Publications by authors named "Brian A Derstine"

Purpose: Early detection of steatotic liver disease (SLD) is critically important. In clinical practice, hepatic steatosis is frequently diagnosed using computed tomography (CT) performed for unrelated clinical indications. An equation for estimating magnetic resonance proton density fat fraction (MR-PDFF) using liver attenuation on non-contrast CT exists, but no equivalent equation exists for post-contrast CT.

View Article and Find Full Text PDF

Background: The Joint Trauma System (JTS)'s resuscitative endovascular balloon occlusion of the aorta (REBOA) positioning guidance is derived from a predominantly male patient population. We aimed to validate these measurements in women.

Methods: Aortic computed tomography scans of 404 women from a trauma patient data set were analyzed.

View Article and Find Full Text PDF
Article Synopsis
  • Sarcopenia refers to the decline in muscle mass and function that occurs with aging, and assessing it through CT scans involves looking at muscle area, fat content in muscles, and adjusting for body size.
  • It’s important to standardize muscle area measurements for height and BMI to get accurate assessments of low muscle mass, and using specific vertebrae locations can optimize these adjustments.
  • The study analyzed CT scan data from healthy kidney donors to evaluate muscle measurements across various vertebrae, aiming to establish reference values and determine the best methods for normalizing these measurements.
View Article and Find Full Text PDF

Rib fractures remain the most frequent thoracic injury in motor vehicle crashes. Computational human body models (HBMs) can be used to simulate these injuries and design mitigation strategies, but they require adequately detailed geometry to replicate such fractures. Due to a lack of rib cross-sectional shape data availability, most commercial HBMs use highly simplified rib sections extracted from a single individual during original HBM development.

View Article and Find Full Text PDF

Evidence supporting aortic calcification as a leverageable cardiovascular risk factor is rapidly growing. Given aortic calcification's potential as a clinical correlate, we assessed granular vertebral-indexed calcification measurements of the abdominal aorta in a well curated reference population. We evaluated the relationship of aortic calcification measurements with Framingham risk scores.

View Article and Find Full Text PDF

Background: CT contrast media improves vessel visualization but can also confound calcification measurements. We evaluated variance in aorta attenuation from varied contrast-enhancement scans, and quantified expected plaque detection errors when thresholding for calcification.

Methods: We measured aorta attenuation (AoHU) in central vessel regions from 10K abdominal CT scans and report AoHU relationships to contrast phase (non-contrast, arterial, venous, delayed), demographic variables (age, sex, weight), body location, and scan slice thickness.

View Article and Find Full Text PDF

Rib fractures are a common and serious outcome of blunt thoracic trauma and their likelihood is greater in older individuals. Osteoporotic bone loss is a well-documented aging phenomenon with sex-specific characteristics, but within rib bones, neither baseline maps of regional thickness nor the rates of bone thinning with age have been quantified across whole ribs. This study presents such data from 4014 ribs of 240 adult subjects aged 20-90.

View Article and Find Full Text PDF

Measurements of visceral adipose tissue cross-sectional area and radiation attenuation from computed tomography (CT) scans provide useful information about risk and mortality. However, scan protocols vary, encompassing differing vertebra levels and utilizing differing phases of contrast enhancement. Furthermore, fat measurements have been extracted from CT using different Hounsfield Unit (HU) ranges.

View Article and Find Full Text PDF

Aims: Patients with low muscle mass have increased risk of paclitaxel-induced peripheral neuropathy, which is dependent on systemic paclitaxel exposure. Dose optimization may be feasible through the secondary use of radiologic data for body composition. The objective of this study was to interrogate morphomic parameters as predictors of paclitaxel pharmacokinetics to identify alternative dosing strategies that may improve treatment outcomes.

View Article and Find Full Text PDF

Background: Aortic wall calcification shows strong promise as a cardiovascular risk factor. While useful for visual enhancement of vascular tissue, enhancement creates heterogeneity between scans with and without contrast. We evaluated the relationship between aortic calcification in routine abdominal computed tomography scans (CT) with and without contrast.

View Article and Find Full Text PDF

The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. By assuming that vulnerable road users (VRUs) have limited protection resulting from vehicles and safety equipment, the current study analyzed the characteristics of fat distribution measured by computed tomography (CT) imaging and investigated the existence of a "cushion effect" in VRUs. This retrospective study enrolled 592 VRUs involved in MVCs who underwent CT scans.

View Article and Find Full Text PDF

:Lung volume reduction surgery continues to have a high morbidity despite National Emphysema Treatment Trial selection criteria. This study evaluated the association between analytic morphomics on chest computed tomography scans and outcomes after lung volume reduction surgery. In a retrospective review of 85 lung volume reduction surgery patients from 1998-2013, dorsal muscle group area, subcutaneous and visceral fat area, and bone mineral density were assessed using analytic morphomics.

View Article and Find Full Text PDF

Background: Frailty has been shown to be an independent negative predictor of surgical outcomes in geriatric patients. Traditional measurements of muscle strength and mass are impractical in emergency settings, and computed tomography (CT)-measured skeletal muscle mass has been proposed as an alternative. However, the cutoff values for low muscle mass are still unknown, and their impact on abdominal emergencies in the elderly population is unclear.

