Cicero Silva MD
Associate Professor of Diagnostic Radiology
Neonatal imaging; hi-resolution ultrasound applications; pediatric oncology
My research and scholarly contributions involve mainly the imaging of the pediatric chest and abdomen. This is a field that, although exciting, historically has attracted relatively few investigators and little funding. Consequently, discoveries in this area usually lag their adult counterparts. My research and educational endeavors aim to close that gap, taking advantage of the cutting-edge equipment available at Yale Diagnostic Radiology.
Extensive Research Description
I have co-authored studies on the use of ultrasound in the evaluation of the neonatal gastrointestinal tract. Necrotizing enterocolitis (NEC) is the most common neonatal gastrointestinal emergency, potentially leading to death. Its diagnosis has traditionally relied on radiographs. My colleagues and I have recently shown that ultrasound can be used for early diagnosis of NEC , when the radiographs are still nonspecific. That discovery may potentially impact on disease outcome, as early diagnosis and treatment have been shown to decrease morbidity and mortality. On a previous study  we had shown that ultrasound can be used to stratify patients and identify those that may need surgery, before corresponding changes are apparent on radiographs. That study has been pivotal in helping establish the clinical use of ultrasound in NEC, has won a Walter E. Berdon award for best paper published in Pediatric Radiology, and has stimulated an extensive body of subsequent related research (more than 40 citations to date).
I have co-authored two studies on the use of practice MRI [3, 4], showing that young children can often successfully undergo MRI scans without sedation or anesthesia, if coached on a mock scanner. One of these studies has won a Walter E. Berdon award for best paper published in Pediatric Radiology. These studies have helped to disseminate the concept of MRI preparation as a replacement to sedation or anesthesia, with more than 30 citations to date.
I have co-authored two studies on the computed tomography (CT) evaluation of pulmonary nodules in pediatric oncology patients [5, 6]. One study showed that no CT finding can differentiate benign from malignant nodules in children. The other study showed that computer-aided detection software is able to detect pulmonary nodules missed by radiologists, making it potentially useful as a second reader. These studies have advanced the knowledge of interpretation of pulmonary nodules on pediatric CT, with more than 20 citations to date. One of them has won a Walter E. Berdon award for best paper published in Pediatric Radiology.
Currently I am working with colleagues within and outside Yale on projects that entail novel uses of high-resolution ultrasound in neonates and critically-ill children.
1. Silva CT, Daneman A, Navarro OM, et al. A prospective comparison of intestinal sonography and abdominal radiographs in a neonatal intensive care unit. Pediatric Radiology in press
2. Silva CT, Daneman A, Navarro OM, et al. Correlation of sonographic findings and outcome in necrotizing enterocolitis. Pediatric Radiology 2007; 37:274-282
3. Silva CT, Mackenzie A, Hallowell L, et al. Practice MRI: reducing the need for sedation and general anaesthesia in children undergoing MRI. Australasian Radiology 2006; 50:319-323
4. Hallowell LM, Stewart SE, Silva CT, et al. Reviewing the process of preparing children for MRI. Pediatric Radiology 2008; 38:271-279
5. Helm E, Silva CT, et al. Computer-aided detection for the identification of pulmonary nodules in pediatric oncology patients: initial experience. Pediatric Radiology 2009; 39:685-693
6. Silva CT, Amaral JG, Moineddin R, et al. CT characteristics of lung nodules present at diagnosis of extrapulmonary malignancy in children. AJR American Journal of Roentgenology 2010;194:772-778