22^nd Canada Meetings on Radiology & Novel Cancer Therapies June 12-13, 2019 Montreal,Canada

Biography:

Antony Bertrand-Grenier has completed his Ph.D. at the age of 30 years from Universite de Montreal in medical physics. Since 2016, he has been a Medical Physicist, a Researcher at Centre Integre Universitaire de sante et de services sociaux de la Mauricie-et-du-Centre-du-Quebec and an Associate Professor at Universite du Quebec a Trois-Rivieres. During his graduate studies, he published more than 12 papers and acquired expertise in medical imaging and radio-oncology, including elastography and radiotherapy. His research interests include introducing elastography (safely assess mechanical properties [rigidity] of tissues with ultrasounds) to diagnosis disease and treatment monitoring, image processing and optimize radiotherapy, spasticity and chemotherapy treatments.

Abstract:

Introduction: The fight against cancer is often hampered by the physical resistance of tumors and the collateral damage caused by treatments. Every year, several million people are treated with radiotherapy, a treatment that uses radiation to destroy cancer cells. In Canada, breast cancer remains the leading cause of death for women between the ages of 35 and 55, where the risk of reoffending ranges from 10% to 40% over 15 years. The difficulty of radiotherapy lies in the destruction of tumor cells while sparing the surrounding healthy tissue. The mechanical properties of tumors differ substantially from normal tissues, in particular by the collagen content and extracellular matrix. In addition to being a marker of malignancy, tumor stiffening can promote the proliferation of cancer cells and the migration of metastases. Radiation treatments induce a deposition of energy (dose) causing a local modification of the mechanical properties of the tissues. The study of these properties during radiotherapy treatment would provide new information on the radioresistance of tumors, the response to treatment and the risk of recurrence.

Solution: Dynamic elastography is used to measure tissue stiffness using focused ultrasound beams. This technique could observe the evolution of the mechanical properties of the tumor zone and tissues throughout the radiotherapy treatment.

Hypothesis: We assume stiffness as a marker of changes in the microenvironment of the tumor cavity, as well as a marker in response to treatment of dosimetric planning. We assume that a tumor region with higher stiffness would respond less well to radiotherapy treatment. Conversely, a tumor with low stiffness would respond better to treatment. Alternatives for treatment planning would be proposed depending on the rigidity obtained, in particular by modifying the total dose, the dose per fraction, the number of fractions, and so on.

Methods: 10 patients with breast cancer and radiotherapy of nearly 20 fractions were selected to have 5 elastography exams, one before the 1st treatment, 3 during the treatments and one few weeks after all the treatments. Correlations will be made between the stiffness of the tumor zone/surrounding tissues and the physical factors (total dose, dose per fraction, irradiated volume), the characteristics of the patients (age, smoker, hemoglobin level, diabetes, hypertension, vascularization), the features of the tumor cavity (region, depth, volume, stage), radiobiological mechanisms and other features (tumor cavity decrease, risk of recurrence).

Results-Clinical Relevance: The study of stiffness could be a therapeutic marker in order to modulate radiation doses as a consequence of physical and other characteristics, notably by observing the progression of the mechanical properties of tumors and the inflammation of tissues during radiotherapy treatment. The use of elastography in radiation oncology would be used to adapt the treatments for each patient in order to optimize radiotherapy treatments, reduce the mortality rate, reduce the risk of recurrence and save healthy tissue.

Biography:

Maryam Liaqat, Assistant Professor in the Department of Physics at the University of Agriculture, Faisalabad, Pakistan. She is completed her doctorate in 2018 from Electrical engineering department, UFPE, worked on a project of Microwave Antenna modifications for the detection of Breast Cancer. Designing flexible antennas for MI system, which will be user-friendly, cost-effective and more precise in results as compared to X-ray Mammography Technique.