View Article and Find Full Text PDF

Measurements of skeletal muscle cross-sectional area (SMA) at the level of the third lumbar (L3) vertebra derived from clinical computed tomography (CT) scans are commonly used in assessments of sarcopenia, the loss of skeletal muscle mass and function associated with aging. As SMA is correlated with height and Body Mass Index (BMI), body size adjustment is necessary to fairly assess sarcopenic low muscle mass in individuals of different height and BMI. The skeletal muscle index, a widely used measure, adjusts for height as [Formula: see text] but uses no BMI adjustment.

View Article and Find Full Text PDF

Purpose: The key landmark for tip position of a central venous catheter (CVC) is the SVC-RA junction. In adults, localization of the SVC-RA junction may be assessed as a function of vertebral body units (VBU) below the carina during CVC placement. We investigated the relationship between the SVC-RA junction and the carina in children.

View Article and Find Full Text PDF
Article Synopsis
  • Sarcopenia negatively impacts various diseases, and measuring skeletal muscle in acute patients is often difficult; this study uses psoas muscle area via CT imaging as an alternative in trauma cases.
  • Researchers analyzed CT scans of 939 trauma patients to calculate the psoas muscle index (PMI) and determined sex-specific cut-off values for extremely low psoas muscle index (ELPMI).
  • Findings show that males have higher PMIs, which decrease with age, and that ELPMI is an independent predictor of longer ICU stays, suggesting these cut-off values may be applicable in other acute diseases.
View Article and Find Full Text PDF

Background: In patients undergoing neoadjuvant chemoradiotherapy (nCRT) followed by surgery for locally advanced esophageal squamous cell carcinoma (ESCC), patients with a pathologic complete response (pCR) have the greatest benefit. The purpose of this study was to identify morphomic factors obtained from pretreatment computed tomography scans associated with a pCR in ESCC.

Methods: We retrospectively analyzed patients with ESCC treated with nCRT who underwent esophagectomy between 2006 and 2016.

View Article and Find Full Text PDF

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a valuable resuscitative adjunct in a variety of clinical settings. In resource-limited or emergency environments, REBOA may be required with delayed or absent image-guidance or verification. Catheter insertion lengths may be informed by making computed tomography (CT) correlations of skeletal landmarks with vascular lengths.

View Article and Find Full Text PDF

Here we present detailed regional bone thickness and cross-sectional measurements from full adult ribs using high resolution CT scans processed with a cortical bone mapping technique. Sixth ribs from 33 subjects ranging from 24 to 99 years of age were used to produce average cortical bone thickness maps and to provide average ± 1SD corridors for expected cross-section properties (cross-sectional areas and inertial moments) as a function of rib length. Results obtained from CT data were validated at specific rib locations using direct measurements from cut sections.

View Article and Find Full Text PDF

Measurements of skeletal muscle cross-sectional area, index, and radiation attenuation utilizing clinical computed tomography (CT) scans are used in assessments of sarcopenia, the loss of skeletal muscle mass and function associated with aging. To classify individuals as sarcopenic, sex-specific cutoffs for 'low' values are used. Conventionally, cutoffs for skeletal muscle measurements at the level of the third lumbar (L3) vertebra are used, however L3 is not included in several clinical CT protocols.

View Article and Find Full Text PDF

This study assesses the ability to measure local cortical bone thickness, and to obtain mechanically relevant properties of rib cross-sections from clinical-resolution computed tomography (CT) scans of human ribs. The study utilized thirty-four sections of ribs published by Perz et al. (2015) in three modalities: standard clinical CT (clinCT), high-resolution clinical CT (HRclinCT), and microCT (µCT).

View Article and Find Full Text PDF

Purpose: The purpose of the study is to determine whether a novel semi-automated DIXON-based fat quantification algorithm can reliably quantify visceral fat using a CT-based reference standard.

Methods: This was an IRB-approved retrospective cohort study of 27 subjects who underwent abdominopelvic CT within 7 days of proton density fat fraction (PDFF) mapping on a 1.5T MRI.

View Article and Find Full Text PDF

Background: Granular diagnostic criteria for adult malnutrition are lacking.

Objective: This study uses analytic morphomics to define the Morphomic Malnutrition Score (MMS), a robust screening tool for severe malnutrition.

Methods: The study population (n = 643) consisted of 2 cohorts: 1) 124 emergency department patients diagnosed with severe malnutrition by a registered dietitian (RD) and an available computed tomography (CT) scan within 2 days of RD evaluation, and 2) 519 adult kidney donor candidates to represent a healthy cohort.

View Article and Find Full Text PDF

A consistent approach to the dosing of aminoglycosides across the modern body size distribution has been elusive. We evaluated whether radiologically derived measures of body composition could explain more of the interpatient variability in aminoglycoside pharmacokinetics (PK) than standard body size metrics. This retrospective study included adult patients treated with gentamicin or tobramycin with at least three drug concentrations and computed tomography (CT) imaging available.

View Article and Find Full Text PDF

Background: The "Cushion Effect," the phenomenon in which obesity protects against abdominal injury in adults in motor vehicle accidents, has not been evaluated among pediatric patients. This work evaluates the association between subcutaneous fat cross-sectional area, quantified using analytic morphomic techniques and abdominal injury.

Methods: This retrospective study includes 119 patients aged 1 to 18years involved in frontal impact motor vehicle accidents (2003-2015) with computed tomography scans.

View Article and Find Full Text PDF