Mohammad al-Shatouri - Academia.edu (original) (raw)
Papers by Mohammad al-Shatouri
Egyptian Journal of Radiology and Nuclear Medicine, May 4, 2023
Background Worldwide, there are more than 550,000 new instances of head and neck cancer per year,... more Background Worldwide, there are more than 550,000 new instances of head and neck cancer per year, with over 300,000 fatalities. Among the Middle Eastern nations, Egypt had one of the highest overall incidence rates of oral cavity and pharynx cancer (5.5/105). A consistent reporting form for head and neck cancer monitoring provides many crucial functions, including directing patient care with simply explained numerical scores for tumor recurrence suspicion levels. The Neck-Imaging Reporting and Data System (NI-RADS) assigns a numerical grade, from 0 to 4, where 0 represents incomplete, 1 represents no evidence of local recurrence (primary site) or adenopathy (neck), 2 represents low suspicion, 3 represents high suspicion, and 4 represents definite recurrence. Our aim was to improve the management outcome for patients liable to recurrence of head and neck cancers post-treatment with radio or chemotherapy using Neck-imaging Reporting and Data System (NI-RADS) after imaging with Fluro-Deoxy-Glucose-Positron Emission Tomography/Computed Tomography Scan (FDG-PET/CT Scan). Materials and methods The study setting was done at our institution and the type of study was combined prospective and retrospective study for 24 months from June 2020 to June 2022. The study population included 71 scans for 55 patients aged between 18 and 70 years, who had suffered from head and neck cancer and underwent treatment by chemotherapy or radiotherapy to follow up on their cases and determine recurrence or resolution of tumors. Results The results demonstrated the classification of tumor findings according to the degree of malignancy with 16.9% of scans were diagnosed as low pathological grade, 60.6% were diagnosed as intermediate pathological grade and 22.5% were diagnosed as high pathological grade. The initial tumor subsites in our study were as follow: the oral cavity with its different subsites represented the largest group constituting 11 cases (20%) of the total cases, and the larynx and vocal cords came next and constituted 10 cases (18.2%) of the total scans, nasopharynx constituted 9 cases (16.4%) of the cases. According to application of NI-RADS score, cases were classified as 17 cases NI-RADS (1), representing 30.1% of cases, 9 cases NI-RADS (2), representing 16.36% of cases, 18 cases NI-RADS (3), representing 32.7% of cases and 11 cases NI-RADS (4) representing 20% of cases. Percentage of recurrence in NI-RADS (1) was 1/17
Evidence-based Complementary and Alternative Medicine, 2013
Evidence-based Complementary and Alternative Medicine, 2015
Egyptian Journal of Radiology and Nuclear Medicine
Background Lung cancer is one of the most common causes of cancer-related deaths in developed and... more Background Lung cancer is one of the most common causes of cancer-related deaths in developed and developing countries. Therefore, early detection of lung cancer has a significant impact on lung cancer surveillance. Interpretation of lung CT scans for cancer screening is considered an intensive task for most radiologists, and long experience is required for accurate diagnosis through visual processing. This cross-sectional study introduces automated CAD software (Careline Soft’s AVIEW Metric software). This software can detect and classify lung nodules in CT scans. The performance of a deep learning (DL) model embedded in that software will be compared with that of the radiologists. Also, the feasibility of lung cancer screening protocol is evaluated in Suez Canal University Hospital, Ismailia, Egypt, by implementing Lung Imaging Reporting and Data System (Lung-RADS). Results As for the detection of the pulmonary nodules, the initial review by the CAD system (without validation by t...
Cureus
Background Rheumatoid arthritis (RA) is an autoimmune disease associated with endothelial dysfunc... more Background Rheumatoid arthritis (RA) is an autoimmune disease associated with endothelial dysfunction (ED) and vascular morbidity. The study aimed to use ultrasound to assess the relationships of lp13.3 genomic region-rs646776 polymorphism with ED and subclinical cardiovascular disease (CVD) in patients with RA from the Suez Canal region in Egypt. Results This case-control study included 66 patients with RA and 66 healthy controls. Polymerase chain reactionrestriction fragment length polymorphism showed that the genotype frequencies for lp13.3 genomic region-rs646776 polymorphism in the RA group were 62.1% (n = 41), 34.8% (n = 23), and 3% (n = 2) for the AA, AG, and GG genotypes, respectively. The prevalence of the G allele was higher in the RA group than in the control group (20.5% and 7.6%, respectively; p < 0.01). Furthermore, ED was more prevalent in G allele carriers than in A allele carriers, suggesting a greater probability of ED and CVD in patients with RA with the GG genotype than in those with other genotypes. Conclusions This study indicated the validity of ultrasound in detecting the association between lp13.3 genomic region-rs646776 polymorphism and ED in Egyptian patients with RA. These findings could help identify high-risk patients with RA who may benefit from active treatment to help prevent CVD.