Abstract:

Breast cancer is the deadliest disease among all the types of skin cancer. Every second woman is in danger in Canada and every 8^th women in Pakistan and USA. Therefore, it needs to focus on this issue seriously, from diagnosis to the cure very carefully. Mammography is a potential tool for breast cancer screening, works on ionizing X-rays exposure on the skin which is one of the dark sides of mammography. Whereas the other features like early detection, detection in the dense breast or in a pregnant woman are still not really satisfied with mammography. After 40years of age, every woman must pass through screening once in a year but the American Cancer society did not allow mammography in a period of two years. In the light of these facts, Scientist thinks that there is a desperate need of an alternating technique, that is Microwave Imaging (MWI). MWI is a non-ionizing technique for diagnosis of breast cancer at an early stage which is suitable for all age groups and size of the breast but still underdeveloped. The early detection of breast cancer can save life. The technique depends on the contrast of dielectric properties of the cancerous and healthy tissues and does not need compression of the breast for diagnosis which makes it user-friendly. For mammography, usually the biopsy is needed for results confirmation, therefore, it's expensive too but MWI is cost effective also.

Biography:

Meltem Kirli has completed her medical school at the age of 24years from Hacettepe University and radiation oncology residency from Dokuz Eylul University School of Medicine. Until February 2019, she worked in Erzurum Regional Training and Research Hospital, Department of Radiation Oncology as the head of the department. In 2018, she made observations on brachytherapy and stereotactic radiation therapy at Leiden University Medical Center. She continues her work at Kocaeli State Hospital

Abstract:

Purpose: We developed a heart atlas for breast radiation therapy and evaluated the influence of education on intra and interobserver similarity and cardiac dose reporting.

Materials and Methods: The data of 16 left breast cancer patients were analyzed. Eight observers delineated heart and cardiac subunits [left (LCA) and right (RCA) coronary arteries, left anterior descending artery (LAD), bilateral atrium and ventricles] before the education. A radiologist and radiation oncologist developed the atlas and delineated the gold standard (GS) volumes. Observers repeated the delineation after education. RT plans were made for pre/post-atlas contours. The similarity was assessed by Dice (DSC) and Jaccard (JSC) similarity coefficient indices. The absolute difference rate was calculated for the dose analysis.

Results: The inter-observer similarity increased in heart and all subunits. The intra-observer similarity showed a heterogeneous distribution. The absolute difference rate in dose reporting was statistically significant for the bilateral atrium, right ventricle, LAD, LCA+LAD, RCA’s maximum doses (p<0.05). The maximum dose reporting differences from the GS decreased from 16.9 to 8.9% for LAD (p=0.011); from 14.8 to 9.3% for LCA+LAD (p=0.010).

Conclusion: The cardiac atlas reduces the intra interobserver differences and improves dose reporting consistency. The first intra-observer similarity analysis was made in our study and revealed the need for repeated education to increase consistency.

Biography:

Bessi Qorri is a PhD trainee in the laboratory of Dr Szewczuk at Queen’s University, Kingston, Ontario Canada. Bessi’s research has focused on the novel multi-modal targeted therapy for the treatment of cancer. The research is in collaboration with Dr William Harless, MD, PhD,and CEO of Encyt Biotechnologies Inc., Nova Scotia Canada and Dr Cecile Malardier-Jugroot, Professor and Chair of Chemistry and Chemical Engineering at the Royal Military College, Kingston, Ontario B Qorri is the recipient of the Queen’s Graduate Award (QGA), the 2017 Terry Fox Research Institute Transdisciplinary Training Program in Cancer Research, the 2018 Dean’s Doctoral Award, and Queen’s Nomination of the Vanier Canada PhD Graduate Scholarship (Vanier CGS).

Abstract:

