.m.    Renal Function: Serum Creatinine, Calculated Creatinine Clearance and
              Glomerular Filtration Rate
              Joshua Becker

11:35 a.m.    Determination of Split Renal Function by 3D Reconstruction of CT
              Angiograms: Comparison to Gamma Camera renography
              Adam L. Summerlin

11:45 a.m.    CT Urography (CTU): Evaluation of an opacification Strategy Based on
              Individual Acquisition Delay and Furosemide
              Joern Kemper, MD

11:55 a.m.    Radiation Dose Reduction in CT-Urography (CTU): Experimental
              Experience
              Joern Kemper, MD

Session VI:   Ovarian Cancer; Innovative Imaging Techniques
              Marcia Javitt, MD, Moderator

12:05 p.m.    Dual-Energy CT Iodine-Subtraction “Virtual Non-Contrast” Technique
              for Detection of Urinary Stones in the Opacified Collecting System:
              Feasibility PhantomStudy
              Naoki Takahashi, MD

12:15 p.m.    Comparison of Contrast-Enhanced MRI and Integrated FDG PET/CT
              for the Prediction of Recurrent Ovarian Cancer
              Chan Kyo Kim, MD

12:25 p.m.    Intraluminal Optical Coherence Tomography and Intravascular
              Ultrasound in the Delineation of Different Wall Layers of Porcine
              Ureters ex Vivo
              Ulrike L. Mueller-Lisse, MD
7:45 a.m.
Characterization of T1 Hyperintense Renal Lesions with Diffusion-weighted MRI:
Preliminary Experience
Sooah Kim, MD, NYU Medical Center; Bachir Taouli; Monica Jain; Elizabeth Hecht;
Vivian Lee
Purpose: Evaluate diffusion-weighted MRI (DWI) for characterization of T1 hyperintense
renal lesions, including hemorrhagic/proteinaceous cysts and neoplasms.
Materials and Methods: 27 patients with T1 hyperintense renal lesions were retrospectively
evaluated (1.5T) with single-shot EPI DWI (b=0-400 sec/mm²) and pre- post-contrast
dynamic 3D GRE T1. Based on contrast enhancement evaluated on subtraction images,
pathologic findings, and prior/follow-up MRI, renal lesions were categorized by two
observers in consensus as hemorrhagic/proteinaceous cysts vs. neoplasms. Lesion ADC
(apparent diffusion coefficient) was measured using ROIs encompassing the largest section
of the lesion. ADCs of hemorrhagic/proteinaceous cysts were compared with those of T1
hyperintense neoplasms.
Results: 36 T1 hyperintense lesions > 1 cm (mean size 3.7 cm) were evaluated in 27 patients.
On consensus reading, 25 lesions were characterized as hemorrhagic/proteinaceous cysts and
11 as neoplasms. There was a significant difference (p=0.001) between ADCs of benign vs.
malignant lesions: 2.38 ± 0.41x10-3 mm²/sec vs. 1.80 ± 0.47 x 10-3 mm²/sec. Using a
threshold ADC value < 1.90 x 10¯³ mm²/sec for diagnosis of malignancy, we obtained
sensitivity, specificity, PPV, NPV and accuracy of 82%, 92%, 82%, 92% and 89%,
respectively.
Conclusions: In our preliminary experience, DWI can be used to characterize T1
hyperintense renal lesions.


7:55 a.m.
Papillary and Clear Cell Renal Cell Carcinomas: MRI Features Correlated with
Histopathology
M. Raquel B. Oliva, MD, Brigham and Women's Hospital - Harvard Medical School;
Jonathan N. Glickman; Kelly H. Zou; Sze Yiun Teo; Manoel de Souza Rocha; Koenraad J.
Mortele; Stuart G. Silverman
Purpose: To determine if MRI can be used to differentiate papillary (PRCC) from clear cell
renal cell carcinoma (CCRCC), and to examine the histopathologic basis for their MRI
appearance.
Material and Methods: Of 539 RCC, 49 (21 PRCC and 28 CCRCC) underwent MRI; two
radiologists independently compared T1 and T2 tumor signal intensity (SI) relative to renal
cortex, qualitatively and quantitatively (SI ratio=tumor SI/renal cortex SI). Thirty-seven
tumors were examined by a pathologist for tumor architecture, hemosiderin, ferritin, necrosis,
and fibrosis. Statistical analysis included summary statistics, accuracy, and Student\'s t-test.
Results: On T2WI MRI, most PRCC (reader 1:13/21; reader 2:14/21) were hypointense
(PRCC SI ratio=0.62±0.2); none were hyperintense. Most CCRCC (reader 1:21/28; reader
2:17/28) were hyperintense (CCRCC SI ratio=1.44±0.4). Tumor T2 SI ratio<0.05).
Conclusions: MRI can be used to differentiate PRCC from CCRCC. On T2WI, PRCC are
typically hypointense, and never hyperintense. CCRCC are typically hyperintense. Contrary
to prior reports, the hypointense feature of PRCC is due to architectural features, not the
presence of hemosiderin.
8:05 a.m.
Lymphotrophic Magnetic Nanoparticle Enhanced MRI (LNMRI) – A Novel Approach
for Noninvasive Assessment of Lymph Node Assessment in Renal Cell Cancer – Pilot
study
Alexander R. Guimaraes, MD, Ph.D., Center for Molecular Imaging Research;
Massachuset; Mansi A. Saksena; Shahin A. Tabatabaei; Douglas A. Dahl; Mukesh G.
Harisinghani; Ralph Weissleder
Purpose: To assess prospectively LNMRI in characterizing nodal involvement in patients
with renal neoplasm.
Materials and Methods: MRI was performed in 10 patients with renal masses on a 1.5T
system with phased array body coil by using T2 and multi-contrast T2* weighted imaging
prior to and following administration of ferumoxtran-10(Combidex). Nodes that lacked
contrast uptake were malignant, and those with homogeneous uptake were benign.
Results: 6 of 10 patients had lymph nodes that could be assessed by both MRI and histology.
5 of 6 lymph nodes demonstrated concordance (4 benign/1 malignant). There was one false
positive lymph node. Sensitivity was 100% and specificity 80%. T2* was quantified
retrospectively in two primary tumors by using a mono-exponential fit (Osirix): a) RCC
demonstrated a decrease in T2* of 5msec, which resolved at 24hrs; while b) oncocytoma
demonstrated a decrease in T2* of 77.8 ms, which did not normalize after 24hrs.
Conclusions: The high sensitivity (100%) and specificity (80%) of LNMRI in distinguishing
metastatic lymph nodes in patients with kidney cancer is encouraging. Dramatic differences
in contrast uptake between benign (oncocytoma) and malignant (RCC) renal neoplasms may
further offer non-invasive characterization of this poorly understood disease and should be
studied prospectively.


8:15 a.m.
Oncologic Efficacy and Factors Influencing the Success of Computerized Tomography
Guided Percutaneous Radiofrequency Ablation of Renal Cell Carcinomas
Ronald J. Zagoria, MD, Wake Forest University Health Sciences; Michael Traver; David
Werle; Molly Perini; Satoru Hayasaka; Peter Clark; Ronald Zagoria
Purpose: We evaluated a single institution’s experience with CT guided percutaneous
radiofrequency ablation (RFA)of renal cell carcinomas(RCCs).
Materials and Methods: Results from RFA of 124 biopsy-proved RCCs, treated using 128
RFA percutaneous RFA sessions, in 103 patients were reviewed. All RFA treatments were
done using conscious sedation.
Results: The mean age was 70.6 (range 30 - 89) years. Tumors were 0.6 to 8.8 cm (mean 2.2
cm). 108 RCCs (87.1%) were completely ablated. All 94 RCCs < 3.7 cm was significantly
associated with achieving complete tumor eradication (p< 0.001). 5 of the 12 initial treatment
failures were successfully retreated. With each 1 cm increase in tumor diameter over 3.6 cm,
there is a consequent decrease in the likelihood of tumor free survival by a factor of 2.15.
There were 8 (6.3) complications, none of which resulted in long-term morbidity.
Conclusions: This study indicates that RFA can safely and reliably result in complete
eradication of renal cell carcinomas smaller than 3.7 cm in diameter. Treatment of larger
RCCs will result in an increased risk of residual RCC that may require multiple ablation
sessions.
8:25 a.m.
Comparison of Cost Effectiveness and Outcome of Percutaneous and Laparoscopic
Renal Cryoablation
Tony Shadid, MD, University of Wisconsin School of Medicine and Pub; Louis Hinshaw;
Anthony Shadid; Fred Lee, Jr.; Timothy Moon; Stephen Nakada; Sean Hedican
Purpose: The goal of this study is to compare the cost, complications and outcome of
percutaneous (PRC) and laparoscopic renal cryoablation (LRC).
Materials and Methods: A total of 19 PRCs (18 patients, mean age 68.6, mean followup 7.3
months) were compared to 48 LRCs (46 patients, mean age 68.2, mean followup 13.3
months). The groups were compared for pre-ablation tumor size, local recurrence,
complications, hospital charges, and length of hospital stay. Approach was chosen based on
tumor location, proximity to bowel, and co-morbidities. Post-ablation results were monitored
every 3 months with contrast-enhanced MRI (CT if patient had a contraindication to MRI).
Results: PRC had a slightly lower local recurrence rate vs. LRC (10.5 vs. 12.5% p>0.05), a
shorter hospital stay (1.1 +/- 0.2 days vs. 2.5 +/- 2.3 days, p
Conclusions: In select cases, PRC is a safe, effective and more cost effective therapy than
LRC for small renal tumors.


8:35 a.m.
Stereotactic Radiosurgical Ablation of Renal Tumors: Initial Experience with CT
Evaluation
Shetal N. Shah, MD, Cleveland Clinic; Arul Mahadaven; Inderbir Gill; Ming Zhou; Brian
Herts
Purpose: To evaluate CT changes status-post Stereotactic Radiosurgical Ablation (SRSA)
for treatment of renal tumors.
Materials and Methods: Enrolled patients underwent multiphasic CT, CT-guided renal
biopsy with fiducial placement for tracking, and SRSA with delivery of 16 Gy (4 fractions) to
a renal mass. Following post-SRSA multiphasic CT, all underwent partial nephrectomy (IRB
approved clinical trial). Tumor characteristics post-SRSA and changes in kidney and adjacent
tissues were evaluated. Pathologic evaluation was correlated with CT findings. All patients
tolerated the treatment without complications.
Results: To date 5 patients have been treated (mean age 55.4 years, mean tumor size 1.8 cm).
Post-SRSA CT (mean 61 days) showed no injury of the treated kidney or adjacent soft
tissues. Three tumors showed persistent contrast enhancement; all had viable tumor at
pathology. Two hyperdense tumors on NCCT became hypodense (mean decrease 45 HU)
and marginally-enhancing after treatment; both had no viable tumor at pathology. At surgery
there was no injury noted to the adjacent renal parenchyma or soft tissues. The planning
treatment volume margins were visualized pathologically.
Conclusion: From our small pilot study, SRSA is a promising technique for treatment of
renal tumors. Multiphasic CT shows promise determining tumor viability following SRSA.
8:45 a.m.
Standardized Threshold Approach using Three-Dimensional Proton MR Spectroscopic
Imaging in Prostate Cancer Localization of the Entire Prostate
Jurgen J. Futterer, MD, PhD, University Medical Center Nijmegen; Tom W.J. Scheenen;
Stijn W.T.P.J. Heijmink; Henkjan Huisman; Alfred Witjes; Christina Hulsbergen-van de Kaa;
Arend Heerschap; Jelle O. Barentsz
Purpose: To determine the localization accuracy using 3D-proton-MR spectroscopic
imaging (MRSI) of the entire prostate with a standardized thresholds approach in prostate
cancer patients.
Materials and methods: In a prospective study 32 consecutive patients underwent T2-
weighted MR imaging and 3D-MRSI. Three readers recorded the location of suspicious
peripheral zone and central gland cancer nodules on a standardized division of the prostate
(14 regions of interest (ROI)) using a standardized thresholds approach on a five-point scale.
Whole-mount section histopathology was the standard of reference. The sensitivity,
specificity, positive and negative predictive value, overall accuracy and interobserver
agreement were calculated. Areas under the ROI based receiver operating characteristic curve
(AUC) was determined.
Results: The standardized thresholds approach had an accuracy of 81% and an AUC of 0.85-
0.86 for differentiation between benign and malignant ROIs in the peripheral zone and an
accuracy of 87% and an AUC of 0.86-0.91 for this differentiation in the central-gland,
respectively. Moderate to near-perfect interobserver agreement was demonstrated (k=0.42-
0.91).
Conclusion: Our data indicate that a standardized threshold zone-specific approach in MRSI
of the prostate is able to prospectively differentiate between benign and malignant tissues in
the peripheral zone and the central-gland with good accuracy and interobserver agreement.


8:55 a.m.
Value of Endorectal Coil T2-Weighted MRI Combined with 3D-CSI Spectroscopy in
the Diagnosis of Prostate Cancer in Patients with Elevated PSA (≥ 4 NG/ML)
Gert O. De Meerleer, MD, PhD, Ghent University Hospital; Geert M. Villeirs; Sabine
Meersschaut; Antony Verbaeys; Willem Oosterlinck
Purpose: To evaluate combined magnetic resonance imaging and spectroscopy (MRI/MRS)
in the detection of prostate cancer.
Materials and Methods: Between March 2002 and October 2006, 511 patients were
examined with 4-mm transverse, coronal and sagital fast-T2-weighted images and 3D-CSI
MRS on a 1.5T scanner. Interim follow-up data (pathology report or at least 12 months
follow-up) were available for 193 patients.
Results: One hundred patients (mean PSA 18.0 ng/ml) had an abnormal MRI/MRS and all
except two were histologically verified, revealing 96 carcinomas and 4 false-positive findings
(mean follow-up 16.0 months).
Ninety-three patients (mean PSA 8.0 ng/ml) had a normal MRI/MRS. Twenty-five showed
stabilization or decrease of PSA after at least 12 months (mean 21.2 months) and 68 were
histologically verified: 24 showed normal or benign findings (mean follow-up 22.0 months)
and 44 revealed carcinoma.
The sensitivity, specificity, and accuracy was 56.4%, 94.3%, and 66.8% for MRI alone,
60.0%, 94.3%, and 69.4% for MRS alone, and 68.6%, 92.5%, and 75.1% for combined
MRI/MRS, respectively.
Conclusion: MRS is a valuable adjunct to MRI in the non-invasive assessment of patients
with elevated PSA.


9:05 a.m.
The Usefulness of Diffusion-weighted Imaging for the Prediction of Prostate Cancer
Localization at 3T
Chan Kyo Kim, MD, Samsung Medical Center; Hyun Moo Lee; Jae Joon Han
Purpose: To prospectively compare combined T2-weighted imaging (T2WI) and diffusion-
weighted imaging (DWI) with T2WI alone for the prediction of prostate cancer localization
at 3T phased-array MRI.
Materials and Methods: A total of 37 patients underwent MRI prior to radical
prostatectomy. A single-shot EPI DWI technique with b=0 and b=1000 sec/mm2 was used.
At only T2WI and combined T2WI and DWI, the presence or absence of prostate cancer
confined within the prostate was visually evaluated in the peripheral (PZ) and transition zone
(TZ) of both lobes. Final decisions on prostate cancer localization at T2WI and combined
T2WI and DWI were made by consensus between two radiologists.
Results: All 37 patients had 68 tumors. Combined T2WI and DWI could detect accurately 57
(84%) of 68 tumors, while T2WI could detect accurately 45 (66%) of 65 tumors (P < 0.05).
False-positive rate of T2WI and combined T2WI and DWI were 37% and 14%, respectively.
In eight (22%) patients, T2WI could not depict the prostate cancer. However, combined
T2WI and DWI could predict the prostate cancer in all 37 (100%) patients.
Conclusion: Combined T2WI and DWI at 3T using phased-array coil can provide better
detection of prostate cancer than that of T2WI.


9:15 a.m.
Feasibility of MR Imaging Guided Biopsy of the Prostate Using a 32-channel Phased-
array Coil at 3 Tesla
Thomas Hambrock, MD, MBChB, University Medical Centre St. Radboud; Jürgen
Fütterer; Axel Winkel; Christina Hulsbergen-vandeKaa; Henkjan Huisman; Leo Schultze-
Kool; Jelle Barentsz
Purpose: To investigate the feasibility of MR imaging guided biopsy of the prostate at 3T,
using a 32-channel phased-array coil and prototype biopsy device, in patients with rising
prostate specific antigen (PSA) and previous negative biopsies or previous radiotherapy.
Material and Methods: Ten patients with rising PSA and previous negative biopsies or
radiotherapy, underwent MR imaging (T2-weighted imaging, dynamic contrast-enhanced and
spectroscopic imaging) for localization of tumor suspicious areas. After evaluation, these
patients received a 3T, 32-channel phased-array coil MR imaging guided biopsy of MR-
suscpicious lesions using a prototype biopsy device (Invivo, Germany). After re-identifying
the lesions on T2-w images, the biopsy device was positioned, aligning the needle guider
towards suspicious lesions. Correct needle positioning within lesions was confirmed by
additional imaging with the needle in situ. Image quality was also evaluated.
Results: In total, 25/25 representative prostate core biopsy specimens were obtained.
Histological analysis of these specimens revealed prostate cancer in 9/25 cores, chronic
prostatitis in 11/25, necrosis in 1/25, atrophy in 1/25. 3/25 Cores revealed no pathology.
Image quality was excellent. No procedure related complications occured.
Conclusion: MR-guided biopsy at 3T using 32-channel phased-array coil MR imaging is
feasible, yielding excellent image quality and representative biopsy cores.


9:25 a.m.
Focal Hypermetabolism in the Prostate Gland on FDG-PET/CT: Frequency of Prostate
Cancer and Correlation with PSA
Mark Alan Nathan, MD, Mayo Clinic; Mark A. Nathan; Eric M. Rohren; Kawashima Akira
Purpose: To determine the frequency of prostate carcinoma in oncologic patients with
incidental prostate hypermetabolism on FDG-PET/CT. Compare the FDG uptake with PSA
level.
Materials and Methods: We retrospectively reviewed 18 patients with incidental prostate
hypermetabolism on FDG-PET/CT for the presence of carcinoma. We compared the degree
of hypermetabolism (SUV) with PSA level.
Results: Twelve of the 18 patients received a prostate biopsy after the FDG-PET/CT with 10
positive for carcinoma. For these biopsied patients there was no correlation between the SUV
and PSA (r= -.60). Also, five of the 10 biopsy proven prostate cancer patients had a normal
PSA at the time of the FDG-PET/CT. The 6 remaining patients with prostate activity on the
FDG-PET/CT did not undergo prostate biopsy due to a normal PSA near the time of the scan.
Two of these patients presented with bone metastatic prostate cancer at 12 and 14 months
after the FDG-PET/CT.
Conclusions: Studies have shown that FDG-PET/CT is insensitive for prostate carcinoma.
However, our study shows prostate hypermetabolism on FDG-PET/CT to be highly specific
for carcinoma even with a normal PSA. Therefore, prostate hypermetabolic activity should be
further evaluated with prostate biopsy. The SUV has no correlation with PSA level.


