Publications

@article{Solbiati1999,

title = {Radio-frequency ablation of hepatic metastases: postprocedural assessment 

	with a US microbubble contrast agent--early experience},

author = {L. Solbiati and S. N. Goldberg and T. Ierace and M. Dellanoce and T. Livraghi and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/10352586},

year  = {1999},

date = {1999-01-01},

journal = {Radiology},

volume = {211},

pages = {643-9},

abstract = {PURPOSE: To evaluate contrast agent-enhanced ultrasonography (US) 

	in the detection of untreated tumor after radio-frequency (RF) ablation 

	of hepatic metastases. MATERIALS AND METHODS: Twenty patients with 

	solitary colorectal liver metastases underwent percutaneous RF tumor 

	ablation. Pre- and postablation imaging was performed with nonenhanced 

	and enhanced color and power Doppler US and contrast-enhanced helical 

	computed tomography (CT). Initial follow-up CT and US were performed 

	24 hours after ablation. The findings at US and CT were compared. 

	RESULTS: Nonenhanced US demonstrated intratumoral signal in 15 of 

	20 metastases before ablation. This signal increased after contrast 

	agent administration. Contrast-enhanced US performed 24 hours after 

	ablation demonstrated residual foci of enhancement in three tumors, 

	whereas no US signals were seen in any tumor on nonenhanced scans. 

	CT demonstrated small (textless 3-mm) persistent foci of residual 

	enhancement in these three tumors and in three additional lesions 

	that were not seen at US (US sensitivity, 50 specificity, 100 diagnostic 

	agreement with CT, 85. All six patients with evidence of residual 

	tumor underwent repeat RF ablation. CONCLUSION: Contrast-enhanced 

	US may depict residual tumor after RF application and thereby enable 

	additional directed therapy. The potential reduction in treatment 

	sessions and/or ancillary imaging procedures might increase the ease 

	and practicality of percutaneous ablation of focal hepatic metastases.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kopans1999,

title = {Re: Benefits and risks of screening mammography for women in their 

	forties: a statistical appraisal},

author = {D. B. Kopans and Elkan F. Halpern},

url = {http://www.ncbi.nlm.nih.gov/pubmed/10050875},

year  = {1999},

date = {1999-01-01},

journal = {J Natl Cancer Inst},

volume = {91},

pages = {382-4},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1999,

title = {Radio-frequency-induced coagulation necrosis in rabbits: immediate 

	detection at US with a synthetic microsphere contrast agent},

author = {S. N. Goldberg and R. C. Walovitch and J. A. Straub and M. T. Shore and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/10551224},

year  = {1999},

date = {1999-01-01},

journal = {Radiology},

volume = {213},

pages = {438-44},

abstract = {PURPOSE: To determine whether a synthetic ultrasonographic (US) contrast 

	agent can be used to differentiate coagulation necrosis from untreated 

	tumor immediately after radio-frequency ablative therapy. MATERIALS 

	AND METHODS: VX2 (adenocarcinoma) tumors (0.8-1.5-cm diameter) were 

	implanted into 12 rabbits. Gray-scale and color Doppler US were performed 

	with or without intravenous injection of a US contrast agent composed 

	of poly-lactide-co-glycolic acid polymeric (PLGA) microspheres (2-micron 

	diameter) filled with perfluorocarbon gas. Radio frequency was applied 

	to each nodule for 6 minutes at 127 mA +/- 33 (mean +/- SD) (tip 

	temperature, 92 degrees C +/- 2). Repeat US with a second dose of 

	the contrast agent was performed immediately after ablation. In four 

	animals, a third dose was administered 30-120 minutes after ablation. 

	Radiologic-histopathologic correlation was performed and included 

	in vivo staining and studies of mitochondrial function. RESULTS: 

	Intense contrast agent enhancement was seen throughout the tumor 

	prior to ablation. At gray-scale US, ablation produced hyperechoic 

	foci, which were within 1 mm of the foci identified at histopathologic 

	examination in seven of 12 animals (58. After the administration 

	of contrast material, foci devoid of previously visualized enhancement, 

	which measured 7.3-15.0 mm, were identified. These were within 1 

	mm of the size of the foci identified at histopathologic examination 

	in 11 of 12 animals (92 P textless .01). In two animals, enhancement 

	depicted viable tumor, which appeared hyperechoic, on nonenhanced 

	images. On delayed images, hyperechoic areas decreased in size, whereas 

	the nonenhanced region remained unchanged. CONCLUSION: A PLGA microspherical 

	US contrast agent enabled the immediate detection of coagulation 

	necrosis as a region devoid of contrast enhancement after radio-frequency 

	ablation in rabbit hepatic tumors. Therefore, this agent could provide 

	real-time guidance during complex ablative procedures and may provide 

	an efficient technique for postprocedural assessment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1999a,

title = {Percutaneous radiofrequency tissue ablation: optimization of pulsed-radiofrequency 

	technique to increase coagulation necrosis},

author = {S. N. Goldberg and M. C. Stein and G. Scott Gazelle and R. G. Sheiman and J. B. Kruskal and M. E. Clouse},

url = {http://www.ncbi.nlm.nih.gov/pubmed/10435709},

issn = {1051-0443 (Print) 1051-0443 (Lin},

year  = {1999},

date = {1999-00-01},

journal = {J Vasc Interv Radiol},

volume = {10},

number = {7},

pages = {907-16},

abstract = {PURPOSE: To develop a computerized algorithm for pulsed, high-current 

	percutaneous radiofrequency (RF) ablation, which maximally increases 

	the extent of induced coagulation necrosis. MATERIALS AND METHODS: 

	An automated, programmable algorithm for pulsed-RF deposition was 

	designed to permit high-current deposition by periodically reducing 

	current for 5-30 seconds during RF application. Two strategies for 

	pulsed-RF deposition were evaluated: (i) constant peak current (900-1,800 

	mA) of variable duration and (ii) variable peak current (1,200-2,000 

	mA) for a specified minimum duration. The extent of induced coagulation 

	was compared to results obtained with continuous (lower current) RF application. Trials were performed in ex vivo calf liver (n = 115) and in vivo porcine liver (n = 30) and muscle (n = 18) with 

	use of 2-4-cm tip, internally cooled electrodes. RESULTS: For 3-cm 

	electrodes in ex vivo liver, applying pulsed-RF with constant peak 

	current for 12 minutes produced 3.5 cm +/- 0.2 of necrosis. Greater 

	necrosis was produced with use of the variable current strategy, 

	in which 4.5 cm +/- 0.2 of coagulation was achieved with use of an initial current \> or =1,500 mA (minimum peak-RF duration of 10 sec, 

	with 15 sec of reduced current to 100 mA between peaks; P \< .01). 

	This variable peak current algorithm also produced 3.7 cm +/- 0.6 

	of necrosis in in vivo liver, and 6.5 cm +/- 0.9 in in vivo muscle. 

	Without pulsing, a maximum of 750 mA, 1,100 mA, and 1,500 mA could 

	be applied in ex vivo liver, in vivo liver, and in vivo muscle, respectively, 

	which resulted in 2.9 cm +/- 0.2, 2.4 cm +/- 0.2, and 5.1 cm +/- 

	0.4 of coagulation (P \< .05, all comparisons). CONCLUSIONS: A variable 

	peak current algorithm for pulsed-RF deposition can increase coagulation 

	necrosis diameter over other ablation strategies. This innovation 

	may ultimately enable the percutaneous treatment of larger tumors.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1998d,

title = {Radio-frequency tissue ablation: effect of pharmacologic modulation 

	of blood flow on coagulation diameter},

author = {S. N. Goldberg and P. F. Hahn and Elkan F. Halpern and R. M. Fogle and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9844671},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {1998},

date = {1998-12-01},

journal = {Radiology},

volume = {209},

number = {3},

pages = {761-7},

abstract = {PURPOSE: To determine whether vasoactive pharmacologic agents can 

	alter radio-frequency (RF)-induced coagulation necrosis by modulating 

	hepatic blood flow. MATERIALS AND METHODS: RF ablation was performed 

	in normal, in vivo porcine liver with 1.5-cm internally cooled electrodes 

	and a standardized RF application (i.e., 500 mA for 10 minutes). Ablation was performed without (n = 9) and with pharmacologic modulation of blood flow with halothane (n = 7), vasopressin (n = 6), or epinephrine (n = 7). Laser Doppler techniques were used to quantify changes in 

	hepatic blood flow. Remote thermometry was also performed. Blood 

	flow was correlated with both induced coagulation necrosis and tissue 

	temperatures. RESULTS: Halothane reduced mean blood flow (+/- SD) 

	to 46.1% +/- 8.5 of normal, and vasopressin increased mean blood 

	flow to 132.7% +/- 13.9. Epinephrine caused increased hepatic blood 

	flow centrally (171.1% +/- 31.7) but not peripherally (102.8% +/- 

	15.4). Mean coagulation diameter was 1.4 cm +/- 0.3 with vasopressin, 

	2.2 cm +/- 0.4 with normal blood flow, and 3.2 cm +/- 0.1 with halothane 

	(P \< .01). After epinephrine infusion, mean coagulation measured 

	2.3 cm +/- 0.3 peripherally and 1.4 cm +/- 0.5 centrally (P \< .01). 