Pancreatic cancer is the only malignancy with a 5year survival rate still in the single digits. The poor prognosis is attributed to the advent of metastatic disease that renders surgery, the only curative option, possible in less than 25% of patients at the time of diagnosis. As a result, the golden standard remains to be palliative chemotherapy, such as gemcitabine. However, patients invariably develop resistance and succumb to disease progression. Thus, there is an urgent need for a therapy that targets the multimodal components contributing to tumorigenesis while sensitizing cells to the cytotoxic effects of chemotherapy. We have previously reported on the role of mammalian lysosomal enzyme neuraminidase-1 (Neu-1) that regulates the activity of several receptor tyrosine kinases (RTKs) including the epidermal growth factor receptor (EGFR). Neu-1 cleaves terminal a-2, 3 sialic acid residues on the ectodomain of the receptor to relieve steric hindrance and allow for receptor dimerization and downstream signaling following ligand binding. Anti-viral oseltamivir phosphate (OP) acts as a structural analog to the a-2, 3 sialic acid, inhibiting Neu-1 activity and ultimately shutting down signaling that is implicated in multistage tumorigenesis. To enhance the efficacy of treatment, anti-diabetic metformin and non-steroidal anti-inflammatory drug acetylsalicylic acid (aspirin) were added to the drug cocktail due to their recently reported chemoprotective roles. Sialidase assays on live aspirin treated, EGF-stimulated PANC-1 pancreatic cancer cells have demonstrated a novel action of aspirin on Neu-1 activity. Immunocytochemistry on PANC-1 cells has revealed that each drug alone alters expression of markers of epithelial-to-mesenchymal transition (EMT) that is characteristic of metastatic cancer, suggesting that they act to prevent EMT and prevent metastasis. Collectively, this multimodal therapy works synergistically to sensitize pancreatic cancer cells to chemotherapy, prevent metastasis, angiogenesis and tumor growth. 

Biography:

Alexandria DeCarlo is a trainee specializing in Biotechnology in the laboratory of Dr. Szewczuk at Queen’s University, Kingston, Ontario Canada. Dr. Szewczuk’s research has focused on the role of glycosylation in receptor activation with a particular focus on a novel receptor-signaling platform, and its targeted translation in multistage tumorigenesis. The research is now in the development of engineered drug delivery systems in collaboration with Dr. Cecile Malardier-Jugroot, Professor and Chair of Chemistry and Chemical Engineering at the Royal Military College.

Abstract:

The current clinical approach for cancer treatment broadly targets proliferating malignant cells. This treatment also affects healthy cells. It is essential to develop a highly specific chemotherapy drug carrier which targets explicitly only cancerous cells. We have previously reported on a pH-responsive folic acid (FA)-functionalized amphiphilic alternating copolymer poly(styrene-alt-maleic anhydride) (FA-DABA-SMA) via a biodegradable linker 2,4-diaminobutyric acid (DABA) that has the requisite features for efficient drug delivery specifically targeting the overexpression of the folic acid receptor alpha (FRa) on cancer cells and tumor spheroids. Interestingly, we reported that the empty FA-DABA-SMA nanoparticle also decreased spheroid volume revealing a previously unknown intracellular mechanism of action of the nanopolymer. Reports have shown that FRa can act as a transcription factor responsible for transcribing DNA repair enzymes. We propose that the FA-DABA-SMA binds to the FRa and is transported into the cell towards the nucleus where, due to its large size, directly interferes with the binding of transcription factors, and thus reducing cancer cell viability. Through the use of immunocytochemistry, fluorescent microscopy, and WST-1 proliferation assays, preliminary results suggest that the empty FA-DABA-SMA is internalized and brought to the nucleus within 48 hours where it begins to exert its effect. These results provide valuable insights into the mechanism(s) of smart delivery systems allowing for a new generation of treatments to increase specificity and reduce systemic toxicity. This novel targeting delivery system may overcome many of the cytotoxic effects experienced by patients receiving chemotherapy. These results reveal the dual actions of the smart functionalized nanocarrier, showing that this novel drug delivery system is an effective and potent delivery system specifically targeting cancer cells.

Biography:

Sherif Y Shalaby graduated from the University of Mansoura in 2011. Upon graduating he pursed a research fellowship at Yale University. He has published many peer reviewed papers, book chapters, and reviews. He is currently appointment as a general surgery registrar at the University of Witwatersrand, South Africa

Abstract:

Introduction: The middle East and Northern Africa have the highest prevalence of diabetes as a world region, with Egypt making the top 10 ranking. The number of patients with diabetes is on the rise. Also, healthcare expenditure and utilization of healthcare services are on the rise contributed to lower cases of diabetic lower limb amputation. However, the prevalence of complications in the Egyptian diabetic population characteristics is quite high. Prevalence of retinopathy is 20.5%, albuminuria 21%, nephropathy 6.7% neuropathy at 21.9%. However, diabetic foot complications are low with active diabetic foot ulcers relatively constant at 1%. How does this contrasting trend between diabetic foot complications and other diabetic complications compare to the United States to determine how pivotal large healthcare expenditure in preventing major diabetic foot amputations.

