Rendon Nelson

Overview:

Diagnostic Imaging of the Liver; Specifically the Detection and Characterization of Focal and Diffuse Processes by US, CT and MRI.
Percutaneous Image-Guided Thermal Ablation of Hepatic and Renal Tumors

Positions:

Reed and Martha Rice Distinguished Professor of Radiology, in the School of Medicine

Radiology, Abdominal Imaging
School of Medicine

Professor of Radiology

Radiology, Abdominal Imaging
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1980

Loma Linda University, School of Medicine

M.D. 0

Kent State University

Grants:

Optimization of radiofrequency ablation with electrically conductive particles

Administered By
Radiology, Interventional Radiology
Awarded By
National Institutes of Health
Role
Collaborator
Start Date
End Date

Large aperture and wideband modular ultrasound arrays for the diagnosis of liver cancer

Administered By
Biomedical Engineering
Awarded By
Stanford University
Role
Co Investigator
Start Date
End Date

Improved Image Quality of Focal Liver Lesions Using the Coherence of Ultrasound

Administered By
Biomedical Engineering
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Image Rich Radiology Reports: A Value-Based Model to Improve Clinical Workflow

Administered By
Radiology, Abdominal Imaging
Awarded By
Radiological Society of North America
Role
Collaborator
Start Date
End Date

Characterization of Early Anti-Angiogensis Treatment Effects in Colorectal Carcinoma Using High-Resolution Dynamic Contrast-Enhanced Ultrasound and Magnetic Resonance Imaging

Administered By
Radiology, Abdominal Imaging
Awarded By
Radiological Society of North America
Role
Principal Investigator
Start Date
End Date

Publications:

Comparison of clinical efficacy, subjective user experience, and safety for two different core biopsy needles, the Achieve® and Marquee®.

PURPOSE: To compare clinical efficacy, subjective radiologist preference, and complication rates for two different core biopsy needles, the Achieve® and Marquee®. METHODS: Retrospective review included consecutive patients who underwent 18 gauge non-targeted core liver biopsy, 30 with Achieve® (Merit Medical) and 30 with Marquee® (BD Bard) Pathologist (blinded to needle type) reviewed specimen total length, maximum width, and portal triad count. Sixteen radiologists subjectively rated (1 to 5(best)) each needle for cocking, firing, recoil, chamber exposure, handling, and overall. A medical records search of all (targeted and non-targeted) core liver biopsies 1/1/17-9/30/2020 compared rates of major (requiring transfusion and/or embolization) and minor (self-limited bleeding) hemorrhagic complications. Comparison between needle types was performed using t-test. RESULTS: For Achieve® and Marquee® needles, the respective mean (SD) for total length(mm) was 29.7(7.0) and 31.9(4.6), p = 0.1; max width(mm) was 0.78(0.1) and 0.85(0.1), p < 0.01; and number of portal triads was 15.3(5.3) and 17.3(5.3), p = 0.2. Radiologists subjectively preferred the Marquee® for several measures including cocking, chamber exposure, and overall (p < 0.02 for each), while the needles were rated similarly for firing, recoil, and handling. Review of 800 cases showed no difference in major (1.0% Achieve®, 1.9% Marquee®, p = 0.5) or minor (1.5% Achieve®, 0.5% Marquee®, p = 0.3) rates of hemorrhagic complications. CONCLUSION: Liver biopsy specimens were significantly wider with Marquee® compared to Achieve®. Radiologists preferred the Marquee® for multiple tactile measures, while the major complication rate was not significantly different. While both needles have a similar side-notch design, the Marquee® needle demonstrates better sample quality and higher user preference, without compromising safety.
Authors
Ho, LM; Pendse, AA; Ronald, J; Desai, H; Dai, R; Ziegler, C; Nelson, RC; Wildman-Tobriner, B
MLA Citation
Ho, Lisa M., et al. “Comparison of clinical efficacy, subjective user experience, and safety for two different core biopsy needles, the Achieve® and Marquee®.Abdom Radiol (Ny), June 2021. Pubmed, doi:10.1007/s00261-021-03187-5.
URI
https://scholars.duke.edu/individual/pub1487340
PMID
34181039
Source
pubmed
Published In
Abdom Radiol (Ny)
Published Date
DOI
10.1007/s00261-021-03187-5

Occult Regions of Suppressed Coherence in Liver B-Mode Images

Ultrasound is an essential tool for diagnosing and monitoring diseases, but it can be limited by poor image quality. Lag-one coherence (LOC) is an image quality metric that can be related to signal-to-noise ratio and contrast-to-noise ratio. In this study, we examine matched LOC and B-mode images of the liver to discern patterns of low image quality, as indicated by lower LOC values, occurring beneath the abdominal wall, near out-of-plane vessels and adjacent to hyperechoic targets such the liver capsule. These regions of suppressed coherence are often occult; they present as temporally stable uniform speckle on B-mode images, but the LOC measurements in these regions suggest substantially degraded image quality. Quantitative characterization of the coherence suppression beneath the abdominal wall reveals a consistent pattern both in simulations and in vivo; sharp drops in coherence occurring beneath the abdominal wall asymptotically recover to a stable coherence at depth. Simulation studies suggest that abdominal wall reverberation clutter contributes to the initial drop in coherence but does not influence the asymptotic LOC value. Clinical implications are considered for contrast loss in B-mode imaging and estimation errors for elastography and Doppler imaging.
Authors
Offerdahl, K; Huber, M; Long, W; Bottenus, N; Nelson, R; Trahey, G
MLA Citation
Offerdahl, K., et al. “Occult Regions of Suppressed Coherence in Liver B-Mode Images.” Ultrasound in Medicine and Biology, Jan. 2021. Scopus, doi:10.1016/j.ultrasmedbio.2021.09.007.
URI
https://scholars.duke.edu/individual/pub1500861
Source
scopus
Published In
Ultrasound in Medicine & Biology
Published Date
DOI
10.1016/j.ultrasmedbio.2021.09.007

Hemodialysis catheter integrity during mechanical power injection of iodinated contrast medium for computed tomography angiography.

