Dexter P. Mendoza's research while affiliated with Icahn School of Medicine at Mount Sinai and other places
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Publications (53)
Background: Chest imaging, including chest X-ray (CXR) and computed tomography (CT), can be a helpful adjunct to nucleic acid test (NAT) in the diagnosis and management of Coronavirus Disease 2019 (COVID-19). Lung point of care ultrasound (POCUS), particularly with handheld devices, is an imaging alternative that is rapid, highly portable, and more...
Introduction
Interventions and surgical procedures are common for nonmalignant lung lesions detected on lung cancer screening (LCS). Inadvertent surgical resection of benign nodules with a clinical suspicion of lung cancer can occur, can be associated with complications, and adds to the cost of screening. The objective of this study is to assess th...
Establishing a clinical education track as part of a radiology residency is essential in shaping future radiology educators. Many obstacles will be encountered while starting, maintaining, and improving these educational pathways. Hurdles may include recruiting suitable residents for the track, recruiting and supporting faculty advisors, sustaining...
Objective:
To quantify the association between computed tomography abdomen and pelvis with contrast (CTAP) findings and chest radiograph (CXR) severity score, and the incremental effect of incorporating CTAP findings into predictive models of COVID-19 mortality.
Methods:
This retrospective study was performed at a large quaternary care medical c...
To tune and test the generalizability of a deep learning-based model for assessment of COVID-19 lung disease severity on chest radiographs (CXRs) from different patient populations.
A published convolutional Siamese neural network-based model previously trained on hospitalized patients with COVID-19 was tuned using 250 outpatient CXRs. This model p...
Purpose
To assess radiology representation, multimedia content, and multilingual content of United States lung cancer screening (LCS) program websites.
Materials and methods
We identified the websites of US LCS programs with the Google internet search engine using the search terms lung cancer screening, low-dose CT screening, and lung screening. W...
The axilla contains several important structures which exist in a relatively confined anatomic space between the neck, chest wall, and upper extremity. While neoplastic lymphadenopathy may be among the most common axillary conditions, many other processes may be encountered. For example, expanded use of axillary vessels for access routes for endova...
Background: Lung-RADS category 3 and 4 nodules account for most cancers among screening-detected lung cancers and are considered actionable nodules with management implications. The cancer frequency among such nodules is estimated in the Lung-RADS recommendations and has been investigated primarily using retrospectively assigned Lung-RADS classific...
Background Isoattenuating and hyperattenuating thymic cysts at CT are often misinterpreted as lymphadenopathy or thymic epithelial neoplasms. Purpose To evaluate the longitudinal change in thymic cyst appearance at CT and MRI. Materials and Methods All chest MRI studies showing thymic cysts between July 2008 and December 2019, identified from a ret...
KRAS G12C mutations are important oncogenic mutations that confer sensitivity to direct G12C inhibitors. We retrospectively identified patients with KRAS+ NSCLC from 2015 to 2019 and assessed the imaging features of the primary tumor and the distribution of metastases of G12C NSCLC compared to those of non-G12C KRAS NSCLC and NSCLC driven by oncoge...
Objectives: To assess the diagnostic performance of lung point-of-care ultrasound (POCUS) compared to either a positive nucleic acid test (NAT) or a COVID-19-typical pattern on computed tomography (CT) and to evaluate opportunities to simplify a POCUS algorithm.
Methods: Hospital-admitted adult inpatients with (1) either confirmed or suspected COVI...
Background: Previous studies have compared CT findings of COVID-19 pneumonia with those of other infections; however, to our knowledge, no studies have included non-infectious organizing pneumonia (OP) as a comparison group. Objective: To compare chest CT features of COVID-19, influenza, and OP using a multireader design, and to assess radiologists...
Reports are rising of patients with unilateral axillary lymphadenopathy, visible on diverse imaging examinations, after recent coronavirus disease 2019 vaccination. With less than 10% of the US population fully vaccinated, we can prepare now for informed care of patients imaged after recent vaccination. The authors recommend documenting vaccination...
Background and purpose:
Severe respiratory distress in patients with COVID-19 has been associated with higher rate of neurologic manifestations. Our aim was to investigate whether the severity of chest imaging findings among patients with coronavirus disease 2019 (COVID-19) correlates with the risk of acute neuroimaging findings.
Materials and me...
Rationale and Objectives
Radiographic findings of COVID-19 pneumonia can be used for patient risk stratification; however, radiologist reporting of disease severity is inconsistent on chest radiographs (CXRs). We aimed to see if an artificial intelligence (AI) system could help improve radiologist interrater agreement.