Methodology: Estimation of diabetic population at risk of lower limb amputation in Mansoura, Egypt (aged 25+ years old) in the year 2008-2013 was determined using percent (Straight-Line) growth rates equation of the general population of Mansoura. Prevalence of diabetic lower limb amputations in Mansoura, Egypt was estimated using recorded total (below and above the knee) diabetic lower limb amputations in Mansoura University hospital from 2009-2012. Based on the estimated number of patients with diabetes who are above the 25years of age and the number of amputations in each year, the prevalence of diabetic foot amputation in Mansoura is estimated. Egypt’s overall prevalence of diabetic foot amputation was estimated as a larger scale of Mansoura’s prevalence of diabetes taking into account the difference in the diabetic population. The results and other published trend in Egypt were compared to all Medicare parts A and B Fee-for-Service (FFS) cohort population.

Results: After calculating Egypt’s prevalence of major diabetic foot amputation, there is a consistent decrease in major diabetic foot amputations with an average of 0.3% of the diabetic population (0.5% average for all diabetic foot amputations in other large studies in Egypt). Comparing this phenomenon to the prevalence of diabetic foot amputations in the United States, the prevalence is much higher with 1.3% and 1.8% of diabetic patients undergo a major or lower extremity amputation. However, diabetic foot in Egypt has been documented at 6.9%, still lower than the United States.

Conclusion: Prevalence of diabetic foot amputation is decreasing both in Egypt and the United States but with a much larger prevalence rate in the United States. Considering the fact, Egypt diabetes-related healthcare expenditure is a fraction of the United States and lacks primary health care monitoring evidenced by high diabetic complications but yet has a lower prevalence of both foot ulcers and major lower extremity amputations. This may account for environmental or personal habits that may play a pivotal role in preventing diabetic foot amputations.

Biography:

Gauri Mukhiya has completed MBBS in 2013, MD (Radio-diagnosis) in 2017, Ph.D. in 2^nd year in first affiliated hospital of Zhengzhou University, Henan Zhengzhou, China.

Abstract:

Purpose: To conduct a meta-analysis study of evaluating the efficacy and outcome of interventional radiological diagnosis and therapeutics approach in Budd-Chiari syndrome (BCS).

Methods: Studies identify using a search strategy in the PubMed, EMBASE, Cochrane Library databases and CNKI. Search items are lists below: Budd-Chiari syndrome or hepatic outflow obstructed or hepatic vein thrombosis, transjugular intrahepatic portosystemic shunting or balloon angioplasty, percutaneous transluminal angioplasty, a vascular stent, and vascular recanalization. Study the published article papers on interventional radiology treatment for BCS and review reference lists from retrieved articles. The meta-analysis applied to calculate the combined rates and intervals. Articles are selected according to the eligibility criteria of the meta-analysis. The following data are collected from all studies: the first author, publication year, country where the study was conducted, number of interventional sample, demographic data (age and gender), interventional means, site of stenosis and clinical type of BCS, study results (the successful rate of operation, the rate of vascular re-occlusion after initial treatment, and the survival rate at 1 and 5 years after initial treatment).

Predicative Results: (1) The success rate of the combining treatment of interventional radiology in Budd-Chiari syndrome. (2) The rate of the re-occlusion between at 6 months to 2 years after initial treatment of the interventional radiology. (3) The survival rate of the interventional treatment in Budd-Chiari syndrome patients. (4) The rate of failure and complications after the initial treatment of interventional radiology between at 1 year to 5 years.

Conclusion: The interventional radiological diagnosis and therapeutic approach for Budd-Chiari syndrome patients have very good efficacy and low reoccurrence rate, low restenosis with successful therapy, good patency and have long-term survival rate.

Biography:

Angel Joel Maldonado Velazquez completed his studies in medicine at the age of 23 years from the Autonomous University of Hidalgo, later he finished the radiology specialty in the Autonomous University of Mexico at 30 years old. He did a fellowship in IRM diagnostic in the Ramon y Cajal Hospital in Madrid, Spain, He did an interventional radiology subspecialty course in the General Hospital of Mexico City in 2011. He performed the subspecialty of neuro intervention in Buenos Aires Argentina. Actually, he is the Director of the Radiology department in the Hospital San Angel Inn University and in the Star Medica Lomas Verdes Hospital.

