Publications by authors named "Ahmed W Moawad"

Purpose: This study aims to identify radiomic features from contrast-enhanced CT (CECT) scans that differentiate osteoradionecrosis (ORN) from normal mandibular bone in head and neck cancer (HNC) patients treated with radiotherapy (RT).

Materials And Methods: CECT images from 150 patients with confirmed ORN diagnosis (2008-2018) at MD Anderson Cancer Center (MDACC) were analyzed (80 % train, 20 % test). Radiomic features were extracted using PyRadiomics from manually segmented ORN regions and automated contralateral healthy mandible regions.

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Objective: To compare the diagnostic performance of non-contrast MRI versus MRI with contrast for differentiating atypical lipomatous tumors (ALT) from lipomas.

Materials And Methods: This multicenter retrospective study included subjects with a histopathologic diagnosis of lipoma or ALT and a preoperative MRI study with contrast. An experienced musculoskeletal radiologist reviewed the images in two sessions, the first session with non-contrast only, and the second session, including postcontrast sequences.

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Adrenocortical carcinoma (ACC) is a rare condition with a poor and hardly predictable prognosis. This study aims to build and evaluate a preoperative computed tomography (CT)-based score (CT score) using features previously reported as biomarkers in ACC to predict overall survival (OS) in patients with ACC. A CT score based on preoperative CT examinations combining shape elongation, maximum tumour diameter, and the European Network for the Study of Adrenal Tumors (ENSAT) stage was built using a logistic regression model to predict OS duration in a development cohort of 89 patients with ACC.

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Article Synopsis
  • The study focuses on using radiomic features from contrast-enhanced CT scans to distinguish between osteoradionecrosis (ORN) and normal mandibular bone in head and neck cancer patients treated with radiotherapy.
  • Data from 150 patients was analyzed, with feature extraction performed using PyRadiomics and a Random Forest classifier used to identify key features, resulting in an accuracy of 88%.
  • The findings highlight specific radiomic features that can differentiate ORN from healthy tissue, paving the way for future research on early detection and intervention strategies.
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Meningiomas are the most common primary intracranial tumor in adults and can be associated with significant morbidity and mortality. Radiologists, neurosurgeons, neuro-oncologists, and radiation oncologists rely on multiparametric MRI (mpMRI) for diagnosis, treatment planning, and longitudinal treatment monitoring; yet automated, objective, and quantitative tools for non-invasive assessment of meningiomas on mpMRI are lacking. The BraTS meningioma 2023 challenge will provide a community standard and benchmark for state-of-the-art automated intracranial meningioma segmentation models based on the largest expert annotated multilabel meningioma mpMRI dataset to date.

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Article Synopsis
  • Automated brain tumor segmentation methods have reached a level of performance that is clinically useful, relying on MRI modalities like T1, T2, and FLAIR images.
  • These methods often face challenges due to missing sequences caused by issues like time constraints and patient motion, making it crucial to find ways to substitute missing modalities for better segmentation.
  • The Brain MR Image Synthesis Benchmark (BraSyn) was established to evaluate image synthesis techniques that can generate these missing MRI modalities, aiming to enhance the automation of brain tumor segmentation processes.
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The translation of AI-generated brain metastases (BM) segmentation into clinical practice relies heavily on diverse, high-quality annotated medical imaging datasets. The BraTS-METS 2023 challenge has gained momentum for testing and benchmarking algorithms using rigorously annotated internationally compiled real-world datasets. This study presents the results of the segmentation challenge and characterizes the challenging cases that impacted the performance of the winning algorithms.

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Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20%. Due to their rarity, the diagnosis of these entities is often delayed, their treatment is mainly based on historic treatment concepts, and clinical trials require multi-institutional collaborations.

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Deep learning (DL) has been proposed to automate image segmentation and provide accuracy, consistency, and efficiency. Accurate segmentation of lipomatous tumors (LTs) is critical for correct tumor radiomics analysis and localization. The major challenge of this task is data heterogeneity, including tumor morphological characteristics and multicenter scanning protocols.

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  • Hepatocellular carcinoma (HCC) is the most common type of liver cancer, and its occurrence has significantly increased due to various risk factors, though many cases are still found at later stages, complicating treatment options.
  • Treatments like transarterial chemo-embolization (TACE) can fail in up to 60% of patients, leading to significant financial and emotional stress.
  • Radiomics is being used to enhance treatment prediction by analyzing pre-procedural CT scans of HCC patients, allowing for better algorithm training to forecast how well tumors will respond to TACE.
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Background: The increasing use of computed tomography (CT) has identified many patients with incidental adrenal lesions. Further evaluation of these lesions is often dependent on the language used in the radiology report. Compared to the general population, patients with cancer have a higher risk for adrenal abnormalities, yet data on the prevalence and type of incidental adrenal lesions reported on radiologic reports in cancer patients is limited.