9:35 a.m.
Diagnostic Performance of Conventional Cystography on Vesicourethral Leaks
Following Radical Prostatectomy: As Compared with MDCT Cystography
Hak Jong Lee, MD, Department of Radiology, Seoul National University; Cheong-Il Shin;
Jeong Yeon Cho; Seung Hyup Kim; Chang Kyu Sung
Purpose: To evaluate the diagnostic performance of cystography following radical
prostatectomy.
Materials and Methods: 51 patients who had undergone prostatectomy and cystography
were prospectively evaluated. Cystograms including anterioposterior view, and both oblique
views were performed. And then, CT cystograms were performed.
The images were interpreted by two uroradiologists. They evaluated vesicourethral leakage,
blinded to the results of MDCT cystography. The leakage and the amount of leakage were
evaluated with MDCT cystography.
The sensitivity, specificity, false positive and negative rates of conventional cystography
were evaluated. The leakage amounts in groups with false negative results and true positive
results in conventional cystography were compared (unpaired t-test).
Results: The sensitivity, specificity, false positive and negative rates of conventional
cystography were 71.4%, 100%, 0%, and 57.1 %, respectively. Out of 21 patients who
showed negative findings on cystography, 12 patients showed leakages on MDCT
cystography.
The mean amounts of leakage were 2.2 cc and 18.5 cc in false negative and true positive
groups, respectively. The leakage amounts in two groups were statistically different.
Conclusion: Cystography revealed high false negative rate, which means that CT
cystography could help the confirmation of clinically suspected vesicourethral leakage even
in cases with negative conventional cystography results.


9:45 a.m.
Cystography after Robotic Assisted Laparoscopic Prostatectomy: Predictor of Foley
Catheter Duration?
Isabel Rudolf, MD, University of Alabama at Birmingham; Desiree E. Morgan; Mark E.
Lockhart; Therese Weber; Philip J. Kenney
Purpose: To correlate urethrovesical anastomotic extravasation during cystography after
robotic assisted laparoscopic prostatectomy (RALP) with duration of foley drainage.
Materials and Methods: 60 consecutive RALP patients had postoperative cystography.
Presence and degree of extravasation were determined independently by three GU
radiologists, and compared to total drainage interval, drainage after cystogram, and clinical
parameters including intraoperative blood loss.
Results: Thirty (50%) of 60 patients (mean age 59, range 39-71, 55/45% caucasian/ African-
American) had extravasation (9 minimal, 20 moderate, 1 marked) at mean of 10 days. Time
to catheter removal was 10.8 days and 14.2 days, respectively, for patients with none or
minimal extravasation versus those with moderate or marked extravasation (p=0.002). The
time the catheter remained in place after the cystogram was greater for higher grades of
extravasation, but not statistically significant (p=0.051). There was no correlation between
intraoperative blood loss and extravasation.
Conclusions: Despite increasing emphasis on accelerating recovery by decreasing foley
drainage interval after prostatectomy, clinical predictors (to replace or limit cystography) for
potential leakage from the urethrovesical anastomosis are not robust. In our RALP
population, 50% of patients had extravasation on cystogram at 10 days. However, those with
no or minimal extravasation can have catheters pulled safely.


10:30 a.m.
Frequency of Iodinated and Gadolinium Contrast Reactions: A Retrospective Review of
407,589 Doses
Christopher Harker Hunt, MD, Mayo Clinic; Christopher H. Hunt; Gina K. Hesley; Robert
P. Hartman
Purpose: Determine the frequency and characteristics of iodinated (IC) and gadolinium (GC)
contrast reactions.
Materials and Methods: Retrospective review of all intravascular doses of IC and GC from
2002 through 6/2006 was conducted. Adverse reactions were examined for type/severity of
reaction, treatment required, and outcome.
Results: From a total of 407,589 contrast doses (267,659 IC doses, 140,200 GC doses), 500
reactions (0.12% of total) were identified (440/267,659 [.2%] IC; 60/140,200 [.04%] GC).
The most common reactions were hives and nausea. Of all reactions, 187 (.06%) IC and 27
(.02%) GC reactions required treatment. Only 28 reactions required transfer to an Emergency
Department for further observation or treatment. Thirty-two of the IC reactions (32/440,
7.3%) occurred in patients with prior history of allergy who were premedicated. Only one of
these premedicated reactions required transfer to the emergency room. One death with IC
occurred in a patient who had no immediate symptoms, but died suddenly within one hour of
the dose.
Conclusions: Both iodinated and gadolinium contrast are associated with a very low rate of
adverse reactions. Most contrast reactions are mild and can be treated in the radiology
department with only rare need for transfer for additional treatment or observation.


10:40 a.m.
Contrast Induced Nephrotoxicity vs. "Hospital Nephrotoxicity" – What is the Relative
Risk with Intravenous Injection?
Richard J. Bruce, MD, Univeristy of Wisconsin; Myron A. Pozniak; Fred Lee
Purpose: Compare changes in SCr in patients receiving IV contrast vs. hospitalized patients
not receiving contrast.
Materials and Methods: Between 1/1/2003 and 8/15/2006, 65,572 patients had either
noncontrast or IV contrast enhanced CT. Patients receiving contrast with normal SCr
(≤ 1.5mg/dl, n=779) and elevated creatinine (1.5< SCr ≤ 2.5 mg/dl, n=18) were compared
with those not receiving contrast (SCr≤ 1.5mg/dl, n=3182, 1.5< SCr ≤2.5mg/dl, n=919).
Significant creatinine rise is defined as elevation of 0.5 mg/dl over baseline, or a 25% rise
over baseline within three days of the scan compared to pre-CT levels.
Results: Subjects with normal renal function:
Patients receiving iohexol increased serum creatinine by a mean of 0.04mg/dl. Of these,
33/779 (4.2%) experienced a significant SCr rise. This compares to a rise of 0.02mg/dl and
142/3182 (4.4%) in the noncontrast group (p>0.05).
Subjects with impaired renal function:
Patients receiving iohexol increased serum creatinine by a mean of 0.62mg/dl. Of these
patients, 4/18 (22.2%) experienced a significant SCr rise. This compares to a mean rise of
0.0mg/dl and 100/919 (10.9%) in the noncontrast group (p=0.04).
Conclusions: Hospitalized patients with normal renal function receiving iodinated
intravenous contrast (iohexol) for CT have no greater incidence of serum creatinine elevation
as do control patients undergoing non-contrast CT.
10:50 a.m.
Nephrogenic Systemic Fibrosis - A Very Late Severe and Serious Adverse Reaction to
Gadodiamide
Henrik S. Thomsen, MD, Copenhagen University Hospital at Herlev; Peter Marckmann;
Mette Brimnes Damholt; James Heaf; Lone Skov; Kristian Rossen; Anders Dupont
Nephrogenic systemic fibrosis is a new, rare disease of unknown etiology affecting renal
failure patients. Single cases led us to suspect an etiological role of gadodiamide used for
magnetic resonance imaging. We therefore reviewed all of our confirmed cases of
nephrogenic systemic fibrosis (n = 19) with respect to clinical characteristics, various
diagnostic examinations, surgery, infections, drugs other than gadodiamide, gadodiamide
exposure, and subsequent clinical course. All 19 patients had been exposed to 9 – 25 mmol
gadodiamide prior to the development of nephrogenic systemic fibrosis. They had end-stage
renal failure (GFR < 15 ml/min or on dialysis). The median delay from exposure to first sign
of the disease was 22 days (0-75 days). Nine patients (47%) became severely disabled and
four died 6, 13, 14 an 21 months after exposure. Approximately 370 patients with end-stage
renal failure had gadiodiamide for MRI in the same period. Thus the incidence of NSF was
around 5%. We could not identify any other exposure/event than gadodiamide common to
more than a minority of the patients. Gadodiamide plays an etiological role in nephrogenic
systemic fibrosis and should not be used in patients with end-stage renal failure.


11:00 a.m.
Nephrogenic Systemic Fibrosis: A Preliminary Report from One Institution
Richard H. Cohan, MD, University of Michigan; Isaac R. Francis; Hero K. Hussain; James
H. Ellis; Suresh Mukherji; Wael Shabana; Lyndon Su; Richard Swartz
Purpose: To determine the incidence of nephrogenic systemic fibrosis (NSF) at one
institution and its relationship to renal failure and gadolinium administration.
Materials and Methods: A pathology database search was performed to identify all patients
in whom NSF was diagnosed at our hospital. Medical records were then reviewed.
Results: 27 patients were diagnosed with NSF between 11/15/99 and 7/19/06. Gadolinium
was known to have been administered in 19. All but two patients were on dialysis. Two NSF
patients who had transient acute renal failure did not receive gadolinium at our institution.
Eleven patients received high dose gadolinium for MRA, 10 for conventional angiography,
and 7 had both. Five patients had standard-dose MRI. Biopsy diagnosis of NSF was made
within 3 months of gadolinium administration in 11 patients and within 1 year in 15. Six
patients had symptoms lasting > 1 year prior to diagnosis.
Conclusion: We confirm the association between NSF and gadolinium administration that
has been reported by others. While high dose gadolinium and chronic renal failure has been
implicated in other reports, several of our patients received standard gadolinium doses and
had only transient acute renal failure prior to diagnosis.
11:25 a.m.
Renal Function: Serum Creatinine, Calculated Creatinine Clearance and Glomerular
Filtration Rate
Joshua Becker, NYU Medical Center
Purpose: The assessment of renal function is classically reported in terms of serum
creatinine and calculated creatinine clearance.A comparison of the commonly accepted
parameters of renal function was made to an actual measure of glomerular filtration rate.
Method and Materials: Patients (IRB approved protocol) with normal serum creatinine
undergoing clinically indicated radio-opaque contrast enhanced imaging studies had renal
function evaluation. GFR was determined with the RENALYZER (Diatron, Sweden). The
patients had concurrent serum creatinine assays. Creatinine clearance was calculated by both
the Cockcroft and Gault and the Modified Diet in Renal Disease formulae. The formulae are
based upon serum creatinine modified by such parameters as: age, gender, weight and, where
applicable, hypertension, diabetes mellitus, and race.
Results: There is close agreement between the calculated creatinine clearances. The
comparison of either formula to measured GFR resulted in a mismatch where the calculated
level was in error of > 25% of the measured GFR: 44% (C/G) and 56% (MDRD) patients.
Conclusions: The estimation of GFR by means of calculated creatinine clearance is of
questionable accuracy to renal status in almost half the patients with normal renal function.


11:35 a.m.
Determination of Split Renal Function by 3D Reconstruction of CT Angiograms:
Comparison to Gamma Camera renography
Adam L. Summerlin, University of Alabama at Birmingham; Mark E. Lockhart; Andrew M.
Strang; Peter N. Kolettis; Naomi S. Fineberg; Michael J. Hanaway; J. Kevin Smith
Purpose: To utilize renal 3-D reconstruction from donor CTA to correlate CT split renal
function with nuclear renograms.
Materials and Methods: After IRB approval, renal donor evaluations from 3/1/05 to 2/28/06
were identified to create semi-automated 3-D models of each kidney in pre-contrast, arterial,
and excretory phases. Contrast accumulations (renal attenuation difference x volume) yielded
split function. Split function was also calculated using renal volumes. Paired-sample t-tests
and Pearson correlations compared CT split determination to the renogram split.
Results: 152 renal donors (mean age 40 years, female 54%, Caucasian 73%) had right split
function 49.2% +/- 4.3 (range 29-63%). Mean CT excretory phase split (49.3% +/-
3.0)(p>0.776), arterial phase split (49.7% +/- 3.7)(p>0.256), and volume split (49.3% +/-
2.8)(p>0.828) did not differ from nuclear renograms. Pearson correlations between each split
function data set and the renogram demonstrate significant correlation (p
Conclusions: Renal 3-D reconstruction to measure split renal function correlates well with
nuclear renogram results. CT volume split and CT excretory split are the most accurate
measures. 3-D CT determination of split renal function has potential to eliminate the cost and
time of nuclear renograms.
11:45 a.m.
CT Urography (CTU): Evaluation of an opacification Strategy Based on Individual
Acquisition Delay and Furosemide
Joern Kemper, MD, University Medical Center Hamburg Eppendorf - Clin; Marc Regier;
Gerhard Adam; Claus Nolt-Ernsting
Purpose: To retrospectively analyze the opacification and image quality of a CTU-protocol
using test images and furosemide.
Materials and Methods: CTU examinations in 103 patients (69 men,34women) were
reviewed by two radiologists. CTUs were performed by using furosemide. Urographic timing
was individually adjusted by performing low-dose test images of the distal ureters to display
their opacification. Opacification and image quality was graded. Average urographic delay
was calculated. Stratified comparisons of mean scores kappa values were assessed.
Results: Median scan delay for patients with normal creatine (n=92) was 420 sec (mean 453
sec;SD,121 sec). The analysis of opacification demonstrated that 97% of the ICS,89% of the
proximal, 86% of the middle, and 81% of the distal ureter segments showed opacification
greater than 90%. 7.8% of the distal ureteral segments could not be visualized. Statistics did
not show significant differences (p>.05). Image quality showed to be high when latest test
images indicated homogeneous bilateral contrasted ureters (Pearson correlation coefficient r=
0.81). Kappa-values were 0.8 and 0.78.
Conclusion: Furosemide and scan timing based on test-images proved to be a reliable
procedure. It features the individual adaption of MDCTU to the excretory rate of the kidneys.


11:55 a.m.
Radiation Dose Reduction in CT-Urography (CTU): Experimental Experience
Joern Kemper, MD, University Medical Center Hamburg Eppendorf - Clin; Marc Regier;
Paul Martin Bansmann; Alexander Stork; Hans Dieter Nagel; Gerhard Adam; Claus Nolte-
Ernsting
Purpose: To evaluate the reduction of X-ray exposure during CTU in consideration of image
quality using a porcine-model.
Material and Methods: CTU was performed in 8 healthy pigs. Scanning was performed
using a gradual reduction of the tube current-time product at 120kV
(200,125,100,80,70,60,50,40,30,20 eff.mAs). Three blinded observers independently
evaluated the image data for depiction of anatomic detail, subjective image quality, and
subjective image noise. Overall image quality was compared to mAs-settings and radiation
dose. Objective noise measurements were assessed. Noise measurements were also
performed in patients to verify the comparabilty of the animal model.
Results: Adequate image quality allowing for detailed visualization of the upper urinary tract
was obtained when the tube current-time product was decreased to 70 eff.mAs at 120kV.
Image noise did not impair image quality to a relevant degree using these parameters. There
was high agreement among the observers (ICC=0.95). Noise measurements proved human
and animal settings to be comparable.
Conclusion: In the animal experiments, reduced-dose CTU produced good image quality. A
maximum current-time product reduction to 70 eff.mAs at 120kV (CTDIvol=5.3mGy)
proved to be feasible, thereby offering an advantageous dosage reduction. The study provides
a basis for the development of reduced-dose MDCTU protocols in humans.
12:05 p.m.
Dual-Energy CT Iodine-Subtraction “Virtual Non-Contrast” Technique for Detection
of Urinary Stones in the Opacified Collecting System: Feasibility Phantom Study
Naoki Takahashi, MD, Mayo Clinic; Robert P. Hartman, Andrew N. Primak; Oleksandr P.
Dzyubak; Terri J. Vrtiska; Akira Kawashima; Joel G. Fletcher; Cynthia H. McCollough
Purpose: To determine the ability of a dual-energy CT (DE-CT) iodine-subtraction technique
to depict urinary stones in the opacified collecting system in a phantom study.
Methods and Materials: 15 urinary stones (calcium oxalate, calcium hydroxyapatite, uric
acid, size 3 to 5 mm) were placed in 5x20 mm plastic vials. The vials were consecutively
filled with iodine solutions with CT attenuation values of 500, 1000, 1500, 2000, and
2500HU to simulate opacified urine. DE-CT scans (Siemens Definition) were obtained
through the phantom with 80 + 140 kVp. Iodine-subtraction "virtual non-contrast" images
were reconstructed from the DE-CT scans.
Results: All 15 stones were clearly visible as high density structures on iodine-subtraction
"virtual non-contrast" images when vials were filled with 500, 1000 and 1500HU iodine
solutions. Stones were not visible with 2000 and 2500HU iodine solutions due to residual
unsubtracted iodine. The cause of residual unsubtracted iodine was saturation of CT
attenuation numbers (>3071HU) for the high density iodine with 80 kVp scans and brake-
down of subtraction algorithm.
Conclusion: DE-CT iodine-subtraction technique allowed depiction of urinary stones when
the iodine solution's density was 1500HU or below. This capability may allow for the
elimination of the non-contrast phase of CT urogram studies.


12:15 p.m.
Comparison of Contrast-Enhanced MRI and Integrated FDG PET/CT for the
Prediction of Recurrent Ovarian Cancer
Chan Kyo Kim, MD, Samsung Medical Center; Byung Kwan Park; Joon Young Choi;
Byoung-Gie Kim
Purpose: To compare the diagnostic performance of contrast-enhanced magnetic resonance
imaging (MRI) with integrated positron emission tomography (PET) and computed
tomography (CT) for the prediction of recurrent ovarian tumor.
Materials and Methods: Thirty-six patients who performed primary cytoreductive surgery
underwent both contrast-enhanced MRI and PET/CT to evaluate recurrent ovarian tumor.
Recurrent ovarian tumor in abdomen and pelvis were divided to four specific sites as follows:
1) local pelvic recurrence, 2) peritoneal lesion, 3) lymph nodal metastasis, and 4) distant
metastasis. Patient-based and lesion-based analysis for predicting recurrent tumor was
retrospectively performed.
Results: Histopathologic findings and clinical findings with radiologic follow-up revealed
recurrent ovarian tumor in 35 sites of 22 patients. A total of 35 sites with recurred ovarian
tumor consisted of local pelvic recurrence (n=15), peritoneal lesions (n=14), lymph nodal
metastasis (n=4), and abdominal wall metastasis (n=2). For the prediction of recurrent tumor,
patient-based sensitivity and accuracy of PET/CT and MRI were 73% and 91% (P < 0.05),
81% and 89%, respectively. Overall lesion-based sensitivity and accuracy of PET/CT and
MRI for peritoneal lesions was 43% and 86%, 75% and 94%, respectively (P < 0.05).
Conclusion Contrast-enhanced MRI is more sensitive than PET/CT for the prediction of
recurrent ovarian tumor.
12:25 p.m.
Intraluminal Optical Coherence Tomography and Intravascular Ultrasound in the
Delineation of Different Wall Layers of Porcine Ureters ex Vivo
Ulrike L Mueller-Lisse, MD, Department of Urology, LMU Munich; Oliver A. Meissner;
Margit Bauer; Christoph Weber; Frigga Roggel; Maximilian Reiser; Ullrich G. Mueller-
Lisse
Purpose: Catheter-guided optical coherence tomography (OCT) is a new intraluminal
microstructural imaging technique (spatial resolution of 10-20 µm). We compared
delineation of tissue layers of porcine ureters ex vivo between OCT and intravascular
ultrasound (IVUS).
Materials and Methods: Porcine ureters and kidneys were cannulated with a 7 F catheter
sheath, flushed with saline solution, marked on the outside. Marked positions were examined
from within the ureter lumen by means of both OCT and IVUS (spatial resolution at 40 MHz
was 37.5 µm). Delineation of urothelium, lamina propria, and muscle layer was rated as
possible (1) or not possible (0). Rates of delineation were compared between OCT and IVUS
(Chi-Square testing with Yates’s continuity correction).
Results: OCT images were obtained in 224 different positions and IVUS images in 144.
Wall layers were distinguished in 200 OCT and 73 IVUS images. Delineation of
Urothelium/lamina propria, lamina propria/muscle layer, and inner/outer muscle layer was
possible in 191/159/7 of OCT images and 3/64/2 of IVUS images (chi square, 240.0024,
p0.25) respectively.
Conclusions: Different wall layers of porcine ureters are better demonstrated by OCT. OCT
therefore appears to be better suited for detection of microstructural lesions of the ureter wall.
                     Society of Gastrointestinal Radiologists
                                Scientific Posters