Materials and Methods
We per...
Background: Incidental findings are frequently encountered during lung cancer screening (LCS). Limited data describe the prevalence of suspected acute infectious and inflammatory lung processes on LCS and how they should be managed. Objective: To determine the prevalence, radiologic reporting and management, and outcome of suspected infectious and...
The first year of radiology residency presents many unique challenges, from transitioning into a completely new, specialized field to preparing for call. Implementation of a longitudinal lecture series dedicated towards the clinical demands of being a first-year radiology resident may improve their knowledge and comfort level, as well as benefit th...
Purpose: The aims of this study were to determine the prevalence and outcomes of extrapulmonary malignancies identified on lung cancer screening (LCS) and to determine the cost associated with the investigation of these lesions.
Methods: This retrospective study included 7,414 low-dose CT studies performed between June 2014 and December 2019 on 4,...
Background
Non–small-cell lung cancer (NSCLC) in young adult patients is rare, with scarce data available in patients aged < 40 years and even less in those aged < 35 years. Our goal was to determine the presenting symptoms, clinicopathologic characteristics, and imaging features of young patients with NSCLC at time of diagnosis and compare them to...
Background:
RSNA expert consensus guidelines provide a framework for reporting CT findings related to COVID-19, but have had limited multireader validation.
Purpose:
To assess the performance of the RSNA guidelines and quantify interobserver variability in application of the guidelines in patients undergoing chest CT for suspected COVID-19 pneum...
Purpose: To improve and test the generalizability of a deep learning-based model for assessment of COVID-19 lung disease severity on chest radiographs (CXRs) from different patient populations.
Materials and Methods: A published convolutional Siamese neural network-based model previously trained on hospitalized patients with COVID-19 was tuned usin...
Rationale and Objectives
While affiliated imaging centers play an important role in healthcare systems, little is known of how their operations are impacted by the COVID-19 pandemic. Our goal was to investigate imaging volume trends during the pandemic at our large academic hospital compared to the affiliated imaging centers.
Materials and Methods...
Background:
Lung cancer associated with cystic airspaces (LC-CAS) is an uncommon morphology that is under recognized on imaging. There is also limited understanding of its underlying pathology and risk factors. These can contribute to delays in diagnosis.
Evidence acquisition:
In accordance with Preferred Reporting Items for Systematic Reviews a...
Lung cancer remains the leading cause of cancer-related deaths worldwide. The treatment of non-small cell lung cancer (NSCLC), which accounts for a vast majority of lung cancers, has shifted to personalized, targeted therapy following discoveries of several targetable oncogenic mutations. Targeting of specific mutations has improved outcomes in man...
Background: Disease severity on chest radiographs (CXR) has been associated with higher risk of disease progression and adverse outcomes from COVID-19. Few studies have evaluated COVID-19-related racial/ethnic disparities in radiology. Purpose: To evaluate whether Non-White minority patients hospitalized with confirmed COVID-19 infection presented...
Background:
The clinical features and traditional semantic imaging characteristics of BRAF-mutated non-small cell lung cancer (NSCLC) have been previously reported. The radiomic features of BRAF-mutated NSCLC and their role in predicting cancer stage, however, have yet to be investigated. This study's goal is to assess the differences in CT radiom...
Purpose:
To develop an automated measure of COVID-19 pulmonary disease severity on chest radiographs (CXRs), for longitudinal disease tracking and outcome prediction.
Materials and methods:
A convolutional Siamese neural network-based algorithm was trained to output a measure of pulmonary disease severity on CXRs (pulmonary x-ray severity (PXS)...
Background:
Computed tomography (CT) imaging findings in the lungs in the setting of an acute allergic response and following bronchoalveolar lavage (BAL) are not well established. Our goals are to characterize the pulmonary CT findings of acute allergic response in both asthmatic and non-asthmatic subjects and, secondarily, to characterize the pu...
Purpose:
The purpose of this article was to report the utility of computed tomography (CT) for detecting unsuspected cases of Coronavirus disease 2019 (COVID-19) and the utility of the Radiological Society of North America (RSNA)/Society of Thoracic Radiology (STR)/American College of Radiology (ACR) consensus guidelines for COVID-19 reporting.
M...
Purpose:
To investigate pulmonary vascular abnormalities at CT pulmonary angiography (CT-PE) in patients with coronavirus disease 2019 (COVID-19) pneumonia.
