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Papers by Sandro Galea-Soler

Research paper thumbnail of Dual-Energy CT in the Assessment of Gout

Research paper thumbnail of Blunt Hepatobiliary Trauma: Role of Low Dose MDCT in Diagnosis and Patient Management

Research paper thumbnail of The Diagnosis and Management of Traumatic Pancreatic Duct Injury

Research paper thumbnail of Blunt Urinary Trauma: The Impact of Low-Dose MDCT on Diagnosis and Management of Patients with Renal/Ureteric Trauma

Research paper thumbnail of Role of Imaging in Penetrating and Blunt Traumatic Injury to the Heart

RadioGraphics, 2011

Cardiac injury due to blunt or penetrating chest trauma is common and is associated with signific... more Cardiac injury due to blunt or penetrating chest trauma is common and is associated with significant morbidity and mortality. Understanding the mechanisms, types, and complications of cardiac injuries and the roles of various imaging modalities in characterizing them is important for appropriate diagnosis and treatment. These injuries have not been well documented at imaging, but there are now fast and accurate methods for evaluating the heart and associated mediastinal structures. The authors review the broad spectrum of injuries that can result from blunt or penetrating trauma to the chest, as well as the imaging modalities commonly used in the acute trauma setting for evaluation of the heart and mediastinal structures. A pictorial review of both common and, to date, rarely documented cardiac injuries imaged with a variety of modalities is also presented. While many imaging modalities are available, the authors demonstrate the value of multidetector computed tomography (CT) for the initial evaluation of patients with blunt or penetrating chest trauma. With the advent of multidetector CT, imaging of cardiac injury has increased and accurate identification of these rare but potentially lethal injuries has become paramount for improving survival. Selection of the most appropriate modality for evaluation and recognition of the imaging findings in cardiac injuries in the acute trauma setting is important to expedite treatment and improve survival. ©

Research paper thumbnail of Ductus diverticulum: A confusing normal variant in the setting of trauma

European Journal of Radiology Extra, 2010

Research paper thumbnail of Dual-Energy CT as a Potential New Diagnostic Tool in the Management of Gout in the Acute Setting

American Journal of Roentgenology, 2010

OBJECTIVE. Gout is the most common crystal deposition arthropathy currently diagnosed clinically ... more OBJECTIVE. Gout is the most common crystal deposition arthropathy currently diagnosed clinically and with arthrocentesis. Dual-energy CT is a promising new imaging technique offering potential new applications in a number of clinical areas. CONCLUSION. The ability of dual-energy CT to diagnose early gout and its use as a problem-solving tool is shown here. Diagnosis of subclinical gout could avert associated longterm complications, thereby reducing disease burden and improving overall quality of life.

Research paper thumbnail of Reproducibility and Diagnostic Accuracy of Kellgren-Lawrence Grading for Osteoarthritis using Radiographs and Dual Energy X-ray Absorptiometry ( DXA ) images Running Title : Osteoarthritis grading using DXA

Introduction: Advances in image quality from modern Dual Energy X-ray absorptiometry (DXA) scanne... more Introduction: Advances in image quality from modern Dual Energy X-ray absorptiometry (DXA) scanners now allow near radiograph-like quality images at a low radiation dose. This opens potential new applications for the use of DXA scanners to study other musculoskeletal conditions, such as osteoarthritis which is often investigated by visual assessment of radiographs. Together, osteoporosis and osteoarthritis are the two most common musculoskeletal conditions, both of which primarily affect older people. The aim of this study was to determine whether Kellgren-Lawrence grading of DXA images can be used to grade hip osteoarthritis as effectively as radiographs. Methodology: People who had attended for recent pelvic radiographs underwent DXA images of hips (50 hips from 25 people) using a GE Healthcare iDXA scanner. Three observers assigned Kellgren-Lawrence grades to each image and grading was repeated at least one week apart. Intraobserver and inter-observer reliability for radiograph a...