1    Cross Sectional Imaging Spectrum of Acute Wsophageal Disorders
     Srinivas Gujjarappa, MD

2    Paraduodenal Hernias – Importance of the Vessels
     Gagan Ahuja, MD

3    CT Enterography: Shortening the Long and Winding Road
     Brian C. Lucey, MD

4    Value of Cross-sectional Imaging in Intussusception
     Bart J. Op de Beeck, MD

5    Gastrointestinal Stromal Tumor (GIST): A Proposed Method for CT
     Assessment of Tumor Viability
     Shetal N. Shah, MD

6    Atypical Bowel Perforation: What’s the Point?
     Brian C. Lucey, MD

7    Uncommon, Atypical, and Rare Presentations of Appendicitis on CT
     Douglas S. Katz, MD

8    Intraabdominal Gas Patterns on Conventional Plain Abdominal Radiographs: A
     Pictorial Essay
     Halemane S. Ganesh, MBBS, FRCR

9    Colonic Volvulus: Review of Clinical & Imaging Findings, and Treatment
     Douglas S. Katz, MD

10   Detection of Occult Colon Perforation Prior to Same Day CT Colonography for
     Failed Colonoscopy: Perforation Rates and the Use of a Low-Dose Diagnostic
     Scan Prior to CO2 Insufflation; Initial Results
     Martin A. Kuntz, MD

11   Appearance of Colonic Lesions on Computed Tomographic Colonography using
     the Virtual Dissection View with Axial and Endoluminal View Correlation
     Rizwan Aslam, MD

12   CT Colonography Interpretation using Colon Flattening Methods: Advantages,
     Drawbacks and Pitfalls
     Jamie T. Caracciolo, MD

13   Evaluation of Routine use of Chest CT in the Workup and Follow-up of Patients
     with Resectable Liver Metastases from Colorectal Carcinoma
     Helena Maria Dekker, MD
14   Emerging Concepts in the Cytogenetics and the Molecular Biology of Colorectal
     Adenocarcinomas: Evolving Implications on Diagnosis and Treatment
     Srinivasa R. Prasad, MD

15   Making Sense of Peritoneal Tumors and Pseudotumors: A Pattern-based
     Approach & Radiologic-Pathologic Correlation
     Srinivasa R. Prasad, MD

16   Could Splenosis be Differentiated from Peritoneal Metastatic Nodules after
     SonoVue Microbubble Injection Basing on Contrast Enhancement
     Characteristics? A Quantitative Study
     Michele Bertolotto, MD

17   Can T2-weighted Breath-hold Fast Spin Echo (FSE) Sequences Obtained After
     Gadolinium Enhancement Improve Conspicuity of Focal Liver Lesions?
     Silvia Diana Chang, MD

19   Hepatic Vascular and Perfusion Disorders Simulating Mass Lesions
     Maha Torabi, MD

21   Spectrum and Clinical Relevance of Hepatic Gas on CT or Ultrasound Imaging
     Priti Shah, MD

22   Intravenous CT Cholangiography: Hepatobiliary Enhancement Pattern in
     Normal Subjects
     Sebastian Tobias Schindera, MD

23   Imaging Approach to Hepatic Hilar Malignancies
     Stephan Anderson, MD

24   Update on Biliary Tract Inflammation: Relevance to Imaging
     Joshua Q. Knowlton, MD

25   64 MDCT: Imaging Features of Bowel Injury in Blunt Trauma
     Stephan Anderson, MD

26   Multidetector CT of the Diaphragm: A Pictoral Essay
     Travis Glenn Browning, MD

27   Burkitt’s Lymphoma: Spectrum of Radiologic Manifestations
     Steve C. Hong, MD

28   Multi-modality Imaging for Complications Associated with Pancreatic
     Transplantation
     Maha Torabi, MD

29   Congenital Variations of the Inferior Vena Cava and their Importance in
     Gastrointestinal Radiology
     Felice Esposito, DO
30   Fluoroscopically Guided Basket Extraction of Blunt Esophageal Impactions
     Joshua D. Adams, MD

31   Combined Endoscopic-Fluoroscopic Guided Placement of Eelf Expandable
     Metallic Stents for Obstructive Colonic Lesions
     Halemante S. Ganesh, MBBS, FRCR

32   Ex-vivo Perfused Bovine Liver: A Better Model for the Evaluation of RFA
     Devices
     Hayden Head, MD
Poster #1
Cross Sectional Imaging Spectrum of Acute Wsophageal Disorders
Srinivas Gujjarappa, MD, UT Health Science Center; Kedar Chintapalli; Carlos Restrepo;
Srinivasa R. Prasad
Purpose: 1. To review the broad spectrum of acute esophageal disorders (AED). 2. To
emphasize the roles of CT and MRI in accurate diagnosis and localization of AED and
discuss the importance of multi-planar reformations (MPR) in the diagnosis and management
of patients with AED.
Materials & Methods: We have reviewed cases of AED and noted that the subjects often
underwent cross-sectional imaging. In this exhibit we review the CT/MRI scanning
techniques and imaging findings of a wide spectrum of AED such as perforation esophagitis
(caustic & infectious), intramural hematoma & fistula. CT/MRI findings of complications
related to AED such as mediastinitis, mediastinal abcess, hemorrhage, pneumomediastinum
& cardiac tamponade are also included. Role of MPR in the diagnosis & management of
AED are discussed.
Results/ Conclusions: AED can present with nonspecific symptoms and are sometimes
missed or misdiagnosed clinically. Increased awareness of (AED) and knowledge of their
appearances on CT and MR helps to establish accurate diagnosis. CT and MR with MPR are
invaluable in demonstrating the full extent of the disorders which facilitates appropriate
surgical intervention. Early diagnosis and surgical intervention when needed avoids life
threatening complications and decreases morbidity and mortality.


Poster #2
Paraduodenal Hernias – Importance of the Vessels
Gagan Ahuja, MD, Northwestern Memorial Hospital; Frank H. Miller; Nancy A.
Hammond; Paul Nikolaidis; Laura Merrick; Christopher D. Scheirey; Francis J. Scholz
Purpose: Paraduodenal hernias(PDH) are rare entities that can be associated with significant
morbidity and mortality. We sought to define a set of MDCT criteria to aid radiologists in the
diagnosis.
Materials and Methods: We conducted a retrospective review of the clinical and MDCT
findings of ten patients with surgically proven PDH. A list of 25 specific CT criteria was
developed by an independent radiologist based on literature review. Three radiologists
retrospectively reviewed the CT scans using the provided checklist.
Results: Of the 10 surgically proven cases, 5 were left and 5 were right sided. In all patients
with left PDH, the inferior mesenteric vein was draped around the hernia, a finding not
emphasized sufficiently in the literature. All patients with right PDH demonstrated a
displaced ileocolic artery lying anterior to the hernia sac. Both types of PDH had
encapsulated clustered small bowel loops and had converging mesenteric vessels into the
hernia. Other suggested features in the literature were less reliable.
Conclusions: CT is an accurate test in the diagnosis of PDH. Identifying the location and
course of regional vessels, particularly the ileocolic vessels on the right and inferior
mesenteric vessels on the left are critical in making the diagnosis.
Poster #3
CT Enterography: Shortening the Long and Winding Road
Brian C. Lucey, MD, Boston University Medical Center; Stephan W. Anderson; Jorge A.
Soto; Jamie Caracciolo; Daniel Mishkin
Purpose: The purpose of this poster is to illustrate the value of CT enterography (CTE) in the
evaluation of patients with suspected small bowel pathology.
Materials and Methods: We evaluated the impact of the addition of CTE to the imaging
armamentarium for patients with suspected small bowel disease. The patient population
included patients with either suspected or known Crohn disease and patients with suspected
occult GI bleeding. We will describe the technique of CTE and discuss the practicalities of
integrating the technique into clinical practice. We will describe the resultant imaging
findings in both Crohn disease and small bowel masses. Where applicable, we will illustrate
the correlative small bowel follow through imaging in addition to wireless video capsule
endoscopy images. We will show examples of how CTE altered the clinical management of
patients.
Results: CTE has been integrated into our daily practice in the evaluation of suspected small
bowel pathology. CTE may differentiate between active and quiescent Crohn disease. In
addition, CTE has proven to be of value pre wireless video capsule endoscopy.
Conclusions: CTE is a valuable imaging technique that is easy to perform and integrate into
clinical practice. CTE is useful in the evaluation of patients with Crohn disease and occult GI
bleeding.


Poster #4
Value of Cross-sectional Imaging in Intussusception
Bart J. Op de Beeck, MD, UZ Antwerp; Maarten Spinhoven; Filip Deckers; Katrijn de
Jongh; Rodrigo Salgado; Bob Corthouts
Purpose: To present a pictorial review of intussusception and their imaging characteristics,
mainly focused on cross-sectional imaging.
Methods and Materials: 20 Cases of intussusceptions were reviewed (15 surgically proven).
All patients underwent at least a CT-scan examination. Site, level, cause and degree of
obstruction as well as signs of threatened bowel viability were evaluated and correlated with
surgical findings.
Results: The etiologies of the small bowel intussusceptions were: Crohn’s disease (3), celiac
disease (2), Meckel diverticulum, lipoma, leiomyoma, post-operative adhesions, lymphoma,
metastasis lung carcinoma and melanoma. Large bowel intussusceptions were due to: colon
carcinoma (2), lymphoma (2), caecum carcinoma, appendiceal mucocele, fibroid polyp and
angiolipoma. Most relevant cross-sectional imaging findings were: a target or doughnut
lesion, or a reniform or “sausage-shaped” mass. Signs of obstruction were visible in 3
patients (15%). Only one patient showed signs of threatened bowel viability (5%). There
were 12 small bowel and 8 large bowel intussusceptions. Malignant lesions constituted 25%
of the small bowel intussusceptions and 62% of the large bowel intussusceptions.
Conclusion: Intussusception in adults is a rare pathological finding, but becoming more
frequently in day-to-day radiological practice. Radiologists should be familiar with the
imaging characteristics and look for the underlying cause.
Poster #5
Gastrointestinal Stromal Tumor (GIST): A Proposed Method for CT Assessment of
Tumor Viability
Shetal N. Shah, MD, Cleveland Clinic; Annapurneswara rao Chimpiri; Bohdan Bybel;
Smith Andrew; Brian Herts
Purpose: There are no established CT criteria to assess therapeutic response to Imitanib for
treatment of GIST. We assessed the ability of CT to detect metastatic GIST, and propose a
post-therapy CT-grading system to assess tumor viability as determined by PET.
Methods: 11 patients on Imitanib for GIST underwent CECT and PET exams within a 4-
week interval. Lesions at CT were classified into a morphologic grade 0-4 based on
subjective estimate of solid tissue (0%, 1-49%, 50%, 51-99%, 100%). The sensitivity,
specificity, PPV, and NPV were determined and ROC curves configured for accuracy.
Results: 122 lesions (visceral 47, peritoneal 62, other 13) on 16 exams were evaluated. 45%
of lesions were classified as ≥ 50% solid component. For lesions at least 50% solid, CT
sensitivity, specificity, PPV, and NPV was 1.00, 0.94, 0.89, 1.00 for visceral lesions; and
0.85, 0.07, 0.51, 0.29 for peritoneal lesions. The area under the ROC curve for lesion
detection by CT was: all lesions - moderate accuracy, visceral lesions - very high accuracy,
and peritoneal lesions - low accuracy.
Conclusion: CT is of low accuracy for detection of peritoneal disease. The proposed CT-
grading system is highly accurate for assessing PET-positive viable tumor in viscera.


Poster #6
Atypical Bowel Perforation: What’s the Point?
Brian C. Lucey, MD, Boston University Medical Center; Jamie Caracciolo; Stephan W.
Anderson; Jorge A. Soto
Purpose: To describe the imaging findings, investigation and management of unusual bowel
perforation from the oropharynx to the rectum.
Materials and Methods: We present a plethora of cases of bowel perforation of unusual
etiology and describe the imaging findings, subsequent investigations and ultimate
management of these patients. We will show the value of 64MDCT with MPR imaging in
making the diagnosis of unsuspected bowel perforation and also show how multi modality
imaging, including endoscopy, may be invaluable in elucidating an underlying cause for the
perforation.
Results: Bowel perforation may be difficult to detect. This is particularly true in cases
without a history of either trauma or inflammatory disease. Our series shows that a combined
approach with radiologist, gastroenterologist and surgeon is required to optimally manage
these patients.
Conclusions: Bowel perforation may result from a variety of causes, not all of them are
obvious from first glance. This poster describes the imaging findings from a collection of
unsuspected bowel perforations.
Poster #7
Uncommon, Atypical, and Rare Presentations of Appendicitis on CT
Douglas S. Katz, MD, Winthrop-University Hospital; Vladimir Merunka; John P. Fantauzzi;
John J. Hines; Joseph P. Mazzie; Michael Sadler; Evan M. Meiner; Shiobhan R. Weston
Purpose: To demonstrate the spectrum of uncommon, atypical, and rare presentations of
appendicitis on CT.
Materials and Methods/Results: The following presentations of appendicitis on CT will be
shown, and the corresponding imaging, surgical, and pathologic literature will be reviewed:
tip, resolving, stump, perforated, foreign body, Amyand\'s hernia, femoral and umbilical
hernia, non-rotation/left-sided, related to tumor, and secondary appendicitis.
Conclusions: Radiologists need to be familiar with the broad spectrum of uncommon,
unusual, and rare variants/presentations of appendicitis as may be identified on CT, and the
implications or appropriate patient management.


Poster #8
Intraabdominal Gas Patterns on Conventional Plain Abdominal Radiographs: A
Pictorial Essay
Halemane S. Ganesh, MBBS, FRCR, Sheffield Teaching Hospitals NHS Trust; Ram Vijay;
Anil Paturi; Matthew J. Bull
Purpose: To outline the various types of intra and extra luminal gas patterns on plain
abdominal radiographS.To understand their clinical significance in an emergency setting to
assist further management.
Materials and Methods: Plain radiographs are commonly requested to investigate acute
abdominal pain. Although most radiographs show nonspecific features, there are several
distinctive and subtle gas patterns which guide towards a particular diagnosis. The entities
where broadly categorised into intra luminal or extra luminal gas patterns. The intra luminal
gas patterns were divided into 1) Luminal gas within bowel 2) Gas within other luminal
structures. The Extra luminal gas patterns were divided into 1) Free intraperitoneal gas 2)
Gas within intra abdominal collections 3)Intramural air and gas within solid viscera 4)Gas
within the abdominal wall. These specific clues are essential for accurate diagnosis and in
deciding further imaging studies. We have reviewed the above gas patterns on plain
radiographs in patients presenting with acute abdomen. The diagnosis in each case was
confirmed by further imaging studies or surgical intervention.
Conclusion: Plain radiography remains a primary screening modality for most acute
abdominal conditions. Plain film interpretation can be challenging and it is crucial to be
familiar with subtle abdominal gas patterns.
Poster #9
Colonic Volvulus: Review of Clinical & Imaging Findings, and Treatment
Douglas S. Katz, MD, Department of Radiology; Vladimir Mernuka; David I. Winger; John
J. Hines; James Brock; Shiobhan R. Weston; Bruce R. Javors
Purpose: To demonstrate the spectrum of plain film, CT, and barium enema findings of
colonic volvulus, and to review its presentation, imaging, and treatment.
Materials and Methods/Results: The diagnosis and treatment of colonic volvulus includes
emergency consultations among radiologists, gastroenterologists, and surgeons. Imaging
modalities include plain films, barium enema, and CT, which are often used in conjunction
with each other to exclude or establish the diagnosis. Imaging algorithms, findings, variants,
and pitfalls (especially that of pseudo-obstruction) will be reviewed and demonstrated.
Conclusions: The diagnosis and management of colonic volvulus often requires a multi-
modality and multi-disciplinary approach.


Poster #10
Detection of Occult Colon Perforation Prior to Same Day CT Colonography for Failed
Colonoscopy: Perforation Rates and the Use of a Low-Dose Diagnostic Scan Prior to
CO2 Insufflation; Initial Results
Martin A. Kuntz, MD, Mayo Clinic; David Hough; Jeff Fidler; C. Daniel Johnson; Kay
Egner; Bret Petersen; J.G. Fletcher
Purpose: To determine the prevalence of clinically unsuspected colonic perforation
diagnosed with a low-dose CT scan, prior to CO2 insufflation for CT colonography in
patients who are referred for same-day CT colonography after incomplete colonoscopy.
Materials and Methods: One hundred and eighteen consecutive patients (31 men, 87
women, mean age = 63.6 years, age range = 21 to 92 years) who were referred for same day
CT colonography following incomplete colonoscopy underwent a low-dose diagnostic CT
scan prior to CO2 insufflation.
Results: Two of 118 patients had a perforation revealed on low-dose CT scan.
Conclusions: There may be a significant occult perforation rate after incomplete
colonoscopy. The use of a low-dose diagnostic scan prior to gas insufflation for CT
colonography is indicated in order to prevent exacerbation of the perforation.


Poster #11
Appearance of Colonic Lesions on Computed Tomographic Colonography using the
Virtual Dissection View with Axial and Endoluminal View Correlation
Rizwan Aslam, MD, UCSF, SFVAMC; Niusha Rafie; Luis Landeras; Judy Yee
Purpose: The virtual dissection view is a 3D rendering technique that displays the luminal
surface of the colon as a flattened image.
This approach enables a greater proportion of the colonic surface to be seen on a single pass,
which could shorten interpretation times. Drawbacks include distortion in the appearance of
the colonic wall and haustra and distortion of significant lesions complicating interpretation.
We present the appearances of mucosal lesions; e.g polyps, flat lesions and carcinomas.
Differences in appearance of these and other lesions are highlighted in comparison to 2D
axial and endoluminal views. We aim to demonstrate that most colonic lesions are well
depicted by this 3D rendering technique.
Materials and Methods: CTC was performed using 4/16–slice CT with collimation
Conclusions: The virtual dissection view is a novel way to display the colon. This exhibit
provides information to help readers utilize this technique for the interpretation of these
complex studies. The appearance of significant colonic lesions, pitfalls and limitations using
the virtual dissection view are reviewed.


Poster #12
CT Colonography Interpretation using Colon Flattening Methods: Advantages,
Drawbacks and Pitfalls
Jamie T. Caracciolo, MD, MBA, Boston University Medical Center; Alice W. Fung; Jorge
A. Soto
Purpose: Describe the principles of colonic flattening software and illustrate how this
display method may be implemented successfully for CT colonography interpretation.
Methods and Materials: We reviewed 120 CTC studies acquired with MDCT scanners
performed for various indications. After loading the cases onto a dedicated workstation, we
segmented the colon and interpreted the data employing commercially available or prototype
software packages from three vendors utilizing a flattening view for primary review.
Traditional 2D and 3D views were used for confirmation or problem solving. Polyps > 5 mm,
masses, and potential sources of error were recorded. Results were compared with optical
colonoscopic and/or surgical findings.
Results: Use of flattening views for primary interpretation can improve reader efficiency.
However, training is necessary as multiple potential sources of error may cause
misinterpretation. This exhibit depicts the typical appearance of polyps and morphologic
distortion created by the software applications. Potential pitfalls and their effects on different
vendor products are illustrated.
Conclusion: Although colonic flattening is attractive for primary interpretation, caution is
necessary to avoid erroneous results. Readers must become familiar with potential sources of
error and continue to use traditional views for confirmation of findings and problem solving.