	A linear correlation between coagulation diameter and blood flow was demonstrated (r2 = 0.78). Temperatures 10 and 15 mm from the 

	electrode correlated with both blood flow and coagulation diameter (r2 = 0.65 and 0.60, respectively). CONCLUSION: The coagulation necrosis 

	achieved for a standardized RF application correlates with relative 

	tissue perfusion. Pharmacologic reduction of blood flow during thermally 

	mediated percutaneous ablation may induce greater coagulation necrosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Charous1998,

title = {Hydroxychloroquine improves airflow and lowers circulating IgE levels 	in subjects with moderate symptomatic asthma},

author = {B. L. Charous and Elkan F. Halpern and G. C. Steven},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9723661},

issn = {0091-6749 (Print) 0091-6749 (Lin},

year  = {1998},

date = {1998-08-01},

urldate = {1998-08-01},

journal = {J Allergy Clin Immunol},

volume = {102},

number = {2},

pages = {198-203},

abstract = {BACKGROUND: Although antiinflammatory therapy is accepted as the cornerstone 

	of asthma treatment, available systemic immunosuppressive agents 

	are not widely used because of justified concerns over potential 

	toxicity. Hydroxychloroquine (HCQ) is a well-tolerated, safe immunomodulating 

	drug, with proven efficacy in rheumatic diseases and known actions 

	that suggest potential utility in the treatment of asthma. OBJECTIVE: 

	We sought to assess the effectiveness of HCQ in subjects with moderate 

	symptomatic asthma. METHODS: Symptomatic asthmatic subjects receiving 

	stable doses of at least 6 puffs of inhaled corticosteroid per day 

	with daily need for beta2-adrenergic agonists were studied. After 

	baseline run-in, these subjects were randomized to 30 weeks of HCQ (n = 8) or placebo (n = 9). Objective measures included change from 

	baseline mean FEV1, morning and evening peak flows, beta2-agonist 

	use, IgE level, and need for rescue corticosteroids. Subjective symptom 

	scores from bidaily diaries were also obtained. RESULTS: In the treatment 

	group, mean FEV1 at the last 2 visits on therapy increased by 10.8% 

	(P \< .05), morning peak flows rose 16.2% (P \< .03), evening peak 

	flows rose 14.2% (P \< .04), and beta2-agonist use fell 18.6% (P \< 

	.03). Mean IgE level declined 48% from 240 to 125 IU/mL. (P \< .05). 

	In the placebo group no significant change in these parameters occurred. 

	Comparison of changes in these objective measures between the treatment 

	and placebo groups failed to reach significance in the small population 

	studied. Corticosteroid rescue interventions were required in 4 patients 

	receiving placebo and 2 receiving HCQ. HCQ was well tolerated without 

	notable side effects. CONCLUSIONS: Although the size of our sample 

	population precludes definitive conclusions, these findings extend 

	previous open-label observations. The late improvement in the HCQ 

	group is consistent with its known slow onset of action. Further 

	studies are warranted to confirm the antiasthmatic and antiallergic 

	effects of HCQ and to investigate its potential as a disease-modifying 

	agent.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Slanetz1998,

title = {Previous breast biopsy for benign disease rarely complicates or alters 

	interpretation on screening mammography},

author = {P. J. Slanetz and A. A. Giardino and K. A. McCarthy and D. A. Hall and Elkan F. Halpern and R. H. Moore and D. B. Kopans},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9609170},

issn = {0361-803X (Print) 0361-803X (Lin},

year  = {1998},

date = {1998-06-01},

journal = {AJR Am J Roentgenol},

volume = {170},

number = {6},

pages = {1539-41},

abstract = {OBJECTIVE: It has been suggested that breast screening leads to too 

	many biopsies for benign disease that permanently scar the breast 

	and confuse the interpretation of subsequent mammograms. We undertook 

	retrospective and prospective studies to determine how often an excisional 

	biopsy for benign breast disease complicates or alters interpretation 

	of screening mammograms. MATERIALS AND METHODS: Retrospective review 

	of our screening center database yielded 31,025 asymptomatic patients 

	who had routine mammographic screening studies between 1993 and 1996. 

	Of the 58,538 examinations of these patients, 53,510 were of patients 

	who had no history of breast biopsy and 5028 were of patients who 

	had a history of breast biopsy for benign disease. Recall rates were 

	compared between the two groups. In the prospective study, radiologists 

	reviewed the mammograms of 1997 consecutive patients presenting to 

	the screening center, 173 of whom reported a prior breast biopsy 

	for benign disease. The radiologist interpreting the images determined 

	how often evidence of the biopsy site was apparent on the mammogram 

	and how often such changes necessitated additional imaging. RESULTS: 

	In the retrospective study, 3296 (6%) of the 53,510 studies done 

	in patients who did not have a biopsy for benign disease and 360 

	(7%) of the 5028 studies done in women who had a biopsy for benign 

	disease led to additional imaging. Eight recalls for further imaging 

	(0.16%) among the 5028 studies in women with a prior biopsy for benign 

	disease were related to the biopsy site. In the prospective study, 

	24 (14%) of the 173 women who had a biopsy for benign disease had 

	mammographic evidence of the biopsy site. Nine (5%) of the 173 women 

	who had previously had a biopsy for benign disease and 86 (5%) of 

	the 1824 patients without a prior biopsy were recalled for additional 

	imaging. No women were recalled because a previous breast biopsy 

	for benign disease led to confusion or diagnostic concern. CONCLUSION: 

	Changes in patients' breasts due to previous excisional biopsies 

	for benign breast disease rarely pose a diagnostic dilemma in the 

	interpretation of routine screening mammograms.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Boland1998a,

title = {Asymptomatic hydropneumothorax after therapeutic thoracentesis for malignant pleural effusions},

author = {G. W. Boland and G. Scott Gazelle and M. J. Girard and P. R. Mueller},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9530040},

issn = {0361-803X (Print) 0361-803X (Lin},

year  = {1998},

date = {1998-04-01},

urldate = {1998-04-01},

journal = {AJR Am J Roentgenol},

volume = {170},

number = {4},

pages = {943-6},

abstract = {OBJECTIVE: The purpose of this study was to document in a historical 

	cohort the incidence and clinical observations of pneumothorax ex 

	vacuo after therapeutic thoracentesis for malignant pleural effusions 

	in patients with underlying parenchymal lung disease. MATERIALS AND 

	METHODS: Forty pneumothoraces resulted from 512 therapeutic thoracentesis 

	performed for malignant pleural effusions over a 3-year period. Twenty-nine 

	patients with pneumothoraces underwent catheter placement in the 

	pleural space for treatment. Of these, 12 pneumothoraces resolved 

	and 17 remained unchanged. We reviewed the charts of these 17 patients 

	to document the cause of malignant pleural effusion, presence of 

	underlying malignant parenchymal disease, volume of fluid aspirated, 

	and improvement in symptoms. Clinical outcome was then evaluated, 

	including size of residual pneumothorax, duration of catheter drainage, 

	and reaccumulation of effusion. RESULTS: No patients' lungs reexpanded 

	despite insertion of large-bore (16- to 35-French) chest tubes. All 

	had pneumothoraces that occupied at least 30% of the hemithorax; 

	all were asymptomatic; all had underlying parenchymal disease and 

	noncompliant lungs. Pleural effusion reaccumulated in all 17 after 

	removal of the chest tube. CONCLUSION: A subgroup of patients with 

	malignant lung parenchymal disease who undergo therapeutic thoracentesis 

	will develop asymptomatic hydropneumothoraces due to poor lung compliance. 

	These patients do not require further catheter drainage. Pleural 

	effusion will reaccumulate in the residual space over a variable 

	period of time.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Steiner1998,

title = {Radio-frequency-induced thermoablation: monitoring with T1-weighted and proton-frequency-shift MR imaging in an interventional 0.5-T environment},

author = {P. Steiner and R. Botnar and B. Dubno and G. G. Zimmermann and G. Scott Gazelle and J. F. Debatin},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9494505},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {1998},

date = {1998-03-01},

urldate = {1998-03-01},

journal = {Radiology},

volume = {206},

number = {3},

pages = {803-10},

abstract = {PURPOSE: To evaluate the feasibility and accuracy of monitoring radio-frequency 

	(RF) ablation with an open-configuration, 0.5-T magnetic resonance 

	(MR) imager. MATERIALS AND METHODS: Thirty-six in vivo RF ablation experiments were performed in porcine paravertebral muscle (n = 24) and liver (n = 12). A 90 degrees C tip temperature was applied for 

	3-9 minutes. MR images were acquired after continuous or during intermittent 

	RF application. Temperature changes were monitored as signal intensity 

	and proton-frequency-shift (PFS) alterations in two T1-weighted gradient-echo 

	sequences. An update image was obtained every 2.5 seconds (20/10 

	[repetition time msec/echo time [TE] msec]) or every 5.0 seconds 

	(40/20). A color-coded subtraction technique enhanced the signal 

	intensity and PFS changes. Macroscopic coagulation size was compared 

	with MR image lesion size. RESULTS: The RF application mode had no 

	significant effect on coagulation size in muscle or liver (P \> .05). 

