Michael Moore - Academia.edu (original) (raw)

Papers by Michael Moore

Research paper thumbnail of The imaging of paediatric thoracic trauma

Pediatric Radiology, Jan 17, 2009

Major chest trauma in a child is associated with significant morbidity and mortality. It is most ... more Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity.

Research paper thumbnail of Dose Reduction and Compliance with Pediatric CT Protocols Adapted to Patient Size, Clinical Indication, and Number of Prior Studies

Radiology, Jul 1, 2009

To assess compliance and resultant radiation dose reduction with new pediatric chest and abdomina... more To assess compliance and resultant radiation dose reduction with new pediatric chest and abdominal computed tomographic (CT) protocols based on patient weight, clinical indication, number of prior CT studies, and automatic exposure control. The study was institutional review board approved and HIPAA compliant. Informed consent was waived. The new pediatric CT protocols, which were organized into six color zones based on clinical indications and number of prior CT examinations in a given patient, were retrospectively assessed. Scanning parameters were adjusted on the basis of patient weight. For gradual dose reduction, pediatric CT (n = 692) examinations were performed in three phases of incremental stepwise dose reduction during a 17-month period. There were 245 male patients and 193 female patients (mean age, 12.6 years). Two radiologists independently reviewed CT images for image quality. Data were analyzed by using multivariate analysis of variance. Compliance with the new protocols in the early stage of implementation (chest CT, 58.9%; abdominal CT, 65.2%) was lower than in the later stage (chest CT, 88%; abdominal CT, 82%) (P < .001). For chest CT, there was 52.6% (9.1 vs 19.2 mGy) to 85.4% (2.8 vs 19.2 mGy) dose reduction in the early stage of implementation and 73.5% (4.9 vs 18.5 mGy) to 83.2% (3.1 vs 18.5 mGy) dose reduction in the later stages compared with dose at noncompliant examinations (P < .001); there was no loss of clinically relevant image quality. For abdominal CT, there was 34.3% (9.0 vs 13.7 mGy) to 80.2% (2.7 vs 13.7 mGy) dose reduction in the early stage of implementation and 62.4% (6.5 vs 17.3) to 83.8% (2.8 vs 17.3 mGy) dose reduction in the later stage (P < .001). Substantial dose reduction and high compliance can be obtained with pediatric CT protocols tailored to…

Research paper thumbnail of P383 Stroke in children; consider parvovirus B19 infection

Research paper thumbnail of SDHB gene positive metastatic paraganglioma associated with lesions which demonstrate both positive and negative uptake of 18FDG PET and 131MIBG

Research paper thumbnail of Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting

CardioVascular and Interventional Radiology, Oct 23, 2007

Percutaneous transluminal angioplasty and stent placement is now an established treatment option ... more Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

Research paper thumbnail of PET/CT in Abdominal and Pelvic Malignancies: Principles and Practices

MDCT, 2008

ABSTRACT Current multi-detector computed tomography (MDCT) allows for rapid acquisition of data s... more ABSTRACT Current multi-detector computed tomography (MDCT) allows for rapid acquisition of data sets with accurate anatomic detail and high spatial resolution. This provides valuable multi-planar information regarding the morphologic features and attenuation values of both normal anatomic structures and pathologic lesions. Since its introduction more than 25 years ago, CT has become widely used and can be considered the modality of choice for much cross-sectional imaging, particularly of oncologic entities. A limitation of CT, however, is its reliance on morphologic changes in the size, shape, or attenuation values of a structure to detect pathologic processes. Therefore, CT is less sensitive in the imaging of early disease processes and in the detection of disease recurrence in tissues that are already morphologically abnormal as a result of treatment.

Research paper thumbnail of PET and PET/CT Clinical Applications

Research paper thumbnail of Chest trauma in children: current imaging guidelines and techniques

Radiologic clinics of North America, 2011

Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailore... more Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child's clinical condition, and the initial radiographic findings, taking the age-related pretest probabilities of serious injury into account. The principles of as low as reasonably achievable and Image Gently should be followed. The epidemiology and pathophysiology, imaging techniques, characteristic findings, and evidence-based algorithms for pediatric chest trauma are discussed.