Poster #13
Evaluation of Routine use of Chest CT in the Workup and Follow-up of Patients with
Resectable Liver Metastases from Colorectal Carcinoma
Helena Maria Dekker, MD, Department of radiology 667, University Medical Ce; Theo
Ruers; Yvonne Hoogeveen; Jelle Barentsz
Purpose: To evaluate the routine use of chest CT as part of the extent-of-disease work-up in
selecting patients for resection of colorectal liver metastases, and for follow-up
postoperatively.
Materials and Methods: Patients with potentially resectable liver metastases from colorectal
cancer were evaluated using liver CT in combination with chest CT. Postoperatively all
patients were monitored for the development of pulmonary metastases. Chest CT was
performed with a slice thickness of 3 mm. A prospective analysis was performed. Patients
with ≤ 3 highly suspicious pulmonary lesions on chest CT underwent a lung metastasectomy.
Results: Forty-three colorectal cancer patients with liver metastases were evaluated using
chest CT. All underwent a liver resection and/or radiofrequency ablation. Preoperative CT
was lesion positive in 32 patients (74%): 26 patients with lesions 1-5 mm and 6 patients with
lesions 6-10 mm.
Ten patients (23%) developed pulmonary metastases during follow-up: one in the group
without lesions (9%), 4 with 1-5 mm lesions (15%) and 5 with 6-10 mm lesions (83%). Three
patients underwent a lung metastasectomy.
Conclusions: Chest CT appears valuable in determining the extent of pulmonary lesions,
particularly those > 5 mm, suspicious for pulmonary metastases in preoperative and
postoperative colorectal cancer patients.


Poster #14
Emerging Concepts in the Cytogenetics and the Molecular Biology of Colorectal
Adenocarcinomas: Evolving Implications on Diagnosis and Treatment
Srinivasa R. Prasad, MD, University of Texas HSC at San Antonio; venkateswar rao
surabhi; Dushyant V. Sahani; Neal C. Dalrymple; Lawrence Zukerberg; Christine O. Menias
Purpose: 1. To review recent advances in molecular biology & cytogenetics of colorectal
carcinomas 2.To review hereditary cancer syndromes (with emphasis on oncologic pathways)
3. To discuss preventive, imaging & therapeutic implications
Materials & Methods: • Epidemiology • Hereditary polyposis (FAP, Gardner & Turcot) /
non polyposis (HNPCC, Muir-Torre) / hamartomatous (Peutz-Jeghers, Cowden, Ruvalcaba-
Myhre-Smith) syndromes associated with colorectal cancers • Characteristic Cytogenetics
and Oncologic pathways of colorectal Carcinomas • Imaging Spectrum of colorectal
Carcinomas (including CT Colonography) • Molecular Biology of colorectal Carcinomas:
Implications on Screening, Diagnosis, & Management
Results: Most colorectal cancers show step-wise progression from adenomas. Tumors in
FAP syndromes harbor APC mutations; nonpolyposis syndromes are characterized by
mutations of DNA mismatch repair genes. Tumors in Hamaratomatous syndromes follow
PTEN oncologic pathway. High-grade cancers show K-ras/p53 mutations & are associated
with worse prognosis. Different oncologic pathways have been clarified; molecular drugs that
target specific pathways are being developed to improve patient outcomes. CT/MR findings
including virtual colonoscopy techniques supplement colonoscopy in the diagnosis & staging
of colorectal cancers.
Conclusion: Knowledge of cytogenetics and molecular biology of hereditary and sporadic
colorectal adenocarcinomas is extremely useful to understand tumor biology and to design
screening/imaging/treatment strategies.
Poster #15
Making Sense of Peritoneal Tumors and Pseudotumors: A Pattern-based Approach &
Radiologic-Pathologic Correlation
Srinivasa R. Prasad, MD, University of Texas HSC at San Antonio; Kedar N. Chintapalli;
Abhijit A. Raut; Christine O. Menias; Venkateswar R. Surabhi; Hanlin L. Wang
Purpose: 1. To review the surgical anatomy of the peritoneum. 2. To discuss neoplastic and
non-neoplastic conditions that involve the peritoneum. 3. To discuss an algorithmic pattern-
based approach to characterize peritoneal tumors & pseudotumors based on imaging findings.
Materials & Methods: 1. Introduction 2. Functional anatomy of the peritoneal spaces.
3.Classification of the peritoneal neoplastic and non neoplastic conditions. 4. Histogenesis
and pathology of peritoneal conditions 5. Pattern based approach to peritoneal lesions based
on anatomic distribution and imaging findings. 6.Diffuse, plaque like thickening 7.Diffuse,
Infiltrative pattern. 8. Fat containing lesions. 9.Cystic masses. 10.Imaging implications on
patient management
Results: Peritoneal conditions may be categorized based on distribution and imaging
findings. Peritoneal carcinomatosis and malignant mesothelioma manifest with diffuse plaque
like thickening. Cystic mesotheliomas and PEComas present as cystic and fatty focal masses
respectively. Imaging findings of select peritoneal conditions are pathognomonic and reflect
pathologic findings. The imaging spectrum of neoplastic and non neoplastic diseases are
discussed and correlated to histopathology. An algorithmic approach to characterize
peritoneal diseases based on imaging findings is presented.
Conclusion: A wide spectrum of neoplastic and non-neoplastic diseases involve the
peritoneum. A pattern-based approach to imaging diagnosis facilitates optimal patient
management.


Poster #16
Could Splenosis be Differentiated from Peritoneal Metastatic Nodules after SonoVue
Microbubble Injection Basing on Contrast Enhancement Characteristics? A
Quantitative Study
Michele Bertolotto, MD, Dept Radiology, University of Trieste; Giacomo Cester; Matteo
Coss; Elena Trincia; Stefano Cernic; Maria Assunta Cova
Purpose: To compare signal intensity (SI) of splenic and of metastatic peritoneal implants
after SonoVue injection using low-acoustic-power, contrast specific modes.
Materials and Methods: Thirteen consecutive patients with metastatic peritoneal nodules
and 12 consecutive patients with splenectomy and spontaneous (n=2) or surgically implanted
(n=10) splenic grafts were evaluated with contrast-enhanced US (CEUS). After SonoVue
injection, lesion enhancement was observed in real time for 240s using a non-destructive
mode (PIHI-ATL, Bothell, USA). All examinations were recorded digitally for off-line
retrospective analysis.
SI was evaluated in regions of interest (ROI) encompassing the entire nodules before and
every 10s after injection for 240s.
Results: Splenic grafts presented with intense contrast enhancement without significant
wash-out up to 240s after microbubble injection. Peritoneal metastases had variable contrast
enhancement and progressive wash-out. In comparison with non splenic nodules, SI of
splenic grafts was statistically higher 60-240s after microbubble injection. Only splenic tissue
displayed SI>70% of the enhancement peak 150-240 seconds after microbubble injection.
Conclusions: Evidence for Spleen-specific uptake of SonoVue microbubbles was recently
demonstrated in the normal spleen. Specific uptake occurs also in peritoneal splenic grafts
and allows differential diagnosis between these nodules and malignant peritoneal implants.


Poster #17
Can T2-weighted Breath-hold Fast Spin Echo (FSE) Sequences Obtained After
Gadolinium Enhancement Improve Conspicuity of Focal Liver Lesions?
Silvia Diana Chang, MD, University of British Columbia; Ruedi F. Thoeni
Purpose: To determine if FSE T2-weighted sequences obtained following gadolinium
improves conspicuity of focal liver lesions.
Material and Methods: We reviewed T2-weighted sequences before (T2-pre-gad) and after
(T2-post-gad) gadolinium enhancement in 85 patients with132 focal liver lesions. Solid
lesions were proven pathologically (hepatoma 22, metastases 12, ablated hepatomas 7, focal
nodular hyperplasia 6, dysplastic nodule 5, adenoma 1) and nonsolid lesions were diagnosed
as hemangiomata (n=33) or cysts (n=32).
Two blinded radiologists interpreted the images independently. The T2-pre-gad sequences
were interpreted first and the T2-post-gad sequences were read two weeks later. Lesion
conspicuity was ranked on a four point scale.
Results: 118/132 lesions (89.39%, 53 solid and 65 nonsolid)) were visible on T2. No
statistically significant difference was found between studies before and after gadolinium
(p=0.11, Sign test), but a trend towards improved visualization with T2-post-gad was seen.
Subgroup analysis showed significant improvement (Fisher’s exact test p=0.01) in
visualizing solid liver lesions with T2-post-gad compared to nonsolid lesions.
Conclusions: Focal liver lesions demonstrated a trend towards better visualization with T2-
post-gad than T2-pre-gad. However, subgroup analysis demonstrated that solid lesions
benefited significantly more from T2-post-gad than nonsolid lesions. We recommend
acquiring T2–weighted sequences after gadolinium for assessing focal liver lesions.


Poster #19
Hepatic Vascular and Perfusion Disorders Simulating Mass Lesions
Maha Torabi, MD, University of Pittsburgh Medical Center; Michael P. Federle
The goals of this educational exhibit are to: 1) Familiarize radiologists with various types of
vascular and perfusion disorders of the liver that might be mistaken for neoplasm, such as
hepatic infarction, passive congestion, arterio-portal shunting, Budd-Chiari syndrome,
peliosis hepatis and hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu). 2) Present
imaging criteria that will allow for more accurate and confident diagnosis with emphasis on
multiphasic CT.
Poster #21
Spectrum and Clinical Relevance of Hepatic Gas on CT or Ultrasound Imaging
Priti Shah, MD, University of Maryland; Barry Daly; Steve Cunningham
Purpose: A wide range of clinical conditions and the recent development of many liver-
directed interventional therapies may result in the presence of hepatic gas on imaging studies.
This exhibit reviews the many causes of hepatic gas detected on CT and Ultrasound Imaging.
Materials and Methods: This exhibit is based upon a recent computer search of imaging
findings of hepatic gas over 15 years at our academic medical center and a review of the
literature. The importance of such gas was determined on the basis of patient’s clinical status,
and other imaging or laboratory findings.
Results: Multiple causes of hepatic gas were noted including abscess, infarct, trauma,
radiofrequency ablation, coil and chemo-embolization, Yttrium-90 brachytherapy, and bowel
infarction or infection. Incidental causes included post-surgical, post-colonoscopy or post-
sphincterotomy changes, hepatic vein extension of gas from systemic veins and mimics such
as alcohol ablation or oxidized cellulose surgical packing.
Conclusions: There is a widening spectrum of causes for hepatic gas on CT and US imaging.
Some are harbingers of serious acute disease while others may be expected findings
following therapy. Some are incidental and of no importance. Familiarity with these various
scenarios allows the radiologist to determine the clinical relevance of such findings.


Poster #22
Intravenous CT Cholangiography: Hepatobiliary Enhancement Pattern in Normal
Subjects
Sebastian Tobias Schindera, MD, Duke University Medical Center; Rendon Nelson; Erik
Paulson; David DeLong; Elmar Merkle
Purpose: To determine hepatobiliary enhancement pattern of intravenous CT
cholangiography in healthy subjects.
Materials and Methods: Fifteen volunteers (eight women; mean age, 38 years) underwent
dynamic CT cholangiography consisting of two unenhanced images at the level of the porta
hepatic and 15 pairs of images separated by a 5-minute interval starting five minutes after the
initiation of intravenous 20mL iodipamide meglumine 52% (Cholografin, Bracco).
Attenuation measurements of the extrahepatic bile duct (EBD) and the liver parenchyma
were performed. Two readers graded by consensus the visualization of higher-order biliary
branches.
Results: The first biliary opacification occurred between 15 and 25 minutes (mean, 22.3
minutes ± 3.2) following the initiation of the contrast agent. Biliary attenuation plateaued
between the 35- and the 75-minute time points. Maximum hepatic enhancement was 18.5HU
± 2.7. Twelve subjects demonstrated poor or non-visualization of higher-order biliary
branches, whereas three showed good or excellent. Significant correlation was found between
body weight and the magnitude of biliary attenuation and visualization of higher-order biliary
branches (P<0.05).
Conclusion: For peak biliary enhancement, CT cholangiography should be performed no
earlier than 35 minutes following the initiation of infusion. Superior visualization of the
biliary system is achieved in subjects with lower weight.
Poster #23
Imaging Approach to Hepatic Hilar Malignancies
Stephan Anderson, MD, Boston University medical center; Eunjin Rho; Jorge Soto
Purpose: To discuss the current imaging approach to hepatic hilar malignancies. With the
implementation of 64MDCT and its increasing use in various applications, biliary
pathologies are often initially visualized by CT. As 64MDCT affords the ability to generate
isotropic datasets, these techniques offer unprecedented ability to identify and characterize
biliary pathology. Given these advances, the role of MRI is evolving but MRI remains an
exquisitely powerful tool in characterizing and staging hepatic hilar malignancies.
Methods and Materials: This exhibit will be a didactic presentation organized into
discussion and illustration of issues specific to hepatic hilar malignancies. This is followed by
discussion and illustration of issues specific 64MDCT and MRI in their approach to biliary
pathology, specifically hepatic hilar malignancy.
Results: The use of 64MDCT and its application to biliary imaging, including specific
protocol issues are discussed. Post-processing techniques, including MPR and MinIP
reformations, techniques particularly suited to the evaluation of biliary pathology, are
detailed.
This exhibit describes the current applications of MRI in evaluating biliary pathology,
particularly hepatic hilar malignancies. The use of MRCP in characterizing and staging
hepatic hilar malignancies is discussed.
Conclusion: This exhibit highlights imaging features of hepatic hilar malignancies using
both 64MDCT and MRI techniques.


Poster #24
Update on Biliary Tract Inflammation: Relevance to Imaging
Joshua Q. Knowlton, MD, U of WI; Andrew John Taylor; Jason Stangl; Mark Reichelderfer
Purpose: Biliary tract inflammation and the imaging of these disorders have changed greatly
over the past 10 years. Some of the common diagnoses a decade of ago have nearly vanished.
New concepts of disease processes have developed. Noninvasive imaging of the biliary tract
continues to improve. This poster will provide an update to alert the radiologist of these
transitions.
Materials and Methods: A review of the literature will be used to report the clinically
important new concepts related to biliary tract inflammation. Examples will be used to
illustrate the relevant aspects of imaging.
Results: HIV cholangiopathy is an example of one transition with its incidence sharply
declining following the introduction of the successful antiretrovirus therapy. There are
recently evolving concepts of autoimmune cholangitis and pancreatitis that can produce
varying changes within the biliary tract. Advancements in MRI increasingly rival the duct
display at ERC, and in some cases MR will provide much more information.
Conclusion: There have been many significant changes in biliary tract inflammation over the
past decade. Knowledge of these changes is important for successfully imaging and
interpreting this clinical area.
Poster #25
64 MDCT: Imaging Features of Bowel Injury in Blunt Trauma
Stephan Anderson, MD, Boston University medical center; Jorge Soto; Eric Drasin
Purpose: The purpose of this exhibit is to describe and illustrate the manifestations of bowel
injury encountered in blunt trauma patients at our Level 1 trauma center using 64MDCT.
Methods and Materials: This exhibit will be a didactic presentation organized into
discussion and illustration of issues specific to bowel injury in blunt trauma. This includes a
discussion of protocol issues specific to bowel injury. CT imaging findings encountered at
our Level 1 trauma center and critical to the diagnosis of bowel injury are described and
illustrated, specifically using 64MDCT technology. These include a discussion of the direct
findings of bowel injury such as mural thickening and the significance of secondary finding
such as free intraperitoneal fluid.
Results: 64MDCT technology, given its increasing image quality secondary to marked
increases in temporal resolution, affords an unprecedented ability to diagnose and
characterize bowel injury in blunt trauma. This exhibit describes the use of multi-planar
capability afforded by isotropic datasets, allowing for advanced postprocessing and detailed
characterization of bowel injury. Additionally, protocol issues such as the controversial use
of oral contrast agents are detailed.
Conclusion: This exhibit details the use of 64MDCT technology in its application to bowel
injuries in blunt trauma.


Poster #26
Multidetector CT of the Diaphragm: A Pictoral Essay
Travis Glenn Browning, MD, University of Texas Southwestern Medical Center; Julie
Gibson Champine; Jeffrey Hamilton Pruitt
Purpose: To review diaphragmatic anatomy and pathology on multiplanar reconstructions of
multidetector CT.
Methods: With an emphasis on multiplanar images, the anatomy of the diaphragm is
reviewed. Multiplanar CT images of diaphragmatic injuries and abnormalities are described
and presented.
Results: The diaphragm forms the cepalad barrier of the abdominal cavity. Three major
normal openings in the diaphragm are the aortic hiatus, esophageal hiatus, and the vena caval
hiatus. Diaphragmatic variants and abnormalities are often encountered on abdominal CT and
include: diaphragmatic slips, scalloping, and crus hypertrophy. Congenital defects in the
diaphragm visible on mutiplanar images include Bochdalek and Morgagni hernias. Hiatal and
paraesophageal hernias are also encountered and well seen on multiplanar reconstructions.
Abnormal position of the diaphragm can be due to partial or complete diaphragmatic
eventration, diaphragmatic paralysis or secondary diaphragmatic elevation. Traumatic
diaphragmatic injuries which can be difficult to confirm with axial CT can be seen to better
advantage with the multiplanar reconstructive capabilities of MDCT, often precluding need
for additional studies such as MRI.
Conclusion: MDCT with mutiplanar reconstructions allows detection and characterization of
abnormalities of the diaphragm with high confidence.
Poster #27
Burkitt’s Lymphoma: Spectrum of Radiologic Manifestations
Steve C. Hong, MD, William Beaumont Hospital; Ali Shirkhoda; David Bloom; Donald
Gibson
Purpose: To display and review the various radiologic presentations of Burkitt\'s Lymphoma
(BL).
Materials and Methods: In this exhibit, we will review patients with both typical and
atypical radiologic presentations of BL with an emphasis on CT records of patients who were
referred to our institution from 1996 through 2006.
Results: The study group includes 22 patients with biopsy-proven BL with an age range from
10 to 75; and although BL usually affects children and young adults, almost half of the
patients in our exhibit were diagnosed at age 50 and above.
Conclusions: BL is a highly aggressive subtype of Non-Hodgkin’s Lymphoma that responds
favorably to high-dose, short-term chemotherapy. Therefore, the spectrum of radiologic
manifestations of BL should be familiar to the radiologist and thereby allowing prompt
diagnosis and appropriate clinical management.


Poster #28
Multi-modality Imaging for Complications Associated with Pancreatic Transplantation
Maha Torabi, MD, University of Pittsburgh Medical Center; Keyanoosh Hosseinzadeh
The objectives of this presentation are: 1) Define the normal anatomy of the most common
surgical procedures for pancreas transplantation. 2) Demonstrate the commonly seen
complications of the allograft including vascular compromise, rejection, pancreatitis, fluid
collections, PTLD and exocrine leak.



