Interventional Radiology Research

The Department of Diagnostic Radiology is a nationally well-established program that includes an ACGME (Accreditation Council for Graduate Medical Education) approved 40-resident teaching program, ACGME approved fellowships in the fields of Neuroradiology, Interventional Radiology and and Musculoskeletal Radiology, and non-ACGME approved fellowships in MRI, Cross-sectional imaging, and Mammography. Over the years, with strong impetus from a wide-ranging faculty, the department has aimed to provide superior clinical care and academic excellence in one of the fastest developing and changing fields of medicine.

Key Research Interests

1. Interventional Radiology, including novel techniques such as:

a. Radioembolization as well as Radiofrequency ablation and microwave ablation of unresectable hepatic malignancies (cancers of the liver that cannot be surgically excised): Minimally invasive image-guided therapy for patients with cancers that are not amenable to surgical resection with the goals of evaluating survival benefit and determining the complication rate.

b. Radiofrequency ablation of primary lung cancers that are not surgically excisable: A similar technique that involves placement of an electrode under CT, or ultrasound guidance into a tumor to heat and thereby "kill" it.

c. Inferior vena cava filters: Protecting the lungs from damage from blood clots circulating in the legs by placing a mechanical filter without surgery. Evaluation of retrievable filters and factors impacting retrieval.

d. Ascites (fluid build-up in the belly) treatment with peritoneal ports and external drains. Minimally invasive treatment that replaces repeated trips to hospital for drainage of the fluid collection.

e. Catheter associated deep vein thrombosis of the upper extremities and treatment methods.
f. Reviewing experience with treatment of upper GI bleeding localized to the gastroduodenal artery.

2. Neuroradiology:

a. Carotid artery stenting: Non-surgical treatment of narrowing of the vessels that supply blood to the brain that can result in strokes. Various trials are ongoing on improving techniques and patient safety.

b. Vertrebroplasty and Kyphoplasty investigations: Techniques that relieve pain, and augment fractures of the spinal vertebrae without surgery.

3. Breast Imaging:

a. Tomosynthesis: Acquisition of multiple x-ray projections (views) of the breast that can permit even closer evaluation of the breast tissue for detection of cancer and can create a 3-D picture of the breast (routine mammograms provide usually two 2-D views of the breast).

b. Evaluating the utility of Breast MRI in patients with prior lumpectomy and Radiation therapy.

c. Other areas including digitization of old film screen mammograms (in addition to acquiring present studies on a digital format), and examining papillary lesions of the breast.

4. Cross-sectional Imaging, current topics include:

a. Incidence of renal ischemia (decreased blood supply to the kidneys) following aortic endostent placement (a minimally invasive device placed within the aorta in patients with abnormal expansion of the blood vessel) and its clinical implications.

b. Assessing the kidney function after receiving contrast (dye) for a CT scan in patients on certain diabetes medications (metformin).

5. Magnetic Resonance Imaging including:

a. Contrast-enhanced coronary artery and coronary artery bypass graft imaging using aortic root catheter injection with computed tomographic angiography (non-invasive means of imaging the coronaries and coronary grafts with a lower dose of dye).

b. Detection of load-induced changes in articular cartilage using a whole-body MRI System. The objective of this proposal is to go beyond the characterization of small tissue blocks at microscopic resolution, to determine the effect of static loading using intact animal joints using a human MRI system.

Overall Research Department Goals

1.

Extend life and improve quality of life in conditions where other existing modalities (surgery, cancer medications) have failed.

2.

Novel catheter design to decrease patient discomfort (such as obviating the need for repeated drainage of abdominal fluid collections).

3.

Fostering better patient care and academic excellence.

4.

Designing improvements in MR technology

Michael Savin, M.D.
Interventional Radiology Researcher
msavin@beaumont.edu
Research interests: Radiofrequency ablation, Ascites catheter design, IVC filters

Chris Kazmierczak, M.D.
Chief, Interventional Neuroradiology
ckazmierczak@beaumont.edu
Research interests: Carotid Stent trials including among others: PROTECT, EPIC, NEXSTENT, SENTIS, Vertebroplasty trials (KAVIAR)

Murray Rebner, M.D.
Cheif, Breast Imaging
mrebner@beaumont.edu
Research interests: Tomosynthesis, Breast MRI

S. Zafar Jafri
Chief, Genitourinary Imaging
sjafri@beaumont.edu
Research Interest: Contrast nephropathy

Kostoki Bis
Chief, Magnetic Resonance Imaging
kbis@beaumont.edu
Research interest: Cardiac imaging

Anil Shetty, PhD
Physicist, MR Research
ashetty@beaumont.edu
Research interests: CT angiography coronaries, MR angiography

Department Research Highlights

William Beaumont Hospital Radiologists have consistently presented at national and international meetings, and are well published. Residents have also been active participants at scientific meetings. Various patents have been awarded over the years for breakthrough work including:

  1. Developing a mechanical device to manually reposition a patient inside the magnet gantry (in an MRI scanner) to perform whole body magnetic resonance angiography.
  2. Developed a catheter device to image coronary arteries and coronary bypass grafts using minimum contrast dose (20%)
  3. Developed a methodology to rapidly image multiple territories of tissue and vessels in MR.