Abstract:

Objective: To present the results obtained in 273 patients treated in the Department of Vascular and Surgical Radiology of the Hospital General de Mexico Radiology and Image Service as a result of post-surgical complications of the bile duct.

Material and Method: Radiological files of all patients with post-surgical bile duct complications treated at the hospital’s Department of Vascular and Surgical Radiology over a 5-year period were reviewed retrospectively.

Results: In a 5-year period, between January 2007 and December 2011, 273 patients with post-surgical bile duct complications were attended: 209 women (76.6%) and 64 men (23.4%). The complications were: residual lithiasis 158 patients (57.7%); fistula 8 (3%); bile duct lesion 23 (8.5%); biliary lesion without biliodigestive communication 11 (4%); abscess in vesicular bed 1 patient (0.3%); biloma 15 patients (5.5%); stenosis of biliodigestive bypass 57 patients (21%). Percutaneous management consisted of: extraction of bile duct stones with a stone basket in 158 patients; placement of external or mixed biliary bypass catheter depending on pathology, desired image characteristics and outcome in 31 patients; percutaneous biliodigestive traction and fertilization with catheter in 11 patients; drainage and percutaneous catheterization in 16 patients; dilation with balloon of the stenosis site and progressive dilation with biliary bypass catheter, increasing the gage in each replacement, in 57 patients.

Conclusions: Post-surgical complications of the bile duct can be serious and may occur in patients with benign disease, requiring careful and multidisciplinary management by doctors with experience and interest in this kind of case. Surgical management in suitably screened patients has increased as a therapeutic approach due to its advantages: minimal invasion, short recovery time, and ambulatory treatment.

Biography:

Richard M Gore MD, FACR received his MD and completed his residency at Northwestern University Medical School. He is director of Gastrointestinal Radiology at North Shore University Health System and Professor of Radiology at the University of Chicago Pritzker School of Medicine. He is co-author of Textbook of Gastrointestinal Radiology, now in its 4^th edition.

Abstract:

Introduction: Over the last 10years, the management of cancer patients has been revolutionized by the advances in molecular targeted therapy and immunotherapy with significant benefits for patient outcomes and comfort. These therapies, however, are associated with new toxicities and complications that can be mild, moderate or life-threatening; may require alteration or cessation of therapy, or simulate disease progression. In this presentation, the various classes of molecular targeted and immunotherapy associated with pulmonary complications are reviewed and the drug associated injuries and their differential diagnosis are presented.

Pneumonitis: Drug-induced pneumonitis develops in up to 10% of patients on immunotherapy and remains a diagnosis of exclusion that must be differentiated from infection and malignant lung infiltration. Five different patterns have been described on CT: Ground glass opacities with preserved bronchovascular markings; increased interstitial markings, interlobular septal thickening, peribronchovascular infiltration, subpleural reticulation, and honeycomb pattern in severe cases ; cryptogenic organizing pneumonia-like, with discrete patchy or confluent consolidation with or without air bronchograms, predominantly peripheral or subpleural in location; non-specific, with a mixture of nodular and other subtypes, not clearly fitting into other subtype classifications.

Bronchiolitis obliterans: There is myxoid fibrous tissue filling the distal bronchioles and extending into alveolar ducts and associated with inflammatory cells. On CT imaging findings include bilateral regions of patchy consolidation or small irregular nodular opacities, bronchial wall thickening and dilation, and small pleural effusions.

Radiation recall pneumonitis: This is an inflammatory reaction in previously irradiated areas of lung producing well-defined areas of alveolar consolidation, ground-glass opacities or infiltrates corresponding to the radiation portals. This pneumonitis usually presents 3-4months following radiotherapy and the patient presents with cough and dyspnea.

Pulmonary veno-occlusive disease: Progressive occlusion of postcapillary pulmonary venules leads to increased pulmonary resistance, pulmonary hypertension, and right ventricular failure. CT findings include diffuse ground-glass opacification, septal thickening, peribronchial thickening, soft tissue edema around the hila and mediastinum, small pleural effusions, and dilatation of the central pulmonary arteries.