	Twenty-two of 24 coagulative lesions in muscle and nine of 12 in 

	liver were demonstrated with the PFS technique. Accuracy of lesion size determination depended on TE (TE = 20 mse},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Swan1998,

title = {Patient preference for magnetic resonance versus conventional angiography. Assessment methods and implications for cost-effectiveness analysis: an overview},

author = {J. Shannon Swan and C. P. Langlotz},

url = {https://www.ncbi.nlm.nih.gov/pubmed/9766040},

doi = {10.1097/00004424-199809000-00011},

issn = {0020-9996 (Print) 

0020-9996 (Li},

year  = {1998},

date = {1998-01-01},

journal = {Invest Radiol},

volume = {33},

number = {9},

pages = {553-9},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Willig1998,

title = {Contrast-enhanced 3D MR DSA of the carotid artery bifurcation: preliminary study of comparison with unenhanced 2D and 3D time-of-flight MR angiography},

author = {D. S. Willig and P. A. Turski and R. Frayne and V. B. Graves and F. R. Korosec and J. Shannon Swan and C. A. Mistretta and T. M. Grist},

url = {https://www.ncbi.nlm.nih.gov/pubmed/9680574},

doi = {10.1148/radiology.208.2.9680574},

issn = {0033-8419 (Print) 0033-8419 (Li},

year  = {1998},

date = {1998-01-01},

urldate = {1998-01-01},

journal = {Radiology},

volume = {208},

number = {2},

pages = {447-51},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Westmoreland1998,

title = {Simian immunodeficiency virus encephalitis in rhesus macaques is 

	associated with rapid disease progression},

author = {S. V. Westmoreland and Elkan F. Halpern and A. A. Lackner},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9639069},

year  = {1998},

date = {1998-01-01},

journal = {J Neurovirol},

volume = {4},

pages = {260-8},

abstract = {Central nervous system (CNS) disease is a major feature of simian 

	immunodeficiency virus (SIV) infection of macaques. To define the 

	spectrum of CNS lesions in SIV-infected macaques and the potential 

	associations with viral strain and disease course, we performed a 

	retrospective analysis of necropsies on 124 macaques with SIV-induced 

	AIDS. Histologic evidence of CNS disease was observed in 71 (57.3 

	of the 124 animals. SIV encephalitis was the most common CNS lesion 

	occurring in 43.7% (31/71) of the animals with CNS disease and 25% 

	of all animals. The incidence of SIVE correlated significantly with shortened survival (P=0.0207). In addition, SIVE was seen in 42.9% 

	(15/35) of rapid progressors (animals that died within 200 days) 

	compared to only 18% (16/89) of normal progressors (animals that lived longer than 200 days) (P=0.011). Animals with SIVE had higher 

	viral loads in peripheral blood than those that did not, but this 

	difference did not reach statistical significance. Similarly, while 

	animals infected with uncloned SIVmac251 had a higher incidence of 

	SIVE (27.5 14/51) than animals infected with molecularly cloned SIVmac239 

	and its T-cell tropic derivatives (18.5 10/54) this difference was 

	not statistically significant. In this study rapid disease progression 

	and SIVE were highly correlated making separation of viral determinants 

	of virulence from those of neurovirulence difficult.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kong1998,

title = {Monte Carlo Study of Adsorption of a Polyelectrolyte onto Charged Surfaces},

author = {Chung Yin Kong and M. Muthukumar},

url = {http://scitation.aip.org/content/aip/journal/jcp/109/4/10.1063/1.476703},

year  = {1998},

date = {1998-01-01},

journal = {J. Chemical Physics},

volume = {109},

pages = {1522},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1998,

title = {Ablation of liver tumors using percutaneous RF therapy},

author = {S. N. Goldberg and G. Scott Gazelle and L. Solbiati and T. Livraghi and K. K. Tanabe and P. F. Hahn and P. R. Mueller},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9530053},

year  = {1998},

date = {1998-01-01},

urldate = {1998-01-01},

journal = {AJR Am J Roentgenol},

volume = {170},

pages = {1023-8},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1998c,

title = {Benign prostatic hyperplasia: US-guided transrectal urethral enlargement 

	with radio frequency--initial results in a canine model},

author = {S. N. Goldberg and P. F. Hahn and F. J. McGovern and R. M. Fogle and P. R. Mueller and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9680581},

year  = {1998},

date = {1998-01-01},

journal = {Radiology},

volume = {208},

pages = {491-8},

abstract = {PURPOSE: To enlarge the prostatic urethra with thermal coagulation 

	with transrectal radio-frequency (RF) application in dogs. MATERIALS 

	AND METHODS: Eight aged dogs underwent RF ablation of periurethral 

	prostatic tissue for 6 minutes. Eighteen-gauge electrodes were placed 

	into the periurethral tissues with a transrectal approach and ultrasound 

	(US) guidance. Prostatic and rectal temperatures were measured during 

	RF application. US, conventional and computed tomographic (CT) retrograde urethrography (RUG), and CT were performed immediately (n = 8) and at 3-96 days (n = 6) after ablation. Histopathologic analysis was performed at sacrifice immediately (n = 2), at 28 days (n = 2), or at 3 months (n = 4) after treatment. RESULTS: All procedures were 

	successful with no complications and were performed in less than 

	30 minutes. Rectal mucosal temperature did not exceed 38 degrees 

	C. Immediately after treatment, CT and US demonstrated 1.2-cm foci 

	of altered periurethral tissue that corresponded to solid coagulated 

	tissue at histopathologic analysis. By day 3, CT, RUG, and US demonstrated 

	that these foci had begun to cavitate, resulting in enlargement of 

	the urethra. Complete cavitation was demonstrated by day 28. Minimal 

	reduction in the degree of urethral enlargement was noted by day 

	60, but narrowing, urethral strictures, or fistulas were not observed 

	at 3 months. At histopathologic analysis, focal cavitary enlargement 

	with at least doubling of the urethral diameter and with normal urothelium 

	was noted in all dogs surviving at least 28 days. CONCLUSION: Transrectal 

	RF urethral enlargement is feasible and safe in animals and merits 

	investigation for alleviating urethral obstruction due to benign 

	prostatic hyperplasia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1998b,

title = {Percutaneous radiofrequency tissue ablation: does perfusion-mediated 

	tissue cooling limit coagulation necrosis?},

author = {S. N. Goldberg and P. F. Hahn and K. K. Tanabe and P. R. Mueller and W. Schima and C. A. Athanasoulis and C. C. Compton and L. Solbiati and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9468403},

year  = {1998},

date = {1998-01-01},

journal = {J Vasc Interv Radiol},

volume = {9},

pages = {101-11},

abstract = {PURPOSE: To determine, by decreasing hepatic perfusion during radiofrequency 

	(RF) ablation, whether perfusion-mediated tissue cooling can explain 

	the reduced coagulation observed in in vivo studies compared to that 

	seen with RF application in ex vivo tissue. MATERIALS AND METHODS: 

	RF was applied in vivo with use of cooled-tip electrodes to normal porcine liver without (n = 8) and with balloon occlusion of the portal vein (n = 8), celiac artery (n = 3), or hepatic artery (n = 2), and to ex vivo calf liver (n = 10). In vivo trials of vasopressin (0.3-0.6 U/min) infusion during RF application with (n = 10) and without (n = 2) arterial balloon occlusion were also performed. Intraoperative 

	RF was subsequently performed in seven patients with hepatic colorectal 

	metastases with and without portal inflow occlusion. Remote thermometry 

	was performed in four patients. RESULTS: RF application (12 minutes) 

	during portal venous occlusion produced larger areas of coagulation 

	necrosis than RF with unaltered blood flow (2.9 cm +/- 0.1 vs 2.4 

	cm +/- 0.2 diameter; P textless .01). With celiac and hepatic artery 

	occlusion, coagulation diameter measured 2.7 cm +/- 0.2 and 2.5 cm 

	+/- 0.1, respectively. Infusion of vasopressin without vascular occlusion 

	reduced coagulation diameter to 1.1 cm. However, different methods 

	of hepatic or celiac arterial balloon occlusion with simultaneous 

	vasopressin infusion produced a mean 3.4 cm +/- 0.2 of necrosis. 

