Rajan Gupta

Overview:

Abdominal Imaging; Multiparametric MR imaging of prostate cancer; MR imaging of the hepatobiliary system; Applications of dual energy CT in the abdomen and pelvis

Positions:

Associate Professor of Radiology

Radiology, Abdominal Imaging
School of Medicine

Associate Professor in Surgery

Surgery, Urology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2003

Northwestern University

Grants:

Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) of Bone Marrow In Acute Myeloid Leukemia

Administered By
Radiology, Abdominal Imaging
Awarded By
Bayer Healthcare Pharmaceuticals Inc
Role
Principal Investigator
Start Date
End Date

Publications:

The SCARD Fellowship Policy and the Abdominal Imaging Fellowship: A Follow-up Survey After the First Year.

RATIONALE AND OBJECTIVES: To assess resident and fellowship program director (PD) perceptions of the abdominal radiology fellowship application process following the first cycle in which an embargo on interviews until December 1, 2019 was set according to the Society of Chairs of Academic Radiology Departments (SCARD) timeline for the 2021-2022 abdominal imaging fellowship year. MATERIALS AND METHODS: Eligible study participants included fellowship PDs of all abdominal imaging programs in the United States and residents that attended the Society of Abdominal Radiology (SAR) 2020 Annual Meeting. A questionnaire was developed by content and survey experts, pilot tested, and administered from May to June 2020. RESULTS: A total of 39% (36/92) of all PDs and 30% (46/152) of all individuals identified as residents with valid email addresses that attended the SAR 2020 Annual Meeting responded to the survey with an overall response rate of 34%. Only 42% of PDs and 33% of residents supported moving to a match, while 62% of PDs and 70% of residents thought that a match would limit the autonomy of applicants. While most PDs and residents also agreed that the first iteration of the SCARD timeline allowed residents to make a more informed choice, the majority of PDs were dissatisfied with their experience. Most PDs and residents additionally want applications to be accepted no earlier than July and/or August of the R3 year (initial SCARD guidelines did not restrict timing), interviews to begin on November 1st or earlier of the R3 year (compared to December 1st set in the first iteration of the guidelines), and a gap of 2-4 weeks between the date of first interviews and notification of first offers (initial SCARD guidelines did not restrict timing). Lastly, an overwhelming majority of PDs and residents agreed that SAR should enforce the abdominal imaging fellowship application process. CONCLUSION: Following the first cycle of abdominal imaging fellowship applications conducted according to the SCARD guidelines, a majority of trainees and PDs felt the changes were favorable and were opposed to a formal match. Specific suggestions for improvement were elicited from stakeholders and will be incorporated for the next cycle.
Authors
Magudia, K; Sugi, MD; Balthazar, P; Donelan, K; Gupta, RT; Maturen, KE
MLA Citation
Magudia, Kirti, et al. “The SCARD Fellowship Policy and the Abdominal Imaging Fellowship: A Follow-up Survey After the First Year.Acad Radiol, Dec. 2020. Pubmed, doi:10.1016/j.acra.2020.12.004.
URI
https://scholars.duke.edu/individual/pub1469922
PMID
33341373
Source
pubmed
Published In
Acad Radiol
Published Date
DOI
10.1016/j.acra.2020.12.004

ACR Appropriateness Criteria® Indeterminate Renal Mass.

Renal masses are increasingly detected in asymptomatic individuals as incidental findings. CT and MRI with intravenous contrast and a dedicated multiphase protocol are the mainstays of evaluation for indeterminate renal masses. A single-phase postcontrast dual-energy CT can be useful when a dedicated multiphase renal protocol CT is not available. Contrast-enhanced ultrasound with microbubble agents is a useful alternative for characterizing renal masses, especially for patients in whom iodinated CT contrast or gadolinium-based MRI contrast is contraindicated. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Authors
Expert Panel on Urologic Imaging,; Wang, ZJ; Nikolaidis, P; Khatri, G; Dogra, VS; Ganeshan, D; Goldfarb, S; Gore, JL; Gupta, RT; Hartman, RP; Heilbrun, ME; Lyshchik, A; Purysko, AS; Savage, SJ; Smith, AD; Wolfman, DJ; Wong-You-Cheong, JJ; Lockhart, ME
MLA Citation
Expert Panel on Urologic Imaging, Mark E., et al. “ACR Appropriateness Criteria® Indeterminate Renal Mass.J Am Coll Radiol, vol. 17, no. 11S, Nov. 2020, pp. S415–28. Pubmed, doi:10.1016/j.jacr.2020.09.010.
URI
https://scholars.duke.edu/individual/pub1463125
PMID
33153554
Source
pubmed
Published In
Journal of the American College of Radiology : Jacr
Volume
17
Published Date
Start Page
S415
End Page
S428
DOI
10.1016/j.jacr.2020.09.010

Can procedure time for paracentesis be optimized based on bottle selection?

PURPOSE: The purpose of our study was to assess if plastic containers could decrease the overall procedure time for paracentesis relative to more commonly used glass containers. METHODS: In this IRB exempt study, initial pilot data comparing filling time of glass and plastic containers in an ex vivo setting under identical conditions revealed power calculations that n = 37 patients per group would be needed to achieve standard deviation (SD) = 60 s, difference (diff) = 40 s, two-tailed alpha-level 0.05, and power 80%. Total of 43 patients (93 containers) were enrolled and randomized to glass or plastic bottles at enrollment. Timing of bottle filling was assessed using standardized sonographic screen captures. RESULTS: An interim look at statistics at n = 20 patients indicated that original conjectures from pilot data were conservative and smaller sample size was sufficient to stop the study and conduct the analyses. Specifically, SD = 54 s, diff = 49 s, two-tailed alpha-level 0.05, and power 80% required n = 21 patients per group. Plastic containers had a statistically significantly lower average filling time per bottle (162.7 ± 53.3 s) compared to glass (212.2 ± 50.4 s) (p = 0.003). Viscosity was calculated for each specimen and did not affect the statistical significance of the results (p = 0.32). CONCLUSION: Plastic containers have 50 s time savings of per bottle filling time as compared to glass bottles as theorized based on their faster flow rate. This holds true in both an ex vivo setting and in patients and can have important downstream impacts on patient throughput, provider efficiency and system wide cost savings.
Authors
Perry, WP; Barrett, JJ; Secic, M; Ehieli, WL; Leder, RA; Marin, D; Nelson, RC; Gupta, RT
MLA Citation
Perry, William P., et al. “Can procedure time for paracentesis be optimized based on bottle selection?Abdom Radiol (Ny), Mar. 2021. Pubmed, doi:10.1007/s00261-021-03033-8.
URI
https://scholars.duke.edu/individual/pub1477407
PMID
33783568
Source
pubmed
Published In
Abdom Radiol (Ny)
Published Date
DOI
10.1007/s00261-021-03033-8

Editorial Comment on "Prevalence of Prostate Cancer in PI-RADS Version 2.1 Transition Zone Atypical Nodules Upgraded by Abnormal DWI: Correlation With MRI-Directed TRUS-Guided Targeted Biopsy".

Authors
URI
https://scholars.duke.edu/individual/pub1459994
PMID
32876484
Source
pubmed
Published In
Ajr. American Journal of Roentgenology
Volume
216
Published Date
Start Page
690
DOI
10.2214/AJR.20.24501

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