Sarcoid-like granulomatous reactions: Intrathoracic lymphadenopathy simulating sarcoidosis develops in up to 10% of patients following ipilimumab and nivolumab therapy. The adenopathy may manifest and newly enlarged lymph nodes or enlargement of pre-existing lymph nodes that occur in isolation or associated with bilateral upper lobe and middle lobe predominant ground-glass opacities, parenchymal consolidations and/or irregular nodules. Most patients are asymptomatic and biopsy show non-caseating granulomas with elevated CD4: CD8 levels. Extrathoracic diffuse adenopathy and cutaneous non-caseating granulomas have also been described.

Pseudoprogression: Immunotherapy often may initially provoke infiltration of cytotoxic T lymphocytes and other immune cells into the tumor bed. This may cause an increase in tumor size or the development of new lesions as an early response. Pseudoprogression is defined as ≥ a 25% increase in tumor burden that is not seen on repeat imaging performed 4 weeks or more after the initial study. Mixed immune-related responses or pseudoprogression are quite problematic in assessing treatment response using RECIST criteria.

Biography:

Angeline A Aywak MBCHB (UON) Mmed Radiology (UON) Fellowship in Ultrasound Jefferson University PA USA. She is the Senior lecturer University of Nairobi College of Health Sciences School of Medicine Dept Diagnostic Imaging & Radiation Medicine.

Abstract:

Purpose: To establish the prevalence of cancer in patients referred for breast ultrasound guided biopsy at Kenyatta National Hospital, Nairobi, Kenya.

Methods and Materials: A total number of 115 patients were included after approval from the local ethical review committee. The patients were referred by clinicians for ultrasound-guided biopsy for palpable breast lesions confirmed by imaging as solid masses. Detailed ultrasound examination per American College of Radiology (ACR) guidelines was performed before core biopsy or fine needle aspiration (FNA). Histological diagnosis was made and the prevalence of cancer analyzed.

Results: Of the 115 patients, final histology was available for 112 lesions; two cases could not be traced and one was inconclusive. Females accounted for 96.5% of cases; median age 28years (range of 15-79years). The median age of patients with cancer was 48years (range 28-79years). Cancer was diagnosed in 28(25%) specimens, the remaining 84 revealing benign histology, with 74/84(88%) fibroadenomas. There were 32/112 patients aged >40years (28.6%), of which 22(78.6%) had cancer (p<0.0001). BI-RADS final assessment categories were assigned prior to biopsy; all solid masses in BI-RADS 2 and BI-RADS 3 were histologically benign. One of 11 lesions in BI-RADS 4 category and 2 of 20 in BI-RADS 5 were histologically benign. Elastography assisted in identifying all cancers in these groups as suspicious, based on strain ratio.

Conclusion: Most breast masses in our cohort (75%) were benign. Patients with a breast lump, especially young ones, need not assume it is cancer until thorough clinical and imaging evaluation has been done to characterize lesions and biopsy performed when indicated. Of the 25% of patients with cancers in this study, almost 79% were >40years of age; younger women had benign lesions, mostly fibroadenomas.

Biography:

Nazrul Islam has completed his MBBS at the age of 23 years from Rajshahi Medical College and MPhil in Radiology & Imaging from Bangabandhu Sheikh Mujib Medical University. He is a member of Royal College of Radiologists’ since 2016. He has published more than 20 papers in reputed journals and has been serving as an editorial board member of Clinical Radiology & Imaging Journal (CRIJ).

Abstract:

Study Design: A rare case report in a male and review of the literature.

Objectives: To describe a case report of invasive glomus jugulare tumor with intracranial extension.

Methods: A 35-year-old male complaints of pulsating tinnitus on his left ear and progressive ipsilateral hearing loss for 4 years. Audiological examination and radiological assessment including Computerized Tomography and Magnetic Resonance Image were carried out. We diagnosed it as invasive glomus jugulare tumor with the intracranial extension (type D2).

Conclusion: Glomus tumors are uncommon slow growing and the hypervascularized benign tumor that arises within the jugular foramen of temporal bone but often locally aggressive and produce a permeative pattern of bone destruction. It is commoner in females (F: M ratio 3-6:1) and an estimated annual incidence of 1 case per 1.3 million people. In most cases diagnosis confirmed by imaging studies.