	Coagulation in ex vivo liver was 2.9 cm +/- 0.1 in diameter. Clinical 

	studies demonstrated greater coagulation diameter for metastases 

	treated during portal inflow occlusion (4.0 cm +/- 1.3) than for 

	tumors treated with normal blood flow (2.5 cm +/- 0.8; P textless 

	.05). Thermometry documented a 10 degrees C increase compared to 

	baseline at 10 mm and 20 mm from the electrode after 5 minutes of 

	portal inflow occlusion during constant RF application. CONCLUSIONS: 

	Perfusion-mediated tissue cooling reduces coagulation necrosis achievable 

	with RF ablation. Reduction of blood flow during RF application increases 

	coagulation in both an animal model and human liver metastases.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1998a,

title = {Large-volume tissue ablation with radio frequency by using a clustered, 

	internally cooled electrode technique: laboratory and clinical experience 

	in liver metastases},

author = {S. N. Goldberg and L. Solbiati and P. F. Hahn and E. Cosman and J. E. Conrad and R. Fogle and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9807561},

year  = {1998},

date = {1998-01-01},

journal = {Radiology},

volume = {209},

pages = {371-9},

abstract = {PURPOSE: To evaluate whether coagulation necrosis achievable with 

	radio-frequency (RF) ablation can be increased by using a cluster 

	of closely spaced electrodes. MATERIALS AND METHODS: RF was applied to ex vivo liver (n = 68), in vivo liver (n = 12), and in vivo muscle (n = 15) by using a cluster array of three separate internally cooled 

	electrodes spaced 0.5 cm apart. The diameter of coagulation necrosis 

	achieved with optimal RF deposition (1,400-2,150 peak mA) for 5-60 

	minutes of RF application was determined for electrode tip lengths 

	of 1.5-3.0 cm and compared with that obtained by using a single electrode 

	and otherwise similar technique. Ten patients with solitary intrahepatic 

	colorectal metastases were also treated by using cluster electrode 

	RF ablation. RESULTS: In ex vivo liver, simultaneous RF application 

	to electrode clusters for 15, 30, and 45 minutes produced 4.7 cm 

	+/- 0.1, 6.2 cm +/- 0.1, and 7.0 cm +/- 0.2 of coagulation necrosis, 

	respectively. In in vivo liver and muscle, RF applied to electrode 

	clusters for 12 minutes yielded 3.1 cm +/- 0.2 and 7.6 cm +/- 0.4 

	of coagulation, respectively. RF application to a single electrode 

	produced maximal coagulation of 2.9 cm in ex vivo liver, 1.8 cm in 

	in vivo liver, and 4.3 cm in muscle (P textless .01, all tissues). 

	In colorectal metastases, a single 12-15-minute application of RF 

	to an electrode cluster induced 4.5-7.0 cm of coagulation necrosis. 

	CONCLUSION: Simultaneous RF application to a cluster of three closely 

	spaced internally cooled electrodes enables a larger volume of coagulation 

	in ex vivo liver, in vivo tissues, and hepatic colorectal metastases 

	than previously reported.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Boland1998,

title = {Characterization of adrenal masses using unenhanced CT: an analysis 

	of the CT literature},

author = {G. W. Boland and M. J. Lee and G. Scott Gazelle and Elkan F. Halpern and M. M. McNicholas and P. R. Mueller},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9648789},

year  = {1998},

date = {1998-01-01},

journal = {AJR Am J Roentgenol},

volume = {171},

pages = {201-4},

abstract = {OBJECTIVE: Unenhanced CT scanning can reliably characterize incidentally 

	detected adrenal masses when observers use density measurements of 

	the adrenal gland. However, controversy exists as to the optimal 

	density threshold required to differentiate benign from malignant 

	lesions. This study attempts to establish a consensus by performing 

	a pooled analysis of data found in the CT literature. MATERIALS AND 

	METHODS: Ten CT reports were analyzed, from which individual adrenal 

	lesion density measurements were obtained for 495 adrenal lesions 

	(272 benign lesions and 223 malignant lesions). Threshold analysis 

	generated a range of sensitivities and specificities for lesion characterization 

	at different density thresholds. RESULTS: Sensitivity for characterizing 

	a lesion as benign ranged from 47% at a threshold of 2 H to 88% at 

	a threshold of 20 H. Similarly, specificity varied from 100% at a 

	threshold of 2 H to 84% at a threshold of 20 H. CONCLUSION: The attempt 

	to be absolutely certain that an adrenal lesion is benign may lead 

	to an unacceptably low sensitivity for lesion characterization. The 

	threshold chosen will depend on the patient population and the cost-benefit 

	approach to patient care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lewin1998,

title = {Interactive MRI-guided radiofrequency interstitial thermal ablation of abdominal tumors: clinical trial for evaluation of safety and feasibility},

author = {J. S. Lewin and C. F. Connell and J. L. Duerk and Y. C. Chung and M. E. Clampitt and J. Spisak and G. Scott Gazelle and J. R. Haaga},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9500259},

issn = {1053-1807 (Print) 1053-1807 (Lin},

year  = {1998},

date = {1998-00-01},

urldate = {1998-00-01},

journal = {J Magn Reson Imaging},

volume = {8},

number = {1},

pages = {40-7},

abstract = {This clinical trial was performed to evaluate the safety and feasibility 

	of interactive MR-guided radiofrequency (RF) interstitial thermal 

	ablation (ITA) performed entirely within the MR imager. RF-ITA was 

	performed on 11 intra-abdominal metastatic tumors during 13 sessions. 

	The RF electrode was placed under MR guidance on a .2-T system using 

	rapid fast imaging with steady state precession (FISP) and true FISP 

	images. A custom 17-gauge electrode was used and was modified in 

	four sessions to allow circulation of iced saline for cooling during 

	ablation. Tissue necrosis monitoring and electrode repositioning 

	were based on rapid T2-weighted and short-inversion-time inversion 

	recovery (STIR) sequences. Morbidity and toxicity were assessed by 

	clinical and imaging criteria. The region of tissue destruction was 

	visible in all 11 tumors treated, as confirmed on subsequent contrast-enhanced 

	images. No significant morbidity was noted, and patient discomfort 

	was minimal. In conclusion, interactive MR-guided RF-ITA is feasible 

	on a clinical .2-T C-arm system with supplemental interventional 

	accessories with only minor patient morbidity. The ability to completely 

	ablate tumors with RF-ITA depends on tumor size and vascularity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Solbiati1997a,

title = {Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip 

	electrodes},

author = {L. Solbiati and S. N. Goldberg and T. Ierace and T. Livraghi and F. Meloni and M. Dellanoce and S. Sironi and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9356616},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {1997},

date = {1997-11-01},

journal = {Radiology},

volume = {205},

number = {2},

pages = {367-73},

abstract = {PURPOSE: To assess the feasibility and safety of using cooled-tip 

	electrodes to increase the volume of coagulation necrosis obtained 

	or reduce the number of treatment sessions necessary with percutaneous 

	tumor radio-frequency (RF) ablation. MATERIALS AND METHODS: Twenty-nine 

	patients with 44 hepatic metastases (1.3-5.1 cm diameter) from colorectal (n = 22), gastric (n = 5), pancreatic (n = 1), or breast (n = 1) 

	carcinoma were treated with RF ablation using cooled-tip, 18-gauge 

	electrodes with 2-3 cm tip exposure. Each tumor was treated in one 

	or two treatment sessions. RESULTS: Technical success, ablation of 

	all visualized tumor, was achieved in 40 (91%) metastases. Findings 

	at computed tomography (CT) and magnetic resonance (MR) imaging performed 

	3-6 months after treatment confirmed complete necrosis of the entire 

	metastasis in 66%. Disease-free survival was 50% at 12 months and 

	33% at 18 months, with localized progression of disease in 34% of 

	treated lesions. Overall survival was 100%, 94%, and 89% at 6, 12, 

	and 18 months, respectively. Only one complication, self-limited 

	hemorrhage, was seen. CONCLUSION: Use of cooled-tip electrodes was 

	a safe and feasible adjunct for tumor RF ablation therapy that produced 

	larger volumes of coagulation necrosis with fewer electrode insertions 

	than is produced with other RF ablation techniques.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Steiner1997,

title = {Monitoring of radio frequency tissue ablation in an interventional 

	magnetic resonance environment. Preliminary ex vivo and in vivo results},

author = {P. Steiner and R. Botnar and S. N. Goldberg and G. Scott Gazelle and J. F. Debatin},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9387054},

issn = {0020-9996 (Print) 0020-9996 (Lin},

year  = {1997},

date = {1997-11-01},

journal = {Invest Radiol},

volume = {32},

number = {11},

pages = {671-8},

abstract = {RATIONALE AND OBJECTIVES: The authors evaluate the feasibility of 

	monitoring radio frequency (RF) ablation in an interventional, open-configuration, 

