Browsing by Author "Adity Prakash"

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Comparison of T2-weighted and diffusion-weighted imaging for the diagnosis of placenta accreta spectrum abnormality
(SAGE Publications Inc., 2023) Adity Prakash; Ishan Kumar; Ashish Verma; Ram C Shukla
Background: Diffusion-weighted imaging (DWI) is feasible in prenatal imaging, and it exhibits better contrast between the placenta and the myometrium compared to T2-weighted (T2W) images. Purpose: To compare magnetic resonance imaging (MRI) features of placenta accreta on T2W and DW imaging. Material and Methods: In this retrospective study, 42 pregnant patients who underwent prenatal MRI were included. MRI was performed on a Siemens 1.5-T scanner. T2W and DWI sequences in the axial, sagittal, and/or coronal planes were compiled for review. Two radiologists independently interpreted T2W and DW images for placenta accreta. T2W and DWI scores were calculated based on the presence of features and graded as low, intermediate, and high risk. The association between imaging features and placental invasion on pathology was calculated using chi-square tests. Sensitivity, specificity, and positive and negative predictive values (NPV) were compared between T2W and DWI interpretations. Inter-reader agreement between the two radiologists for T2W and DWI scores was calculated using Cohen's kappa coefficient. Results: Out of 42 pregnant patients, 10 were pathologically/surgically proven to have placenta accreta. There were no significant differences between T2W and DWI interpretations. Considering a cutoff >6 as positive, the T2W score had higher sensitivity (90% vs. 80%) and NPV (96.9% vs. 94.1%) than the DWI score. The specificity and positive predictive value were 100% for both scores. The inter-reader agreement of T2W score was higher (k = 0.943 vs. 0.882). Conclusion: T2W and DWI are comparable in diagnosing placenta accreta spectrum. T2W sequences have higher sensitivity, NPV, and inter-reader agreement than DWI. © The Foundation Acta Radiologica 2022.
CT-Based Definition and Structured Reporting of Abdominal Lymph Node Stations
(Georg Thieme Verlag, 2022) Ishan Kumar; Srishti Sharma; Adity Prakash; Priyanka Aggarwal; Ram C. Shukla; Ashish Verma
Background Meticulous evaluation of abdominal lymph nodes on computed tomography (CT) is a fundamental task in radiological practice especially in oncological reporting. Although various reporting systems exist to define abdominal nodal stations for malignancies of individual abdominal organs, a complete and uniform framework for radiological reporting of abdominal lymph nodes does not exist in the literature. Purpose The goal of this review was to provide a step-wise reporting template and precise definitions of the radiological anatomy of abdominal lymph nodes and to generate a CT-based illustration of the lymph node stations of the abdomen. Conclusion This CT-based illustration and reporting template will help the radiologists to aptly describe the extent of the lymph nodal diseases and will help in comparison with posttherapy scans. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Disorders of sexual development: structured radiological reporting and practical approach
(Springer, 2024) Ishan Kumar; Adity Prakash; Priyanka Aggarwal; Sarita Chowdhary; Ashish Verma
Disorders of sexual development (DSD) comprise a complex group of conditions with varied clinical presentations, such as atypical genitalia, non-palpable testes, primary amenorrhea, or infertility. Besides being associated with other congenital anomalies, DSDs bear substantial ethical issues regarding assigning the sex of rearing to the child and future fertility options. Establishing the correct diagnosis is essential for the appropriate management of such cases. Various imaging modalities, such as ultrasonography, genitography, and MRI, when complemented with detailed clinical evaluation and karyotyping, are the key to diagnosing the condition. This article attempts to present a concise approach to various patterns of DSD, which will aid radiologists to solve these diagnostic dilemmas. Graphical abstract: [Figure not available: see fulltext.] © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Initial comparative analysis of pulmonary involvement on HRCT between vaccinated and non-vaccinated subjects of COVID-19
(Springer Science and Business Media Deutschland GmbH, 2022) Ashish Verma; Ishan Kumar; Pramod Kumar Singh; Mohammad Sharoon Ansari; Harsh Anand Singh; Shashank Sonkar; Adity Prakash; Ritu Ojha; Ram Chandra Shukla