Proceedings of the 7th International Conference on Software and Information Engineering
This work introduces a computer-aided diagnosis (CAD) system for diagnosing liver cirrhosis in ul... more This work introduces a computer-aided diagnosis (CAD) system for diagnosing liver cirrhosis in ultrasound (US) images. The proposed system uses a set of features obtained from different feature extraction methods. These features are the first order statistics (FOS), the fractal dimension (FD), the gray level co-occurrence matrix (GLCM), the Gabor filter (GF), the wavelet (WT) and the curvelet (CT) features. The measured features are presented in two different classifiers such as support vector machine (SVM) and k-nearest neighbors (K-NN). The proposed system is applied on dataset consists of 72 cirrhosis and 75 normal regions each of 128x128 pixels. The classification accuracy rates are calculated using a 10-fold cross validation. A correlation-based feature selection (CFS) is used resulting in better accuracy predictions. The results showed that SVM and K-NN classifiers achieved higher performance with the combination of the wavelet and curvelet feature vectors than other feature extraction methods.
Ultrasound International Open
Purpose To compare the outcomes of different mammographic lesions based on the presence of an ult... more Purpose To compare the outcomes of different mammographic lesions based on the presence of an ultrasound (US) correlate and to estimate how often targeted US can identify such lesions. Materials and Methods This retrospective study included all consecutive cases from 2010 to 2016, with Breast Imaging Reporting and Database System (BI-RADS) categories 4 & 5 who underwent US as part of their diagnostic workup. We compared the incidence of malignancy between lesions comprising a US correlate that underwent US-guided core needle biopsy (CNB) and those without a correlate that underwent stereotactic CNB. Results 833 lesions met the study criteria and included masses (64.3%), architectural distortion (19%), asymmetries (4.6%), and calcifications (12.1%). The CNB-based positive predictive value (PPV) was higher for lesions with a US correlate than for those without (40.2% [36.1, 44.4%] vs. 18.9% [14.5, 23.9%], respectively) (p<0.001). Malignancy odds for masses, asymmetries, architectur...
Suez Canal University Medical Journal, 2022
Background: Shoulder arthrography is an accurate method that can help in diagnosing several disea... more Background: Shoulder arthrography is an accurate method that can help in diagnosing several diseases. When shoulder arthrography is done in combination with magnetic resonance imaging (MRI), a more comprehensive assessment of the cartilaginous structures of the glenohumeral joint could be achieved . Objective: To compare the anterior and posterior arthrography injection approaches through the detection of the widest joint space in cases of anterior and posterior shoulder dislocations and to identify the suitable approach for MR arthrography. Subjects and Methods: A total of eighty individuals were included in this study. The average age of patients was thirty-two years old. Magnetic resonant images were used in the comparison of the measures of anterior and posterior joint spaces in different types of shoulder dislocations. Results: On measuring anterior space with reverse Hill-Sachs depth, it was significantly larger in patients with posterior dislocation (p < 0.05), 16.93 mm ve...
2013 IEEE Nuclear Science Symposium and Medical Imaging Conference (2013 NSS/MIC), 2013
ABSTRACT
2016 IEEE Nuclear Science Symposium, Medical Imaging Conference and Room-Temperature Semiconductor Detector Workshop (NSS/MIC/RTSD), 2016
Interventional pain management surgery is a clinical application performed though the guidance of... more Interventional pain management surgery is a clinical application performed though the guidance of x-ray fluoroscopy. Several protocols requires the injection of a needle close to the spinal cord to deliver a medication directly to the nerve system. The needle position information in the 3D space is important to avoid possible damage to the nerve system. It is common to perform the pain management surgery using C-arm scanner to follow up the treatment procedure. In many cases, it is difficult to observe the exact position of the injected needle through 2D images acquired using conventional C-arm scanner especially with complicated bone structures. It requires several attempts to image the patient from different positions and physician requires a mental process to imagine how the 3D structure looks like before starting the interventional procedure. This process may be repeated several times during a single interventional session, which cause a significant increase of radiation dose given to both patient and surgeon. In this paper, we introduce a method for needle detection in interventional pain management surgery using a clinical C-arm scanner. First, an in-house made gantry control unit (GCU) is mounted to the C-arm gantry to control the scanner orbital rotation. Second, the gantry rotation is traced using inertial measurement unit (IMU) sensor attached. A single cine loop is acquired by automatically rotate the C-arm gantry around the patient using GCU. Geometry information obtained from the IMU sensor is used to define the gantry position in the 3D space and synchronized with detector measurements in cine loop frames. The SCAN algorithm is then adopted for the 3D reconstruction of bone structures and injected needle.
