Welcome to brand new Ask the Fish. Post your questions in different boards to get in touch with CTisus team & Dr. Elliot K. Fishman!
Our old Ask the Fish forum can be still viewed as an archive at https://ctisus.com/redesign-askfish/index.html.
We encourage all the users to register in this new forum to get answers to their questions since the posts in old forum will no longer be reviewed!
Thank you for visiting & looking forward to your feedback!

Recent Posts

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Lectures & Quizzes / March 2019 Quiz
« Last post by Lilly Kauffman on March 05, 2019, 02:47:29 pm »
The march 2019 quiz is up!


How many did you get right?  What were the hardest/easiest questions?
Journal Club / Texture Analysis of Imaging: What Radiologists Need to Know.
« Last post by Lilly Kauffman on March 05, 2019, 12:57:47 pm »
Texture Analysis of Imaging: What Radiologists Need to Know.

AJR Am J Roentgenol. 2019 Mar;212(3):520-528. doi: 10.2214/AJR.18.20624. Epub 2019 Jan 15.
Varghese BA1, Cen SY1, Hwang DH1, Duddalwar VA1.

OBJECTIVE: Radiologic texture is the variation in image intensities within an image and is an important part of radiomics. The objective of this article is to discuss some parameters that affect the performance of texture metrics and propose recommendations that can guide both the design and evaluation of future radiomics studies.

CONCLUSION: A variety of texture-extraction techniques are used to assess clinical imaging data. Currently, no consensus exists regarding workflow, including acquisition, extraction, or reporting of variable settings leading to poor reproducibility.

DOI: https://doi.org/10.2214/AJR.18.20624


What are your thoughts?  Comments?
General Questions / Does modulation for CT scan of the brain.
« Last post by Jpersak on March 04, 2019, 03:14:11 pm »
 Dr. Fishman,

 Any experience or recommendations for Dose modulation of CT scans of the brain.   Increase mas for Improve resolution/noise  of the posterior fossa/brainstem  with decreased mas for supratentorial structures.  And overall decrease CDTI compared to standard helical imaging.

Joe Persak MD
Using a Deep Learning Network to Diagnose Congestive Heart Failure.

Long H. Ngo

Medical imaging technologies such as radiography, US, CT, and, increasingly, MRI are indispensable in the screening and diagnosis of diseases of the heart, lungs, bones, and other organs. Chest radiography to detect congestive heart failure (CHF) and related complications is one of the most common radiologic procedures performed in the United States. A positive screening result for CHF at chest radiography may be followed by serum B-type natriuretic peptide (BNP) assessment to help confirm the diagnosis. The diagnostic accuracy of BNP in the detection of CHF is excellent, with a sensitivity above 95%. However, BNP testing is not performed for all patients, the laboratory test is expensive, and the final result may be delayed if an off-site laboratory is used. In the absence of BNP data, what is the loss in diagnostic accuracy of using just the chest radiograph? Is there a data-driven solution to compensate for this loss?

DOI: https://doi.org/10.1148/radiol.2018182341


What are your thoughts?  Comments?
Journal Club / Current Update on Desmoid Fibromatosis.
« Last post by Lilly Kauffman on February 21, 2019, 02:42:46 pm »
Current Update on Desmoid Fibromatosis.

J Comput Assist Tomogr. 2019 Jan/Feb;43(1):29-38. doi: 10.1097/RCT.0000000000000790.
Ganeshan D1, Amini B2, Nikolaidis P3, Assing M4, Vikram R2.

OBJECTIVE: The purpose of this article is to review the etiopathogenesis, molecular cytogenetics, histopathology, clinical features, and multimodality imaging features of desmoid fibromatosis. Recent advances in the management of desmoid fibromatosis will also be discussed.

CONCLUSIONS: Desmoid fibromatosis is a rare soft tissue neoplasm with a high incidence of local recurrence. Imaging plays an important role in the diagnosis and management of this disease.

DOI: https://doi.org/10.1097/RCT.0000000000000790


What are your thoughts?  Comments?
Journal Club / Connective Tissue Disorders in Childhood: Are They All the Same?
« Last post by Lilly Kauffman on February 15, 2019, 10:29:37 am »
Connective Tissue Disorders in Childhood: Are They All the Same?

Radiographics. 2019 Jan-Feb;39(1):229-250. doi: 10.1148/rg.2019180078.
Navallas M1, Inarejos Clemente EJ1, Iglesias E1, Rebollo-Polo M1, Antón J1, Navarro OM1.

Systemic connective tissue disorders are characterized by the presence of autoantibodies and multiorgan system involvement. Juvenile systemic lupus erythematosus with or without associated antiphospholipid syndrome; juvenile dermatomyositis; sclerodermiform syndromes, including systemic and localized sclerodermas and eosinophilic fasciitis; mixed connective tissue disease; and Sjögren syndrome are the disorders that affect children most frequently. Diagnosis is difficult, because the clinical presentation of patients is diverse, from mild to severe disease. In addition, all organs may be affected. However, a variety of imaging techniques are now available to investigate rheumatic disease in children. These imaging modalities offer the potential for earlier diagnosis and improved assessment of therapeutic response. This article reviews the main connective tissue disorders that affect children, highlighting their key imaging features on images acquired with different diagnostic imaging modalities and correlating these features with clinical and pathologic findings, when available. ©RSNA, 2019.

DOI: https://doi.org/10.1148/rg.2019180078


What are your thoughts?  Comments?
CT Scan Protocols / Re: Two Phase Vs. Three Phase Liver
« Last post by Elliot K. Fishman, MD on February 08, 2019, 09:53:29 am »
in most cases 2 phases is enough. for masses occasional delays are good as in cases of Cholangioarcinoma where the lesions enhance on delayed phase images.
Case Studies / Re: Looking for a second opinion
« Last post by Elliot K. Fishman, MD on February 08, 2019, 09:51:36 am »
i have not received the images
Journal Club / Imaging of Unusual Renal Tumors.
« Last post by Lilly Kauffman on February 08, 2019, 09:46:33 am »
Imaging of Unusual Renal Tumors.

Curr Urol Rep. 2019 Jan 21;20(1):5. doi: 10.1007/s11934-019-0867-7.
Castillo RP1, Santoscoy JF2, Pisani L1, Madrazo BL1, Casillas VJ1.

PURPOSE OF REVIEW: Renal masses are a wide entity and a common finding in clinical practice. Detection of these masses has increased in the last years, yet mortality rates have slightly decreased.

RECENT FINDINGS: According to the World Health Organization classification, there are 8 types, 51 subtypes, and a lot more subsequent subclassifications of renal tumors. Histopathological analysis should always be assessed for final diagnosis of theses tumors. However, imaging can be an important diagnostic guidance. The most common diagnoses of renal tumor are clear cell carcinoma, papillary renal cell carcinoma, angiomyolipoma, and transitional cell carcinoma. Nonetheless, a considerable variety of particular tumors can arise from the kidney, challenging the expertise of radiologists and urologists on this subject. The awareness of these unusual entities is vital for professionals working at a complex medical facility with greater volume of patients. We hereby present uncommon renal tumors and its pathological and radiological features.

DOI: https://doi.org/10.1007/s11934-019-0867-7


What are your thoughts?  Comments?
« Last post by Lilly Kauffman on February 05, 2019, 12:23:38 pm »
Today is CTisus's 20th birthday!!

Thank you everyone for supporting us over the past two decades.  We look forward to continuing several more years of radiology and CT education!

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