PURPOSE: CT angiography (CTA) requires vascular access with flow rates of 5-7 mL/s. Hemodialysis (HD) is performed at 6-10 mL/s. The purpose of our study is to evaluate the structural integrity of HD catheters in the administration of contrast media via a mechanical power injector under varying conditions. METHODS: Four HD catheters were evaluated in an in vitro study. Tested were contrast media type (iopamidol 300 and 370 mgI/mL), temperature (25 and 37 °C), catheter diameter (14 Fr to 16 Fr all with double-lumen capacity), catheter length (19-32 cm), and simultaneous double-lumen or single-lumen injection within each of the catheters. Peak plateau pressures (psi) were recorded with flow rates from 5 to 20 mL/s in 5 mL/s increments. In total, 864 unique injections were performed. RESULTS: No catheter failure (bulging/rupture) was observed in 864 injections. Maximum pressure for single-lumen injection was 51.7 psi (double-lumen: 26.3 psi). Peak pressures were significantly lower in simultaneous double-lumen vs. single-lumen injections (p < 0.001) and low vs. high viscosity contrast media (p < 0.001). Neither larger vs. smaller diameter lumens (p = 0.221) nor single-lumen injection in arterial vs. venous (p = 0.834) were significantly different. CONCLUSION: HD catheters can be used to safely administer iodinated contrast media via mechanical power injection in in vitro operating conditions. Maximum peak pressure is below the manufacturer's 30 psi limit at flow rates up to 20 mL/s in double-lumen injections and up to 10 mL/s in single-lumen injections, which is higher than the usual maximum of 8 mL/s for CT angiography in clinical settings.
Authors
Schwartz, FR; Lewis, DS; King, AE; Murphy, FG; Howle, LE; Kim, CY; Nelson, RC
MLA Citation
Schwartz, Fides R., et al. “Hemodialysis catheter integrity during mechanical power injection of iodinated contrast medium for computed tomography angiography.Abdom Radiol (Ny), vol. 46, no. 6, June 2021, pp. 2961–67. Pubmed, doi:10.1007/s00261-020-02905-9.
URI
https://scholars.duke.edu/individual/pub1470719
PMID
33386919
Source
pubmed
Published In
Abdom Radiol (Ny)
Volume
46
Published Date
Start Page
2961
End Page
2967
DOI
10.1007/s00261-020-02905-9

How frequently does hepatocellular carcinoma develop in at-risk patients with a negative liver MRI examination with intravenous Gadobenate dimeglumine?

OBJECTIVE: To determine the rate of development of clinically significant liver nodules (LR-4, LR-5, LR-M) after a negative MRI in an HCC screening population. METHODS: This retrospective study included patients at risk of developing HCC requiring imaging surveillance who had undergone multiphase Gadobenate dimeglumine-enhanced MRI that was negative and had follow up LI-RADS compliant multiphase CTs or MRIs for at least 12 months or positive follow-up within 12 months. Follow-up examinations were classified as negative (no nodules or only LR-1 nodules) or positive (nodule other than LR-1). Time-to-first positive examination, types of nodules, and cumulative incidence of nodule development were recorded. RESULTS: 204 patients (mean age 58.9 ± 10.2 years, 128 women), including 172 with cirrhosis, were included. Based CT/MRI follow-up (median 35 months, range 12-80 months), the overall cumulative incidence of developing a nodule was 10.5%. Cumulative incidence of nodule development was: 0.5% at 6-9 months and 2.1% at 12 ± 3 months, including one LR-4 nodule, one LR-M nodule, and two LR-3 nodules. The cumulative incidence of clinically significant nodule development was 1.1% at 9-15 months. 70% (143/204) of patients also underwent at least one US follow-up, and no patient developed a positive US examination following index negative MRI. CONCLUSION: Clinically significant liver nodules develop in 1.1% of at-risk patients in the first year following negative MRI. While ongoing surveillance is necessary for at-risk patients, our study suggests than longer surveillance intervals after a negative MRI may be reasonable and that further research is needed to explore this possibility.
Authors
Zaki, IH; Shropshire, E; Zhang, S; Xiao, D; Wildman-Tobriner, B; Marin, D; Gupta, RT; Erkanli, A; Nelson, RC; Bashir, MR
MLA Citation
Zaki, Islam H., et al. “How frequently does hepatocellular carcinoma develop in at-risk patients with a negative liver MRI examination with intravenous Gadobenate dimeglumine?Abdom Radiol (Ny), vol. 46, no. 3, Mar. 2021, pp. 969–78. Pubmed, doi:10.1007/s00261-020-02771-5.
URI
https://scholars.duke.edu/individual/pub1461101
PMID
32951065
Source
pubmed
Published In
Abdom Radiol (Ny)
Volume
46
Published Date
Start Page
969
End Page
978
DOI
10.1007/s00261-020-02771-5

Genitourinary case of the day. Renal lymphangiomatosis.

Authors
Leder, RA
MLA Citation
Leder, R. A. “Genitourinary case of the day. Renal lymphangiomatosis.Ajr Am J Roentgenol, vol. 165, no. 1, July 1995, pp. 197–98. Pubmed, doi:10.2214/ajr.165.1.7785592.
URI
https://scholars.duke.edu/individual/pub714958
PMID
7785592
Source
pubmed
Published In
Ajr. American Journal of Roentgenology
Volume
165
Published Date
Start Page
197
End Page
198
DOI
10.2214/ajr.165.1.7785592