Objectives: To compare the high-resolution computed tomography (HRCT)–derived severity score in COVID-19 patients between those who had earlier received the vaccine against the SARS-CoV-2 and those who did not. Methods: A retrospective cross-sectional analysis of HRCT of the chest was done in correlation with the vaccination status of clinically diagnosed COVID-19 patients. The variable under evaluation was the CT severity score, whereby differential analysis of the variability on this parameter between incompletely (single dose) vaccinated, completely (both doses) vaccinated, and non-vaccinated individuals was the outcome. Results: The analysis included 826 patients of which 581 did not receive any vaccination whereas 196 patients received incomplete (single dose) vaccination and 49 received complete vaccination. Mean CT severity score was lower in completely vaccinated patients (3.5 ± 6.3) vis-à-vis incompletely vaccinated (10.1 ± 10.5) and non-vaccinated (10.1 ± 11.4) individuals. The mean CT score was significantly lower in completely vaccinated patients of lower ages (≤ 60 years) compared to patients above that age. The incidence of severe disease (CT score ≥ 20) was significantly higher in the incompletely vaccinated and non-vaccinated patients compared to that in the completely vaccinated group. Conclusions: CT severity scores in individuals receiving both doses of SARS-CoV-2 vaccination were less severe in comparison to those receiving a single dose of vaccine or no vaccine at all. Key Points: • Patients who received complete two doses of vaccination had significantly low mean CT scores compared to the partially vaccinated patients and non-vaccinated patients. • The mean CT scores were significantly lower in completely vaccinated patients of lower ages (< 60 years) while patients > 60 years did not show significantly different CT scores between the vaccinated and non-vaccinated groups. • Consolidations and ground-glass opacities were significantly lower in the group receiving complete vaccination as compared to the unvaccinated and incompletely vaccinated patients. © 2022, The Author(s), under exclusive licence to European Society of Radiology.
Multilevel Multimodal Framework for Automatic Collateral Scoring in Brain Stroke
(Institute of Electrical and Electronics Engineers Inc., 2024) Rishi Raj; Dayananda Pruthviraja; Ayush Gupta; Jimson Mathew; Santhosh Kumar Kannath; Adity Prakash; Jeny Rajan
In patients with ischemic brain stroke, collateral circulation plays a crucial role in selecting patients suitable for endovascular therapy. The presence of well-developed collaterals improves the patient's chances of recovery. In clinical practice, the presence of collaterals is diagnosed on a Computed Tomography Angiography scan. The radiologist grades it on the basis of subjective visual assessment, which is prone to interobserver and intraobserver variability. Computer-based methods of collateral assessment face the challenge of non-uniform scan volume, leading to manual selection of slices, meaning that the most imperative slices have to be manually selected by the radiologist. This paper proposes a multilevel multimodal hierarchical framework for automated collateral scoring. Specifically, we propose deploying a Convolutional Neural Network for image selection based on the visibility of collaterals and a multimodal model for comparing the occluded and contralateral sides of the brain for collateral scoring. We also generate a patient-level prediction by integrating automated machine learning in the proposed framework. While the proposed multimodal predictor contributes to Artificial Intelligence, the proposed end-to-end framework is an application in engineering. The proposed framework has been trained and tested on 116 patients, with five-fold cross-validation, achieving an accuracy of 91.17% for multi-class collateral scores and 94.118% for binary class collateral scores. The proposed multimodal predictor achieved a weighted F1 score of 0.86 and 0.95 on multi-class and binary-class collateral scores, respectively. The proposed framework is fast, efficient, and scalable for real-world deployments. Automated evaluation of collaterals with attention maps for explainability would complement radiologists' efforts. Code for the proposed framework is available at: https://github.com/rishiraj-cs/collaterals_ML_MM. © 2013 IEEE.
Short-term follow-up HRCT Chest of COVID-19 survivors and association with persistent dyspnea
(Springer Science and Business Media Deutschland GmbH, 2021) Ishan Kumar; Adity Prakash; Manoj Ranjan; Sankha Shubhra Chakrabarti; Ram C. Shukla; Ashish Verma
Background: There is an increasing concern that a proportion of the survivors of COVID 19 might develop fibrotic and/or other non-reversible lung changes. The aim of this retrospective study was to review the imaging findings of HRCT of lungs in a cohort of COVID 19 survivors, coming for short-term clinical follow-up and to assess the relation of the observed HRCT changes with the presence of dyspnea. Results: In total, 40 patients with residual CT findings were included in this study with a mean age of 44.3 years and male: female ratio of 3:2. The presence of residual ground-glass opacities (85%) and reticular opacities (80%) was the most common findings. 25% of the cases had cystic changes in their lung. The presence of dyspnea was significantly associated with male sex and a history of smoking. On HRCT, the presence of cystic changes, involvement of > 10 lung segments, and an HRCT severity score > 7 were significantly associated with dyspnea. Conclusion: Survivors of COVID 19 demonstrate persistent changes in the lung on HRCT. We recommend that a follow-up HRCT should be performed in these patients to identify those with post-COVID sequelae. © 2021, The Author(s).