Recent publications and presentations in 2007 include:

Articles Published in Refereed Journals

Vrachliotis TG, Bis, KG, Haidary A, Kosuri R, Balasubramaniam M, Gallagher M, Raff G, Ross, M, O'Neil B, O'Neill W. Atypical Chest Pain: Coronary, Aortic, and Pulmonary Vasculature Enhancement at Biphasic Single-Injection 64-Section CT Angiography. Published Online. Radiology 2007, 10.1148/radiol.2432060447.

Kumar A, Bis KG, Shetty AN, Vyas A, Anderson A, Balasubramaniam M, O'Neill WO, Stein W. Aortic Root Catheter-Directed Coronary CT Angiography in Swine: Coronary Enhancement with Minimum Volume of Iodinated Contrast Material. Am.J.Roentgenol., May 2007;188, p. 415-422.

Haidary A, Bis KG, Vrachliotis TG, Kosuri R, Balasubramam M. Enhancement Performance of 64-slice and 10-slice Multidetector CT-Angiography Protocols for Evaluation of Aortic and Pulmonary Vasculature. Accepted by Journal of Computer Assisted Tomography. To be published in Journal of Computer Assisted Tomography in late 2007.

Bis KG, Vrachliotis TG, Haidary A, Kosuri R, Balasubramaniam M, Gallegher M, Raff G, Ross M, O'Neil B, O'Neill W. "Uniform Enhancement of Coronary, Aortic and Pulmonary Vasculature Using a Biphasic Single Injection 64-slide CT-Angiography Protocol in Emergency Department Patients with Atypical Chest Pain". Radiology, May 2007;243(2):368-376.

Haidary A, Leider JS, Silbergleit R. Unsuspected Swallowing of a Partial Denture. Accepted by American Society of Neuroradiology. To be published in American Society of Neuroradiology in late 2007.

Nandalur KR, Dwamena BA, Choudhri AF, Nandalur MR, Carlos RC. Diagnostic Performance of Stress Cardiac Magnetic Resonance Imaging in the Detection of Coronary Artery Disease. Published Online September 14, 2007. J Am Coll Cardiol, doi:10.1016/j.jacc.2007.06.030.

Scientific Poster Exhibit

Krishnan, A, Silbergleit R, Vyas A, Werner E. MR Imaging in Bisphosphonate-Induced Osteonecrosis of the Jaw. American Society of Neuroradiology, Chicago, Illinois, June 11-14, 2007.

Hong SC, Jafri SZ, Amendola M, Gibson D, Francis I, Roy A, Amin M. Multimodality Imaging of Traumatic, Inflammatory and Neoplastic Conditions of the Urethra. Electronic exhibit presented at American Roentgen Ray Society, Orlando, Florida, May 6-11, 2007.

Silbergleit R, Haidary A, Wang AM. Imaging of Pigmented Villonodular Synovitis of the Spine. American Society of Spine Radiology, Marco Island, Florida, February 21-23, 2007.

Shetty A, Bis KG, Vyas A, Kumar A, Anderson A, Balasubramanian M. Contrast Volume Reduction with Superior Vena Cava Catheter Directed Coronary CT Angiography: Comparison with Peripheral IV Contrast Enhancement in a Swine Model. Society of Thoracic Radiology Annual Meeting, Las Vegas, Nevada, March 24 - March 28, 2007

Yadavalli S, Vartanian AS, Koshy PG. Traumatic and Stress Fractures of the Hip - A Review. American Roentgen Ray Society, Orlando, Florida, May 6-11, 2007.

Qadri N, Savin M, Arpasi P, Picotte J, Haidary A, Hong S. Factors Effecting Inferior Vena Cava Filter Occlusion Rate in 622 Consecutive Patients. Society of Interventional Radiology 32nd Annual Meeting, Seattle, Washington, March 1-3, 2007.

Kendra J, Mezwa D. Creation of a Feature-Rich Radiology Program Web Site. American Roentgen Ray Society, Orlando, Florida, May 6-11, 2007

Hong S, Shirkhoda A, Rooney M, Bloom D, Gibson D. Burkitt's Lymphoma: Spectrum of Radiologic Manifestations. Abdominal Radiology Course 2007, Bonita Springs, Florida, April 15-20, 2007.

Noujaim S, Vohra M, Cardoso L. Nasal Passage Obstruction in the Newborn: A Pictorial Review of Causes of Cyanosis Respiratory Distress. To be presented at the Radiology Society of North America (RSNA) Annual Meeting, Chicago, Illinois, November 25-30, 2007.

Erogul J, Gkogkas C, Shetty A, Bis G, Anderson A, Stein W. Catheter Directed Intra-Arterial Carotid CT-Angiography of the Abdomen and Pelvis Using 20 mL Iodinated Contrast. Poster Exhibit. Presented at the North American Society of Cardiac Imaging (NASCI) Annual Meeting, Washington D.C., October 5-9, 2007.

