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
Value and Validity of Coronavirus Antibody Testing.
Mahajan A, Manchikanti L. Value and Validity of Coronavirus Antibody Testing. Pain Physician 2020, 23: s381-s390. PMID: 32942795, DOI: 10.36076/ppj.2020/23/s381.Peer-Reviewed Original ResearchConceptsAntibody testIgM antibodiesImmune response to SARS-CoV-2 infectionTesting health care workersInterventional proceduresElective interventional proceduresPain management communityResponse to SARS-CoV-2 infectionElective surgical proceduresDays post-symptom onsetSARS-CoV-2 infectionPost-symptom onsetInfected patientsSurgical proceduresViral infectionPatientsIgG antibodiesImmunoglobulin MRe-infectionDetect IgGInfectionSARS-CoV-2Total antibodiesAntibodiesIgG/IgM testChoice 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 experienceFatal cryptococcal meningitis in an AIDS patient complicated with immune reconstitution syndrome refractory to prolonged amphotericin B treatment
Bandaranayake TD, Ogbuagu OE, Mahajan A, Vortmeyer AO, Villanueva MS. Fatal cryptococcal meningitis in an AIDS patient complicated with immune reconstitution syndrome refractory to prolonged amphotericin B treatment. International Journal Of STD & AIDS 2018, 29: 1250-1254. PMID: 29749873, DOI: 10.1177/0956462418773219.Peer-Reviewed Case Reports and Technical NotesConceptsCentral nervous system diseaseNervous system diseasesCryptococcal meningitisSystem diseasesSevere central nervous system diseaseFatal cryptococcal meningitisLiposomal amphotericin BAmphotericin B treatmentImmune recoveryPatient refractoryAntiretroviral therapyTherapeutic challengeTreatment failureAIDS patientsCystic lesionsFatal casesTreatment approachesMeningitisAmphotericin BC. neoformansMultiple coursesCryptococcus neoformansPatientsB treatmentDiseaseIncidence 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 cohortMelanoma Brain Metastasis Pseudoprogression after Pembrolizumab Treatment
Cohen JV, Alomari AK, Vortmeyer AO, Jilaveanu LB, Goldberg SB, Mahajan A, Chiang VL, Kluger HM. Melanoma Brain Metastasis Pseudoprogression after Pembrolizumab Treatment. Cancer Immunology Research 2016, 4: 179-182. PMID: 26701266, PMCID: PMC4881844, DOI: 10.1158/2326-6066.cir-15-0160.Peer-Reviewed Original ResearchConceptsCentral nervous systemBrain metastasesActive brain lesionsNew immunomodulating agentsImmune checkpoint inhibitorsRole of immunotherapyPembrolizumab treatmentCheckpoint inhibitorsCNS lesionsReactive astrocytosisImmune suppressionPerilesional edemaInflammatory cellsMicroglial cellsImmunomodulating agentMental statusBrain lesionsHistologic evaluationMost trialsNervous systemCentral enhancementTumor cellsPatientsMetastasisLesionsPractice 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
2015
Novel somatic mutations in primary hyperaldosteronism are related to the clinical, radiological and pathological phenotype
Scholl UI, Healy JM, Thiel A, Fonseca AL, Brown TC, Kunstman JW, Horne MJ, Dietrich D, Riemer J, Kücükköylü S, Reimer EN, Reis AC, Goh G, Kristiansen G, Mahajan A, Korah R, Lifton RP, Prasad ML, Carling T. Novel somatic mutations in primary hyperaldosteronism are related to the clinical, radiological and pathological phenotype. Clinical Endocrinology 2015, 83: 779-789. PMID: 26252618, PMCID: PMC4995792, DOI: 10.1111/cen.12873.Peer-Reviewed Original ResearchConceptsAldosterone-producing adenomaAdrenal hyperplasiaHyperplastic adrenal glandsUnilateral adrenal hyperplasiaClinical pathological featuresBilateral adrenal hyperplasiaSomatic mutationsNovel somatic mutationsPredominant histologySecondary hypertensionPrimary hyperaldosteronismRetrospective studyAdrenal glandPathological characteristicsMale genderClear cellsCACNA1D mutationsComputed tomographyImportant causeTumorsKCNJ5HyperplasiaAdenomasExome sequencingPathological phenotypes
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
2010
4D Parathyroid CT as the Initial Localization Study for Patients with De Novo Primary Hyperparathyroidism
Starker LF, Mahajan A, Björklund P, Sze G, Udelsman R, Carling T. 4D Parathyroid CT as the Initial Localization Study for Patients with De Novo Primary Hyperparathyroidism. Annals Of Surgical Oncology 2010, 18: 1723-1728. PMID: 21184187, DOI: 10.1245/s10434-010-1507-0.Peer-Reviewed Original ResearchConceptsPrimary hyperparathyroidismMultiglandular diseaseParathyroid tumorsIntraoperative parathyroid hormone measurementParathyroid hormone measurementDe novo patientsMajority of patientsPreferred imaging modalityFour-dimensional computed tomographyIntact PTHInvasive parathyroidectomyConsecutive patientsNovo patientsPathologic findingsParathyroid lesionsComputed tomographyHormone measurementsPatientsCorrect quadrantBiochemical measurementsLocalization studiesTumorsS-CaImaging modalitiesHyperparathyroidism