Research paper thumbnail of Congenital tufting enteropathy and chronic arthritis: a clinical and radiological perspective

BMJ Case Reports, 2016

Congenital tufting enteropathy is a rare condition which presents in early infancy. It is a condi... more Congenital tufting enteropathy is a rare condition which presents in early infancy. It is a condition which should be suspected in infants who present with diarrhoea soon after birth. A rare association with arthritis has been observed with a handful of cases documented in the literature. Our case differs as the arthritis described is erosive in nature, a feature which is not present in other cases.

Research paper thumbnail of Rapid imaging protocol in trauma: a whole-body dual-source CT scan

Emergency Radiology, 2013

The purpose of this study is to determine whether a single acquisition whole-body trauma multi-de... more The purpose of this study is to determine whether a single acquisition whole-body trauma multi-detector CT scan is able to reduce resuscitation time, scan time, and effective radiation dose without compromising diagnostic quality in the setting of polytrauma. Retrospective analysis of 33 trauma patients undergoing single acquisition whole-body CT with injury severity scores of ≥16 was compared to 34 patients imaged with a segmented whole-body CT protocol. Time spent in the emergency department, effective radiation dose, image quality, and mortality rates were compared. The single acquisition group spent 53.7 % less time in the emergency department prior to imaging (p=0.0044) and decreased scanning time by 25 %. The protocol yielded a 24.5 % reduction in mean effective radiation dose (24.66 mSv vs. 32.67 mSv, p<0.0001). The image noise was similar in both groups. Standardized mortality ratios were comparable. The single acquisition protocol significantly reduces time spent in the emergency department by allowing faster imaging at a lower radiation dose while maintaining image quality. Other contributors to reduction in radiation dose include use of dual-source CT technology, removal of delayed CT intravenous pyelogram, and arm positioning.

Research paper thumbnail of An evaluation of the use of oral contrast media in abdominopelvic CT

European Radiology, 2014

Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdomin... more Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Methods Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n=46) were recruited and prospectively placed into either the water (n=25) or no OCM (n=21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Results Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. Conclusion All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. Key Points • Positive oral contrast media are routinely used for abdominopelvic multidetector computed tomography • Experimental study comparing image quality using three different oral contrast materials • Three different oral contrast materials result in comparable CT image quality • Benefits for patients and medical imaging department

Research paper thumbnail of An evaluation of the use of oral contrast media in abdominopelvic CT

European Radiology, 2014

Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdomin... more Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Methods Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n=46) were recruited and prospectively placed into either the water (n=25) or no OCM (n=21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Results Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. Conclusion All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. Key Points • Positive oral contrast media are routinely used for abdominopelvic multidetector computed tomography • Experimental study comparing image quality using three different oral contrast materials • Three different oral contrast materials result in comparable CT image quality • Benefits for patients and medical imaging department

Research paper thumbnail of Parathyroid Scintigraphy in the Localisation of Parathyroid Adenomas: a four-year experience at St.Luke’s Hospital

Research paper thumbnail of Imaging in Acute Stroke

Research paper thumbnail of Dynamic MRI of the Lumbar Spine in the Upright Position modifies Patient Management

Research paper thumbnail of The Value of Upright Positional MRI in the Diagnosis and treatment of Symptomatic Patients referred after prior nondiagnostic conventional supine MRI Scan of the Lumbar spine

Research paper thumbnail of Use of imaging DXA to grade osteoarthritis at the hip and knee: comparison with standard radiographs

Research paper thumbnail of Artifacts in MDCT Coronary Angiography: How to Overcome Them