Background Data: Treatment of failed back surgery syndrome (FBSS) is challenging to any spine sur... more Background Data: Treatment of failed back surgery syndrome (FBSS) is challenging to any spine surgeon or pain specialist. Purpose: The study aims to evaluate pain and functional outcome in response to lumbar spine interventional procedures in failed back. Study Design: Prospective non-randomized clinical case study. Patients and methods: Between Jan 2013 to Jan 2016, 35 patients with FBSS were included. Every patient was subjected to history taking, physicalexamination, and diagnostic imaging. Patients received a fluoroscopy guided lumbar spine procedures according to the failed back cause. A visual analog scale (VAS) for pain intensity, and Oswestry Disability index (ODI) were completed before the intervention maneuverand continued for one year during follow up. Patients were prepared for another intervention or surgery if he didn’t respond to the maneuver according to the case. Results: Patients were predominately females (62.9%) with a mean age of 39.74±12.37 years. Clinical and ...
Iranian Journal of Radiology, 2021
Background: Hepatobiliary disorders are common problems during pregnancy, causing significant mor... more Background: Hepatobiliary disorders are common problems during pregnancy, causing significant morbidity and mortality in both mother and fetus. Biliary pancreatitis and cholangitis are common sequelae that warrant urgent endoscopic interventions. However, fetal radiation exposure is a major concern during endoscopic retrograde cholangiopancreatography (ERCP). Fetal malformation, preterm labor, and intrauterine fetal death are the recognized complications of ERCP. Objectives: To evaluate the application of transabdominal ultrasound (US) guidance in endoscopic biliary stenting as a substitute for fluoroscopy and contrast injection. Patients and Methods: In this study, we reviewed the data of ten pregnant patients, who had undergone endoscopic biliary stenting under US guidance without fluoroscopy between January 2018 and October 2020. An abdominal US examination was performed to confirm that the guide wire and the stent were placed inside the common bile duct (CBD) without fluoroscopy...
Egyptian Journal of Radiology and Nuclear Medicine, 2020
Background Digital transvaginal examination of fetal head progression is subjective evaluation wi... more Background Digital transvaginal examination of fetal head progression is subjective evaluation with many limitations. Using ultrasound (US) in the assessment of labor progression in prolonged labor is the current trend to predict the mode of delivery. The study intends to evaluate the women’s acceptance to the transperineal ultrasound (TPUS) compared with digital transvaginal examination, and its ability to predict the mode of delivery in prolonged labor. We included 28 pregnant ladies in a prolonged active phase of first or second stages of labor and followed them till delivery. TPUS was used to measure the fetal head–perineum distance (FHPD) and the angle of fetal head descent. Results Of the 28 participants, 53.5% of them delivered vaginally and 46.5% by Cesarean section (CS). All pregnant ladies described the TPUS as more convenient and less painful than digital vaginal examination. Cervical dilatation was negatively correlated with FHPD, and positively correlated with angle of ...
Benha Medical Journal, 2021
Background: Esophageal varices is one of the most common complications of liver cirrhosis, which ... more Background: Esophageal varices is one of the most common complications of liver cirrhosis, which lead to hematemesis with high morbidity and mortality rates. Tthis study aimed to assess the role of triphasic computed tomography (CT) scan in detection and grading of esophageal varices (EV) and gastric varices (GV) compared to endoscopy. Patients and methods: A cross-sectional study was conducted on 35 patients (26 male & 9 female) who had cirrhosis. All patients were referred to perform triphasic abdominal CT scan then upper gastro-intestinal (UGI) endoscopy. Results: We have noticed that there is only 1 patient had oesophageal varices confirmed by UGI endoscopy not seen in CT. while there were 15 patients confirmed by endoscopy and CT. There is only 1 patient had gastric varix confirmed by UGI endoscopy not seen in CT. while there were 8 patients confirmed by endoscopy and CT. CT has 88.9 sensitivity comparing to endoscopy and 100 specificity with 97.14 accuracy with highly significant p value (p<0.05). CT detected 8 positive cases of gastric varices and one negative case while EGD detected 9 positive cases. So CT has 88.9 sensitivity comparing to endoscopy and 100 specificity with 97.14 accuracy with highly significant p value (p<0.05). Conclusion: CT scan could be used as independent method for diagnosis of gastric and esophageal varices.
Nephrology Dialysis Transplantation, 2018
Suez Canal University Medical Journal, 2018
Background: Factors involved in individual's response to loop diuretics in cirrhotic patients wit... more Background: Factors involved in individual's response to loop diuretics in cirrhotic patients with ascites are many, which renders it difficult to austerely predict response to diuretic therapy in those patients. The aim of this study was to evaluate factors which determine initial response to loop diuretic therapy in those patients and to determine whether such factors can predict a sustained diuresis response. Patients and Methods: One hundred and ten patients with non-malignant chronic liver disease and ascites were treated with IV furosemide in doses according to serum creatinine together with oral spironolactone 50mg twice daily. Before and during the diuretic therapy a set of clinical and laboratory variables were investigated as possible predictive factors influencing the therapeutic response to diuretics. The renal arterial resistive index (RI) (reflecting renal vascular resistance) was estimated with duplex Doppler ultrasonography. Results: Our study revealed statistically significant relation between high ascites grade(p=0.013), higher Child-Pugh class (p< 0.001), higher baseline serum creatinine & lower eGFR (p< 0.001), and high renal resistive index (p=0.002) with poor diuretic response. Conclusion: combining both clinical and laboratory findings together with elevated baseline renal resistive index would be helpful in early identification of the subgroup of patients who are at higher risk of diuretic resistance.