	0.5-tesla magnetic resonance (MR) environment. METHODS: Ex vivo and 

	in vivo RF coagulation necrosis were induced in porcine paraspinal 

	muscle tissue using a 300 kHz monopolar RF generator applying 5 to 

	20 W over 3 to 9 minutes. Images were acquired simultaneous to RF 

	application, after RF application, and in an intermittent mode (60 

	seconds of RF followed by 15 seconds of MR imaging). Temperature 

	changes were monitored based on amplitude (ex vivo) and phase alterations 

	(in vivo) of a T1-weighted graded refocused echo (GRE) sequence enabling 

	an update every 2.5 seconds. A standardized color-coded subtraction 

	technique enhanced signal changes. Additionally, T2- and T1-weighted 

	spin echo (SE) images were acquired with and without intravenous 

	contrast. Macroscopic coagulation size was compared with lesion size 

	seen on MR images. RESULTS: Although lesion diameters were related 

	directly to applied RF power, the application mode had no significant 

	impact on coagulation size (P \> 0.05). As could be expected, MR imaging 

	during RF ablation resulted in major image distortion. Radio frequency 

	effects were seen on images acquired in the continuous and intermittent 

	modes. Coagulation size seen on GRE images correlated well with macroscopy both ex vivo (r = 0.89) and in vivo (r = 0.92). Poorer correlation was found with postinterventional SE sequences (r = 0.78-0.84). CONCLUSIONS: 

	Magnetic resonance monitoring of RF effects is feasible both ex vivo 

	as well as in vivo using temperature-sensitive sequences in an open-configuration 

	MR environment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hahn1997,

title = {Liver tumor ablation: real-time monitoring with dynamic CT},

author = {P. F. Hahn and G. Scott Gazelle and D. Y. Jiang and C. C. Compton and S. N. Goldberg and P. R. Mueller},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9288191},

issn = {1076-6332 (Print) 1076-6332 (Lin},

year  = {1997},

date = {1997-09-01},

journal = {Acad Radiol},

volume = {4},

number = {9},

pages = {634-8},

abstract = {RATIONALE AND OBJECTIVES: To determine whether incomplete contact 

	of ethanol with tumor limits the success of percutaneous ethanol 

	injection therapy. MATERIALS AND METHODS: Percutaneous ethanol injection 

	was performed in seven normal New Zealand white rabbits and 18 rabbits 

	with 1-3-cm liver tumors 10-14 days after percutaneous implantation 

	of suspended tumor cells. A 3-5 mL dose of ethanol was injected at 

	a rate of 0.2 mL/sec either into normal liver remote from large vessels 

	or directly into tumor. During and immediately after injection, axial, 

	2-mm-thick, contrast material-enhanced computed tomography scans 

	were obtained at reach of three levels every 9 seconds. RESULTS: 

	In normal animals, virtually all injected ethanol tracked to the 

	hepatic capsule. As ethanol was injected into tumors, peripheral 

	tracking, similar to that seen in normal livers, or extratumoral 

	puddling was observed. Ethanol-tumor contact was incomplete in 16 

	of 18 animals (89%). Histopathologic analysis showed incomplete tumor 

	necrosis. CONCLUSION: In this model of hepatic carcinoma metastasis, 

	the tumor failed to hold sufficient ethanol for successful ablation 

	by means of percutaneous ethanol injection therapy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lazor1997,

title = {Evaluation of the accuracy and response time of STAT-mode continuous 

	cardiac output},

author = {M. A. Lazor and E. T. Pierce and G. D. Stanley and J. L. Cass and Elkan F. Halpern and Jr. R. H. Bode},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9187990},

issn = {1053-0770 (Print) 1053-0770 (Lin},

year  = {1997},

date = {1997-06-01},

journal = {J Cardiothorac Vasc Anesth},

volume = {11},

number = {4},

pages = {432-6},

abstract = {OBJECTIVES: This study was conducted to compare continuous cardiac 

	output (CCO) with bolus thermodilution cardiac output (BTD) at steady 

	state, and to compare the response time of STAT CCO with that of 

	trend CCO, mean arterial pressure, and mixed venous oxygen saturation 

	[SvO2] during an acute hemodynamic change. DESIGN: Prospective study. 

	SETTING: University hospital. PARTICIPANTS: Twenty-nine patients 

	undergoing cardiac surgery or liver transplantation. INTERVENTIONS: 

	STAT and trend CCO were compared with BTD cardiac output during steady 

	state intraoperatively and postoperatively in the intensive care 

	unit. Ten patients, who required epicardial pacing after cardiac 

	surgery, were studied to compare the response time of STAT CCO with 

	that of trend CCO, mean arterial pressure, and BvO2 after a 10% to 

	20% increase in pacing rate. MEASUREMENTS AND MAIN RESULTS: A total 

	of 108 cardiac output data sets were analyzed at steady state. Steady 

	state was defined as stable heart rate and mean arterial pressure 

	(+/- 5%) and stable central venous pressure (+/- 2 mmHg) measured 

	immediately before and after each data set. Cardiac output ranged 

	from 2.3 to 8.5 L/min. The correlation between STAT CCO and BTD was r = 0.94, and for trend CCO and BTD was r = 0.94. The bies and precision 

	for STAT CCO versus BTD were 0.06 L/min (Cl 95%: -0.08 to 0.18) and 

	0.61 L/min. The bias and precision for trend CCO versus BTD were 

	0.06 L/min (Cl 95%: -0.04 to 0.16) and 0.49 L/min. Eleven data sets 

	were analyzed to study response time of STAT CCO, which was defined 

	as the first time the percent change of the mean of each variable 

	was significantly increased from baseline. Significant increases 

	in mean arterial pressure and SvO2 were detected after 30 seconds (2.5},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Slanetz1997a,

title = {Screening mammography: effect of national guidelines on current physician 

	practice},

author = {P. J. Slanetz and R. H. Moore and C. A. Hulka and Elkan F. Halpern and D. A. Habunek and G. J. Whitman and K. A. McCarthy and D. A. Hall and D. B. Kopans},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9114084},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {1997},

date = {1997-05-01},

journal = {Radiology},

volume = {203},

number = {2},

pages = {335-8},

abstract = {PURPOSE: To evaluate the effect of national breast cancer screening 

	guidelines on current physician attitudes toward and practice of 

	screening mammography. MATERIALS AND METHODS: Questionnaire responses 

	from 278 physicians were analyzed. The questionnaire had four sections: 

	general information on physician practice and experience, current 

	use of breast cancer screening, perceptions of screening mammography, 

	and physician awareness of and response to the controversy in breast 

	cancer screening. RESULTS: In women aged 40-49 years, 144 (52%) of 

	278 physicians performed annual clinical breast examination and screening 

	mammography every 2 years; 57 (21%) favored annual mammography and 

	clinical breast examination. In women aged 50 years and older, 232 

	(83%) physicians screened patients annually with clinical breast 

	examination and mammography. Two hundred seventeen (78%) physicians 

	were aware of the recommended changes in screening guidelines; 54 

	(19%) were not aware of the changes. Of those aware of the changes, 

	56 (26%) changed to the new guidelines, 150 (69%) did not change, 

	and six (3%) modified their practice somewhat. CONCLUSION: Physician 

	practice as regards screening mammography is influenced by national 

	guidelines.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hamm1997,

title = {Liver metastases: improved detection with dynamic gadolinium-enhanced 

	MR imaging?},

author = {B. Hamm and A. E. Mahfouz and M. Taupitz and D. G. Mitchell and R. Nelson and Elkan F. Halpern and A. Speidel and K. J. Wolf and S. Saini},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9051015},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {1997},

date = {1997-03-01},

journal = {Radiology},

volume = {202},

number = {3},

pages = {677-82},

abstract = {PURPOSE: To compare dynamic gadolinium-enhanced with unenhanced magnetic 

	resonance (MR) imaging in detection of liver metastases. MATERIALS 

	AND METHODS: Two groups of patients were prospectively examined with 

	unenhanced and dynamic gadolinium-enhanced MR imaging. The first group (n = 48) had proved liver metastases; the second group (n = 

	49) did not. One set of unenhanced and one set of gadolinium-enhanced 

	MR images were selected per patient. Three independent, blinded readers 

	assessed the images for presence, number, location, and conspicuity 

	of lesions. Data were analyzed with receiver operating characteristic 

	curves, and contrast-to-noise ratios were calculated for the images. 