PURPOSE/AIM In coronary computer angiography, artifacts are a major cause affecting the proper in... more PURPOSE/AIM In coronary computer angiography, artifacts are a major cause affecting the proper interpretation of coronary artery stenosis, plaque, coronary stent and cardiac morphology assessment. This pictorial review identifies common artifacts, and discusses how to recognize, prevent and mitigate them. CONTENT ORGANIZATION • To recognize the impact of cardiac image artifacts on proper interpretation of coronary CTA, (ie. even on a 64 slice scanner, 11% of coronary segments are not evaluable) • Provide an overview of cardiac CT technique (i.e. retrospective gated helical acquisition and prospective axial gated acquisition) • Describe common artifacts such as: blur/star artifact, blooming, streaking, stair-step, beat-to-beat variability, poor signal to noise • Mitigation techniques: sharp algorithms, ECG edits SUMMARY Cardiac image artifiacts are a major cause of false positive and false negative assessments of coronary artery stenosis, particularly in the presence of coronary arte...

Research paper thumbnail of A Pictorial Review of the Complications of Upper Urinary Tract Infections: The Role of MDCT in Diagnosis and Management

PURPOSE/AIM 1. Provide a pictorial review of salient features of complications of infectious rena... more PURPOSE/AIM 1. Provide a pictorial review of salient features of complications of infectious renal diseases including: emphysematous, xanthogranulomatous and chronic pyelonephritis, renal abscesses as well as hydronephrosis and pyonephrosis 2. Describe the role of MDCT in the management and diagnosis of complicated renal infections CONTENT ORGANIZATION This poster illustrates the pathologic features of the complications of renal infection, describes the role of diagnostic imaging, and correlates radiologic findings with the underlying disease process. A discussion of how the advent of MDCT allows for better assessment of the renal parenchyma and dynamic function of the kidney over conventional techniques. Finally, a review of MDCT scanning protocol in complicated renal infections will be described. SUMMARY MDCT plays a pivotal role in demonstrating the nature and extent of renal disease and has the potential to reveal complications such abscess or obstruction. Furthermore, MDCT prov...

Research paper thumbnail of Delayed abdominal imaging: A retrospective analysis of the 5 minute delayed CT abdomen in the setting of trauma

Research paper thumbnail of Dual-Energy CT in the Assessment of Gout

Research paper thumbnail of Blunt Hepatobiliary Trauma: Role of Low Dose MDCT in Diagnosis and Patient Management

Research paper thumbnail of The Diagnosis and Management of Traumatic Pancreatic Duct Injury

Research paper thumbnail of Blunt Urinary Trauma: The Impact of Low-Dose MDCT on Diagnosis and Management of Patients with Renal/Ureteric Trauma

Research paper thumbnail of Role of Imaging in Penetrating and Blunt Traumatic Injury to the Heart

RadioGraphics, 2011

Cardiac injury due to blunt or penetrating chest trauma is common and is associated with signific... more Cardiac injury due to blunt or penetrating chest trauma is common and is associated with significant morbidity and mortality. Understanding the mechanisms, types, and complications of cardiac injuries and the roles of various imaging modalities in characterizing them is important for appropriate diagnosis and treatment. These injuries have not been well documented at imaging, but there are now fast and accurate methods for evaluating the heart and associated mediastinal structures. The authors review the broad spectrum of injuries that can result from blunt or penetrating trauma to the chest, as well as the imaging modalities commonly used in the acute trauma setting for evaluation of the heart and mediastinal structures. A pictorial review of both common and, to date, rarely documented cardiac injuries imaged with a variety of modalities is also presented. While many imaging modalities are available, the authors demonstrate the value of multidetector computed tomography (CT) for the initial evaluation of patients with blunt or penetrating chest trauma. With the advent of multidetector CT, imaging of cardiac injury has increased and accurate identification of these rare but potentially lethal injuries has become paramount for improving survival. Selection of the most appropriate modality for evaluation and recognition of the imaging findings in cardiac injuries in the acute trauma setting is important to expedite treatment and improve survival. ©

Research paper thumbnail of Ductus diverticulum: A confusing normal variant in the setting of trauma