Suez Canal University Medical Journal, 2018
Background: Ascites due to cirrhosis can be mobilized with a treatment regimen consisting of diet... more Background: Ascites due to cirrhosis can be mobilized with a treatment regimen consisting of dietary sodium restriction and oral diuretics. Ascites resistant to diuretic therapy requests adopting balanced approaches in its management but treatment responses are variable and frequently difficult to assess. Aim: To quantify response to an experimental dose of furosemide in patients with decompensated chronic liver disease and ascites. Subjects and Methods: a pre-post intervention study was carried out on 110 patients with ascites grade 2 or 3 receiving IV furosemide, and response was assessed by Absolute and percentage weight loss, the average daily weight loss, average daily urine output and % deviation from the pre-intervention 24-h output, 24h urinary sodium, and fractional excretion of sodium. Results: our study revealed that 42.7% were responders to furosemide, and presence of moderate positive significant correlation between average daily urine output and average daily weight reduction (r = 0.682), also there is significant relationship between baseline urinary sodium level and FENa and diuretic response. Conclusion: This study revealed that the median point for diuretic response using absolute weight loss is around-0.4kg and average daily urine output around 1500ml, and that there is significant correlation between 24h urinary sodium and diuretic response.
The Egyptian Journal of Radiology and Nuclear Medicine, 2017
Objectives: To create a systematic approach using computed tomography (CT) and magnetic resonance... more Objectives: To create a systematic approach using computed tomography (CT) and magnetic resonance imaging (MRI) findings to facilitate identifying the etiology of hearing loss, evaluating the anatomy for surgery, and predicting complications. Methods: Twenty nine pediatric patients with congenital or acquired sensory-neural hearing loss (SNHL) requiring cochlear implant (CI) were included. They underwent combined CT, 3D DRIVE MRI axial plane and axial T2WIs for the whole brain. The inner ear, cochlear nerve development, temporal bone anatomy, operative window, normal variants and causes of central hearing loss were assessed. Results: CT showed that 100% of the patients are suitable for CI while MRI showed that 96.5% of studied patients are suitable. The examined ears were categorized into 4 groups according the candidacy for operation; 86.2% were suitable for CI, 5.1% were suitable for CI but with expected poor response, 1.7% of examined ears were suitable for CI with modification of surgical procedure and 6.8% were not suitable for CI. Conclusion: In Suez Canal area, the combined CT/MRI approach categorized the majority of patients with SNHL (96.6%) as good candidates for CI.
Nephrology Dialysis Transplantation, 2017
2015 IEEE Nuclear Science Symposium and Medical Imaging Conference (NSS/MIC), 2015
Three-dimensional (3D) computed tomography (CT) imaging is becoming an essential demand in severa... more Three-dimensional (3D) computed tomography (CT) imaging is becoming an essential demand in several clinical procedures. Mobile C-arm is a useful imaging tool for image-guided interventional radiology. C-arm systems are provided with X-ray image intensifier (XRII) or flat-panel detectors. Essentially, C-arm CT systems requires scanners with flat-panel detectors for its ability to provide homogenous image quality and improve the resolution of low-contrast subjects compared to those equipped with XRII. However, C-arm systems with XRIIs are widely used in several interventional procedures. Such systems can provide a high quality two-dimensional (2D) fluoroscopic images that facilitates minimal invasive surgery. However, it is unable to provide depth information for 3D imaging due to several factors. First, the gantry of XRII-based C-arms is usually operated manually, where the rotation angle is determined using printed angle scale attached to the scanner gantry. Second, the gantry orbital rotation is normally limited to angular range less than theoretically required for exact 3D reconstruction. Third, considering the offset-scan geometry, which is common configuration in mobile C-arm with XRII, the number of rays passing through field-of-view (FOV) is limited. In this paper, we develop a 3D angiographic imaging system using commercial C-arm system equipped with XRII. First, an in-house made gantry rotation unit is developed to control the scanner orbital rotation. Second, the gantry rotation is traced using inertial measurement unit (IMU) sensor attached to the scanner gantry. Geometry information obtained from IMU sensor are used to define the gantry position in the 3D space and synchronized with detector measurements. The SCAN algorithm is used for the 3D reconstruction and achieved results are of high quality.