Materials and methods:
In this retrospective study, 48 patients with reverse-transcription polymerase chain reaction-confirmed COVID-19 infection who had undergone CT-PE between March 23 and...
Background:
Esophago-airway fistula (EAF) is an abnormal connection between the esophagus and the trachea or a major bronchus. While contrast esophagography remains the primary radiographic tool for the diagnosis of EAF, computed tomography (CT) is often employed in its evaluation. A systematic analysis of CT findings of EAF in adults has not been...
Purpose
To develop an automated measure of COVID-19 pulmonary disease severity on chest radiographs (CXRs), for longitudinal disease evaluation and clinical risk stratification.
Materials and Methods
A convolutional Siamese neural network-based algorithm was trained to output a measure of pulmonary disease severity on anterior-posterior CXRs (pulmo...
Rearranged during transfection proto-oncogene (RET) fusions represent a potentially targetable oncogenic driver in non-small cell lung cancer (NSCLC). Imaging features and metastatic patterns of advanced RET fusion-positive (RET+) NSCLC are not well established. Our goal was to compare the imaging features and patterns of metastases in RET+, ALK+ a...
Importance
The internet is an important source of medical information for many patients and may have a key role in the education of patients about lung cancer screening (LCS). Although most LCS programs in the United States have informational websites, the accuracy, completeness, and readability of these websites have not previously been studied....
OBJECTIVE.ALK rearrangements are an established targetable oncogenic driver in non-small cell lung cancer (NSCLC). The goal of this study was to determine the imaging features of the primary tumor and metastatic patterns in advanced ALK-rearranged (ALK+) NSCLC that may be different from those in EGFR-mutant (EGFR+) or EGFR/ALK wild-type (EGFR-/ALK-...
MET exon 14 (METex14) skipping mutations are an emerging potentially targetable oncogenic driver mutation in non-small-cell lung cancer (NSCLC). The imaging features and patterns of metastasis of NSCLC with primary METex14 skipping mutations (METex14-mutated NSCLC) are not well described. Our goal was to determine the clinicopathologic and imaging...
A 34-year-old man was admitted to the hospital because of dyspnea. An antibody differentiation assay confirmed a diagnosis of human immunodeficiency virus type 1 infection, and chest imaging was notable for diffuse ground-glass opacities. After treatment for Pneumocystis jirovecii pneumonia was initiated, acute abdominal pain developed. A diagnosti...
Background:
Coronary artery calcification (CAC) is a common and important incidental finding in low-dose computed tomography (LDCT) performed for lung cancer screening (LCS). The impact of these incidental findings on patient management is unclear.
Purpose:
The goals of our study were to determine the impact of reporting CAC on patient managemen...
Background:
ROS proto-oncogene 1 (ROS1) rearrangements are a known molecular target in non-small-cell lung cancer (NSCLC). Our goal was to determine whether ROS1-rearranged NSCLC has imaging features and patterns of metastasis, which differ from those of anaplastic lymphoma kinase (ALK)-rearranged or epidermal growth factor receptor (EGFR)-mutant...
Diffuse lung metastases have been reported in non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations. The purpose of our study was to compare the incidence of diffuse lung metastases in EGFR-mutant NSCLC and EGFR-wild type NSCLC and to assess other imaging features that may be associated with diffuse lung met...
A 44-year-old man was admitted to the hospital because of pain and swelling on the left side of the neck, which developed 12 weeks after placement of an implantable cardioverter–defibrillator. CT revealed a 4-cm heterogeneous soft-tissue mass located deep to the sternocleidomastoid muscle. Additional diagnostic tests were performed.
Objectives:
The objective of this study was to determine the effect of a lobectomy to the location and orientation of nonresected lung nodule and its corresponding airway.
Methods:
We reviewed preoperative and postoperative computed tomography of patients who underwent lobectomies and have a separate nonresected nodule in the ipsilateral lung. D...
Introduction:
Several studies have suggested that non-small-cell lung cancer (NSCLC) patients who harbor anaplastic lymphoma kinase (ALK) rearrangement might have different imaging features compared with those without the rearrangement. The goal of this work was to systematically investigate the computed tomography (CT) imaging features of ALK-rea...
Objectives:
Mutations in the BRAF gene have emerged as a validated molecular target in the treatment of non-small cell lung cancer (NSCLC). These mutations can be classified into three functional classes based on their mechanisms of oncogenesis. The relationship between these functional classes and their imaging features has not been systematicall...
Purpose:
The objective of this study was to assess the reliability of ancillary imaging findings in distinguishing acute from chronic aortic dissection (AD) and intramural hematoma (IMH) using computed tomography angiography (CTA).