Research paper thumbnail of Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting

CardioVascular and Interventional Radiology, 2007

Percutaneous transluminal angioplasty and stent placement is now an established treatment option ... more Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

Research paper thumbnail of Can Adaptive Filters Help Reduce Radiation Dose for Follow-up Chest and Abdominal CT in Children?

PURPOSE Although post processing non-linear filters have been used in adults for improving image ... more PURPOSE Although post processing non-linear filters have been used in adults for improving image quality of low dose CT images, to the best of our knowledge, use of 2D non linear adaptive filters (2D-NLAF) has not been reported for reducing radiation dose in children. The purpose of our study was to assess if 2D-NLAF can be used for improving image quality with low radiation dose follow up chest and abdominal CT in children. METHOD AND MATERIALS 26 children (age range 3-16 years, M:F 12:14) underwent follow up chest (n= 11) and abdominal (n=15) CT after initial CT examinations. Follow up CT examinations were performed at 25-30% lower dose compared to the initial CT study with use of automatic exposure control, Auto mA using higher noise index (7-13), lower minimum (50-90) and maximum (100-160) mA. The low dose follow up chest and abdominal CT images were post processed with 2D-NLAF. The initial routine, follow up low dose and post-processed low dose CT images were de-identified and ...

Research paper thumbnail of Positron Emission Tomography/Computerized Tomography for the Gastroenterologist and Hepatologist

Clinical Gastroenterology and Hepatology, 2009

C ombined positron emission tomography/computerized tomography (PET/CT) imaging with fluorine 18 ... more C ombined positron emission tomography/computerized tomography (PET/CT) imaging with fluorine 18 fluorodeoxyglucose (FDG) allows fusion of structural and attenuation information provided by CT with functional imaging derived from PET, improving the radiologic assessment of normal anatomic structures and pathologic lesions. PET/CT allows accurate location of hypermetabolic foci identified at PET with its morphologic structure on CT, reducing the incidence of falsepositive and false-negative imaging findings with PET alone.

Research paper thumbnail of Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting

CardioVascular and Interventional Radiology, 2008

Percutaneous transluminal angioplasty and stent placement is now an established treatment option ... more Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

Research paper thumbnail of The imaging of paediatric thoracic trauma

Pediatric Radiology, Jan 17, 2009

Major chest trauma in a child is associated with significant morbidity and mortality. It is most ... more Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity.

Research paper thumbnail of Dose Reduction and Compliance with Pediatric CT Protocols Adapted to Patient Size, Clinical Indication, and Number of Prior Studies

Radiology, Jul 1, 2009

To assess compliance and resultant radiation dose reduction with new pediatric chest and abdomina... more To assess compliance and resultant radiation dose reduction with new pediatric chest and abdominal computed tomographic (CT) protocols based on patient weight, clinical indication, number of prior CT studies, and automatic exposure control. The study was institutional review board approved and HIPAA compliant. Informed consent was waived. The new pediatric CT protocols, which were organized into six color zones based on clinical indications and number of prior CT examinations in a given patient, were retrospectively assessed. Scanning parameters were adjusted on the basis of patient weight. For gradual dose reduction, pediatric CT (n = 692) examinations were performed in three phases of incremental stepwise dose reduction during a 17-month period. There were 245 male patients and 193 female patients (mean age, 12.6 years). Two radiologists independently reviewed CT images for image quality. Data were analyzed by using multivariate analysis of variance. Compliance with the new protocols in the early stage of implementation (chest CT, 58.9%; abdominal CT, 65.2%) was lower than in the later stage (chest CT, 88%; abdominal CT, 82%) (P < .001). For chest CT, there was 52.6% (9.1 vs 19.2 mGy) to 85.4% (2.8 vs 19.2 mGy) dose reduction in the early stage of implementation and 73.5% (4.9 vs 18.5 mGy) to 83.2% (3.1 vs 18.5 mGy) dose reduction in the later stages compared with dose at noncompliant examinations (P < .001); there was no loss of clinically relevant image quality. For abdominal CT, there was 34.3% (9.0 vs 13.7 mGy) to 80.2% (2.7 vs 13.7 mGy) dose reduction in the early stage of implementation and 62.4% (6.5 vs 17.3) to 83.8% (2.8 vs 17.3 mGy) dose reduction in the later stage (P < .001). Substantial dose reduction and high compliance can be obtained with pediatric CT protocols tailored to…