	RESULTS: There was no statistically significant difference between 

	the use of unenhanced and gadolinium-enhanced MR images in the differentiation 

	of patients with from patients without metastases. The numbers of 

	false-positive and false-negative diagnoses of individual lesions 

	were higher (not statistically significant) with dynamic MR images 

	than with unenhanced MR images. At dynamic MR imaging, contrast-to-noise 

	ratio was highest in the early phase (30 seconds after injection 

	of the contrast agent) but was not significantly different from the 

	contrast-to noise ratio of the T2-weighted images. CONCLUSION: Dynamic 

	gadolinium-enhanced MR imaging showed no improvement over unenhanced 

	MR imaging in detectability of liver metastases.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Swan1997,

title = {MR and conventional angiography: work in progress toward assessing utility in radiology},

author = {J. Shannon Swan and D. G. Fryback and W. F. Lawrence and D. A. Katz and D. M. Heisey and M. E. Hagenauer and P. M. Selzer and B. K. Jacobson},

url = {https://www.ncbi.nlm.nih.gov/pubmed/9232166},

doi = {10.1016/s1076-6332(97)80231-0},

issn = {1076-6332 (Print) 

1076-6332 (Li},

year  = {1997},

date = {1997-01-01},

journal = {Acad Radiol},

volume = {4},

number = {7},

pages = {475-82},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Solbiati1997,

title = {Percutaneous US-guided radio-frequency tissue ablation of liver metastases: 

	treatment and follow-up in 16 patients},

author = {L. Solbiati and T. Ierace and S. N. Goldberg and S. Sironi and T. Livraghi and R. Fiocca and G. Servadio and G. Rizzatto and P. R. Mueller and A. Del Maschio and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/8988211},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {1997},

date = {1997-01-01},

journal = {Radiology},

volume = {202},

number = {1},

pages = {195-203},

abstract = {PURPOSE: To determine the potential efficacy of radio-frequency (RF) 

	ablation of liver metastases during long-term follow-up. MATERIALS 

	AND METHODS: Sixteen patients with 31 hepatic metastases were treated 

	with percutaneous, ultrasound-guided RF ablation. RF was applied 

	to monopolar electrodes (2-3-cm tip exposure) either individually 

	or within a multiprobe array (two to four probes) for 6 minutes at 

	90 degrees C over one to four treatment sessions per metastasis. 

	RESULTS: In only one of 75 sessions, a moderate complication, self-limited 

	intraperitoneal hemorrhage, was observed. Four patients (four lesions) 

	underwent surgical resection 15-60 days after RF treatment. Residual, 

	viable tumor was seen in all of these patients. The remaining 12 

	patients were followed up for 9-29 months (mean, 18.1 months). In 

	these patients, 18 of 27 lesions remained stable or decreased in 

	size and showed no enhancement at computed tomography and/or magnetic 

	resonance imaging for at least 9 months. Two patients died of disseminated 

	disease at 13 months and one at 16 months. Disease-free survival 

	was achieved in eight patients. CONCLUSIONS: RF ablation appears 

	to be a simple, safe, and potentially effective treatment for selected 

	patients with liver metastases and may become a less invasive alternative 

	to surgical therapy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Trubetskoy1997,

title = {Block-copolymer of polyethylene glycol and polylysine as a carrier 

	of organic iodine: design of long-circulating particulate contrast 

	medium for X-ray computed tomography},

author = {V. S. Trubetskoy and G. Scott Gazelle and G. L. Wolf and V. P. Torchilin},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9239578},

year  = {1997},

date = {1997-01-01},

journal = {J Drug Target},

volume = {4},

pages = {381-8},

abstract = {In order to obtain small, polymer-stabilized particulate carriers 

	for organic iodine to serve as a contrast agent for X-ray computed 

	tomography (CT) an attempt was made to design a carrier based on 

	polymeric micelles. Here we describe the synthesis of an iodine-containing 

	amphiphilic block-copolymer which can micellize in aqueous solutions. 

	The two blocks of the copolymer consisted of methoxypoly(ethyleneglycol) 

	and poly[epsilon,N-(triiodobenzoyl)-L-lysine]. Upon dispersion in 

	water, the block copolymer formed particles with average diameter 

	80 nm and iodine content up to 44.7 The particles start to dissociate 

	to the individual polymeric chains in the concentration range of 

	0.05-0.5 microM in water at 23 degrees C. Upon intravenous injection 

	at 250 mg of iodine/kg (570 mg of the agent/kg) in rabbits the medium 

	demonstrated exceptional 24 hr half-life in the blood substantiating 

	corona/core structure of the particles with PEG chains protecting 

	the iodine-containing core. The possible use of these particulates 

	as contrast medium for X-ray computed tomography is discussed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Pauker1997,

title = {Medical informatics: where the action is},

author = {S. G. Pauker and James Stahl},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9109336},

year  = {1997},

date = {1997-01-01},

journal = {West J Med},

volume = {166},

pages = {148-50},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Pierce1997,

title = {Anesthesia type does not influence early graft patency or limb salvage 

	rates of lower extremity arterial bypass},

author = {E. T. Pierce and F. B. Pomposelli and G. D. Stanley and K. P. Lewis and J. L. Cass and F. W. LoGerfo and G. W. Gibbons and D. R. Campbell and D. V. Freeman and Elkan F. Halpern and R. H. Bode},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9052557},

year  = {1997},

date = {1997-01-01},

journal = {J Vasc Surg},

volume = {25},

pages = {226},

abstract = {PURPOSE: The effect of anesthesia type on 30-day graft patency and 

	limb salvage rates was evaluated in patients who underwent femoral 

	to distal artery bypass. METHODS: Of 423 patients randomly assigned 

	to receive general, spinal, or epidural anesthetic, 76 did not meet 

	protocol standards and 32 had inadequate anesthesia. A chart review 

	of the remaining 315 patients was undertaken to obtain surgical information 

	not recorded in the original study. All patients were monitored with 

	radial and pulmonary artery catheters. After surgery, patients were 

	in a monitored setting for 48 to 72 hours and had graft function 

	assessments hourly during the first 24 hours and then every 8 hours 

	until discharge. RESULTS: Fifty-one patients were lost to follow-up 

	(15 general, 22 spinal, 14 epidural). Baseline clinical characteristics 

	were similar for the three groups except prior carotid artery surgery, 

	which was more common in the spinal group. Indications for surgery 

	were also similar except for a higher incidence of nonhealing ulcer 

	in the epidural group. There were no differences among groups for 

	30-day graft patency with or without reoperation, 30-day graft occlusion, 

	death, amputation, or length of hospital stay. CONCLUSION: These 

	results suggest that the type of anesthetic given for femoral to 

	distal artery bypass does not significantly affect 30-day occlusion 

	rate, limb salvage rate, or hospital length of stay.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Schima1997,

title = {Contrast-enhanced MR imaging of the liver: comparison between Gd-BOPTA 

	and Mangafodipir},

author = {W. Schima and J. Petersein and P. F. Hahn and M. Harisinghani and Elkan F. Halpern and S. Saini},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9039603},

year  = {1997},

date = {1997-01-01},

journal = {J Magn Reson Imaging},

volume = {7},

pages = {130-5},

abstract = {The purpose of the study was to evaluate the MR contrast agents gadolinium 

	benzyloxypropionictetro-acetate (Gd-BOPTA) and Mangafodipir for liver 

	enhancement and the lesion-liver contrast on T1W spin-echo (SE) and 

	gradient-recalled-echo (GRE) images. Fifty-one patients (three groups 

	of 17 patients each) with known or suspected liver lesions were evaluated 

	with T1W SE (300/12) and GRE (77-80/2.3-2.5/80 degrees) images before 

	and after intravenous (IV) Gd-BOPTA (0.1 or 0.05 mmol/kg) or Mangafodipir 

	(5 mumol/kg) in phase II to III clinical trials. Quantitative analysis 

	by calculating liver signal-to-noise ratio (SNR), lesion-liver contrast-to-noise 

	ratio (CNR), and spleen-liver CNR was performed. Liver SNR and spleen-liver 

	CNR were always significantly increased postcontrast. SNR was highest 

	after application of 0.1 mmol/kg Gd-BOPTA (51.3 +/- 3.6, P textless 

	.05). CNR was highest after Mangafodipir (-22.6 +/- 2.7), but this was not significantly different from others (P = .07). Overall, GRE 

	images were superior to SE images for SNR and CNR. Mangafodipir and 

	Gd-BOPTA (0.1 mmol/kg) provide equal liver enhancement and lesion 

	conspicuity postcontrast. By all criteria, contrast-enhanced T1-weighted 

	GRE were comparable to SE images.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kopans1997,

title = {Should women with implants or a history of treatment for breast cancer 

	be excluded from mammography screening programs?},

author = {Daniel B. Kopans and R. H. Moore and K. A. McCarthy and D. A. Hall and C. A. Hulka and G. J. Whitman and P. J. Slanetz and Elkan F. Halpern},

url = {http://www.ncbi.nlm.nih.gov/pubmed/8976914},

year  = {1997},

date = {1997-01-01},

journal = {AJR Am J Roentgenol},

volume = {168},

pages = {29-31},

abstract = {OBJECTIVE: Our objective was to determine whether it is scientifically 

	justified to require that women with implants or a history of treatment 

	for breast cancer be screened in a diagnostic mammography setting 

	and that they be excluded from mammography screening programs. MATERIALS 

	AND METHODS: The recall rates for women with breast implants or a 

	history of treatment for breast cancer who were screened in a dedicated 

	mammography screening program were compared with those of other women 

	in the screening program. The computerized records for the breast 

	screening program of the Department of Radiology at our institution 

	for January 1, 1990, through December 31, 1995, were reviewed. The 

	recall rates for women who had breast implants and those for women 

	with a history of treatment for breast cancer were compared with 

	the recall rates for the other women who underwent screening. Each 

	recall rate included women who were called back for additional evaluation 

	in addition to those for whom a biopsy was recommended on the basis 

	of the screening study. RESULTS: Of 45,134 screening examinations 

	done during the review period, 43,454 (96 were for women who had 

	no history of breast cancer or of breast implants; 590 (1 were for 

	women who had undergone mastectomy; 991 (2 were for women who had 

	been treated with lumpectomy and irradiation for breast cancer; and 

	99 (0.2 were for women with breast implants. Among the 43,454 examinations 

	of women with no history of breast cancer or implants, 3081 examinations 

	(7 led to interpretations that produced requests for the patient 

	to return for additional evaluation. Thirty-six women who had been 

	treated for breast cancer by mastectomy were recalled (6. Seventy-five 

	women who had undergone lumpectomy and irradiation for breast cancer 

	were recalled (8. Five women with breast implants were recalled (5. 