European Journal of Radiology Extra, 2010

Research paper thumbnail of Dual-Energy CT as a Potential New Diagnostic Tool in the Management of Gout in the Acute Setting

American Journal of Roentgenology, 2010

OBJECTIVE. Gout is the most common crystal deposition arthropathy currently diagnosed clinically ... more OBJECTIVE. Gout is the most common crystal deposition arthropathy currently diagnosed clinically and with arthrocentesis. Dual-energy CT is a promising new imaging technique offering potential new applications in a number of clinical areas. CONCLUSION. The ability of dual-energy CT to diagnose early gout and its use as a problem-solving tool is shown here. Diagnosis of subclinical gout could avert associated longterm complications, thereby reducing disease burden and improving overall quality of life.

Research paper thumbnail of Reproducibility and Diagnostic Accuracy of Kellgren-Lawrence Grading for Osteoarthritis using Radiographs and Dual Energy X-ray Absorptiometry ( DXA ) images Running Title : Osteoarthritis grading using DXA

Introduction: Advances in image quality from modern Dual Energy X-ray absorptiometry (DXA) scanne... more Introduction: Advances in image quality from modern Dual Energy X-ray absorptiometry (DXA) scanners now allow near radiograph-like quality images at a low radiation dose. This opens potential new applications for the use of DXA scanners to study other musculoskeletal conditions, such as osteoarthritis which is often investigated by visual assessment of radiographs. Together, osteoporosis and osteoarthritis are the two most common musculoskeletal conditions, both of which primarily affect older people. The aim of this study was to determine whether Kellgren-Lawrence grading of DXA images can be used to grade hip osteoarthritis as effectively as radiographs. Methodology: People who had attended for recent pelvic radiographs underwent DXA images of hips (50 hips from 25 people) using a GE Healthcare iDXA scanner. Three observers assigned Kellgren-Lawrence grades to each image and grading was repeated at least one week apart. Intraobserver and inter-observer reliability for radiograph a...

Research paper thumbnail of Congenital tufting enteropathy and chronic arthritis: a clinical and radiological perspective

BMJ Case Reports, 2016

Congenital tufting enteropathy is a rare condition which presents in early infancy. It is a condi... more Congenital tufting enteropathy is a rare condition which presents in early infancy. It is a condition which should be suspected in infants who present with diarrhoea soon after birth. A rare association with arthritis has been observed with a handful of cases documented in the literature. Our case differs as the arthritis described is erosive in nature, a feature which is not present in other cases.

Research paper thumbnail of Rapid imaging protocol in trauma: a whole-body dual-source CT scan

Emergency Radiology, 2013

The purpose of this study is to determine whether a single acquisition whole-body trauma multi-de... more The purpose of this study is to determine whether a single acquisition whole-body trauma multi-detector CT scan is able to reduce resuscitation time, scan time, and effective radiation dose without compromising diagnostic quality in the setting of polytrauma. Retrospective analysis of 33 trauma patients undergoing single acquisition whole-body CT with injury severity scores of ≥16 was compared to 34 patients imaged with a segmented whole-body CT protocol. Time spent in the emergency department, effective radiation dose, image quality, and mortality rates were compared. The single acquisition group spent 53.7 % less time in the emergency department prior to imaging (p=0.0044) and decreased scanning time by 25 %. The protocol yielded a 24.5 % reduction in mean effective radiation dose (24.66 mSv vs. 32.67 mSv, p<0.0001). The image noise was similar in both groups. Standardized mortality ratios were comparable. The single acquisition protocol significantly reduces time spent in the emergency department by allowing faster imaging at a lower radiation dose while maintaining image quality. Other contributors to reduction in radiation dose include use of dual-source CT technology, removal of delayed CT intravenous pyelogram, and arm positioning.