Egyptian Journal of Radiology and Nuclear Medicine, May 4, 2023
Background Worldwide, there are more than 550,000 new instances of head and neck cancer per year,... more Background Worldwide, there are more than 550,000 new instances of head and neck cancer per year, with over 300,000 fatalities. Among the Middle Eastern nations, Egypt had one of the highest overall incidence rates of oral cavity and pharynx cancer (5.5/105). A consistent reporting form for head and neck cancer monitoring provides many crucial functions, including directing patient care with simply explained numerical scores for tumor recurrence suspicion levels. The Neck-Imaging Reporting and Data System (NI-RADS) assigns a numerical grade, from 0 to 4, where 0 represents incomplete, 1 represents no evidence of local recurrence (primary site) or adenopathy (neck), 2 represents low suspicion, 3 represents high suspicion, and 4 represents definite recurrence. Our aim was to improve the management outcome for patients liable to recurrence of head and neck cancers post-treatment with radio or chemotherapy using Neck-imaging Reporting and Data System (NI-RADS) after imaging with Fluro-Deoxy-Glucose-Positron Emission Tomography/Computed Tomography Scan (FDG-PET/CT Scan). Materials and methods The study setting was done at our institution and the type of study was combined prospective and retrospective study for 24 months from June 2020 to June 2022. The study population included 71 scans for 55 patients aged between 18 and 70 years, who had suffered from head and neck cancer and underwent treatment by chemotherapy or radiotherapy to follow up on their cases and determine recurrence or resolution of tumors. Results The results demonstrated the classification of tumor findings according to the degree of malignancy with 16.9% of scans were diagnosed as low pathological grade, 60.6% were diagnosed as intermediate pathological grade and 22.5% were diagnosed as high pathological grade. The initial tumor subsites in our study were as follow: the oral cavity with its different subsites represented the largest group constituting 11 cases (20%) of the total cases, and the larynx and vocal cords came next and constituted 10 cases (18.2%) of the total scans, nasopharynx constituted 9 cases (16.4%) of the cases. According to application of NI-RADS score, cases were classified as 17 cases NI-RADS (1), representing 30.1% of cases, 9 cases NI-RADS (2), representing 16.36% of cases, 18 cases NI-RADS (3), representing 32.7% of cases and 11 cases NI-RADS (4) representing 20% of cases. Percentage of recurrence in NI-RADS (1) was 1/17
Evidence-based Complementary and Alternative Medicine, 2013
Evidence-based Complementary and Alternative Medicine, 2015
Egyptian Journal of Radiology and Nuclear Medicine
Background Lung cancer is one of the most common causes of cancer-related deaths in developed and... more Background Lung cancer is one of the most common causes of cancer-related deaths in developed and developing countries. Therefore, early detection of lung cancer has a significant impact on lung cancer surveillance. Interpretation of lung CT scans for cancer screening is considered an intensive task for most radiologists, and long experience is required for accurate diagnosis through visual processing. This cross-sectional study introduces automated CAD software (Careline Soft’s AVIEW Metric software). This software can detect and classify lung nodules in CT scans. The performance of a deep learning (DL) model embedded in that software will be compared with that of the radiologists. Also, the feasibility of lung cancer screening protocol is evaluated in Suez Canal University Hospital, Ismailia, Egypt, by implementing Lung Imaging Reporting and Data System (Lung-RADS). Results As for the detection of the pulmonary nodules, the initial review by the CAD system (without validation by t...
Cureus
Background Rheumatoid arthritis (RA) is an autoimmune disease associated with endothelial dysfunc... more Background Rheumatoid arthritis (RA) is an autoimmune disease associated with endothelial dysfunction (ED) and vascular morbidity. The study aimed to use ultrasound to assess the relationships of lp13.3 genomic region-rs646776 polymorphism with ED and subclinical cardiovascular disease (CVD) in patients with RA from the Suez Canal region in Egypt. Results This case-control study included 66 patients with RA and 66 healthy controls. Polymerase chain reactionrestriction fragment length polymorphism showed that the genotype frequencies for lp13.3 genomic region-rs646776 polymorphism in the RA group were 62.1% (n = 41), 34.8% (n = 23), and 3% (n = 2) for the AA, AG, and GG genotypes, respectively. The prevalence of the G allele was higher in the RA group than in the control group (20.5% and 7.6%, respectively; p < 0.01). Furthermore, ED was more prevalent in G allele carriers than in A allele carriers, suggesting a greater probability of ED and CVD in patients with RA with the GG genotype than in those with other genotypes. Conclusions This study indicated the validity of ultrasound in detecting the association between lp13.3 genomic region-rs646776 polymorphism and ED in Egyptian patients with RA. These findings could help identify high-risk patients with RA who may benefit from active treatment to help prevent CVD.