Haidary A, Shirkhoda A, Richie K. Pitfalls in CT Colonography. Accepted by Radiological Society of North America. To be presented at Radiological Society of North American (RSNA) Annual Meeting, Chicago, Illinois, November 25-30, 2007.

Scientific Presentations

Ebersole JD, Kirsch MJ, Srinivasa R, Noujaim DL, Romano WJ, Savin MA, Wang SK, Arpasi PJ. Conversion of Non-Tunneled to Tunneled Hemodialysis Catheters: Retrospective Comparison to De Novo Placement. Paper presentation. Society of Interventional Radiology, Seattle Washington, March 1-6, 2007.

Erogul J, Shirkhoda A, Bis K, Raff G. Multidetector CT Imaging of the Malignant Coronary Artery Anomalies. Scientific Exhibit. To be presented at the Radiology Society of North America (RSNA) Annual Meeting, Chicago, Illinois, November 25-30, 2007.

Dinan D. Current Thinking and Research in Lesbian, Gay, and Transgender Youth.

Invited lecturer for Wayne State University School of Medicine for Sex and Sexuality Week in March 2007.

Siddiqi A, Fessell D, Wiater JM, Jurist K, Bak S, Roodbeen C, Marcantonio D. Partial thickness tears of the supraspinatus tendon with Surgical Correlation. American Roentgen Ray Society Meeting, Orlando, FL., May 2007.

Seelagan D, Fessell D, Wiater JW, Guettler J, Anderson K, Shapiro P, Marcantonio D. Tears of the Rotator Cuff: Types, Terminology, and Treatment. Presented at American Roentgen Ray Society Meeting, Orlando, FL, May 2007.

Kesala R, Fessell DP, Wiater B, Wiater P, Nowinski G, Balazsy J, Marcantonio D. Helical CT of Tibial Plateau Fractures: What the Orthopedic Surgeon Needs to Know. Presented at American Roentgen Ray Society Meeting, Orlando, FL, May 2007.

Presentations

Hong SC, Savin MA, Desai T, Kumar U, Wong C. Low liver toxicity after radioembolization of hepatocellular carcinoma. 35th Annual Scientific Meeting, Society of Interventional Radiology, Tampa, FL March 14, 2010.

Dobzyniak C, Savin MA. Cystic artery coil embolization prior to Y-90 radioembolization of liver malignancies. Poster Presentation. Global Embolization Symposium and Technologies, San Francisco May 6-9, 2010.

Sag AA, Savin MA, Lal NR, Mehta, RR. The post-yttrium-90 microsphere gallbladder: imaging findings and incidence of cholecystitis. 36th Annual Scientific Meeting, Society of Interventional Radiology, Chicago, IL March 30, 2011.

Scientific Poster Exhibits

Gallardo LJ, Kirsch MJ, Kirsch MA. The Resident Learning Portfolio: One Institution's Experience. Michigan Radiological Society Resident Research Forum, Novi, MI - January 2010.

Kendra JS, Kirsch MJ, Mezwa DG. Creation of a Residency Conference Management Application. Association of University Radiologists, San Diego, CA - March 2010.

Aquino, M, Kirsch MJ, Kirsch AK. Fulfilling the Annual Resident Self-Assessment and Learning Plan Requirement - One Institution's Process. Radiological Society of North America. Chicago, IL - December 2010.

Vartanian, SA, Kirsch MJ, Cash C, Savin M, Wang S, Handel J, Dixit P The ABC"s of GDA Embolization. Radiological Society of North American. Chicago, IL December 2010.

Waters JR, Nandalur KR, Savin MA, Bollampally SR. A primer of therapeutic options for Stage 1 Non-small cell lung cancer: Surgery versus extracranial stereotactic radiation versus image-guided ablation. Educational Exhibit. Radiologic Society of North America, Chicago, IL Nov-Dec 2010.

Awards

  • Sag, Alan, MD Selected to participate in the RSNA / AUR / ARRS Introduction To Research Program. Radiological Society of North America ( RSNA), Chicago, IL, November29- December 2 2010.
  • Nguyen, Anthony, M.D. Selected to participate in Siemens AUR Radiology Resident Academic Development (SARRAD) Program. Association of the University of Radiologists (AUR), San Diego, CA, March 23- 26, 2010.
  • Magna Cum Laude Citation Award - Borovicka K. Gas Forming Infections of the Genitourinary Tract and their Mimickers: Reviewing Imaging and Reviewing Treatment. American Society of Emergency Radiology (ASER) 2010. Seattle, WA. August 11-14th, 2010.
  • Certificate of Merit Award. Educational Exhibit. Gallardo LJ, Pai V, Rebner M. MR Imaging of Axillary Lymphadenopathy in Breast Cancer: A Review of Anatomy and Pathology. RSNA 96th Scientific Assembly and Annual Meeting. Chicago, IL. November 28 - December 3, 2010.
  • Cum Laude Award for education exhibit- Antypas E, Noujaim D. Revealing the Hidden Anatomy of Selected Structures of the Temporal Bone Using High Resolution Multidetector Computed Tomography. Radiological Society of North America (RSNA), 96th Scientific Assembly and Annual Meeting, McCormick Place, Chicago, ILL. November 28-December 3, 2010.