Poster #29
Congenital Variations of the Inferior Vena Cava and their Importance in
Gastrointestinal Radiology
Felice Esposito, DO, Mercy Catholic Medical Center; Rajesh Mithalal
Purpose: Congenital variations of the inferior vena cava (IVC)will be presented and their
importance in gastrointestinal radiology will be emphasized.
Materials and Methods: Computed tomography, magnetic resonance imaging, angiography,
and ultrasound images will illustrate the appearance of the congenital variations of the IVC.
Strengths and weaknesses of each imaging modality will be reviewed, as it pertains to
imaging these anatomical variations. Key imaging points pertinent to gastrointestinal
radiology will be emphasized.
Results: The radiologist should be familiar with the congenital variations of the IVC. These
variations take on special importance in pre-operative planning for abdominal surgeries and
liver/kidney transplants. The anatomical variants of the IVC include duplication of the IVC
,left IVC, azygos continuation of the IVC, circumaortic left renal vein, retroaortic left renal
vein, duplication of IVC with retroaortic right renal vein and hemiazygos continuation of the
IVC, duplication of IVC with retroaortic left renal vein and azygos continuation of the IVC,
circumcaval or retrocaval ureter, and absence of infrarenal IVC or entire IVC.
Conclusions: Knowledge of the imaging appearances of the congenital variations of the IVC
is important for the abdominal imager. This competency takes on exceptional importance in
abdominal surgery patients, especially those undergoing transplantation.


Poster #30
Fluoroscopically Guided Basket Extraction of Blunt Esophageal Impactions
Joshua D. Adams, MD, Unversity of Virginia Healthsystem; Hubert A. Shaffer; Eduard E.
De Lange
Purpose: Several accepted therapeutic methods have been used for treating impactions of
food or foreign bodies in the esophagus, including medical management, Foley catheter
removal, and endoscopic techniques. In 1986, we introduced a novel method for removing
impacted food and blunt foreign bodies from the esophagus using a Dormia-type wire basket
with fluoroscopic guidance.
Materials and Methods: We retrospectively reviewed all patients that underwent basket
extraction of esophageal impactions from 1979 through 2006. The underlying esophageal
pathology, nature of the impactions, and outcomes were specifically analyzed.
Results: 54 patients who underwent 61 procedures were included in the study. Etiologies for
underlying esophageal strictures included GERD with peptic stricture (42%), anastomotic
stricture (24%), Schatzki ring (12%), fundoplication (8%), dissection (6%), malignancy
(4%), caustic (2%), and radiation (2%). The impacted material included meat (72%),
vegetable/nuts (11.3%), mixed food (11.3%), and medications (4.8%). The esophageal
impaction was successfully removed in 57/61 (93%) attempts. No complications were
observed.
Conclusion: In cases of three-dimensional blunt esophageal impactions, fluoroscopically
guided basket extraction is extremely safe and usually successful, and is the procedure of
choice, especially when there is an underlying esophageal stricture.


Poster #31
Combined Endoscopic-Fluoroscopic Guided Placement of Eelf Expandable Metallic
Stents for Obstructive Colonic Lesions
Halemante S. Ganesh, MBBS, FRCR, Sheffield Teaching Hospitals NHS Trust; Adrian A.
Dawkins; Fred Lee
Purpose: To describe the obstructive pathologies affecting the colon and to review the
primary indications for endoluminal metallic stent placement. To highlight the use of
combined approach using endoscopy and fluoroscopy as an effective technique in stent
placement.
Materials and Methods: Self-expandable metallic stents are being used increasingly to treat
the colonic obstruction. Endoluminal metallic stents in the colon are used as a bridge to
surgery and in the palliation of unresectable cancers as an alternative to surgical treatment.
Fluoroscopic guidance alone provides adequate assessment of the point of obstruction in
most cases, but endoscopic guidance adds increased control and facilitates catheterization and
accurate device deployment. Endoscopy also allows biopsies from the obstructing lesion and
facilitates stent deployment in the right colon. We review the spectrum of obstructive lesions
affecting the colon and the technique of combined endoscopic-fluoroscopic placement of
endoluminal colonic stents.
Conclusions: Endoscopy can be effectively combined with fluoroscopy for successful
stenting of colonic lesions. The use of endoscopy also leads to a reduced time and radiation
dose for the procedure.


Poster #32
Ex-vivo Perfused Bovine Liver: A Better Model for the Evaluation of RFA Devices
Hayden Head, MD, UTHSCSA; Patrick Cording; Rex Boykin; Gerald Dodd III
Purpose: To determine if ex-vivo perfused bovine liver is a better model than ex-vivo
unperfused liver for predicting the performance of radiofrequency ablation (RFA) devices in
in-vivo perfused liver.
Materials and Methods: Three fresh bovine livers were procured, flushed with a Krebs-
Henseleit/Heparin solution, chilled, transported to the laboratory, connected to pumps, and
perfused with a 37°C, oxygenated, Krebs-Henseleit solution. Only the portal vein was
perfused. 12 ablations (Valley Lab cluster cooled tip probe) were performed in the livers
which were then imaged by MR and dissected. The mean diameter and volume of the
ablations were compared to published metrics of ablations performed with the same RFA
device in in-vivo perfused and in ex-vivo unperfused liver.
Results: The mean diameter and volume of the ablations were 4.06cm and 37.25cc in the
model, 3.35cm and 20.91cc in the in-vivo perfused liver, and 5.56cm and 66.00cc in the ex-
vivo unperfused liver. The difference in the size of ablations between each group was
significant (p
Conclusion: Ex-vivo perfused bovine liver yields ablations closer in size to in-vivo perfused
liver than does ex-vivo unperfused liver. Failure to produce lesions identical to in-vivo liver
may be due to lack of hepatic artery perfusion.
                             Society of Uroradiology
                                Scientific Posters

1    MR Spectroscopy of Choline as a Biomarker of Fetal Lung Maturity:
     Correlation with Surfactant to Albumin Ratio
     May L. Yong, MD

2    Incidence and Severity of Acute Adverse Events to Intravenous Nonionic
     Iodinated Contrast Material in Children
     Jonathan R. Dillman, MD

3    Role of Multiphasic CT in Conservative management of Shattered Kidney in
     Children
     Tarek El-Diasty, MD

4    Nephrogenic Systemic Fibrosis: An Educational Exhibit
     Christine Lee, MD, Ph.D.

5    Predicators of Shock-wave Lithotripsy Success for Proximal Ureteral Calculi on
     Non-contrast CT
     Jared Christensen, MD

6    Multi-detector Row CT Urography: Comparisosn of Fluid Administration
     Protocols for Depicting the Urinary Collecting System
     Takehiko Gokan, MD

7    CT Urography Using the Split-Dose Protocol in Patients Under 40 Years of Age:
     Which is Better, Saline or Furosemide?
     Herlen Alencar, MD

8    MR Angiography in UPJ (Uretero-Pelvine-Junction) Obstruction
     Vibeke Berg Løgager, MD

9    Contrast Enhanced Ultrasound of the Kidneys – How Does it Help Us?
     Par Dahlman, MD

10   Mixed Mesenchymal and Epithelial Tumors of the Kidney: Imaging
     Characteristics on Multi-phasic CT
     Maxime Freire, MD

11   Benign Adult Renal Neoplasms: Imaging Spectrum with Radiologic-Pathologic
     Correlation
     Srinivasa R. Prasad, MD

12   Cystic Renal Lesions- Characterization with CT & MRI
     Rajesh Mithalal
13   Complications Related to Radiofrequency Ablation (RFA) of Renal Cell
     Carcinoma (RCC): The Leeds Experience
     Tze Min Wah

14   Bellini’s Carcinoma: Radiological Findings
     Josefa Martinez Barcina, Dr

15   Imaging of Thermal Renal Tumor Ablation—Planning, Common Techniques,
     and Assessment of Response
     Michael Wayne Freckleton, MD

16   Image Fusion of MR Lymphography and CT Angiography
     Satoru Takahashi

17   Transitional Cell Carcinoma in Patients with Ureteral Pseudodiverticulosis
     Karolyn Davidson, MD

18   Characterization of Bladder Hernias Identified on CT
     Andrew Y. Choi, MD

19   Multi-Detector CT Urography on a 16-row CT Scanner in the Evaluation of
     Urothelial Tumors
     Athina C. Tsili, MD

20   Acute Gynecological Presentations with Emphasis on Color Flow Doppler
     Evaluation
     Shweta Bhatt, MD

22   Characterization of Adnexal Mass Lesions with Multidetector CT
     Athina C. Tsili, MD

23   16-MDCT and MR Imaging in the Characterization of Ovarian Masses
     Athina C. Tsili, MD

24   Fallopian Tube Malignant Lesions: the Role of MRI
     Maria Manuel Monteiro

25   Multidetector CT in the Preoperative Staging of Endometrial Carcinoma
     Athina C Tsili, MD

26   MRI Pictorial Essay of Congenital Müllerian Duct Anomalies
     Bart J. Op de Beeck, MD

27   Detection of Locally Recurrent Prostate Cancer with Magnetic Resonance
     Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS) in Cases of
     Biochemical Failure After Radical Prostatectomy
     Michael Karl Scherr, Dr
28   MR Imaging (MRI) and MR Spectroscopy (MRS) of Prostate Cancer: Review of
     Technique and Emerging Relevance in Planning Laparoscopic Prostatectomy
     Mittul Gulati, MD

29   Prostate MR Spectroscopy using Surface Phased-array Coils at 1.5T: Feasibility
     and Comparison with Endorectal Coil Acquisition in the same Patients, Early
     Experience
     Bachir Taouli, MD

30   Imaging of Male Urethral Stricture: Comparison of Combined Retrograde
     Urethrography and Sonourethrography Versus Magnetic Resonance
     Urethrography
     Tarek El-Diasty, MD

31   Method to Diagnose Testicular Torsion using Near Infrared Fluorescence
     (NIRF) of Intravenous Indocyanine Green (ICG)
     Ronald Wood, PhD
Poster #1
MR Spectroscopy of Choline as a Biomarker of Fetal Lung Maturity: Correlation with
Surfactant to Albumin Ratio
May L. Yong, MD, UCSF Radiology Department; Bonnie N. Joe; Kiarash Vahidi; Mark
Swanson; Thomas Butler; Ying Lu; Fergus V. Coakley; John Kurhanewicz
Purpose: To determine if quantitative ex-vivo MR spectroscopic evaluation of choline in
amniotic fluid samples correlates with surfactant to albumin ratio, which may ultimately
allow in-vivo non-invasive assessment of fetal lung maturity using MR spectroscopy in
fetuses at risk for respiratory distress syndrome.
Methods and Materials: High resolution (11.7T) ex-vivo MR spectroscopy was performed
on 15 amniotic fluid samples obtained for evaluation of fetal lung maturity (range, 34-40
weeks gestation). Samples were analyzed quantitatively using trimethylsilylpropionic acid
(TSP) as a reference compound. Two readers independently processed the 15 spectra. The
choline concentration of each sample was correlated with surfactant to albumin ratio (current
standard for fetal lung maturity evaluation).
Results: The mean choline concentration was 0.35mM (range, 0.17 to 0.59). The mean
surfactant to albumin ratio was 59 mg/g (range, 34 to 93; values greater than 49 indicating
lung maturity). There was a positive trend of increasing choline concentration with increasing
surfactant to albumin ratio (correlation coefficient of 0.4382, p=0.1023).
Conclusion: Ex-vivo MR Spectroscopy of choline levels shows promise as a marker of fetal
lung maturity. Further research is necessary before in-vivo MR spectroscopy can be adopted
for this indication.


Poster #2
Incidence and Severity of Acute Adverse Events to Intravenous Nonionic Iodinated
Contrast Material in Children
Jonathan R. Dillman, MD, University of Michigan; Peter J. Strouse; Jim H. Ellis; Richard
H. Cohan; Sophia C. Jan
Purpose: To retrospectively evaluate the incidence and severity of acute adverse events
related to the intravenous administration of nonionic iodinated contrast material in children.
Materials and Methods: Department of Radiology contrast material adverse event forms
involving pediatric patients (under the age of 19) from January 1, 1999 through June 30,
2006 were evaluated for the specific types of acute adverse reactions, their severity, and
patient outcomes. The electronic medical record was reviewed for pertinent medical history
and possible risk factors.
Results: Eleven-thousand three-hundred and six pediatric intravenous nonionic iodinated
contrast material administrations were performed during the above time period. Acute
adverse events were documented in twenty pediatric patients (0.18%). Sixteen (80%) acute
adverse events were categorized as mild, one (5%) was moderate, and three (15%) were
severe. There were no deaths attributed to intravenous contrast material administration. Six
patients (30%) had a history of prior allergic-type reaction, including two (10%) that had a
prior history of iodinated contrast material reaction. Four patients (20%) had a history of
asthma.
Conclusions: Acute adverse events related to the intravenous administration of nonionic
iodinated contrast material in children are rare. As with adults, most pediatric reactions are
mild; however, severe reactions do occur.
Poster #3
Role of Multiphasic CT in Conservative management of Shattered Kidney in Children
Tarek El-Diasty, MD, Urology&Nephrology center; Mohamed Abo El-Ghar; Waleed Eassa;
Huda Refaie
Purpose: To evaluate our own single center experience in initial conservative management
of shattered kidneys in children using multiphasic CT study in staging of renal trauma.
Materials and Methods: We retrospectively reviewed 60 pediatric renal injuries since 1990
until july 2006 . Multiphasic CT is immediately done &there were 14 shattered kidneys.
Our selective criteria for conservative management of shattered kidneys were:
Haemodynamic stability, intact pedicle and no avulsion of ureteropelvic junction.CT After 6
months .
Results: Among the 14 child included in the study with shattered kidney, 4 were girls and 10
were boys with age ranging from 3 to 14 years (Mean 8.8 ± 3.63). All 14 patients were
managed initially conservatively, 9 patients (64%) successfully managed and follow up CT
scan showed reduction of the gap and approximation of the shattered perfused ends of the
kidney with formation of thin scar in-between, the other 5 patients had intervention (4
nephrectomy ( 28%) and 1 lower polar selective angioembolization (7%) for a lower polar
aneurysm).
Conclusion: Multiphasic CT study allows accurate selection of pediatric patients amenable
for conservative management provided that the patient is hemodynamically stable.


Poster #4
Nephrogenic Systemic Fibrosis: An Educational Exhibit
Christine Lee, MD, Ph.D., Mayo Clinic Rochester; Robert Hartman; Gina Hesley; Nelson
Leung; Mark Pittelkow; Eric Williamson
Purpose: Educational exhibit on Nephrogenic Systemic Fibrosis (NSF) describing the
disease and its systemic, primarily dermatological manifestations. Examination of risk factors
for the development of NSF including the possible association with Gadolinium contrast
agents.
Materials and Methods: Approximately 40 patients with NSF have been followed at our
institution. This is a multispecialty exhibit including input from nephrology, dermatology and
radiology describing NSF. Retrospective review of patient histories was performed to
identify predisposing factors including history of renal transplant and/or renal failure
requiring dialysis as reported in the literature.
Results: NSF is almost exclusively found in patients with renal insufficiency/failure. Many
had received Gadolinium prior to onset of disease. The patients exhibit specific dermatologic
changes in a typical pattern involving the limbs and most often sparing the trunk.
Conclusions: Practicing radiologists should be aware of NSF as we are often involved in
MRI/MRA imaging of patients with renal dysfunction since this particular patient population
is often referred to MRI to avoid the risk of contrast nephropathy. The FDA has issued an
alert of the use of Gadolinium in patients with renal dysfunction. Further investigations need
to be performed to elucidate the role of Gadolinium in the development of NSF.
Poster #5
Predicators of Shock-wave Lithotripsy Success for Proximal Ureteral Calculi on Non-
contrast CT
Jared Christensen, MD, University of Rochester School of Medicine; Vikram Dogra; Eric
Singer; Erdal Erturk; Jared D. Christensen
Purpose: Determine if CT measurements of skin-to-stone distance (SSD), Hounsfield unit
density (HU),stone size can predict shock-wave lithotripsy (SWL) success for proximal
ureteral calculi (PUC).
Materials and Methods: Patients with PUC on non-contrast CT (NCCT) treated with SWL
were identified by retrospective review from 01/2004 to 12/2005. Average SSD was
calculated by measuring distance from center of stone to skin at 0°, 45°, and 90° angles. PUC
cross-sectional area was calculated and maximal PUC HU densities obtained. BMI (kg/m2)
was calculated. Post SWL patients were categorized into stone-free (SF) or residual stone
(RS) groups at 3 months follow-up. Uni- and multivariant logistic regression analysis was
performed to assess if SSD, HU, stone size, or BMI are predictors of SWL success.
Results: 16/32 patients were SF;16 had residual stones. Univariate analysis revealed stone
size and HU to be independent predictors of SF status. Mean stone size for SF group was
29±17 mm2 vs. 46±31 mm2 for RS group (P<0.03).
Conclusions: Stone size (


Poster #6
Multi-detector Row CT Urography: Comparisosn of Fluid Administration Protocols for
Depicting the Urinary Collecting System
Takehiko Gokan, MD, Showa University School of Medicine; Yoshimitsu Ohgiya; Hidenori
Shinjyo
Purpose: To compare the effects of intravenous administration of saline, oral administration
of water and green tea on urinary tract opacification during multidetector row CT urography
(MDCTU).
Method and Material: Excretory phase images from MRCTU studies in 195 patients were
reviewed. Patients underwent one of four techniques: (A) intravenous administration of 250
ml normal saline (N=40); (B) oral administration of 400 ml green tea (N=51); (C) oral
administration of 400 ml(N=51); (D) no administration of fluid (N=35). Two reviewers
measured urinary tract opacification on CTU images. Scoring system was used to evaluate
the opacification of ureter. 0, unopacified; 1, less than 25% of segment opacified; 2, 26 to
50% of segment opacified; 3, 50 to 75% of segment opacified; 4, 76 to 100 % of segment
opacified.
Results: Mean opacification score of group B was highest. However, thee was no significant
difference among the scores in group A,B and C. Opacification of the ureter in A, B and C
was significantly improved over that in group D.
Conclusion: Intravenous administration of normal saline, oral administration of green tea,
oral administration of water improved opacification of the ureter.
Oral administration of green tea might be beter than oral administration of water.
Poster #7
CT Urography Using the Split-Dose Protocol in Patients Under 40 Years of Age: Which
is Better, Saline or Furosemide?
Herlen Alencar, MD, Brigham and Women's Hospital; Cheryl A. Sadow; Kemal Tuncali;
Stuart G. Silverman
Purpose: Split-dose CT urography (SDCTU) results in less radiation exposure to patients
than three-phase CT urography. However, the collecting system, ureters and bladder are not
always well-visualized. We compared intravenous furosemide to saline in their ability to
improve the depiction of normal urinary collecting system during SDCTU.
Materials and Methods: In 59 patients under 40 years old, SDCTU was performed using
250 mL of intravenous normal saline (n = 25) or 10 mg of IV furosemide (n = 34). Three
blinded readers reviewed nephrographic/excretory phase images and individually assigned
opacification scores to six urinary collecting system segments. One additional reader assessed
ureteral distention and bladder urine attenuation. Data were compared using Student\'s t test.
Results: Mean ureteral opacification with furosemide and saline were similar (furosemide =
2.7; saline = 2.67; P = 0.48). Mean ureteral widths were higher with furosemide (4.17 mm)
than saline (4.06 mm), although this difference was not significant (P = 0.56). Furosemide
resulted in more homogenous bladder urine attenuation than saline (P < 0.0001).
Conclusions: Furosemide and saline produce equal opacification and distention of the
normal urinary collecting system during SDCTU in young patients. However, furosemide
results in a more homogenous bladder urine attenuation.


