Browsing by Author "Gonzalez, Fernando"
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Item Correlation of preoperative imaging characteristics with donor outcomes and operative difficulty in laparoscopic donor nephrectomy(2020) Schwartz, Fides R; Shaw, Brian I; Lerebours, Reginald; Vernuccio, Federica; Rigiroli, Francesca; Gonzalez, Fernando; Luo, Sheng; Rege, Aparna S; Vikraman, Deepak; Hurwitz-Koweek, Lynne; Marin, Daniele; Ravindra, KadiyalaThis study aimed to understand the relationship of preoperative measurements and risk factors on operative time and outcomes of laparoscopic donor nephrectomy. Two hundred forty-two kidney donors between 2010 and 2017 were identified. Patients' demographic, anthropomorphic, and operative characteristics were abstracted from the electronic medical record. Glomerular filtration rates (GFR) were documented before surgery, within 24 hours, 6, 12, and 24 months after surgery. Standard radiological measures and kidney volumes, and subcutaneous and perinephric fat thicknesses were assessed by three radiologists. Data were analyzed using standard statistical measures. There was significant correlation between cranio-caudal and latero-lateral diameters (P < .0001) and kidney volume. The left kidney was transplanted in 92.6% of cases and the larger kidney in 69.2%. Kidney choice (smaller vs. larger) had no statistically significant impact on the rate of change of donor kidney function over time adjusting for age, sex and race (P = .61). Perinephric fat thickness (+4.08 minutes) and surgery after 2011 were significantly correlated with operative time (P ≤ .01). In conclusion, cranio-caudal diameters can be used as a surrogate measure for volume in the majority of donors. Size may not be a decisive factor for long-term donor kidney function. Perinephric fat around the donor kidney should be reported to facilitate operative planning.Item Variability of quantitative measurements of metastatic liver lesions: a multi‑radiation‑dose‑level and multi‑reader comparison(2020) Ding, Yuqin; Marin, Daniele; Vernuccio, Federica; Gonzalez, Fernando; Williamson, Hannah V.; Becker, Hans‑Christoph; Patel, Bhavik N.; Solomon, Justin; Ramirez‑Giraldo, Juan Carlos; Samei, Ehsan; Nelson, Rendon C.; Meyer, MathiasPurpose To evaluate the variability of quantitative measurements of metastatic liver lesions by using a multi-radiation-doselevel and multi-reader comparison. Methods Twenty-three study subjects (mean age, 60 years) with 39 liver lesions who underwent a single-energy dual-source contrast-enhanced staging CT between June 2015 and December 2015 were included. CT data were reconstructed with seven different radiation dose levels (ranging from 25 to 100%) on the basis of a single CT acquisition. Four radiologists independently performed manual tumor measurements and two radiologists performed semi-automated tumor measurements. Interobserver, intraobserver, and interdose sources of variability for longest diameter and volumetric measurements were estimated and compared using Wilcoxon rank-sum tests and intraclass correlation coefficients. Results Inter- and intraobserver variabilities for manual measurements of the longest diameter were higher compared to semi-automated measurements (p < 0.001 for overall). Inter- and intraobserver variabilities of volume measurements were higher compared to the longest diameter measurement (p < 0.001 for overall). Quantitative measurements were statistically different at < 50% radiation dose levels for semi-automated measurements of the longest diameter, and at 25% radiation dose level for volumetric measurements. The variability related to radiation dose was not significantly different from the inter- and intraobserver variability for the measurements of the longest diameter. Conclusion The variability related to radiation dose is comparable to the inter- and intraobserver variability for measurements of the longest diameter. Caution should be warranted in reducing radiation dose level below 50% of a conventional CT protocol due to the potentially detrimental impact on the assessment of lesion response in the liver.