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Artificial intelligence (AI) is the most revolutionizing development in the health care industry in the current decade, with diagnostic imaging having the greatest share in such development. Machine learning and deep learning (DL) are subclasses of AI that show breakthrough performance in image analysis. They have become the state of the art in the field of image classification and recognition.

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The Peutz-Jeghers Syndrome (PJS) is an autosomal dominant neoplastic syndrome defined by hamartomatous polyps through the gastrointestinal tract, development of characteristic mucocutaneous pigmentations, and an elevated lifetime cancer risk. The majority of cases are due to a mutation in the STK11 gene located at 19p13.3.

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The lymphatic system is an anatomically complex vascular network that is responsible for interstitial fluid homeostasis, transport of large interstitial particles and cells, immunity, and lipid absorption in the gastrointestinal tract. This network of specially adapted vessels and lymphoid tissue provides a major pathway for metastatic spread. Many malignancies produce vascular endothelial factors that induce tumoral and peritumoral lymphangiogenesis, increasing the likelihood for lymphatic spread.

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Here we review artificial intelligence (AI) models which aim to assess various aspects of chronic liver disease. Despite the clinical importance of hepatocellular carcinoma in the setting of chronic liver disease, we focus this review on AI models which are not lesion-specific and instead review models developed for liver parenchyma segmentation, evaluation of portal circulation, assessment of hepatic fibrosis, and identification of hepatic steatosis. Optimization of these models offers the opportunity to potentially reduce the need for invasive procedures such as catheterization to measure hepatic venous pressure gradient or biopsy to assess fibrosis and steatosis.

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Article Synopsis
  • The study aimed to assess how well radiomic feature extraction and a machine learning algorithm can distinguish between benign and malignant indeterminate adrenal lesions identified through contrast-enhanced CT scans.
  • Adrenal incidentalomas are unexpected adrenal lesions detected during imaging for unrelated issues, and specific characteristics (size, pre-attenuation value, and absolute percentage of washout) help classify them as indeterminate, necessitating further evaluation.
  • The researchers identified 40 indeterminate lesions, processed CT images to extract relevant radiomic features, and developed a random forest classification model, ultimately narrowing down 3947 initial features to 62 final discriminative ones.
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Artificial Intelligence (AI) continues to shape the practice of radiology, with imaging of hepatocellular carcinoma (HCC) being of no exception. This article prepared by members of the LI-RADS Treatment Response (TR LI-RADS) work group and associates, presents recent trends in the utility of AI applications for the volumetric evaluation and assessment of HCC treatment response. Various topics including radiomics, prognostic imaging findings, and locoregional therapy (LRT) specific issues will be discussed in the framework of HCC treatment response classification systems with focus on the Liver Reporting and Data System treatment response algorithm (LI-RADS TRA).

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Purpose: In the clinical workflow of radiology services, a critical connection exists between technologists and radiologists, yet there is often limited communication between this key link in the chain of patient imaging. Our aim was to quantify and detail the communication between CT technologists and radiologists in our tertiary oncology practice.

Methods: Using the note function in our EMR, as standard operating procedure, CT technologists are instructed to place pertinent notes for the radiologist relevant to any portion of the patient encounter.

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Purpose: To evaluate the value of follow-up chest CT in the surveillance of HCC patients.

Background: Imaging guidelines for the surveillance of hepatocellular carcinoma (HCC) patients recommend multiple follow-up computed tomography (CT) examinations of the chest, abdomen, and pelvis. Imaging studies are a major driver of rising healthcare costs.

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There have been rapid advancements in cancer treatment in recent years, including targeted molecular therapy and the emergence of anti-angiogenic agents, which necessitate the need to quickly and accurately assess treatment response. The ideal tool is robust and non-invasive so that the treatment can be rapidly adjusted or discontinued based on efficacy. Since targeted therapies primarily affect tumor angiogenesis, morphological assessment based on tumor size alone may be insufficient, and other imaging modalities and features may be more helpful in assessing response.

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Hepatocellular carcinoma (HCC) is the most common liver malignancy and the leading cause of death in patients with cirrhosis. Various treatments for HCC are available, including transarterial chemoembolization (TACE), which is the commonest intervention performed in HCC. Radiologic tumor response following TACE is an important prognostic factor for patients with HCC.

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Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide, usually occurring on a background of liver cirrhosis. HCC is a highly vascular tumor in which angiogenesis plays a major role in tumor growth and spread. Tumor-induced angiogenesis is usually related to a complex interplay between multiple factors and pathways, with vascular endothelial growth factor being a major player in angiogenesis.

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Objectives: The objectives of the study are (1) to distinguish lipoma (L) from atypical lipomatous tumor (ALT) using MRI qualitative features, (2) to assess the value of contrast enhancement, and (3) to evaluate the reproducibility and confidence level of radiological readings.

Materials And Methods: Patients with pathologically proven L or ALT, who underwent MRI within 3 months from surgical excision were included in this retrospective multicenter international study. Two radiologists independently reviewed MRI centrally.

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