Poster #8
MR Angiography in UPJ (Uretero-Pelvine-Junction) Obstruction
Vibeke Berg Løgager, MD, Consultant Radiologist, University hospital Herlev; Yousef
Jesper W. Nielsen; Henrik S. Thomsen
Purpose: The purpose was to evaluate the impact of MR angiographies of renal vessels in
early workup of patients with hydronephrosis likely due to functional UPJ obstruction.
Materials and Methods: 47 patients (20 male/17 female, age range 13-86 years) underwent
MR angiography and hydrography in 1.5T unit. The patient records were reviewed.
Results: MRA showed aberrant vessel in 12 of the 47. However only 10 patients underwent
surgery and 12 were treated with uretero-plasty (“Accusize”). No bleeding occurred.
In 2 of the patients who underwent open surgery no vessel was found but instead fibrosis was
found.
One had aberrant vessel with no relation to UPJ. MRA findings were confirmed by open
surgery in 7 of 10.
24 patients never underwent surgery due to various reasons. One patient is waiting for
surgery.
Conclusions: MR angiography is an excellent method for preoperative evaluation of the
renal vessels in patients with functional UPJ obstruction. Never the less it should not be
performed before the patient’s condition, symptoms and demand for treatment as a whole has
been evaluated. Decision of best treatment can then be taken.
Poster #9
Contrast Enhanced Ultrasound of the Kidneys – How Does it Help Us?
Par Dahlman, MD, Department of Radiology, Uppsala University Hospit; Eva Radecka;
Anders Magnusson; Anders Nilsson
Purpose: Contrast Enhanced Ultrasound (CEUS) of the kidneys is a novel technique that still
has not been fully established in clinical practice. The ability of CEUS to help in detection
and characterization of focal liver lesions and tissue perfusion can in general principles be
applied also to renal ultrasound We hereby present our experience of CEUS of the kidneys.
Materials and Methods: Ultrasound contrast agents (Sonovue, Bracco, Milan, Italy) has
been in use at Uppsala University Hospital since 2002. In this retrospective study we
evaluated 153 CEUS exams of the kidneys performed since 2003 focusing on a) the clinical
indication for the scan and b) the imaging information aquired.
Results: In 56 % of the cases CEUS was used to verify findings on CT/MR. In 28 %
ultrasound (US) of the kidneys was the primary investigation and CEUS was used to verify
suspected pathology and to better evaluate renal function or vasculature. 15 % of the patients
underwent abdominal US and CEUS was used to verify unexpected findings – tumours and
anatomic variants.
Conclusions: CEUS was most often used to verify pathology suspected on CT. Another
important use is to improve the diagnostic quality of US.


Poster #10
Mixed Mesenchymal and Epithelial Tumors of the Kidney: Imaging Characteristics on
Multi-phasic CT
Maxime Freire, MD, Cleveland Clinic; Erick M. Remer; Brian Lane; Steven Campbell; Amr
Fergany; Ming Zhou
Purpose: Cystic Nephroma (CN) and mixed epithelial and stromal tumor (MEST) are rare
benign lesions, categorized under a common spectrum of mixed mesenchymal and epithelial
tumors by WHO in 2004. We identify clinical features and imaging characteristics.
Materials and Methods: Pathology database 1987 - 2005 identified 21 patients with 22 CN
and 9 patients with 10 MEST. CT reports searched for side, size, location, cystic components,
septations, calcifications, margins, enhancement, extension into the renal sinus, compression
of collecting system, Bosniak classification and associated lesions.
Results: 28/30 patients (19/21 (90.5%) with CN and all 9 (100%)with MEST were women.
22(73%) had symptoms including hematuria, flank pain, mass, pyelonephritis and anemia.
Median size: CN 6.8 cm (1.9-18), MEST 4.5 cm (1.7-18). 78% (17/22) of CN were Bosniak
III lesions. The majority of MEST (70%; 7/10) had solid enhancing components: 3 were
Bosniak IV lesions and 4 solid enhancing lesions. 89% were central lesions. Associated
enhancing lesions present in 7 patients (4 CN, 3 MEST).
Conclusions: CN/MEST share clinical, pathological and imaging characteristics, and may
have CT features of RCC. In middle-aged women with symptoms, including CN/MEST in
the DDx may alter patient management.
Poster #11
Benign Adult Renal Neoplasms: Imaging Spectrum with Radiologic-Pathologic
Correlation
Srinivasa R. Prasad, MD, University of Texas HSC at San Antonio; Abhijit A. Raut;
Venkateswar Rao Surabhi; Christine O. Menias; Neal C. Dalrymple; Chitra Madiwale; Peter
Humphrey
Purpose: 1. To review histological spectrum of benign renal neoplasms. 2. To discuss the
imaging findings on multiphasic MDCT, MRI, and US 3. To correlate imaging findings with
pathological findings
Materials and Methods: • Introduction • 2004-WHO Classification of Renal Neoplasms •
Epidemiology• Histogenesis, Gross Pathology, Histopathology of benign renal neoplasms •
Cross-sectional Imaging Spectrum & Radiologic-Pathologic Correlation of Benign Renal
Neoplasms • Pattern-based algorithmic approach to diagnosis
Results: Based on the cell of origin, benign renal neoplasms are classified into renal cell
tumors, metanephric tumors, mesenchymal tumors, mixed epithelial and mesenchymal
tumors (MEST), & germ cell tumors. While leiomyomas originate from the renal capsule,
hemangiomas typically arise from the renal sinus. Fibromas are confined to the medulla.
Oncocytoma typically shows a central scar (1/3 of large tumors). Cystic nephroma is cystic;
AML is predominantly fatty and metanephric adenomas are commonly solid. MEST shows
solid areas and cysts that herniate into the renal pelvis.
Conclusions: There is a broad spectrum of benign renal neoplasms that demonstrate
characteristic ontogeny, histology & biologic behavior. Select benign tumors show
characteristic anatomic distribution & imaging features. However, biopsy may be required to
establish definitive diagnosis. Accurate characterization facilitates optimal patient
management.


Poster #12
Cystic Renal Lesions- Characterization with CT & MRI
Rajesh Mithalal, Mercy Catholic Medical Center; Felice Esposito; Avneesh Chabbra
Purpose: 1. Gain Knowledge of cystic renal masses. 2. Learn the characteristic CT & MRI
imaging findings in various cystic renal masses. 3. Gain knowledge of differential diagnostic
considerations with relevant case examples. 4. Formulate a diagnostic algorithm to accurately
diagnose & differentiate various cystic masses in the kidney.
Materials and Methods: Contrast-enhanced CT & MRI evaluation of cystic renal masses
describing the typical features of various cystic renal masses including simple cyst, complex
cysts, polycystic renal disease, renal cell carcinoma, multilocular cystic nephroma, and
metastasis.
Results: Both CT & MRI are powerful techniques in evaluation of cystic renal mass lesions.
MRI adds more specificity in some cases due to better soft tissue contrast resolution.
Conclusion: It is important for the Radiologist to know typical imaging appearances of
various cystic renal masses. Contrast enhanced CT & MRI can help differentiate benign from
malignant lesions in majority of cases & the reader should have a diagnostic algorithm to
characterize the lesions correctly, thus, preventing indiscriminate use of follow-up or
additional studies.
Poster #13
Complications Related to Radiofrequency Ablation (RFA) of Renal Cell Carcinoma
(RCC): The Leeds Experience
Tze Min Wah, FRCR, St. James's University Hospital; Henry Charles Irving
Purpose: Percutaneous RFA of RCC is an important treatment option for patients with RCC.
We wish to report the complications of percutaneous renal RFA encountered in the Leeds
Teaching Hospitals, UK.
Materials and Methods: Between April 2004 and October 2006 we performed percutaneous
RFA for 58 RCCs in 41 patients (age range 37 to 87 years). All tumours were treated with the
Boston Scientific system using the RFA Le Veen needle. All patients were carefully
monitored for post-procedural complications, which were documented prospectively.
Results: Minor complications include pain (n= 35), post-RFA syndrome (n=14), transient
neuropathic pain (n=1), paraesthesia (n=1), grounding pad burn (n=2), minor renal
impairment (n=3) and macroscopic haematuria (n=5).
Major complications (n=3) include acute renal failure secondary to acute tubular necrosis
(n=1) in a patient with a solitary kidney, and infection problems (n=2) in two patients with
ileal conduits (a renal abscess and a calyceal-cutaneous fistula)

Conclusions: Our minor complications are similar to other published series. However,
neither acute tubular necrosis nor infection problems in patients with ileal conduits have been
reported previously. It is important to be aware of these potential complications so as to
ensure that all necessary steps are taken to avoid them.



Poster #14
Bellini’s Carcinoma: Radiological Findings
Josefa Martinez Barcina, Dr, Fundacion Puigvert; Josefa Martínez Barcina; Claudia
Fabiana Quintian Schwieters; Jaime Pierre Samantiego Duque
Purpose: Describing our experience of the radiological characteristics of Bellini’s
carcinoma.
Materials and Methods: We reviewed eight cases with diagnosis of Bellini’s carcinoma.
The radiological explorations included CT in all the patients, seven ultrasound, three
excretory urogram and one MRI. In this form, we could evaluate the different radiological
patterns.
Results: All the patients began with haematuria, with a predominant left kidney affectation
(mean age 67). The CT demonstrated a solid mass in six patients, one case as a focal diffuse
thickening with heterogenous enhancement suggesting infiltrative process. The last patient
presented calyceal filling defect, similar to transitional cells carcinoma. The ultrasound
showed a renal mass in five patients, one case was infiltrative pathology and another was
negative. The excretory urogram showed a filling defect in just one case, the other two were
normal. The MRI exam was realized in only one patient, demonstrating a mass, T1 isointense
and T2 heterogenous. Nephrectomy was made in five cases and renal biopsy in three.
Conclusions: A renal mass is the most frequent presentation of Bellini’s carcinoma.
Exceptionally it appears like infiltrative pathology and filling defect. Nowadays the
radiological exams can not differentiate it from other histologic types as renal carcinoma.
Poster #15
Imaging of Thermal Renal Tumor Ablation—Planning, Common Techniques, and
Assessment of Response
Michael Wayne Freckleton, MD, UTHSCSA; Kedar N. Chintapalli; William J. Harmon
Purpose: Renal tumor ablation using thermal techniques has been under active investigation
since the 1960’s. Recently, these techniques have become more wide-spread. Understanding
the planning, techniques, and evaluation of treatment response is critical for meaningful
interpretation.
Materials and Methods: We review 66 successive cases of renal radiofrequency and cryo
ablation from a local urology group performed between Feb.’04 to Sept. ‘06. CT and some
MRI findings of pre and post thermal renal tumor ablation (TRTA) cases are evaluated by
two radiologists with sub-specialty training in abdominal imaging. A consensus of their
imaging findings is presented as pre, baseline post, and longer term post-ablation timeframes,
assessing, where possible, 1- Preoperative decision-making, 2- Post-procedural findings 3-
Outcomes.
Results: Using the above case material, we provide an overview of preoperative evaluation
and decision-making for TRTA, then present relevant findings for interpretation of short and
longer term post-procedural imaging follow-up.
Conclusions: Increasing use of TRTA in renal malignancies has become more wide-spread.
Understanding pre-ablation planning, techniques, and relevant imaging considerations is
critical in optimizing the role of the radiologist in this growing area.


Poster #16
Image Fusion of MR Lymphography and CT Angiography
Satoru Takahashi, Radboud University Nijmegen Medical Centre; Jelle O. Barentsz;
Michelle Yan; Thomas Moeller
Purpose: Ferumoxtran-10 enhanced MR imaging (MR lymphpgraphy; MRL) has shown to
be extremely accurate for assessing the lymph node status. Although MRL can provide
accurate localization of positive nodes, CT has been the standard for radiation treatment
planning. The purpose of this technical report is to evaluate the values of image fusion of
MRL and CT as a potential tool for radiation planning.
Materials and Methods: Ten patients with prostate cancer underwent both MRL and CT
angiography. Positive nodes on MRL were segmented on a WIP workstation, and then the
MRL and CT images were manually fused by using the bony structure as references. MRL
and CT findings were correlated for all positive nodes. The degree of misregistration was
evaluated for large nodes (>500mm^3).
Results: 134 positive lymph nodes (mean volume of 615 mm^3, range 1-7,883) were
detected on MRL. All but 8 small nodes (range 1-78 mm^3) could be detected on
corresponding CT images.
The degree of misregistration was 0.3±2.0 mm in RL direction, 0.1±2.5mm in CC direction,
and 1.1±2.0 mm in AP direction.
Conclusions: Image fusion of MRL and CT is accurate and can be a potential and acceptable
tool for radiation planning in clinical setting.
Poster #17
Transitional Cell Carcinoma in Patients with Ureteral Pseudodiverticulosis
Karolyn Davidson, MD, Mayo Clinic Rochester; Robert Hartman; John Cheville; Matthew
Gettman
Purpose: Determine the incidence of transitional cell carcinoma (TCC) in patients with
ureteral pseudodiverticulosis against a matched control group.
Materials and Methods: After IRB approval a retrospective chart review was performed
from the years 1997 to present. Intravenous urography and CT urography reports were
examined for patients with ureteral pseudodiverticulosis. These charts were reviewed for
presence of TCC and demographic information including age, sex, time of follow-up and
smoking history. Matched controls were then established and their charts reviewed.
Results: Fifty-four patients with ureteral pseudodiverticulosis were identified with an
average time of follow-up of 31 months (range 1-100). Twenty-eight percent (15/54) of the
patients, all of them men, also had a diagnosis of TCC. Ureteral pseudodiverticulosis was
almost exclusively seen in men (52/54). An equal number of smokers and non-smokers had
pseudodiverticulosis; however 67% (10/15) of those also diagnosed with TCC were smokers.
TCC incidence was lower in the matched control group.
Conclusion: TCC is often found in patients with ureteral pseudodiverticulosis. Given the
higher incidence in this patient group, surveillance as previously suggested, should be
performed once a diagnosis of ureteral pseudodiverticulosis is established. In this study
ureteral pseudodiverticulosis and TCC were almost exclusively seen in men.


Poster #18
Characterization of Bladder Hernias Identified on CT
Andrew Y. Choi, MD, Winthrop-University Hospital; Douglas S. Katz; Steven Perlmutter
Purpose: To determine the frequency and location of incidental bladder hernias
retrospectively identified on CT
Materials and Methods: 451 consecutive pelvic CT examinations were retrospectively
reviewed by a senior radiology resident and a radiology attending. For each CT scan, a
bladder hernia was characterized as definitely present, equivocal, absent, or non-diagnostic.
Hernia location and associated findings were recorded, and demographic information was
collected, as well as the maximal AP and transverse dimensions of the prostate if a hernia
was definitely present.
Results: Thirty-five(7.8%) of cases had a definite bladder hernia, 39(8.6%) had equivocal
findings, 302(66.9%) were negative, and 75(16.6%) were indeterminate. In males(mean age
59), there were 8 right-sided hernias, 5 left-sided hernias, and 6 bilateral hernias; these were
anterior/inferior/lateral in the vicinity of or extension to the inguinal region. The prostate
measured a mean 4.5 x 3.4cm. Eleven of the sixteen hernias in females(mean age 61) were
obturator.
Conclusions: Incidental bladder hernias are relatively common, representing 7.8% of a series
of consecutive CT examinations. Although many such hernias were “classical”, occurring in
older males on the right side at or near the inguinal region, obturator hernias in women as
well as left-side hernias and hernias in younger individuals were also identified.
Poster #19
Multi-Detector CT Urography on a 16-row CT Scanner in the Evaluation of Urothelial
Tumors
Athina C. Tsili, MD, University Hospital of Ioannina; Constantine Tsampoulas; Alexandra
D. Chaidou; Constantia Veliou; Dimitrios Giannakis; Nikolaos Sofikitis; Stavros C. Efremidis
Purpose: The purpose of this study was to assess the role of multi-detector CT urography
(MDCTU), on a 16-row CT scanner in the evaluation of patients presenting with painless
hematuria, with emphasis placed in the detection of urothelial tumors. Materials and
methods: We retrospectively reviewed the MDCT urographies of 75 patients, referred for
painless hematuria. The CT protocol included unenhanced images, obtained with a detector
configuration of 16 X 1.5 mm and pitch of 1.2, nephrographic and excretory-phase images,
obtained with a detector collimation of
16 X 0.75 mm and pitch of 1.2. Axial and coronal reformatted images were evaluated. Three-
dimensional reformation of the excretory-phase images was performed using the volume-
rendering technique. The standard of reference included clinical and imaging follow-up,
cystoscopic, surgical and histologic findings.
Results: In 55 (73%) of 75 patients, the cause of hematuria was identified on MDCTU; the
commonest cause was urothelial cancer, including seven tumors with a diameter equal or
smaller than 0.5 cm in diameter.
Conclusion: 16-row MDCTU provided satisfactory results in the investigation of patients
presenting with painless hematuria, the main advantage of the technique being its ability to
detect uroepithelial malignancies.


Poster #20
Acute Gynecological Presentations with Emphasis on Color Flow Doppler Evaluation
Shweta Bhatt, MD, University of Rochester School of Medicine; Vikram Dogra
Purpose: 1. Describe the role of Color Flow Doppler in patients with Ectopic pregnancy.
2. Describe the variations in color flow Doppler in patients with ovarian torsion.
3. Identify and understand the color flow Doppler features of uterine arterio-venous
malformations and retained products of conception.
This exhibit will present color flow Doppler patterns in ovarian torsion, uterine arteriovenous
malformations, retained products of conception and hemorrhagic leiomyomas. Utility of
color flow Doppler in evaluation of ectopic pregnancy and ruptured ovarian cyst will also be
emphasized. A brief discussion of differential diagnostic possibilities will also be presented.
Conclusion: Color flow Doppler plays a definitive role in evaluation of patients presenting
with acute pelvic pain and helps diagnose/exclude life threatening conditions such as ectopic
pregnancy.
Poster #22
Characterization of Adnexal Mass Lesions with Multidetector CT
Athina C. Tsili, MD, University Hospital of Ioannina; Constantine Tsampoulas; Alexandra
D. Chaidou; Constantia Veliou; Evagelos Paraskevaidis; Stavros C. Efremidis
Purpose: To evaluate the accuracy of multidetector CT on a 16-row CT scanner in the
detection and characterization of adnexal masses.
Materials and Methods: We prospectively examined 76 consecutive women with clinically
or sonographically detected adnexal masses. Preoperative CT examination was performed,
including scanning of the abdomen during the portal phase, using a detector collimation of 16
X 0.75 mm and a pitch of 1.2. Multiplanar reformatted images were evaluated for the
presence of an adnexal mass and differentiation between benign and malignant ones, using
the surgical and pathologic results as standard of reference. CT findings used to diagnose
malignancy were the following: diameter > 4 cm, bilateral masses, cystic-solid mass, necrosis
in a solid lesion, cystic lesion with thick, irregular walls or septa, or with papillary
projections. The presence of ascites, peritoneal metastases and lymphadenopathy were used
to confirm malignancy.
Results: Histopathologic examination demonstrated 97 adnexal masses, 73 of which were
benign and 24 malignant. Multidetector CT detected 92 (95%) of the 97 adnexal masses, with
sensitivity, specificity and an overall accuracy for the diagnosis of malignancy of 90.1%,
92.9% and 92,9%, respectively.
Conclusion: 16-row CT scanner proved accurate in the detection and characterization of
adnexal masses.