Proceedings of the 7th International Conference on Software and Information Engineering
This work introduces a computer-aided diagnosis (CAD) system for diagnosing liver cirrhosis in ul... more This work introduces a computer-aided diagnosis (CAD) system for diagnosing liver cirrhosis in ultrasound (US) images. The proposed system uses a set of features obtained from different feature extraction methods. These features are the first order statistics (FOS), the fractal dimension (FD), the gray level co-occurrence matrix (GLCM), the Gabor filter (GF), the wavelet (WT) and the curvelet (CT) features. The measured features are presented in two different classifiers such as support vector machine (SVM) and k-nearest neighbors (K-NN). The proposed system is applied on dataset consists of 72 cirrhosis and 75 normal regions each of 128x128 pixels. The classification accuracy rates are calculated using a 10-fold cross validation. A correlation-based feature selection (CFS) is used resulting in better accuracy predictions. The results showed that SVM and K-NN classifiers achieved higher performance with the combination of the wavelet and curvelet feature vectors than other feature extraction methods.
Ultrasound International Open
Purpose To compare the outcomes of different mammographic lesions based on the presence of an ult... more Purpose To compare the outcomes of different mammographic lesions based on the presence of an ultrasound (US) correlate and to estimate how often targeted US can identify such lesions. Materials and Methods This retrospective study included all consecutive cases from 2010 to 2016, with Breast Imaging Reporting and Database System (BI-RADS) categories 4 & 5 who underwent US as part of their diagnostic workup. We compared the incidence of malignancy between lesions comprising a US correlate that underwent US-guided core needle biopsy (CNB) and those without a correlate that underwent stereotactic CNB. Results 833 lesions met the study criteria and included masses (64.3%), architectural distortion (19%), asymmetries (4.6%), and calcifications (12.1%). The CNB-based positive predictive value (PPV) was higher for lesions with a US correlate than for those without (40.2% [36.1, 44.4%] vs. 18.9% [14.5, 23.9%], respectively) (p<0.001). Malignancy odds for masses, asymmetries, architectur...
Suez Canal University Medical Journal, 2022
Background: Shoulder arthrography is an accurate method that can help in diagnosing several disea... more Background: Shoulder arthrography is an accurate method that can help in diagnosing several diseases. When shoulder arthrography is done in combination with magnetic resonance imaging (MRI), a more comprehensive assessment of the cartilaginous structures of the glenohumeral joint could be achieved . Objective: To compare the anterior and posterior arthrography injection approaches through the detection of the widest joint space in cases of anterior and posterior shoulder dislocations and to identify the suitable approach for MR arthrography. Subjects and Methods: A total of eighty individuals were included in this study. The average age of patients was thirty-two years old. Magnetic resonant images were used in the comparison of the measures of anterior and posterior joint spaces in different types of shoulder dislocations. Results: On measuring anterior space with reverse Hill-Sachs depth, it was significantly larger in patients with posterior dislocation (p < 0.05), 16.93 mm ve...
2013 IEEE Nuclear Science Symposium and Medical Imaging Conference (2013 NSS/MIC), 2013
ABSTRACT
2016 IEEE Nuclear Science Symposium, Medical Imaging Conference and Room-Temperature Semiconductor Detector Workshop (NSS/MIC/RTSD), 2016
Interventional pain management surgery is a clinical application performed though the guidance of... more Interventional pain management surgery is a clinical application performed though the guidance of x-ray fluoroscopy. Several protocols requires the injection of a needle close to the spinal cord to deliver a medication directly to the nerve system. The needle position information in the 3D space is important to avoid possible damage to the nerve system. It is common to perform the pain management surgery using C-arm scanner to follow up the treatment procedure. In many cases, it is difficult to observe the exact position of the injected needle through 2D images acquired using conventional C-arm scanner especially with complicated bone structures. It requires several attempts to image the patient from different positions and physician requires a mental process to imagine how the 3D structure looks like before starting the interventional procedure. This process may be repeated several times during a single interventional session, which cause a significant increase of radiation dose given to both patient and surgeon. In this paper, we introduce a method for needle detection in interventional pain management surgery using a clinical C-arm scanner. First, an in-house made gantry control unit (GCU) is mounted to the C-arm gantry to control the scanner orbital rotation. Second, the gantry rotation is traced using inertial measurement unit (IMU) sensor attached. A single cine loop is acquired by automatically rotate the C-arm gantry around the patient using GCU. Geometry information obtained from the IMU sensor is used to define the gantry position in the 3D space and synchronized with detector measurements in cine loop frames. The SCAN algorithm is then adopted for the 3D reconstruction of bone structures and injected needle.