Biography:

Saher Jabeen, Master’s in statistics, University of Agriculture, Faisalabad (UAF), worked on various USAID projects to study the statics of social factors which cause abnormalities. Currently she is working as visiting lecturer in Govt. College University for Women, Medina Town Faisalabad, Pakistan. During her projects supposed by USAID and in Master’s degree, she studied the factors which cause the C-section and also the after effects of C-section on the fetus and the mother also.

Abstract:

The rate of caesarean section is increased drastically around the world which can cause blood cancer like acute lymphoblastic leukemia (ALL) in babies delivered by caesarian. An increased risk of childhood ALL after prelabour cesarean delivery is a potential mechanism only if this associated with causal, maladaptive immune activation due to an absence of stress response before birth in children born otherwise not. The present article examined the behavior and trend of C-section with respect to socio-economic factors like maternal age, education, wealth index, the area of residence, place of delivery and antenatal care. It is about 24 % which exceed the recommended rate of the World Health Organization (WHO). The C-section deliveries increased from 17.6% to 24% according to the Multiple Indicator Cluster Survey of 2011-2014. The study concluded that socio-economic factors are highly associated with C-section. The study found that the trend of C-section is high in urban areas.

Biography:

Fuad Bashjawish received his Bachelor of Sciences Degree from Fordham University, Bronx NY. He then obtained his doctorate from Rowan University School of Osteopathic Medicine and is now completing his second year of Internal Medicine at Cape Fear Valley Medical Center. He has multiple publications featuring radiologic imaging and is currently undertaking research in Cardiac CT radiology.

Abstract:

Introduction:Retroperitoneal sarcomas are extremely rare tumors only affecting 2 to 5 people per million population, which accounts for 0.1% of all malignancies. The most important prognostic factors are tumor grade, the presence of positive margins, tumor integrity, and degree of resection.

Purpose: Our purpose is to make the medical community aware of the medical and surgical treatment of a rare and insidious form of cancer to improve the prognosis of these patients.

Case presentation: The patient is a 73yo male who presented to our institution with a large abdominal mass. On workup, a CT abdomen/pelvis demonstrated a 15x15cm heterogeneous, left-sided intra-abdominal mass extending from the inguinal region superiorly to the level of the kidney. The patient underwent radical resection of the retroperitoneal tumor, left colectomy and left nephrectomy. Final pathology demonstrated a high grade, dedifferentiated liposarcoma with the rhabdomyosarcomatous component. The postoperative course is complicated with a small intraabdominal abscess formation diagnosed on imaging as well as a residual tumor in the left abdomen. The abscess was treated with IV antibiotics and the patient was discharged home. The patient was then re-admitted for fascial dehiscence and was taken back to the operating room for an additional resection of a retroperitoneal mass and Hartmann's procedure.

Conclusion: Achieving a complete resection and the grade of the tumor are the most important prognostic factors for a patient’s survival. Further research into different treatment methods with systemic chemotherapy or novel targeted therapeutic trials may improve the outcomes of these patients.

Biography:

Mohammed Ismail is a first year Radiology Resident at the University of Louisville in Louisville, KY, USA. He completed his BA in Biochemistry at the University of South Florida and his DO degree at the University of Pikeville. 

Abstract:

Dual Energy CT (DECT) allows for better material differentiation than conventional single energy CT. Essentially, using low keV and high keV CT beams, the same material will attenuate the different energy beams to a different degree. Then, using this differential attenuation, material decompensation algorithms to are used to determine the type of the material being attenuated. Because of DECT’s improved material differentiation, iodine can be subtracted from images (virtual non-contrast images), bone can be automatically removed from CT angiographic studies, pulmonary perfusion can be depicted (pulmonary perfused blood volume), and renal stones can be characterized. We would like to present cases from our institution that demonstrate the added value of DECT. Depending on the space limitations of a poster presentation, we would like to include as many of the following cases as possible: case of indeterminate renal lesion characterization, automated bone removal on a CTA neck study, metal artifact reduction, active contrast extravasation from the neck, renal stone characterization, and intraparenchymal cerebral contrast staining vs. intracranial hemorrhage following neurointerventional thrombectomy