	Statistically, these rates were not significantly different. CONCLUSION: 

	We find no scientific reason to exclude women who have been treated 

	for breast cancer or who have breast implants from dedicated screening 

	programs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Livraghi1997,

title = {Saline-enhanced radio-frequency tissue ablation in the treatment 

	of liver metastases},

author = {T. Livraghi and S. N. Goldberg and F. Monti and A. Bizzini and S. Lazzaroni and F. Meloni and S. Pellicano and L. Solbiati and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/8988212},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {1997},

date = {1997-01-01},

journal = {Radiology},

volume = {202},

number = {1},

pages = {205-10},

abstract = {PURPOSE: To assess the effect of intraparenchymal saline injection 

	on the results of radio-frequency (RF) tissue ablation. MATERIALS 

	AND METHODS: Ex vivo and in vivo animal RF ablation was performed 

	with and without intraparenchymal saline injection. Initially, saline 

	was injected as a bolus (1-20 mL) before RF application. For subsequent 

	in vivo studies, saline was injected as a bolus before RF application 

	or continuously (1 mL/min) during RF application. Finally, 14 patients 

	with liver metastases and one patient with primary cholangiocarcinoma 

	were treated with the continuous infusion technique. A single RF 

	electrode (tip exposure, 1-3 cm) was used with various ablation parameters. 

	RESULTS: With pretreatment bolus injection of saline, lesions measured 

	1.4 cm +/- 0.1, 1.6 cm +/- 0.2, and 1.2 cm +/- 0.1 in ex vivo liver, 

	in vivo animal muscle, and in vivo animal liver, respectively. Without 

	saline enhancement, lesion sizes were 1.0 +/- 0.2, 1.2 +/- 0.2, and 

	0.8 +/- 0.1 cm, respectively. With continuous saline injection in 

	in vivo pig liver, lesion size was 1.8 - 4.1 cm in diameter. In human 

	tumors, necrosis volume was variable, but complete necrosis was seen 

	in 13 of 25 lesions (diameter, 1.2-3.9 cm). Partial necrosis greater 

	than 50% was seen in 12 lesions (diameter, 1.5-4.5 cm). CONCLUSION: 

	Saline-enhanced RF ablation might permit percutaneous destruction 

	of large liver lesions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1997a,

title = {Transluminal radiofrequency tissue ablation with use of metallic 

	stents},

author = {S. N. Goldberg and T. P. Ryan and P. F. Hahn and W. Schima and S. L. Dawson and K. R. Lawes and P. R. Mueller and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9314376},

year  = {1997},

date = {1997-01-01},

journal = {J Vasc Interv Radiol},

volume = {8},

pages = {835-43},

abstract = {PURPOSE: To determine if transluminal coagulative necrosis can be 

	induced by applying radiofrequency (RF) energy to indwelling metallic 

	stents. MATERIALS AND METHODS: RF energy was applied to metallic 

	alloy stents (20-68 mm length, 5-16 mm diameter) in tissue phantom (n = 31), ex vivo bovine liver (n = 10), and in vivo porcine hepatic veins (n = 4). For ex vivo and in vivo liver experiments, RF was 

	applied for 5-6 minutes, titrating generator output to produce 85 

	degrees-95 degrees C temperatures at the stent surface. Local and 

	remote temperature sensing was performed. Imaging and pathologic 

	studies documented the extent of coagulation necrosis. RESULTS: Phantom 

	studies demonstrated uniform temperature distribution along the entire 

	stent length for all Elgiloy stents powered for 2 minutes with a 

	minimum of 120 watts. Shorter stents required less power or reduced 

	time to achieve uniform temperature. In ex vivo liver, 25-mm stents (n = 5) showed 8-10 mm of uniform circumferential coagulation necrosis 

	along the entire stent length. Fifty-millimeter stents showed less 

	uniform coagulation necrosis. For the in vivo stents (20 mm), 8-10 

	mm of uniform circumferential coagulation necrosis surrounded the 

	stent along its entire length. CONCLUSION: Metallic stents can be 

	used to deliver transluminal RF energy from an external source, inducing 

	heat deposition with resultant circumferential tissue coagulation. 

	Clinical applications might include reduction of intimal proliferation 

	in vascular diseases and/or treatment of periluminal tumors compressing 

	the bile ducts, the urethra, or other luminal structures.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Graf1997,

title = {Enhancement of hepatic parenchyma, aorta, and portal vein in helical 

	CT: comparison of iodixanol and iopromide},

author = {O. Graf and G. Scott Gazelle and S. Kreuzer and Elkan F. Halpern and P. Boehm and G. Lechner and P. R. Mueller},

url = {http://www.ncbi.nlm.nih.gov/pubmed/8976948},

issn = {0361-803X (Print) 0361-803X (Lin},

year  = {1997},

date = {1997-01-01},

journal = {AJR Am J Roentgenol},

volume = {168},

number = {1},

pages = {213-7},

abstract = {OBJECTIVE: The purpose of this study was to determine hepatic, aortic, 

	and portal vein enhancement with a new dimeric, nonionic, isotonic 

	contrast medium (iodixanol) in a routinely performed helical CT protocol 

	and compare enhancement characteristics with those of a monomeric, 

	nonionic, low-osmolality contrast medium (iopromide). SUBJECTS AND 

	METHODS: In 81 patients, we injected 150 ml of iodixanol (320 mg 

	I/ml), iodixanol (300 mg I/ml), or iopromide (300 mg I/ml). Injection 

	rate was 5 ml/sec. A dual-phase helical CT scan was obtained (first 

	helical scan began at 30 sec. second helical scan began at 70 sec), 

	and enhancement characteristics were assessed. Results were analyzed 

	taking into account various intrinsic parameters of patients. RESULTS: 

	During the second imaging phase, iodixanol at 320 mg I/ml and iodixanol 

	at 300 mg I/ml provided significantly higher enhancement of the liver 

	(75 H, 69 H, 62 H), aorta (144 H, 140 H, 122 H), and portal vein 

	(147 H, 147 H, 118 H) than did iopromide at 300 mg I/ml. No significant 

	differences were observed during the first imaging phase. CONCLUSION: 

	The combination of higher vascular and parenchymal enhancement levels 

	after injection of the isotonic agent may represent a different quality 

	of tissue enhancement. Such an enhancement would be characterized 

	more by a higher contribution of the blood pool compartment to absolute 

	enhancement levels than by a contribution of the interstitial compartment. 

	Further studies are needed to determine whether the use of isotonic 

	agents effects lesion conspicuity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Haimovici1997,

title = {Relationship between pulmonary artery diameter at computed tomography 

	and pulmonary artery pressures at right-sided heart catheterization. 

	Massachusetts General Hospital Lung Transplantation Program},

author = {J. B. Haimovici and B. Trotman-Dickenson and Elkan F. Halpern and G. W. Dec and L. C. Ginns and J. A. Shepard and T. C. McLoud},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9156228},

year  = {1997},

date = {1997-01-01},

journal = {Acad Radiol},

volume = {4},

pages = {327-34},

abstract = {RATIONALE AND OBJECTIVES: The purpose of the study was to determine 

	the relationship between pulmonary artery (PA) size at computed tomography 

	(CT) and PA pressures, to develop a noninvasive CT method of PA pressure 

	measurement, and to determine a PA diameter that can enable differentiation 

	of normal subjects from those with pulmonary hypertension. METHODS: 

	PA vessel diameters in 55 candidates for lung and heart-lung transplantation 

	were measured at CT and correlated with PA pressures with both linear 

	and stepwise multiple regression. The multiple regression equations 

	were then tested prospectively in 35 pretransplantation patients. 

