2021
The Utility of Imaging Parameters in Predicting Long-Term Clinical Improvement After Shunt Surgery in Patients with Idiopathic Normal Pressure Hydrocephalus
Subramanian HE, Fadel SA, Matouk CC, Zohrabian VM, Mahajan A. The Utility of Imaging Parameters in Predicting Long-Term Clinical Improvement After Shunt Surgery in Patients with Idiopathic Normal Pressure Hydrocephalus. World Neurosurgery 2021, 149: e1-e10. PMID: 33662608, DOI: 10.1016/j.wneu.2021.02.108.Peer-Reviewed Original ResearchConceptsIdiopathic normal pressure hydrocephalusShunt surgeryNormal pressure hydrocephalusEvans indexCognitive improvementShunt placementPressure hydrocephalusImaging featuresLong-term patient-reported outcomesLong-term clinical improvementTelephone interviewsPreoperative imaging parametersVentriculoperitoneal shunt surgeryCerebrospinal fluid drainagePatient-reported outcomesLong-term outcomesLong-term cognitive improvementMagnetic resonance imagingImaging parametersClinical improvementGait improvementMedian durationClinical outcomesShunt candidatesFluid drainage
2020
Evidence-Based Risk Mitigation and Stratification During COVID-19 for Return to Interventional Pain Practice: American Society of Interventional Pain Physicians (ASIPP) Guidelines.
Shah S, Diwan S, Soin A, Rajput K, Mahajan A, Manchikanti L, Kaye A, Hirsch J, Gharibo C. Evidence-Based Risk Mitigation and Stratification During COVID-19 for Return to Interventional Pain Practice: American Society of Interventional Pain Physicians (ASIPP) Guidelines. Pain Physician 2020, 23: s161-s182. PMID: 32942784, DOI: 10.36076/ppj.2020/23/s161.Peer-Reviewed Original ResearchConceptsAmerican Society of Interventional Pain PhysiciansContinuity of careChronic pain patientsPain specialistsInterventional pain physiciansPain patientsInterventional pain specialistsPain carePain physiciansRisk of COVID-19 morbidityEvidence-informed guidanceCOVID-19 pandemicRisk factorsCOVID-related morbidityEvaluate risk-benefitCare recommendationsNumerous risk factorsManaging symptomsEvidence synthesisDisclosure of conflictsInterventional Pain PracticePain practiceTelemedicine encountersRisk stratification toolGuideline preparationChoice of imaging modality for pre-treatment staging of head and neck cancer impacts TNM staging
Mur T, Sambhu KM, Mahajan A, Payabvash S, Fernandez J, Edwards HA. Choice of imaging modality for pre-treatment staging of head and neck cancer impacts TNM staging. American Journal Of Otolaryngology 2020, 41: 102662. PMID: 32858370, DOI: 10.1016/j.amjoto.2020.102662.Peer-Reviewed Original ResearchConceptsPET/CTLow-dose nonenhanced CTDistant metastasisChest CTNeck cancerNonenhanced CTF-fluorodeoxyglucose positron emission tomographyF-FDG PET/CTDiagnostic chest CTDistant metastatic diseaseInitiation of therapyRetrospective cohort studyPre-treatment stagingTertiary care settingSignificant differencesPositron emission tomographyMetastatic diseaseCohort studyOncologic treatmentTNM stagingInaccurate stagingNeck radiologistsCare settingsSingle patientPatientsPembrolizumab for management of patients with NSCLC and brain metastases: long-term results and biomarker analysis from a non-randomised, open-label, phase 2 trial
Goldberg SB, Schalper KA, Gettinger SN, Mahajan A, Herbst RS, Chiang AC, Lilenbaum R, Wilson FH, Omay SB, Yu JB, Jilaveanu L, Tran T, Pavlik K, Rowen E, Gerrish H, Komlo A, Gupta R, Wyatt H, Ribeiro M, Kluger Y, Zhou G, Wei W, Chiang VL, Kluger HM. Pembrolizumab for management of patients with NSCLC and brain metastases: long-term results and biomarker analysis from a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2020, 21: 655-663. PMID: 32251621, PMCID: PMC7380514, DOI: 10.1016/s1470-2045(20)30111-x.Peer-Reviewed Original ResearchConceptsBrain metastasis responseYale Cancer CenterPD-L1 expressionPhase 2 trialUntreated brain metastasesBrain metastasesAdrenal insufficiencyAdverse eventsMetastasis responseCNS diseaseCancer CenterCohort 2Cohort 1Eastern Cooperative Oncology Group performance statusTreatment-related serious adverse eventsModified Response Evaluation CriteriaStage IV NSCLCTreatment-related deathsAcute kidney injuryPD-1 blockadeSerious adverse eventsSolid Tumors criteriaPhase 2 studyProportion of patientsResponse Evaluation Criteria
