Showing 5 Abstracts.
Prenatal diagnosis of esophageal atresia (EA) remains challenging, with indirect signs such as polyhydramnios, a small or absent stomach bubble, and a dilated upper esophageal pouch often being nonspecific. Only 10-40% of EA cases are diagnosed prenatally. Fetal MRI can overcome ultrasound limitations; however, constraints like motion can hinder evaluation of the esophagus. One approach to improve image quality is super-resolution imaging with slice-to-volume reconstruction (SVR). This technique enhances diagnostic accuracy by generating high-resolution 3D images from standard fetal MRI slices. We present two instances where super-resolution imaging with SVR was employed to accurately diagnose EA and assess the presence or absence tracheoesophageal fistulas (TEF). Case 1: A 30 3/7-week gestation male fetus was referred for fetal MRI following ultrasonographic findings of a dilated right atrium, a single umbilical artery, a small fetal stomach, and a urinary tract dilation observed at 27 2/7 weeks. Fetal MRI revealed a dilated upper esophageal pouch with a small amount of fluid in the distal esophagus, and a diminutive stomach. 3D-rendered super-resolution images demonstrated a dilated atretic upper esophageal pouch and a TEF originating from the left mainstem bronchus. The application of super-resolution imaging with SVR was crucial to determine the precise origin of the TEF from the left mainstem bronchus, findings that were later confirmed by bronchoscopy and surgery. Case 2: A 33 2/7-week gestation male fetus was referred for fetal MRI due to polyhydramnios and inability to visualize the stomach on an ultrasound performed at 31 weeks. Fetal MRI confirmed polyhydramnios with a distended, fluid-filled proximal esophagus, consistent with EA. The stomach was decompressed, and the distal esophagus was not visualized. 3D-rendered super-resolution imaging with SVR confirmed the dilated upper esophagus and revealed that it ended 0.5 cm below the level of the carina. The imaging also demonstrated a gap between the distal end of the esophageal pouch and the gastroesophageal junction at the level of the diaphragm, supporting the absence of the distal esophagus. The use of super-resolution imaging with SVR provided detailed, pre-surgical 3D anatomical depictions in both cases of EA, with and without TEF. This technique demonstrates significant potential for accurately delineating the relevant surgical anatomy, which can improve surgical planning and outcomes. Read More
Meeting name: SPR 2025 Annual Meeting , 2025
Authors: Loken Delaney, Goncalves Luis, Patel Mittun
Keywords: 3D Imaging, Esophageal Atresia, Tracheoesophageal Fistula
The objective of this exhibit is to illustrate common fetal central nervous system (CNS) abnormalities using high-resolution magnetic resonance imaging at 3.0 Tesla. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Pfeifer Cory, Patel Mittun, Bardo Dianna, Cornejo Patricia
Keywords: fetal, central nervous system
To compare image quality ratings between 3D gradient echo mDIXON (GRE) vs. 2D turbo-spin-echo mDIXON (TSE) in pediatric patients with osteomyelitis. Read More
Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016
Authors: Beydoun Tammam, Pokorney Amber, Keehn Brian, Hu Houchun, Patel Mittun, Barnes Craig
Keywords: mDIXON GRE, Osteomyelitis
After reviewing the exhibit, participants will be able to recognize suspicious and non-suspicious ultrasound (US) features of pediatric thyroid nodules which will help to triage nodules that need a biopsy. Read More
Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016
Authors: Biyyam Deepa, Patel Mittun, Dance Logan, Dao Tuan, Youssfi Mostafa, Towbin Richard
Accurate tumor measurement is essential in initial assessment of solid tumors. Furthermore, it is vital when evaluating treatment response. Change in tumor size determines whether a treatment course is effective, if treatment should be prolonged, or whether a more aggressive treatment or chemotherapy drug should be administered. Currently endorsed and widely used guidelines for tumor volume measurement include response evaluation criteria in solid tumors (RECIST), a one dimensional measure (cm) of target lesions which is not routinely the longest axis; World Health Organization (WHO), a 2 dimensional measure of the long and one short tumor axis (cm2) but is not a measure of volume; and Childrens Oncology Group (COG), a 3 dimensional ‘volume’ (cm3) measurement but does not account for shape of the tumor. Pediatric oncology patients are almost exclusively cared for in major academic or community hospital settings where modern CT and MR scanners routinely produce direct or reconstructed multiplanar images. Therefore an evolution of tumor measurement, to determine tumor volume, must be forthcoming. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Willard Scott, Barnes Craig, Augustyn Robyn, Thorkelson Marrit, Chatfield Paige, Hu Harry, Towbin Richard, Bardo Dianna, Pfeifer Cory, Dance Logan, Bailey Smita, Southard Richard, Jorgensen Scott, Biyyam Deepa, Patel Mittun, Cassell Ian