Poster #23
16-MDCT and MR Imaging in the Characterization of Ovarian Masses
Athina C. Tsili, MD, University Hospital of Ioannina; Constantine Tsampoulas; Constantia
Veliou; Alexandra D. Chaidou; Evagelos Paraskevaidis; Stavros C. Efremidis
Purpose: To compare the accuracy of multidetector CT on a 16-row CT scanner and
magnetic resonance (MR) imaging in the characterization of ovarian masses.
Materials and Methods: Preoperative CT examination of the abdomen and MR imaging of
the pelvis was performed in 67 consecutive women, with clinically or sonographically
detected adnexal masses. The CT examinations were performed on a 16-row CT scanner and
the protocol included scanning of the abdomen on the portal phase, using a detector
collimation of 16 X 0.75 mm and a pitch of 1.2. We used a 1.5-T magnet unit to perform T1-
T2- and fat-suppressed T1-weighted sequences, before and after intravenous administration
of gadolinium chelate compounds. The accuracy of multidetector CT and MR imaging in the
differentiation between benign and malignant ovarian masses was evaluated, using surgical
and histological results as the standard of reference.
Results: The sensitivity, specificity and accuracy of MDCT in the characterization of ovarian
masses were 90.5%, 93.7% and 92.9%, respectively, and of MR imaging were 95.2%, 98.4%
and 97.6%, respectively. Although MRI performed slightly better, this did not reach
statistical significance.
Conclusion: Both multidetector CT and MR imaging demonstrated satisfactory results in the
characterization of ovarian masses.
Poster #24
Fallopian Tube Malignant Lesions: the Role of MRI
Maria Manuel Monteiro, Instituto Português de Oncologia de Francisco Gent; Teresa
Margarida Cunha; Ana Felix
Purpose: We proposed to evaluate the MRI finding tubular-shape cystic mass with solid
enhanced vegetation in the diagnosis of adnexal malignant lesions.
Material and Methods: We retrieved 88 adnexal malignant lesions with histological
diagnose which underwent preoperative MRI.
Results: We reviewed and grouped MRI exams in 3 patterns: enhanced solid mass, complex
cystic mass with solid enhanced component and tubular-shape cystic mass with solid
enhanced vegetation. We found tubular-shape cystic mass with solid enhanced vegetation in
4 cases. Pathology diagnosed 7 cases as fallopian tube carcinomas: 6 primary fallopian tube
lesions and 1 tube-ovarian carcinoma and 81 as ovarian carcinomas. All lesions with tubular-
shape cystic mass with solid enhanced vegetation on MRI were histologically confirmed to
be fallopian tube carcinomas. The remaining malignant fallopian tube lesions presented on
MRI as enhanced solid adnexal mass (n=1) and as complex cystic adnexal mass with solid
enhanced component (n=2).
None of the 81 primary ovarian carcinomas showed MRI tubular-shape mass with solid
enhanced vegetation, except the tube-ovarian case.
Conclusion: The tubular-shape of malignant cystic adnexal with solid enhanced seems to be
an important criteria in the diagnosis of fallopian malignant lesions.


Poster #25
Multidetector CT in the Preoperative Staging of Endometrial Carcinoma
Athina C. Tsili, MD, University Hospital of Ioannina; Constantine Tsampoulas; Constantia
Veliou; Alexandra D. Chaidou; Evagelos Paraskevaidis; Stavros C. Efremidis
Purpose: To evaluate the accuracy of multidetector CT (MDCT) on a 16-row CT scanner in
local staging of endometrial carcinoma and more specifically in the assessment of the depth
of myometrial invasion and presence of cervical infiltration.
Materials and Methods: This was a prospective study including 20 consecutive women with
newly diagnosed endometrial carcinoma, referred for CT examination of the abdomen. The
examinations were performed on a 16-row CT scanner and the CT protocol included
scanning of the abdomen after the intravenous administration of iodinated contrast material,
on the portal phase using a detector collimation of 16 X 0.75 mm and a pitch of 1.2. Sagittal,
parasagittal and oblique reformatted images were evaluated by two radiologists in consensus,
for the depth of myometrial invasion, whether superficial or deep and the presence of cervical
infiltration, using the surgicopathologic results as the standard of reference.
Results: The sensitivity, specificity and overall diagnostic accuracy of MDCT in evaluating
myometrial invasion were 100%, 75% and 95%, respectively; those in assessing cervical
invasion were 78%, 82% and 80%, respectively.
Conclusions: Multidetector CT on a 16-row CT scanner proved accurate in local staging of
endometrial carcinoma.
Poster #26
MRI Pictorial Essay of Congenital Müllerian Duct Anomalies
Bart J. Op de Beeck, MD, UZ Antwerp; Maarten Spinhoven; Rodrigo Salgado; Katrijn de
Jongh
Purpose: To present a pictorial review of typical MDAs diagnosed on MRI in order to
highlight its role and to encourage its widespread use.
Materials and Methods: Ultrasound, hysterosalpingography and laparoscopy or surgery
have until now been the mainstays for the diagnosis of Müllerian duct anomalies (MDAs).
All of these modalities have inherent limitations. The purpose of this poster is to review our
15-year MR experience on this field. All MR examinations were performed on 1.5T systems
(Siemens) and correlated with the surgical findings.
Results: MRI has been shown to be an accurate and non-invasive method for the evaluation
of MDAs. MRI is also helpful in elucidating the etiology of obstructed MDAs and is
particularly useful in patients in whom surgical unification is anticipated.
We will present a pictorial review of typical MDAs diagnosed on MRI in order to highlight
its role and to encourage its widespread use. Included in this are examples of segmental
agenesis or hypoplasia, unicornuate uterus, didelphys uterus, bicornuate and septate uterus.
Conclusions: MDAs are clinically relevant because they are associated with an increased
incidence of impaired fertility and menstrual disorders. MRI is the perfect non-invasive tool
to analyse these often complex anomalies.


Poster #27
Detection of Locally Recurrent Prostate Cancer with Magnetic Resonance Imaging
(MRI) and Magnetic Resonance Spectroscopy (MRS) in Cases of Biochemical Failure
After Radical Prostatectomy
Michael Karl Scherr, Dr, Institute of Clinical Radiology - University of Mu; Michael Seitz;
Michael Gebauer; Maximilian F. Reiser; Ullrich G. Mueller-Lisse
Purpose: To evaluate the feasibility of combined MRI and MRS of the pelvic floor in
patients with prostate-specific-antigen (PSA) relapse and suspicion of locally recurrent
prostate cancer (lrPCA) after radical prostatectomy (RP).
Material and Methods: 31 patients underwent MRI (T1ax, T2 ax, cor, sag) and 3D-SE-
MRS (TR/TE 1000/130 msec) with combined body-phased-array and endorectal coils 4 to
216 months (mean, 50 months) after RP. PSA levels at time of MRI+MRS ranged from
undetectable to 24.6 ng/ml (mean, 3.6 ng/ml). MRI data were evaluated for supicious soft
tissue masses in the pelvis, especially at the anastomosis. Small-volume 3D-MRS of
suspicious regions was evaluated for signal quality, citrate detection or elevated choline
and/or creatine.
Results: In 4/31 patients, there were neither morphological signs of local recurrence or
metastasis at MRI nor evidence of prostatic tissue at MRS. In 21/31 patients, MRI was
positive for suspicious soft tissue at the anastomosis. MRS concurred in 17 cases. MRI
demonstrated other lesions in 8/31 patients, including suspicious soft tissue within the urinary
bladder wall, pathologic lymph nodes, or osseous metastasis.
Conclusions: MRI with an endorectal coil is capable of detecting local lrPCA after RP.
However, results imply that MRS may increase specificity for lrPCA.
Poster #28
MR Imaging (MRI) and MR Spectroscopy (MRS) of Prostate Cancer: Review of
Technique and Emerging Relevance in Planning Laparoscopic Prostatectomy
Mittul Gulati, MD, University of California, Los Angeles (UCLA); Steven S. Raman; Albert
Thomas; Robert E. Reiter; David S.K. Lu
Purpose: To review the technique and describe the utility of MRI/MRS in planning
laparoscopic prostatectomy.
Materials and Methods: After an overview of MRI/MRS technique and findings in prostate
cancer, we describe three cases of locally advanced disease in which imaging showed cancer
involving the neurovascular bundles (NVBs) and seminal vesicles. These cancers were not
palpable on digital rectal exam (DRE), and NVB involvement would have been undetected
relying on traditional staging criteria (PSA level plus DRE) alone, in the absence of
MRI/MRS.
Results: Based on MRI/MRS results, the surgeon resected the involved NVB to achieve
negative surgical margins. MRI/MRS correlated with postoperative pathology, which showed
cancer extending beyond the prostatic capsule to involve the NVB. Significantly, these
patients underwent laparoscopic prostatectomy. In this technique, the surgeon lacks tactile
feedback. Preoperative imaging is thus critical when deciding about resecting or sparing vital
structures. In these cases, leaving the NVBs in place would have increased chances of
postoperative potency but provided the patients with an inadequate cancer operation.
Conclusions: This is the first report utilizing MRI/MRS to help plan laparoscopic
prostatectomy, an increasingly prevalent technique in which the surgeon has no tactile
feedback to help judge tumor extent.


Poster #29
Prostate MR Spectroscopy using Surface Phased-array Coils at 1.5T: Feasibility and
Comparison with Endorectal Coil Acquisition in the same Patients, Early Experience
Bachir Taouli, MD, NYU Medical Center, Radiology; Nouha Salibi; Jonathan Melamed;
Samir Taneja
Purpose: To report our experience of MR spectroscopy (MRS) using phased-array coils
(PAC) at 1.5T in patients with prostate cancer, and compare with endorectal coil (ERC) data
in the same patients.
Materials and Methods: Eight men with prostate cancer were evaluated with a 32 channel
1.5T system. 3D PRESS MRS was performed first using ERC alone, and then using pelvic
PAC during the same session. An expert observer measured Choline+Creatine/Citrate ratio
(Ch+Cr/Ci) and signal to noise ratio (SNR) in all diagnostic voxels of the peripheral and
transition zones.
Results: 301 voxels including 79 voxels with cancer were evaluated. Ch+Cr/Ci ratios in all
voxels and in voxels with cancer were significantly correlated between the two datasets.
Mean ERC and PAC Ch+Cr/Ci ratios were 1.58 ± 5.76 and 1.67 ± 6.51 for all voxels (r =
0.94); 5.22 ± 10.45 and 5.50 ± 12.13 for cancer voxels (r = 0.92). SNR was significantly
higher with ERC than PAC, 1.7 vs. 0.7(p < 0.001). When using ER as reference standard,
sensivity and specificity of PAC MRS for diagnosis of cancer were 86.3% and 98.8%.
Conclusions: 3D MRS of the prostate using surface PAC alone is comparable to ERC
acquisitions, despite lower SNR.
Poster #30
Imaging of Male Urethral Stricture: Comparison of Combined Retrograde
Urethrography and Sonourethrography Versus Magnetic Resonance Urethrography
Tarek El-Diasty, MD, Urology&Nephrology center; Mohamed Ibrahim Abou El-Ghar;
Yasser Osman; Huda Refaie; Mohamed Abou El-Ghar
Purpose-To compare the diagnostic value of Magnetic resonance ( MR ) as a single modality
versus sonourethrogrophy & retrograde urethrography (RUG) in evaluation of male urethral
stricture.
Materials and Methods:- 20 men with urethral stricture were investigated by conventional
retrograde urethrography , MR urethrogram with reformatted images, sonourethrography.
The patients were examined by urethroscopy under anaesthesia to be followed by definitive
endoscopic or open intervention. We compared the combined results of RUG and
sonourethrogram versus the data retrieved from MRI using the endoscopic and operative
details as the control in all patients.
Results:-Eight cases were treated with visual internal urethrotomy , one showed normal
caliber while 4 patients required open reconstructive procedures . There were 2 cases
associated with urethrorectal fistula , 2 with periurethral abscess that was managed by
drainage and suprapubic diversion, 2 cases with urethral tumors who underwent radical
cystectomy and one case with \\managed by open diverticulectomy. The overall accuracy of
MR in urethral abnormalities was 90% while for combined RUG and sonourethrogram was
85 %.
Conclusion: MR urethrogram has an overall accuracy comparable to combined RUG &
sonourethrogram in diagnosing urethral stricture.Moreover;MR has high soft tissue resolution
with lack of ionizing radiation

Poster #31
Method to Diagnose Testicular Torsion using Near Infrared Fluorescence (NIRF) of
Intravenous Indocyanine Green (ICG)
Ronald Wood, PhD, University of Rochester; Vikram S. Dogra; Jay E. Reeder; Jorge Yao;
Edward Messing
Purpose: We studied pre and intraoperative NIRF imaging in a rat model of testicular torsion
using intravenous ICG.
Materials and Methods: 12 adult, male, Spague-Dawley rats received intravenous injection
of ICG ten minutes after one of the spermatic cords was constricted using a “bulldog” clamp
or manually from 360 to 1080º. Novadaq technologies system was used for transscrotal and
intraoperative imaging. Detorsion was performed by clamp removal. Return of circulation to
the affected side was followed using NIRF. All testes were harvested for NIRF and H&E
microscopy.
Result: Transscrotal imaging, 15 seconds to 5 minutes after ICG injection precisely detected
the absence of fluorescence on the obstructed side and intense fluorescence of the healthy
hemiscrotum. Subsequently, testes were exteriorized and vascular flow was absent on
obstructed side and seen clearly on nonobstructed side, in all cases. After removal of clamp
or manual detorsion in 7/7 rats, revascularization returned to previously obstructed side: first
to large arterial, then capillary vessels, with venous outflow recovering the last. Histology
showed presence of ICG in normal testicles and testicles after “detorsion”.
Conclusion: NIRF using intravenous ICG in rats with testicular vascular flow obstruction
precisely diagnosed the absence of the flow through completely obstructed testicle.
                                     Faculty

Marco A. Amendola, MD                          Marianne Brehmer, MD
Miami, Florida                                 Stockholm, Sweden

Ronald S. Arellano, MD                         James A. Brink, MD
Boston, Massachusetts                          New Haven, Connecticut

Mark E. Baker, MD                              Boris Brkljacic, MD
Cleveland, Ohio                                Zagreb, Croatia

Dennis M. Balfe, MD                            James L. Buck, MD
St. Louis, Missouri                            Lexington, Kentucky

Richard L. Baron, MD                           William H. Bush, MD
Chicago, Illinois                              Seattle, Washington

Klemens H. Barth, MD                           Cheri L. Canon, MD
Bethesda, Maryland                             Birmingham, Alabama

Clive I. Bartram, MD                           Elaine M. Caoili, MD
Chalfont St. Giles, United Kingdom             Ann Arbor, Michigan

Deborah A. Baumgarten, MD, MPH                 Dina F. Caroline, MD
Atlanta, Georgia                               Philadelphia, Pennsylvania

Joshua A. Becker, MD                           Laura R. Carucci, MD
New York, New York                             Midlothian, Virginia

Lincoln L. Berland, MD, FACR                   David D. Casalino, MD
Birmingham, Alabama                            Chicago, Illinois

Michele Bertolotto, MD                         Martin Charron, MD
Trieste, Italy                                 Toronto, Ontario, Canada

Michael A. Bettmann, MD                        Kedar N. Chintapalli, MD
Winston-Salem, North Carolina                  San Antonio, Texas

Shweta Bhatt, MD                               Kyunghee C. Cho, MD, FACR
Rochester, New York                            New York, New York

Michael Blake, FRCR, FFRRCSI                   Hyuck Jae Choi, MD
Boston, Massachusetts                          Koyang, Kyonggi, South Korea

Giles W. Boland, MD                            Shailendra Chopra, MD
Boston, Massachusetts                          Lexington, Kentucky

Morton A. Bosniak, MD                          Peter L. Choyke, MD
New York, New York                             Bethesda, Maryland
Richard L. Clark, MD           Gerald D. Dodd, III, MD
Chapel Hill, North Carolina    San Antonio, Texas

Fergus V. Coakley, MD, MBBCh   Vikram S. Dogra, MD
San Francisco, California      Rochester, New York

Richard H. Cohan, MD           N. Reed Dunnick, MD
Ann Arbor, Michigan            Ann Arbor, Michigan

François Cornud, MD            Raymond B. Dyer, MD
Paris, France                  Winston-Salem, North Carolina

Nigel C. Cowan, MD             Thomas M. Dykes, MD
Oxford, United Kingdom         Hershey, Pennsylvania

John J. Cronan, MD             Steven C. Eberhardt, MD
Providence, Rhode Island       Albuquerque, New Mexico

Teresa Margarida Cunha, MD     James H. Ellis, MD
Lisbon, Portugal               Ann Arbor, Michigan

Nancy S. Curry, MD             Randy D. Ernst, MD
Charleston, South Carolina     Galveston, Texas

Abraham H. Dachman, MD         Michael P. Federle, MD
Chicago, Illinois              Pittsburgh, Pennsylvania

Neal C. Dalrymple, MD          Jeff L. Fidler, MD
San Antonio, Texas             Rochester, Minnesota

Barry D. Daly, MD              Joel G. Fletcher, MD
Baltimore, Maryland            Rochester, Minnesota

Francesco M. Danza, MD         Isaac R. Francis, MD
Rome, Italy                    Ann Arbor, Michigan

Eduard E. de Lange, MD         Leonard M. Freeman, MD
Charlottesville, Virginia      Bronx, New York

Lorenzo E. Derchi, MD          Jurgen J. Fütterer, MD, PhD
Genova, Italy                  Nijmegen, The Netherlands

Terry S. Desser, MD            Spencer B. Gay, MD
Palo Alto, California          Charlottesville, Virginia

Manjiri K. Dighe, MD           R. Kristina Gedgaudas-McClees, MD
Seattle, Washington            Atlanta, Georgia
David A. Geller, MD            Robert R. Hattery, MD
Pittsburgh, Pennsylvania       Tucson, Arizona

Abraham A. Ghiatas, MD         Stijn Heijmink, MD
Ekali-Athens, Greece           Nijmegen, The Netherlands

Seth N. Glick, MD              Jay P. Heiken, MD
Philadelphia, Pennsylvania     St. Louis, Missouri

Stanford M. Goldman, MD        Gertraud Heinz-Peer, MD
Houston, Texas                 Vienna, Austria

Marc J. Gollub, MD             Michael C. Hill, MD
New York, New York             Potomac, Maryland

Richard M. Gore, MD            Susan Hilton, MD
Evanston, Illinois             Wayne, Pennsylvania

Roberto Grassi, MD             Keyanoosh Hosseinzadeh, MD
Naples, Italy                  Pittsburgh, Pennsylvania

Nicolas Grenier, MD            David M. Hough, MD
Bordeaux, France               Rochester, Minnesota

Agnes M. Guthrie, MD           Gary M. Israel, MD
Houston, Texas                 New York, New York

Peter F. Hahn, MD              Zafar Jafri, MD
Boston, Massachusetts          Royal Oak, Michigan

Peter J. Hallscheidt, MD       Hyun-Jung Jang, MD
Heidelberg, Germany            Toronto, Ontario, Canada

Robert A. Halvorsen, Jr., MD   Marcia C. Javitt, MD
Richmond, Virginia             Washington, DC

Bernd K. Hamm, MD              Bonnie N. Joe, MD, PhD
Berlin, Germany                San Francisco, California

Mukesh G. Harlsinghani, MD     C. Daniel Johnson, MD
Boston, Massachusetts          Rochester, Minnesota

David S. Hartman, MD           Bronwyn Jones, MD
Hummelstown, Pennsylvania      Baltimore, Maryland

Robert P. Hartman, MD          Rajeev Jyoti, MD
Rochester, Minnesota           Canberra, Australia
Douglas S. Katz, MD          Philippe A. Lefere, MD
Mineola, New York            Hooglede, Belgium

Maka Kekelidze, MD, PhD      Marc S. Levine, MD
Rotterdam, The Netherlands   Philadelphia, Pennsylvania

Frederick M. Kelvin, MD      Angela D. Levy, MD
Zionsville, Indiana          Washington, DC