Background Data: Treatment of failed back surgery syndrome (FBSS) is challenging to any spine sur... more Background Data: Treatment of failed back surgery syndrome (FBSS) is challenging to any spine surgeon or pain specialist. Purpose: The study aims to evaluate pain and functional outcome in response to lumbar spine interventional procedures in failed back. Study Design: Prospective non-randomized clinical case study. Patients and methods: Between Jan 2013 to Jan 2016, 35 patients with FBSS were included. Every patient was subjected to history taking, physicalexamination, and diagnostic imaging. Patients received a fluoroscopy guided lumbar spine procedures according to the failed back cause. A visual analog scale (VAS) for pain intensity, and Oswestry Disability index (ODI) were completed before the intervention maneuverand continued for one year during follow up. Patients were prepared for another intervention or surgery if he didn’t respond to the maneuver according to the case. Results: Patients were predominately females (62.9%) with a mean age of 39.74±12.37 years. Clinical and ...
Iranian Journal of Radiology, 2021
Background: Hepatobiliary disorders are common problems during pregnancy, causing significant mor... more Background: Hepatobiliary disorders are common problems during pregnancy, causing significant morbidity and mortality in both mother and fetus. Biliary pancreatitis and cholangitis are common sequelae that warrant urgent endoscopic interventions. However, fetal radiation exposure is a major concern during endoscopic retrograde cholangiopancreatography (ERCP). Fetal malformation, preterm labor, and intrauterine fetal death are the recognized complications of ERCP. Objectives: To evaluate the application of transabdominal ultrasound (US) guidance in endoscopic biliary stenting as a substitute for fluoroscopy and contrast injection. Patients and Methods: In this study, we reviewed the data of ten pregnant patients, who had undergone endoscopic biliary stenting under US guidance without fluoroscopy between January 2018 and October 2020. An abdominal US examination was performed to confirm that the guide wire and the stent were placed inside the common bile duct (CBD) without fluoroscopy...
Egyptian Journal of Radiology and Nuclear Medicine, 2020
Background Digital transvaginal examination of fetal head progression is subjective evaluation wi... more Background Digital transvaginal examination of fetal head progression is subjective evaluation with many limitations. Using ultrasound (US) in the assessment of labor progression in prolonged labor is the current trend to predict the mode of delivery. The study intends to evaluate the women’s acceptance to the transperineal ultrasound (TPUS) compared with digital transvaginal examination, and its ability to predict the mode of delivery in prolonged labor. We included 28 pregnant ladies in a prolonged active phase of first or second stages of labor and followed them till delivery. TPUS was used to measure the fetal head–perineum distance (FHPD) and the angle of fetal head descent. Results Of the 28 participants, 53.5% of them delivered vaginally and 46.5% by Cesarean section (CS). All pregnant ladies described the TPUS as more convenient and less painful than digital vaginal examination. Cervical dilatation was negatively correlated with FHPD, and positively correlated with angle of ...
Benha Medical Journal, 2021
Background: Esophageal varices is one of the most common complications of liver cirrhosis, which ... more Background: Esophageal varices is one of the most common complications of liver cirrhosis, which lead to hematemesis with high morbidity and mortality rates. Tthis study aimed to assess the role of triphasic computed tomography (CT) scan in detection and grading of esophageal varices (EV) and gastric varices (GV) compared to endoscopy. Patients and methods: A cross-sectional study was conducted on 35 patients (26 male & 9 female) who had cirrhosis. All patients were referred to perform triphasic abdominal CT scan then upper gastro-intestinal (UGI) endoscopy. Results: We have noticed that there is only 1 patient had oesophageal varices confirmed by UGI endoscopy not seen in CT. while there were 15 patients confirmed by endoscopy and CT. There is only 1 patient had gastric varix confirmed by UGI endoscopy not seen in CT. while there were 8 patients confirmed by endoscopy and CT. CT has 88.9 sensitivity comparing to endoscopy and 100 specificity with 97.14 accuracy with highly significant p value (p<0.05). CT detected 8 positive cases of gastric varices and one negative case while EGD detected 9 positive cases. So CT has 88.9 sensitivity comparing to endoscopy and 100 specificity with 97.14 accuracy with highly significant p value (p<0.05). Conclusion: CT scan could be used as independent method for diagnosis of gastric and esophageal varices.
Nephrology Dialysis Transplantation, 2018
Suez Canal University Medical Journal, 2018
Background: Factors involved in individual's response to loop diuretics in cirrhotic patients wit... more Background: Factors involved in individual's response to loop diuretics in cirrhotic patients with ascites are many, which renders it difficult to austerely predict response to diuretic therapy in those patients. The aim of this study was to evaluate factors which determine initial response to loop diuretic therapy in those patients and to determine whether such factors can predict a sustained diuresis response. Patients and Methods: One hundred and ten patients with non-malignant chronic liver disease and ascites were treated with IV furosemide in doses according to serum creatinine together with oral spironolactone 50mg twice daily. Before and during the diuretic therapy a set of clinical and laboratory variables were investigated as possible predictive factors influencing the therapeutic response to diuretics. The renal arterial resistive index (RI) (reflecting renal vascular resistance) was estimated with duplex Doppler ultrasonography. Results: Our study revealed statistically significant relation between high ascites grade(p=0.013), higher Child-Pugh class (p< 0.001), higher baseline serum creatinine & lower eGFR (p< 0.001), and high renal resistive index (p=0.002) with poor diuretic response. Conclusion: combining both clinical and laboratory findings together with elevated baseline renal resistive index would be helpful in early identification of the subgroup of patients who are at higher risk of diuretic resistance.