	RESULTS: Combined main and left main PA cross-sectional area corrected 

	for body surface area showed the best correlation with mean PA pressure (r = .87). The multiple regression equations helped predict mean 

	PA pressure within 5 mm Hg in 50% of patients with chronic lung disease 

	and in only 8% of patients with pulmonary vascular disease. CONCLUSION: 

	There was a very good correlation between main and left main PA size 

	and mean PA pressure. At present, however, CT has not demonstrated 

	sufficient accuracy to be used clinically.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Harisinghani1997,

title = {Differentiation of liver hemangiomas from metastases and hepatocellular 

	carcinoma at MR imaging enhanced with blood-pool contrast agent Code-7227},

author = {M. G. Harisinghani and S. Saini and R. Weissleder and Elkan F. Halpern and W. Schima and D. L. Rubin and A. E. Stillman and G. T. Sica and W. C. Small and P. F. Hahn},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9051017},

year  = {1997},

date = {1997-01-01},

journal = {Radiology},

volume = {202},

pages = {687-91},

abstract = {PURPOSE: To evaluate differentiation of liver lesions at magnetic 

	resonance (MR) imaging enhanced with Code-7227. MATERIALS AND METHODS: 

	Thirty-five patients with 38 proved liver lesions (15 hemangiomas, 

	17 metastases, six hepatocellular carcinomas [HCCs]) underwent T1-weighted 

	gradient-echo and T2-weighted fast-spin-echo MR imaging at 1.5 T 

	before and after intravenous administration of Code-7227 (1.1 mg 

	iron per kilogram of body weight). RESULTS: In hemangiomas, the mean 

	contrast-to-noise ratio on precontrast and postcontrast images, respectively, 

	increased from -4.51 +/- 4.7 (standard deviation) to 5.19 +/- 6.3 

	on T1-weighted images and decreased from 14.73 +/- 7.4 to 0.64 +/- 

	5.1 on T2-weighted images. In comparison, metastases remained hypointense 

	to liver on T1-weighted images (from -5.77 +/- 5.9 to -7.8 +/- 6.8) 

	and hyperintense on T2-weighted images (from 8.73 +/- 5.4 to 12.61 

	+/- 6.1). Although HCC enhanced more than metastases, they also remained 

	hypointense to liver on T1-weighted images (from -4.87 +/- 6.1 to 

	-1.79 +/- 5.7) and hyperintense on T2-weighted images (from 10.12 

	+/- 7.9 to 8.7 +/- 6.4). The degree of enhancement on T1-weighted 

	images and of signal intensity drop on T2-weighted images were significantly 

	lower in malignant liver masses than in hemangiomas (P textless .001). 

	CONCLUSION: Distinctly different enhancement patterns with Code-7227 

	helped accurate differentiation of liver lesions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hulka1997,

title = {Patients' opinion of mammography screening services: immediate results 

	versus delayed results due to interpretation by two observers},

author = {C. A. Hulka and P. J. Slanetz and Elkan F. Halpern and D. A. Hall and K. A. McCarthy and R. Moore and S. Boutin and D. B. Kopans},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9124120},

year  = {1997},

date = {1997-01-01},

journal = {AJR Am J Roentgenol},

volume = {168},

pages = {1085-9},

abstract = {OBJECTIVE: The purpose of this study was to evaluate by random questionnaire 

	mailings the preferences of women who have undergone mammography 

	in our region regarding communication of mammography screening results. 

	MATERIALS AND METHODS: Questionnaires were mailed to 400 randomly 

	selected women who were more than 35 years old and who had been treated 

	at our institution for medical or surgical reasons. Questions regarding 

	use of mammography screening at our institution versus services at 

	other locations were included. The questionnaire described two possible 

	mammography services; either a double reading service that would 

	provide delayed reports (DRDR) with the benefit of extra cancers 

	detected, and a service that provides immediate reports given directly 

	to the patient by an on-site radiologist. The presentation of the 

	services was reversed in half the questionnaires to avoid bias. Patients' 

	choices were collected, as were demographic data. The choice of one 

	system over the other was evaluated using the one-sample lest for 

	binomial probability. The chi-square test was used to determine if 

	the order of questions on the survey or the site of patients' screening 

	mammography affected responses. RESULTS: The response rate was 42% (n = 168). Of these, one response informed us of the death of a patient. Of the remaining 167 respondents, 75% (n = 126) preferred the DRDR system, 13% (n = 22) preferred the system providing immediate results 

	(p textless .0001), and the other 19 respondents did not select a 

	preference. Of the 167 respondents, 156 answered the question regarding 

	previous screening mammography experience. Of the 105 patients who had undergone screening mammography at our institution, 78% (n = 

	82) preferred the DRDR system. Of the 51 patients who had undergone 

	mammography elsewhere or who had never undergone mammography, 75% (n = 38) preferred the DRDR system. We found that ordering of presentation 

	of the systems in the questionnaire had no effect on responses. Likewise, 

	whether a respondent had undergone mammography at our institution had no effect on responses (p = 1.0). CONCLUSION: A statistically 

	significant number of women who responded to our questionnaire preferred 

	the DRDR system of reporting screening mammographic results. Educational 

	material about double reading that we included with each patient's 

	questionnaire could account for these results. If the use of a second 

	interpreter is feasible and is done for batch interpretation of screening 

	mammograms, then education of patients about this process may increase 

	acceptance of a delayed mammographic report.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goldberg1997,

title = {Focal hepatic lesions: effect of three-dimensional wavelet compression on detection at CT},

author = {M. A. Goldberg and G. Scott Gazelle and G. W. Boland and P. F. Hahn and W. W. Mayo-Smith and M. Pivovarov and Elkan F. Halpern and J. Wittenberg},

url = {http://www.ncbi.nlm.nih.gov/pubmed/8988206},

year  = {1997},

date = {1997-01-01},

journal = {Radiology},

volume = {202},

pages = {159-65},

abstract = {PURPOSE: To evaluate the effect of three-dimensional, wavelet-based 

	compression on the detection of focal hepatic lesions at computed 

	tomography (CT). MATERIALS AND METHODS: CT images obtained in 69 

	patients with focal hepatic lesions were studied (35 consecutive 

	cases and 34 cases selected to be difficult on the basis of lesion 

	size or contrast). Image data were compressed by means of a three-dimensional, 

	wavelet-based algorIthm at ratios of 10:1, 15:1, and 20:1. Normal 

	and abnormal sections (on original and compressed images) were reviewed 

	by using an interactive workstation. Four readers rated the presence 

	or absence of a lesion with a five-point scale. RESULTS: At receiver 

	operating characteristic analysis, no statistically significant difference 

	was detected for all cases considered together. Differences approached 

	but did not reach statistical significance for the diagnostic performance of one reader with compressed images (15:},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{McDowell1997,

title = {Mucinous ductal ectasia of the pancreas},

author = {R. K. McDowell and G. Scott Gazelle and B. L. Murphy and G. W. Boland and W. W. Mayo-Smith and A. L. Warshaw and P. R. Mueller},

url = {http://www.ncbi.nlm.nih.gov/pubmed/9135644},

issn = {0363-8715 (Print) 0363-8715 (Lin},

year  = {1997},

date = {1997-00-01},

journal = {J Comput Assist Tomogr},

volume = {21},

number = {3},

pages = {383-8},

abstract = {PURPOSE: Pancreatic mucinous ductal ectasia (MDE) is a recently described 

	and poorly understood disorder, with few cases reported in the imaging 

	literature. We undertook this study to describe the spectrum of CT 

	and pancreatographic findings of MDE and to investigate the incidence 

	of associated pancreatic malignancy. METHOD: The medical records, 

	CT scans, and pancreatograms of 12 consecutive patients with pathologically 

	proven MDE were retrospectively reviewed. There were nine men and 

	three women, ranging in age from 37 to 72 years (mean 59 years). 

	RESULTS: Focal lesions involved primarily the uncinate (two patients) 

	and head (eight patients) by CT imaging. The entire gland was involved 

	in two patients. CT findings were variable and included focal pancreatic 

	enlargement, a low attenuation or cystic mass, low attenuation of 

	the entire gland, or marked ductal dilatation. Pancreatographic findings 

	were more consistent, showing ductal dilatation with or without intraluminal 

	filling defects, obstruction, or displacement. In all cases, findings 

	at endoscopy were felt to be characteristic, with ductal dilatation, 

	filling defects, or abundant mucus seen upon cannulation of the pancreatic 

	duct. Carcinoma-in-situ was present in six cases, cellular atypia 

	without malignancy in two, and in three cases the lesions were histologically 

	benign. One case demonstrated invasive adenocarcinoma. No finding 

	or group of findings on CT or pancreatography permitted differentiation 

	between benign and malignant lesions. CONCLUSION: MDE can present 

	with a variety of appearances on CT, none of which is diagnostic. 

	Pancreatography can be diagnostic if dilatation and intraluminal 

	filling defects are seen. Carcinoma-in-situ, invasive adenocarcinoma, 

	or cellular atypia is present in approximately 75%, but cannot be 

	accurately diagnosed prospectively.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}