Materials and methods:
Two radiologists specializing in cardiothoracic and vascular imaging reviewed paired CTAs of...
Research and other scholarly activities are an important and required component of diagnostic radiology training. Several strategies, both at the departmental and the larger organizational levels, have been implemented to encourage radiology trainees to participate in these activities. In this article, we review and discuss our institution's 10-yea...
Effective and dedicated educators are critical to the preservation and advancement of the practice of radiology. The need for innovative and adaptable educators is increasingly being recognized, with several institutions granting academic promotions through clinician-educator tracks. The implementation of resident "clinician-educator tracks" or "te...
Citations
... LUS also offers reduced radiation exposure, reduced chances of disease transmission between patients, and portability when compared to CT [17]. LUS with even a handheld POCUS device showed reasonable diagnostic ability to detect patients with a COVID-19 diagnosis [18]. LUS can be used at all steps during the hospitalization of a patient to evaluate for COVID-19 from triage and diagnosis to serial follow-up exams [19]. ...
Reference: Artificial Intelligence in Lung Ultrasound
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... In [37], a transfer learning method is applied from a large dataset to a small one to show a clear relationship between a lung severity score rating and automated model prediction. Improved generalizability was attained in a subsequent study by the same authors [38]. In [39], pneumonia localization networks were used to produce a geographic extent severity score that was annotated and linked with experts' evaluations on 94 CXRs in addition to lung segmentation models. ...
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... || "Other" includes "Fluid/water," "Fat," "Other," and "Unable to determine" (decided by NLST radiologists Table 2 shows the test AUC, true-positive rate (sensitivity), and true-negative rate (specificity) achieved by the different models for subgroup nodules categorized by the Lung-RADS at the baseline screening year. The nodules in categories of Lung-RADS 3 and 4A are considered indeterminate nodules that require immediate attention with 6-or 3-month LDCT follow-up (29)(30)(31) Figure 3 shows some nodule classification examples by using the S-RRL model and the Brock model. ...
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... However, these cysts did show mural calcification and change in size, CT attenuation, and MRI signal over more than 5 years of follow-up. 40 ...
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... We did not find a statistically significant difference between the groups based on mutation subtype. G12C KRAS mutant lung cancers have been reported to be likely to have a cavitary primary tumour with a higher frequency of lung metastases [18]. Relative to NSCLC with fusion rearrangements, a lower frequency of pleural metastases and lymphangitic carcinomatosis have been reported in G12C KRAS mutant lung cancers; brain and soft tissue metastases are, however, more common. ...
... The crazy paving pattern seen in more severe patients is characterised by thickened interlobular septa superimposed on GGO. Lesion distribution within different lung segments and lobes and the evolution of GGO into consolidation or fibrotic changes can be tracked over time by serial CT scans [65,66]. Serial CT scans are valuable for monitoring disease progression, resolution and development of complications ( pleural effusions, pneumothorax, abscess formation, pulmonary fibrosis) [67]. ...
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... It primarily appears 2-4 days after the vaccine is administered, and the duration is between 2 and 4 weeks. Although, in our series of cases we only found adenopathies at the node level I, they have also been found at levels II and III [5][6][7][8] . ...
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... Based on these findings, the extent of lung involvement during SARS-CoV-2 infection does not correlate with the likelihood of CNS involvement. Our results are in agreement with Lang et al. 15 findings, but Mahammedi et al. declared that lung severity scores were higher among patients with abnormal brain imaging. 16 We should emphasize that the main brain imaging that we used was brain CT which is not very sensitive in detecting different types of brain pathology. ...
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... A study published by Rangarajan et al. [24], by enrolling 236 healthy CXRs, 47 classical and 138 indeterminate for COVID-19 pneumonia CXRs, reported that AI (the CheXnet deep neural network) showed 92% accuracy in classifying "normal" CXR into COVID or non-COVID. Moreover, Li et al. [25], by enrolling 154 CXRs with typical COVID-19 findings, aimed to determine the usefulness of AI-based methods (convolutional Siamese neural network) to implement diagnostic reliability among radiologists, reporting that the agreement can increase significantly when AI is applied to clinical practice. ...
... Many false-positive examinations detected infectious or inflammatory nodules that eventually resolve on followup. [12][13][14] There are, however, limited data on surgically resected benign nodules considered malignant before surgery. The objectives of our study are to determine the rate of resections for benign nodules that were presumed malignant in a large established LCS program and determine the imaging and pathologic features of these nodules. ...