2018
The Subjective Experience of Patients Undergoing Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus
Subramanian HE, Mahajan A, Sommaruga S, Falcone GJ, Kahle KT, Matouk CC. The Subjective Experience of Patients Undergoing Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus. World Neurosurgery 2018, 119: e46-e52. PMID: 29981467, DOI: 10.1016/j.wneu.2018.06.209.Peer-Reviewed Original ResearchConceptsIdiopathic normal pressure hydrocephalusShunt surgeryNormal pressure hydrocephalusPreoperative courseClinical responsePressure hydrocephalusPatient's clinical responseVentriculoperitoneal shunt surgeryCounseling of patientsSaturation of themesClinical courseComorbid conditionsConsecutive seriesPostoperative assessmentDefinitive diagnosisPatients' caregiversPatient outcomesChallenges patientsDiagnostic criteriaPatientsSurgeryTelephone interviewsHydrocephalusDiagnosisSubjective experienceIncidence of radiographically occult nodal metastases in HPV+ oropharyngeal carcinoma: Implications for reducing elective nodal coverage
Loganadane G, Kelly JR, Lee NC, Kann BH, Mahajan A, Hansen JE, Belkacémi Y, Yarbrough W, Husain ZA. Incidence of radiographically occult nodal metastases in HPV+ oropharyngeal carcinoma: Implications for reducing elective nodal coverage. Practical Radiation Oncology 2018, 8: 397-403. PMID: 29730282, DOI: 10.1016/j.prro.2018.03.009.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overCarcinoma, Squamous CellFemaleFollow-Up StudiesHumansImage Processing, Computer-AssistedLymphatic MetastasisMaleMiddle AgedNeoplasm StagingOropharyngeal NeoplasmsPapillomaviridaePapillomavirus InfectionsPositron Emission Tomography Computed TomographyPrognosisRadiotherapy DosageRadiotherapy Planning, Computer-AssistedRadiotherapy, Intensity-ModulatedRetrospective StudiesConceptsRadiation field designPreoperative imagingPathologic involvementN stageOropharyngeal squamous cell carcinomaElective nodal coverageLevel II diseasePercent of patientsPositive lymph nodesOccult nodal metastasisClinical N stageRadiation therapy doseRecords of patientsNodal levelPathologic N stageSquamous cell carcinomaHuman papilloma virusTreatment deescalationNeoadjuvant therapyNodal diseaseNeck dissectionNodal involvementOropharyngeal carcinomaProspective trialSystemic agents
2017
Long-term outcomes of tissue-based ACTH-antibody assay-guided transsphenoidal resection of pituitary adenomas in Cushing disease.
Erfe JM, Perry A, McClaskey J, Inzucchi SE, James WS, Eid T, Bronen RA, Mahajan A, Huttner A, Santos F, Spencer D. Long-term outcomes of tissue-based ACTH-antibody assay-guided transsphenoidal resection of pituitary adenomas in Cushing disease. Journal Of Neurosurgery 2017, 129: 629-641. PMID: 29027854, DOI: 10.3171/2017.3.jns162245.Peer-Reviewed Original ResearchConceptsTranssphenoidal resectionMRI studiesCushing's diseaseCortisol levelsLong-term corticosteroid therapyUrinary free cortisol levelsLong-term disease remissionLong-term patient outcomesResults Fourteen patientsLong-term outcomesPostoperative MRI studiesSurgical tumor samplesFree cortisol levelsPreoperative MRI studiesPrecise tumor localizationACTH antibodiesPituitary microCorticosteroid therapyStudy patientsDisease remissionFourteen patientsRemission rateRetrospective reviewTreatment failureCure rateComparing available criteria for measuring brain metastasis response to immunotherapy
Qian JM, Mahajan A, Yu JB, Tsiouris AJ, Goldberg SB, Kluger HM, Chiang VL. Comparing available criteria for measuring brain metastasis response to immunotherapy. Journal Of Neuro-Oncology 2017, 132: 479-485. PMID: 28275886, DOI: 10.1007/s11060-017-2398-8.Peer-Reviewed Original ResearchConceptsRECIST 1.1Brain lesionsBrain metastasesDurable responsesAdditional patientsNeuro-Oncology Working GroupBrain metastasis responseBrain metastasis patientsUntreated brain metastasesStandardized response criteriaBrain lesion sizeHigh-grade gliomasSimilar clinical trialsHigh-resolution MRIMetastasis patientsMetastasis responseOngoing trialsClinical trialsNovel therapiesResponse assessmentDiscordant casesLesion sizePatientsResponse rateLongest diameter