Philip J. Kenney, MD         John R. Leyendecker, MD
Birmingham, Alabama          Winston-Salem, North Carolina

Bohyun Kim, MD               Mark E. Lockhart, MD
Rochester, Minnesota         Birmingham, Alabama

Tae Kyoung Kim, MD           Brian C. Lucey, MD, MB, BCh, MRCPI
Toronto, Ontario, Canada     Boston, Massachusetts

Bernard F. King, MD          Michael Macari, MD
Rochester, Minnesota         New York, New York

Robert E. Koehler, MD        Beatrice L. Madrazo, MD,FACR
Birmingham, Alabama          Miami, Florida

Thomas J. Kröncke, MD        Dean D.T. Maglinte, MD
Berlin, Germany              Indianapolis, Indiana

Jonathan B. Kruskal, MD      Anders Magnusson, MD
Boston, Massachusetts        Uppsala, Sweden

Klaus Kubin, MD              Soroosh Mahboubi, MD
Wien, Austria                Philadelphia, Pennsylvania

Jill E. Langer, MD           Ahmed-Emad Mahfouz, MD
Philadelphia, Pennsylvania   Doha, Qatar

Francesco Lassandro, MD      Borut Marincek, MD
Naples, Italy                Zurich, Switzerland

Elizabeth Lazarus, MD        Gabriele Masselli, MD
Providence, Rhode Island     Rome, Italy

Robert L. Lebowitz, MD       William W. Mayo-Smith, MD
Boston, Massachusetts        Providence, Rhode Island

Fred T. Lee, MD              Alec J. Megibow, MD
Madison, Wisconsin           New York, New York
Christine O. Menias, MD        Rolf Olsson, MD, PhD
St. Louis, Missouri            Malmo, Sweden

Neil H. Messinger, MD          Aytekin Oto, MD
Miami, Florida                 Galveston, Texas

Frank H. Miller, MD            Nicholas Papanicolaou, MD
Chicago, Illinois              Philadelphia, Pennsylvania

Myrosia M. Mitchell, MD        Rosaleen B. Parsons, MD
Chicago, Illinois              Philadelphia, Pennsylvania

Sameh K. Morcos, MD            Suresh K. Patel, MD
Sheffield, South Yorkshire     Chicago, Illinois
United Kingdom
                               Erik K. Paulson, MD
Desiree E. Morgan, MD          Durham, North Carolina
Birmingham, Alabama
                               Pietro Pavlica, MD
Martina Morrin, MD             Bologna, Italy
Boston, Massachusetts
                               Perry J. Pickhardt, MD
Koenraad J. Mortele, MD        Madison, Wisconsin
Needham, Massachusetts
                               Joel F. Platt, MD
Peter R. Mueller, MD           Ann Arbor, Michigan
Boston, Massachusetts
                               Myron A. Pozniak, MD
Ullrich G. Mueller-Lisse, MD   Madison, Wisconsin
Munich, Germany
                               Srinivasa R. Prasad, MD
Ulrike Mueller-Lisse, MD       San Antonio, Texas
Munich, Germany
                               Aliya Qayyum, MD
Rendon C. Nelson, MD           San Francisco, California
Durham, North Carolina
                               Eva Radecka, MD
Paul Nikolaidis, MD            Uppsala, Sweden
Chicago, Illinois
                               Parvati Ramchandani, MD, FACR
Claus Nolte-Ernsting, MD       Philadelphia, Pennsylvania
Hamburg, Germany
                               Maurice M. Reeder, MD
Pamela A. Nugent, MD           Potomac, Maryland
Washington, DC
                               Erick M. Remer, MD
Andres O'Brien, MD             Cleveland, Ohio
Santiago, Chile
Stefania Romano, MD           F. Graham Sommer, MD
Naples, Italy                 Stanford, California

Catherine Roy, MD             Jorge A. Soto, MD
Strasbourg, France            Boston, Massachusetts

Jonas Rydberg, MD             John A. Spencer, MD
Indianapolis, Indiana         Leeds, United Kingdom

Elizabeth Sadowski, MD        Giles W. Stevenson, MD
Madison, Wisconsin            Duncan, British Columbia, Canada

Dushyant V. Sahani, MD        Eric P. Tamm, MD
Arlington, Massachusetts      Houston, Texas

Carl M. Sandler, MD           Bachir Taouli, MD
Houston, Texas                New York, New York

Kumaresan Sandrasegaran, MD   Andrew Taylor, MD
Indianapolis, Indiana         Madison, Wisconsin

Frank J. Scholz, MD           Ruedi F. Thoeni, MD
Burlington, Massachusetts     San Francisco, California

Arthur J. Segal, MD           Harriet C. Thoeny, MD
Rochester, New York           Bern, Switzerland

Steven E. Seltzer, MD         William M. Thompson, MD
Boston, Massachusetts         Durham, North Carolina

Kohkan Shamsi, MD             Henrik S. Thomsen, MD
Pine Brook, New Jersey        Herlev, Denmark

Hanan Sherif, MD              Jamie Tisnado, MD, FACR, FACC, FSIR
Doha, Qatar                   Richmond, Virginia

Ali Shirkhoda, MD, FACR       William E. Torres, MD
Royal Oak, Michigan           Atlanta, Georgia

Stuart G. Silverman, MD       Richard B. Towbin, MD
Boston, Massachusetts         Philadelphia, Pennsylvania

Claude B. Sirlin, MD          Stephen W. Trenkner, MD
San Diego, California         Rochester, Minnesota

Sat Somers, MD                Mitchell E. Tublin, MD
Dumdas, Ontario, Canada       Pittsburgh, Pennsylvania
Mary Ann Turner, MD, FACR     Antonio Westphalen, MD
Richmond, Virginia            San Francisco, California

Vlastimil A. Valek, MD, PhD   Jon Willatt, MD
Brno, Czech Republic          Ann Arbor, Michigan

Aart J. van der Molen, MD     Ellen L. Wolf, MD, FACR
Leiden, The Netherlands       Bronx, New York

Hubert Vesselle, MD           Jade J. Wong-You-Cheong, MB, ChB
Seattle, Washington           Baltimore, Maryland

Geert M. Villeirs, MD, PhD    Judy Yee, MD
Ghent, Belgium                San Francisco, California

Terri J. Vrtiska, MD          Benjamin M. Yeh, MD
Rochester, Minnesota          San Francisco, California

Brent J. Wagner, MD           Jinxing Yu, MD
West Reading, Pennsylvania    Richmond, Virginia

Tze M. Wah, MD                Ronald J. Zagoria, MD, FRCR
Leeds, United Kingdom         Winston-Salem, North Carolina

David M. Warshauer, MD        Robert K. Zeman, MD
Chapel Hill, North Carolina   Potomac, Maryland

Emily Webb, MD                Christoph L. Zollikofer, MD
San Francisco, California     Zurich, Switzerland
                        Past Presidents – SGR

            1971-1972                Richard H. Marshak, M.D.*
            1972-1973                Alexander R. Margulis, M.D.
            1973-1974                William B. Seaman, M.D.
            1974-1975                H. Joachim Burhenne, M.D.*
            1975-1976                Sidney W. Nelson, M.D.*
            1976-1977                John R. Amberg, M.D.
            1977-1978                Walter M. Whitehouse, M.D.*
            1978-1979                Martin W. Donner, M.D.*
            1979-1980                Robert N. Berk, M.D.
            1980-1981                Joseph T. Ferrucci, Jr., M.D.
            1981-1982                Edward B. Singleton, M.D.
            1982-1983                Harley C. Carlson, M.D.
            1983-1984                Henry I. Goldberg, M.D.*
            1984-1985                Igor Laufer, M.D.
            1986-1987                Reed P. Rice, M.D.*
            1987-1988                Roger K. Harned, M.D.
            1988-1989                Thomas C. Beneventano, M.D.*
            1989-1990                George R. Leopold, M.D.
            1990-1991                Edward T. Stewart, M.D.
            1991-1992                Albert A. Moss, M.D.
            1992-1993                Charles A. Rohrmann, Jr., M.D.
            1993-1994                David W. Gelfand, M.D.
            1994-1995                William M. Thompson, M.D.
            1995-1996                Bronwyn Jones, M.D.
            1996-1997                Patrick C. Freeny, M.D.
            1997-1998                Giles W. Stevenson, M.D.
            1998-1999                Emil J. Balthazar, M.D.
            1999-2000                David H. Stephens, M.D.
            2000-2001                Eric vanSonnenberg, M.D.
            2001-2002                William W. Olmsted, M.D.
            2002-2003                Susan D. Wall, M.D.
            2003-2004                Marc S. Levine, M.D.
            2004-2005                Dennis M. Balfe, M.D.
            2005-2006                Pablo R. Ros, M.D.
            2006-2007                Michael P. Federle, M.D.
*Deceased
                       Past Presidents – SUR

             1972-1974              Joshua A. Becker, M.D.
             1975                   Harry Z. Mellins, M.D.
             1976                   Morton A. Bosniak, M.D.
             1977                   John R. Thornbury, M.D.
             1978                   Lee B. Talner, M.D.
             1979                   Howard M. Pollack, M.D.*
             1980-1981 *            Glenn Hartman, M.D.
             1982                   David M. Witten, M.D.
             1983                   Alan J. Davidson, M.D.
             1984-1985              Richard C. Pfister, M.D.*
             1986                   Erich K. Lang, M.D.
             1987-1988              Robert R. Hattery, M.D.
             1989                   Robert L. Lebowitz, M.D.
             1990                   Bruce L. McClennan, M.D.
             1991-1992              N. Reed Dunnick, M.D.
             1993                   Robert J. Stanley, M.D.
             1994                   Jeffrey H. Newhouse, M.D.
             1995                   Bruce J. Hillman, M.D.
             1996-1997              E. Stephen Amis, Jr., M.D.
             1998                   Richard L. Clark, M.D.
             1999–2000              William H. Bush, Jr., M.D.
             2000-2001              Carl M. Sandler, M.D.
             2001-2002              Hedvig Hricak, M.D., Ph.D.
             2002-2003              Hedvig Hricak, M.D., Ph.D.
             2003-2004              Philip J. Kenney, M.D.
             2004-2005              Peter L. Choyke, M.D.
             2005-2006              John J. Cronan, M.D.
             2006-2007              Richard H. Cohan, M.D.



* Deceased
                                         Officers


The Society of Gastrointestinal Radiologists

President                                           Michael P. Federle, M.D.
President-Elect                                     Richard L. Baron, M.D.
Secretary-Treasurer                                 Richard M. Gore, M.D.
Director-at-Large                                   Peter R. Mueller, M.D.
Director-at-Large                                   Jay P. Heiken, M.D.
Past President                                      Pablo R. Ros, M.D., MPH


The Society of Uroradiology

President                                           Richard H. Cohan, M.D.
President-Elect                                     Nancy S. Curry, M.D.
Secretary-Treasurer                                 Raymond B. Dyer, M.D.
Director-in-Succession                              James H. Ellis, M.D.
Director-in-Succession                              Parvati Ramchandani, M.D.
Past President                                      John J. Cronan, M.D.

The European Society of Urogenital Radiology

President                                           Sameh K. Morcos, M.D.
President-Elect                                     Bernd Hamm, M.D.
Secretary-Treasurer                                 Gertraud Heinz-Peer, M.D.
Member-at-Large                                     Jarl Jakobsen, M.D.
Past President                                      Lorenzo E. Derchi, M.D.
       SUR New Horizons Lecturers

2004                  Farhang Rabbani, M.D
2005                  Ralph V. Clayman, M.D.
2006                  Lee B. Talner, M.D.
2007                  Peter L. Choyke, M.D.
                      Nicolas Grenier, M.D.
                    SUR Gold Medalists

             1996           Joshua A. Becker, M.D.
             1997           Harry W. Fischer, M.D.
             1998           Milton Elkin, M.D.
             1998           Howard M. Pollack, M.D.*
             2000           Morton A. Bosniak, M.D.
             2000           Harry Z. Mellins, M.D.
             2001           Alan J. Davidson, M.D.
             2001           Richard M. Friedenberg, M.D.
             2003           David M. Witten, M.D.
             2004           Richard C. Pfister, M.D.* (posthumously)
             2005           Robert R. Hattery, Jr., M.D.
             2005           John R. Thornbury, M.D.
             2006           Lee B. Talner, M.D.
             2007           Robert L. Lebowitz, M.D.


* Deceased
       SGR Walter B. Cannon Lecturers

1972                    Horace W. Davenport, M.D.
1973                    C. F. Code, M.D.
1974                    J. E. Dunphy, M.D.
1975                    R. M. Zollinger, M.D.
1976                    Wylie J. Dodds, M.D.
1977                    S. C. Sommers, M.D.
1978                    M. H. Sleisenger, M.D.
1979                    J. S. Fordtran, M.D.
1980                    H. M. Spiro, M.D.
1981                    B. C. Morson, M.D.
1982                    M. A. Adson, M.D.
1983                    P. Cotton, M.D.
1984                    L. W. Way, M.D.
1986                    Dame S. Sherlock, M.D.
1987                    T. E. Starzl, M.D., Ph.D.
1988                    A. F. Hofmann, M.D.
1989                    Prof. Dr. G. Paumgartner
1990                    H. Worth Boyce, Jr., M.D.
1991                    David M. Eddy, M.D., Ph.D.
1992                    John H. C. Ranson, M.D.
1993                    David F. Ransohoff, M.D.
1994                    James C. Thompson, M.D.
1995                    Walter J. Hogan, M.D.
1996                    Donald O. Castell, M.D.
1997                    Hans G. Beger, M.D.
1998                    Professor Albert Baert
1999                    Richard M. Friedenberg, M.D.
2000                    Barry J. Marshall, MB, BS, FRACP
2001                    Leslie H. Blumgart, M.D.
2002                    Leslie H. Sobin, M.D.
2003                    Alexander R. Margulis, M.D.
2004                    Joel E. Richter, M.D., FACP, FACG
2005                    Blair S. Lewis, M.D.
2006                    William W. Olmsted, M.D.
2007                    David A. Gellar, M.D.
             SGR Walter B. Cannon Medalists

      1972                    Richard H. Marshak, M.D.*
      1973                    Richard Schatzki, M.D.*
      1974                    J. Friman-Dahl, M.D.*
      1977                    Alexander R. Margulis, M.D.
      1978                    Bernard Wolf, M.D.* (posthumously)
      1979                    William B. Seaman, M.D.
      1980                    Roscoe E. Miller, M.D.*
      1981                    Sidney W. Nelson, M.D.*
      1982                    H. Joachim Burhenne, M.D.*
      1983                    Martin W. Donner, M.D.*
      1984                    Robert N. Berk, M.D.
      1986                    Hikoo Shirakabe, M.D.*
      1987                    John R. Amberg, M.D.
      1988                    Harley C. Carlson, M.D.
      1989                    Igor Laufer, M.D.
      1990                    Wylie J. Dodds, M.D.*
      1991                    Edward B. Singleton, M.D.
      1992                    Joseph T. Ferrucci, Jr., M.D.
      1993                    Morton A. Meyers, M.D.
      1994                    George R. Leopold, M.D.
      1995                    Gerald D. Dodd, Jr., M.D.
      1996                    Hans Herlinger, M.D.*
      1997                    Henry I. Goldberg, M.D.*
      1998                    Albert A. Moss, M.D.
      1999                    Stanley Baum, M.D.
      2000                    Edward T. Stewart, M.D.
      2001                    William M. Thompson, M.D.
      2002                    Patrick C. Freeny, M.D.
      2003                    Emil J. Balthazar, M.D.
      2004                    David H. Stephens, M.D.
      2005                    Charles A. Rohrmann, Jr. M.D.
      2006                    Giles W. Stevenson, M.D.
      2007                    Bronwyn Jones, M.D.

* Deceased
    SGR Richard H. Marshak Award

2000-2001           Eric van Sonnenberg, M.D.
2001-2002           Eric van Sonnenberg, M.D.
2002-2003           Ellen Wolf, M.D.
2003-2004           Sharlene Teefey, M.D.
2004-2005           Robert Halvorsen, M.D
2005-2006           Dean D. T. Maglinte, M.D.
2006-2007           Giovanna Casola, M.D.
       SGR Visiting Professors

1999                 Jay P. Heiken, M.D.
2000                 Gerald D. Dodd, III, M.D.
2001                 Ann S. Fulcher, M.D.
2002                 Mary T. Keogan, M.D.
2003                 Jonathan Kruskal, M.D.
2005                 Michael Macari, M.D.
2006                 Angela Levy, M.D.
2007                 Judy Yee, M.D.
                SGR International Education Conference Faculty

1998 Guatemala                           2003 Uruguay
     SGR Faculty                              SGR Faculty
     Emil J. Balthazar, MD                    Kyunghee Cho, MD
     C. Dan Johnson, MD                       Jonathan Kruskal, MD
     Marc S. Levine, MD                       Marc Levine, MD
     Edward T. Stewart, MD                    William Mayo-Smith, MD
     Gladys M. Torres, MD                     Sharlene Teefey, MD

1999   Peru                              2005 Mexico
       SGR Faculty                            SGR Faculty
       Emil J. Balthazar, MD                  Dennis Balfe, MD
       Richard M. Gore, MD                    Robert Clark, MD
       Jay P. Heiken, MD                      Spencer Gay, MD
       Pablo R. Ros, MD                       Robert Halvorsen, MD
       Edward T. Stewart, MD                  Michael Macari, MD

2000   Chile                             2006   Brazil
       SGR Faculty                              SGR Faculty
       Richard L. Baron, MD                     Angela Levy, MD
       Peter L. Cooperberg, MD                  Brian Lucey, MD
       Gerald D. Dodd, III, MD                  Dean D.T. Maglinte, MD
       Richard M. Gore, MD                      Pablo Ros, MD
       Eric vanSonnenberg, MD                   Benjamin Yeh, MD

2001   Dominican Republic                2007   Argentina
       SGR Faculty                              SGR Faculty
       Ann S. Fulcher, MD                       Richard Baron, MD
       Bruce R. Javors, MD                      Giovanna Casola, MD
       Jaime Tisnado, MD                        Douglas Katz, MD
       Eric vanSonnenberg, MD                   Erik Paulson, MD
                                                Judy Yee, MD
 2002 Ecuador
      SGR Faculty
      Kedar N. Chintapalli, MD
      Mary T. Keogan, MD
      Pablo R. Ros, MD
      Richard B. Towbin, MD
      Ellen L. Wolf, MD
        Past Meeting Sites


  Abdominal Radiology Course 2000
       March 12 – 17, 2000
          Hyatt Regency
          Kauai, Hawaii

  Abdominal Radiology Course 2001
         March 25 – 30, 2001
   Marriott Camelback Inn & Resport
          Scottsdale, Arizona

  Abdominal Radiology Course 2002
         April 14 – 19, 2002
    Hyatt Regency Grand Cypress
          Orlando, Florida

  Abdominal Radiology Course 2003
         February 16 – 21, 2003
  Fiesta American Grand Coral Beach
            Cancun, Mexico

  Abdominal Radiology Course 2004
        March 7 – 12, 2004
    Westin Kierland Resort & Spa
        Scottsdale, Arizona

  Abdominal Radiology Course 2005
      February 27 – March 4, 2005
Hyatt Regency Hill Country Resort & Spa
          San Antonio, Texas

  Abdominal Radiology Course 2006
     February 26 – March 3, 2006
      Grand Hyatt Resort & Spa
            Kauai, Hawaii


        Future Meeting Site
  Abdominal Radiology Course 2008
       February 17 – 22, 2008
 The Westin Mission Hills Resort & Spa
      Rancho Mirage, California

				
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