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5 results on '"Parameswaran, Aishwarya"'

1. Value of pelvis CT during follow-up of patients with pancreatic adenocarcinoma

Author

Bailey, Jason J, Ellis, James H, Davenport, Matthew S, Cohan, Richard H, Nan, Bin, Parameswaran, Aishwarya, Hsu, Lin, Sahai, Vaibhav, and Francis, Isaac R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Digestive Diseases, Pancreatic Cancer, Rare Diseases, Biomedical Imaging, Clinical Research, Cancer, Adenocarcinoma, Adult, Carcinoma, Pancreatic Ductal, Female, Humans, Lymphatic Metastasis, Male, Neoplasm Metastasis, Pancreatic Neoplasms, Pelvis, Registries, Retrospective Studies, Tomography, X-Ray Computed, Pancreatic adenocarcinoma, CT protocol, Pancreaticoduodenectomy, Isolated pelvic metastases, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

PurposeThe purpose of this study was to determine the frequency in which the pelvis component of an abdominopelvic CT provides information that would influence clinical management in two separate groups of patients: those with previously resected pancreatic ductal adenocarcinoma (PDA) and those with locally advanced unresectable PDA.MethodsThis institutional review-board approved HIPAA compliant retrospective study with waived informed consent included 247 subjects with histologically proven PDA, including 153 subjects post-pancreaticoduodenectomy and 94 subjects with locally advanced unresectable disease. Imaging reports interpreted between January 2005 and December 2013 were obtained from our institution's Radiology Information System by searching a Cancer Registry database of PDA patients separately for the words "whipple" and "unresectable." CT findings were separated by location in the abdomen or pelvis, and subsequently reviewed and graded for their likelihood of representing metastatic disease. The probability of pelvic CT influencing clinical management-i.e., of finding isolated pelvic metastatic disease-was determined using 95% binomial proportion confidence intervals for both the post-pancreaticoduodenectomy and locally advanced unresectable groups.ResultsNo subjects who had undergone pancreaticoduodenectomy had an isolated pelvic metastasis on follow-up imaging (0%; 95% CI 0-2.38, p = 0.0004); 33 had metastatic disease in the abdomen, and 120 had no or equivocal evidence of abdominopelvic metastatic disease. One subject with locally advanced unresectable PDA had a possible isolated pelvic metastasis on follow-up imaging (1.1%; 95% CI 0.03-5.79, p = 0.048); 20 had metastatic disease in the abdomen, and 73 had no or equivocal evidence of abdominopelvic metastatic disease.ConclusionIsolated pelvic metastatic disease rarely occurs in patients with PDA who have had prior pancreaticoduodenectomy or have a locally advanced unresectable primary tumor, suggesting routine pelvic CT in follow-up imaging of these patients may not be necessary.

Published
2017

2. Pharmacokinetics and Safety of High-Dose Intravenous Valproic Acid in Healthy Subjects: A Dose Escalation Trial To Support Clinical Translational Studies

Author

Georgoff, Patrick E., Nikolian, Vahagn C., Bonham, Tess, Pai, Manjunath P., Tafatia, Celia, Halaweish, Ihab, To, Kathleen, Watcharotone, Kuanwong, Parameswaran, Aishwarya, Lao, Ruijuan, Sun, Duxin, and Alam, Hasan B.

Subjects
Adult, Male, Adolescent, Dose-Response Relationship, Drug, Maximum Tolerated Dose, Valproic Acid, Middle Aged, Models, Biological, Article, Histone Deacetylase Inhibitors, Young Adult, Double-Blind Method, Humans, Administration, Intravenous, Female
Abstract

Valproic acid, a histone deacetylase inhibitor, has beneficial effects in the setting of cancer, neurologic diseases, and traumatic injuries. In animal models of traumatic injury, a single dose of valproic acid has been shown to reduce mortality. The purpose of this trial was to determine the maximum tolerated single dose of intravenous valproic acid in healthy humans.A double-blinded, placebo-controlled, dose-escalation trial design was used to identify dose-limiting toxicities in healthy subjects who received a single dose of intravenous valproic acid. Patients were monitored for adverse events and data were collected for pharmacokinetic, pharmacodynamic, and safety profiling of valproic acid.Fifty-nine healthy subjects (mean 30 ± 12 years) were enrolled. Forty-four subjects received valproic acid in doses from 15 to 150 mg/kg. The most common adverse events were hypoacusis (n = 19), chills (n = 18), and headache (n = 16). The maximum tolerated dose was 140 mg/kg. Dose-limiting toxicities included headache and nausea lasting longer than 12 h. No drug-related abnormalities were seen in other safety measures including laboratory tests, hemodynamic parameters, cardiac rhythm monitoring, and cognitive testing. A two-compartment model was predictive of valproic acid concentration-time profiles, with a strong correlation (RThe maximum tolerated dose of intravenous valproic acid in healthy subjects is 140 mg/kg. This is significantly higher than the previously established maximum tolerated dose of 60-75 mg/kg. Next, the safety and tolerability of high-dose valproic acid will be tested in trauma patients in hemorrhagic shock. ClinicalTrials.gov Identifier: NCT01951560.

Published
2018

3. Effect of hyperglycemia on brain and liver 18F-FDG standardized uptake value (FDG SUV) measured by quantitative positron emission tomography (PET) imaging

Author

Viglianti, Benjamin L, Wong, Ka Kit, Wimer, Stephanie M, Parameswaran, Aishwarya, Nan, Bin, Ky, Christy, Townsend, Danyelle M, Rubello, Domenico, Frey, Kirk A, and Gross, Milton D

Subjects
Blood Glucose, Male, Clinical Trials and Supportive Activities, Quantitative imaging, Bioengineering, Basal Ganglia, Fluorodeoxyglucose F18, Clinical Research, Humans, Oncology & Carcinogenesis, Liver Disease, Brain, (18)F-FDG biodistribution, Pharmacology and Pharmaceutical Sciences, Middle Aged, PET, Liver, Hyperglycemia, Positron-Emission Tomography, Multivariate Analysis, Linear Models, Biomedical Imaging, Female, Digestive Diseases, PERCIST, Alzheimer’s
Abstract

PurposeBlood glucose is routinely measured prior to 18F-fluorodeoxyglucose (FDG) administration in positron emission tomography (PET) imaging to identify hyperglycemia that may affect image quality. In this study we explore the effects of blood glucose levels upon semi-quantitative standardized uptake value (SUV) measurements of target organs and tissues of interest and in particular address the relationship of blood glucose to FDG accumulation in the brain and liver.Methods436 FDG PET/CT consecutive studies performed for oncology staging in 229 patients (226 male) at the Ann Arbor Veterans Administration Healthcare System were reviewed. All patients had blood glucose measured (112.4±34.1mg/dL) prior to injection of 466.2±51.8MBq (12.6±1.4mCi) of FDG. SUV measurements of brain, aortic arch blood-pool, liver, and spleen were obtained at 64.5±10.2min' post-injection.ResultsWe found a negative inverse relationship of brain SUV with increasing plasma glucose, levels for both absolute and normalized (either to blood-pool or liver) values. Higher blood glucose levels had a mild effect upon liver and blood-pool SUV. By contrast, spleen SUV was independent of blood glucose, but demonstrated the greatest variability (deviation on linear regression). In contrast to other tissues, liver and spleen SUV normalized to blood-pool SUV were not dependent upon blood glucose levels.ConclusionThe effects of hyperglycemia upon FDG uptake in brain and liver, over a range of blood glucose values generally considered acceptable for clinical PET imaging, may have measurable effects on semi-quantitative image analysis.

Published
2017

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