Suez Canal University Medical Journal, 2018
Background: Ascites due to cirrhosis can be mobilized with a treatment regimen consisting of diet... more Background: Ascites due to cirrhosis can be mobilized with a treatment regimen consisting of dietary sodium restriction and oral diuretics. Ascites resistant to diuretic therapy requests adopting balanced approaches in its management but treatment responses are variable and frequently difficult to assess. Aim: To quantify response to an experimental dose of furosemide in patients with decompensated chronic liver disease and ascites. Subjects and Methods: a pre-post intervention study was carried out on 110 patients with ascites grade 2 or 3 receiving IV furosemide, and response was assessed by Absolute and percentage weight loss, the average daily weight loss, average daily urine output and % deviation from the pre-intervention 24-h output, 24h urinary sodium, and fractional excretion of sodium. Results: our study revealed that 42.7% were responders to furosemide, and presence of moderate positive significant correlation between average daily urine output and average daily weight reduction (r = 0.682), also there is significant relationship between baseline urinary sodium level and FENa and diuretic response. Conclusion: This study revealed that the median point for diuretic response using absolute weight loss is around-0.4kg and average daily urine output around 1500ml, and that there is significant correlation between 24h urinary sodium and diuretic response.
The Egyptian Journal of Radiology and Nuclear Medicine, 2017
Objectives: To create a systematic approach using computed tomography (CT) and magnetic resonance... more Objectives: To create a systematic approach using computed tomography (CT) and magnetic resonance imaging (MRI) findings to facilitate identifying the etiology of hearing loss, evaluating the anatomy for surgery, and predicting complications. Methods: Twenty nine pediatric patients with congenital or acquired sensory-neural hearing loss (SNHL) requiring cochlear implant (CI) were included. They underwent combined CT, 3D DRIVE MRI axial plane and axial T2WIs for the whole brain. The inner ear, cochlear nerve development, temporal bone anatomy, operative window, normal variants and causes of central hearing loss were assessed. Results: CT showed that 100% of the patients are suitable for CI while MRI showed that 96.5% of studied patients are suitable. The examined ears were categorized into 4 groups according the candidacy for operation; 86.2% were suitable for CI, 5.1% were suitable for CI but with expected poor response, 1.7% of examined ears were suitable for CI with modification of surgical procedure and 6.8% were not suitable for CI. Conclusion: In Suez Canal area, the combined CT/MRI approach categorized the majority of patients with SNHL (96.6%) as good candidates for CI.
Nephrology Dialysis Transplantation, 2017
2015 IEEE Nuclear Science Symposium and Medical Imaging Conference (NSS/MIC), 2015
Three-dimensional (3D) computed tomography (CT) imaging is becoming an essential demand in severa... more Three-dimensional (3D) computed tomography (CT) imaging is becoming an essential demand in several clinical procedures. Mobile C-arm is a useful imaging tool for image-guided interventional radiology. C-arm systems are provided with X-ray image intensifier (XRII) or flat-panel detectors. Essentially, C-arm CT systems requires scanners with flat-panel detectors for its ability to provide homogenous image quality and improve the resolution of low-contrast subjects compared to those equipped with XRII. However, C-arm systems with XRIIs are widely used in several interventional procedures. Such systems can provide a high quality two-dimensional (2D) fluoroscopic images that facilitates minimal invasive surgery. However, it is unable to provide depth information for 3D imaging due to several factors. First, the gantry of XRII-based C-arms is usually operated manually, where the rotation angle is determined using printed angle scale attached to the scanner gantry. Second, the gantry orbital rotation is normally limited to angular range less than theoretically required for exact 3D reconstruction. Third, considering the offset-scan geometry, which is common configuration in mobile C-arm with XRII, the number of rays passing through field-of-view (FOV) is limited. In this paper, we develop a 3D angiographic imaging system using commercial C-arm system equipped with XRII. First, an in-house made gantry rotation unit is developed to control the scanner orbital rotation. Second, the gantry rotation is traced using inertial measurement unit (IMU) sensor attached to the scanner gantry. Geometry information obtained from IMU sensor are used to define the gantry position in the 3D space and synchronized with detector measurements. The SCAN algorithm is used for the 3D reconstruction and achieved results are of high quality.