2016
Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial
Goldberg SB, Gettinger SN, Mahajan A, Chiang AC, Herbst RS, Sznol M, Tsiouris AJ, Cohen J, Vortmeyer A, Jilaveanu L, Yu J, Hegde U, Speaker S, Madura M, Ralabate A, Rivera A, Rowen E, Gerrish H, Yao X, Chiang V, Kluger HM. Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2016, 17: 976-983. PMID: 27267608, PMCID: PMC5526047, DOI: 10.1016/s1470-2045(16)30053-5.Peer-Reviewed Original ResearchConceptsProgressive brain metastasesUntreated brain metastasesBrain metastasis responseYale Cancer CenterBrain metastasesPhase 2 trialCell lung cancerAdverse eventsMetastasis responseCancer CenterLung cancerMelanoma cohortGrade 3 colitisGrade 3 fatigueGrade 3 pneumonitisPD-1 axisAcute kidney injuryNeurological adverse eventsPD-1 inhibitorsAcceptable safety profilePD-L1 expressionSystemic immunotherapyKidney injuryPrimary endpointNSCLC cohortPractice Building: Achieving Growth Through Computed Tomographic Myelography–Based Stereotactic Body Radiation Therapy for Spinal Metastases
Zohrabian VM, Husain ZA, Laurans MS, Chiang VL, Mahajan A, Johnson MH. Practice Building: Achieving Growth Through Computed Tomographic Myelography–Based Stereotactic Body Radiation Therapy for Spinal Metastases. Current Problems In Diagnostic Radiology 2016, 45: 324-329. PMID: 26920633, DOI: 10.1067/j.cpradiol.2016.01.004.Peer-Reviewed Original ResearchConceptsStereotactic body radiation therapyBody radiation therapySpinal metastasesTomographic myelographyRadiation therapyWorkup of patientsStereotactic radiation treatmentMultidisciplinary careNeural elementsSBRT programRadiation treatmentMyelographyMetastasisPatientsTherapyRadiologistsMagnetic resonanceStandardized method
2013
Ventriculomegaly associated with ependymal gliosis and declines in barrier integrity in the aging human and mouse brain
Shook BA, Lennington JB, Acabchuk RL, Halling M, Sun Y, Peters J, Wu Q, Mahajan A, Fellows DW, Conover JC. Ventriculomegaly associated with ependymal gliosis and declines in barrier integrity in the aging human and mouse brain. Aging Cell 2013, 13: 340-350. PMID: 24341850, PMCID: PMC3954884, DOI: 10.1111/acel.12184.Peer-Reviewed Original ResearchConceptsAged humansPeriventricular tissueVentricle enlargementGlial scarringEpendymal cell lossEpendymal cell liningPeriventricular gliosisReactive gliosisHistological featuresDegenerative lossLateral ventricleGliosisMouse modelVentricular expansionVentricle liningAquaporin-4Barrier integrityEpendymal cellsLateral ventricle surfaceCell lossMouse brainVentriculomegalyCell liningMiceScarring
2011
Parathyroid Four‐Dimensional Computed Tomography: Evaluation of Radiation Dose Exposure During Preoperative Localization of Parathyroid Tumors in Primary Hyperparathyroidism
Mahajan A, Starker LF, Ghita M, Udelsman R, Brink JA, Carling T. Parathyroid Four‐Dimensional Computed Tomography: Evaluation of Radiation Dose Exposure During Preoperative Localization of Parathyroid Tumors in Primary Hyperparathyroidism. World Journal Of Surgery 2011, 36: 1335-1339. PMID: 22146947, DOI: 10.1007/s00268-011-1365-3.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChildChild, PreschoolFemaleFour-Dimensional Computed TomographyHumansHyperparathyroidism, PrimaryInfantInfant, NewbornMaleMiddle AgedParathyroid NeoplasmsParathyroidectomyPreoperative CareRadiation DosageRadiopharmaceuticalsTechnetium Tc 99m SestamibiTomography, Emission-Computed, Single-PhotonYoung AdultConceptsPrimary hyperparathyroidismFour-dimensional computed tomographyParathyroid tumorsPreoperative localizationThyroid cancerComputed tomographyRadiation doseRadiation exposureSingle-photon emission CTMCi of technetiumSex-dependent risk factorsYear old womanThyroid radiation doseRadiation dose exposurePreoperative imaging modalitiesImaging Performance AssessmentPhoton emission CTCT radiation doseRow CT scannerDetector-row CT scannerPHPT patientsInvasive parathyroidectomyRisk factorsOlder womenBackground radiation exposure