Research paper thumbnail of An evaluation of the use of oral contrast media in abdominopelvic CT

European Radiology, 2014

Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdomin... more Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Methods Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n=46) were recruited and prospectively placed into either the water (n=25) or no OCM (n=21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Results Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. Conclusion All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. Key Points • Positive oral contrast media are routinely used for abdominopelvic multidetector computed tomography • Experimental study comparing image quality using three different oral contrast materials • Three different oral contrast materials result in comparable CT image quality • Benefits for patients and medical imaging department

Research paper thumbnail of An evaluation of the use of oral contrast media in abdominopelvic CT

European Radiology, 2014

Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdomin... more Objectives To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Methods Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n=46) were recruited and prospectively placed into either the water (n=25) or no OCM (n=21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Results Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. Conclusion All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. Key Points • Positive oral contrast media are routinely used for abdominopelvic multidetector computed tomography • Experimental study comparing image quality using three different oral contrast materials • Three different oral contrast materials result in comparable CT image quality • Benefits for patients and medical imaging department

Research paper thumbnail of Parathyroid Scintigraphy in the Localisation of Parathyroid Adenomas: a four-year experience at St.Luke’s Hospital

Research paper thumbnail of Imaging in Acute Stroke

Research paper thumbnail of Dynamic MRI of the Lumbar Spine in the Upright Position modifies Patient Management

Research paper thumbnail of The Value of Upright Positional MRI in the Diagnosis and treatment of Symptomatic Patients referred after prior nondiagnostic conventional supine MRI Scan of the Lumbar spine

Research paper thumbnail of Use of imaging DXA to grade osteoarthritis at the hip and knee: comparison with standard radiographs

Research paper thumbnail of Artifacts in MDCT Coronary Angiography: How to Overcome Them

PURPOSE/AIM In coronary computer angiography, artifacts are a major cause affecting the proper in... more PURPOSE/AIM In coronary computer angiography, artifacts are a major cause affecting the proper interpretation of coronary artery stenosis, plaque, coronary stent and cardiac morphology assessment. This pictorial review identifies common artifacts, and discusses how to recognize, prevent and mitigate them. CONTENT ORGANIZATION • To recognize the impact of cardiac image artifacts on proper interpretation of coronary CTA, (ie. even on a 64 slice scanner, 11% of coronary segments are not evaluable) • Provide an overview of cardiac CT technique (i.e. retrospective gated helical acquisition and prospective axial gated acquisition) • Describe common artifacts such as: blur/star artifact, blooming, streaking, stair-step, beat-to-beat variability, poor signal to noise • Mitigation techniques: sharp algorithms, ECG edits SUMMARY Cardiac image artifiacts are a major cause of false positive and false negative assessments of coronary artery stenosis, particularly in the presence of coronary arte...

Research paper thumbnail of A Pictorial Review of the Complications of Upper Urinary Tract Infections: The Role of MDCT in Diagnosis and Management

PURPOSE/AIM 1. Provide a pictorial review of salient features of complications of infectious rena... more PURPOSE/AIM 1. Provide a pictorial review of salient features of complications of infectious renal diseases including: emphysematous, xanthogranulomatous and chronic pyelonephritis, renal abscesses as well as hydronephrosis and pyonephrosis 2. Describe the role of MDCT in the management and diagnosis of complicated renal infections CONTENT ORGANIZATION This poster illustrates the pathologic features of the complications of renal infection, describes the role of diagnostic imaging, and correlates radiologic findings with the underlying disease process. A discussion of how the advent of MDCT allows for better assessment of the renal parenchyma and dynamic function of the kidney over conventional techniques. Finally, a review of MDCT scanning protocol in complicated renal infections will be described. SUMMARY MDCT plays a pivotal role in demonstrating the nature and extent of renal disease and has the potential to reveal complications such abscess or obstruction. Furthermore, MDCT prov...

Research paper thumbnail of Delayed abdominal imaging: A retrospective analysis of the 5 minute delayed CT abdomen in the setting of trauma