Research paper thumbnail of P383 Stroke in children; consider parvovirus B19 infection

Research paper thumbnail of SDHB gene positive metastatic paraganglioma associated with lesions which demonstrate both positive and negative uptake of 18FDG PET and 131MIBG

Research paper thumbnail of Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting

CardioVascular and Interventional Radiology, Oct 23, 2007

Percutaneous transluminal angioplasty and stent placement is now an established treatment option ... more Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

Research paper thumbnail of PET/CT in Abdominal and Pelvic Malignancies: Principles and Practices

MDCT, 2008

ABSTRACT Current multi-detector computed tomography (MDCT) allows for rapid acquisition of data s... more ABSTRACT Current multi-detector computed tomography (MDCT) allows for rapid acquisition of data sets with accurate anatomic detail and high spatial resolution. This provides valuable multi-planar information regarding the morphologic features and attenuation values of both normal anatomic structures and pathologic lesions. Since its introduction more than 25 years ago, CT has become widely used and can be considered the modality of choice for much cross-sectional imaging, particularly of oncologic entities. A limitation of CT, however, is its reliance on morphologic changes in the size, shape, or attenuation values of a structure to detect pathologic processes. Therefore, CT is less sensitive in the imaging of early disease processes and in the detection of disease recurrence in tissues that are already morphologically abnormal as a result of treatment.

Research paper thumbnail of PET and PET/CT Clinical Applications

Research paper thumbnail of Chest trauma in children: current imaging guidelines and techniques

Radiologic clinics of North America, 2011

Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailore... more Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child's clinical condition, and the initial radiographic findings, taking the age-related pretest probabilities of serious injury into account. The principles of as low as reasonably achievable and Image Gently should be followed. The epidemiology and pathophysiology, imaging techniques, characteristic findings, and evidence-based algorithms for pediatric chest trauma are discussed.

Research paper thumbnail of Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting

CardioVascular and Interventional Radiology, 2007

Percutaneous transluminal angioplasty and stent placement is now an established treatment option ... more Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

Research paper thumbnail of Can Adaptive Filters Help Reduce Radiation Dose for Follow-up Chest and Abdominal CT in Children?

PURPOSE Although post processing non-linear filters have been used in adults for improving image ... more PURPOSE Although post processing non-linear filters have been used in adults for improving image quality of low dose CT images, to the best of our knowledge, use of 2D non linear adaptive filters (2D-NLAF) has not been reported for reducing radiation dose in children. The purpose of our study was to assess if 2D-NLAF can be used for improving image quality with low radiation dose follow up chest and abdominal CT in children. METHOD AND MATERIALS 26 children (age range 3-16 years, M:F 12:14) underwent follow up chest (n= 11) and abdominal (n=15) CT after initial CT examinations. Follow up CT examinations were performed at 25-30% lower dose compared to the initial CT study with use of automatic exposure control, Auto mA using higher noise index (7-13), lower minimum (50-90) and maximum (100-160) mA. The low dose follow up chest and abdominal CT images were post processed with 2D-NLAF. The initial routine, follow up low dose and post-processed low dose CT images were de-identified and ...

Research paper thumbnail of Positron Emission Tomography/Computerized Tomography for the Gastroenterologist and Hepatologist

Clinical Gastroenterology and Hepatology, 2009

C ombined positron emission tomography/computerized tomography (PET/CT) imaging with fluorine 18 ... more C ombined positron emission tomography/computerized tomography (PET/CT) imaging with fluorine 18 fluorodeoxyglucose (FDG) allows fusion of structural and attenuation information provided by CT with functional imaging derived from PET, improving the radiologic assessment of normal anatomic structures and pathologic lesions. PET/CT allows accurate location of hypermetabolic foci identified at PET with its morphologic structure on CT, reducing the incidence of falsepositive and false-negative imaging findings with PET alone.

Research paper thumbnail of Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting

CardioVascular and Interventional Radiology, 2008

Percutaneous transluminal angioplasty and stent placement is now an established treatment option ... more Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.