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

Radiology
School of Medicine

Consulting Associate in the Department of Radiology

Radiology
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

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), vol. 47, no. 8, Aug. 2022, pp. 2632–39. Pubmed, doi:10.1007/s00261-021-03187-5.
URI
https://scholars.duke.edu/individual/pub1487340
PMID
34181039
Source
pubmed
Published In
Abdom Radiol (Ny)
Volume
47
Published Date
Start Page
2632
End Page
2639
DOI
10.1007/s00261-021-03187-5

Dual-Energy CT Vital Iodine Tumor Burden for Response Assessment in Patients With Metastatic GIST Undergoing TKI Therapy: Comparison With Standard CT and FDG PET/CT Criteria.

BACKGROUND. CT-based criteria for assessing the gastrointestinal stromal tumor (GIST) response to tyrosine kinase inhibitor (TKI) therapy are limited in part because tumor attenuation is influenced by treatment-related changes including hemorrhage and calcification. The iodine concentration may be less impacted by such changes. OBJECTIVE. The purpose of this study was to determine whether the dual-energy CT (DECT) vital iodine tumor burden (TB) allows improved differentiation between treatment responders and nonresponders among patients with metastatic GIST who are undergoing TKI therapy compared with established CT and PET/CT criteria. METHODS. An anthropomorphic phantom with spherical inserts mimicking GIST lesions of varying iodine concentrations and having nonenhancing central necrotic cores underwent DECT to determine a threshold iodine concentration. Forty patients (25 women and 15 men; median age, 57 years) who were treated with TKI for metastatic GIST were retrospectively evaluated. Patients underwent baseline and follow-up DECT and FDG PET/CT. Response assessment was performed using RECIST 1.1, modified Choi (mChoi) criteria, vascular tumor burden (VTB) criteria, DECT vital iodine TB criteria, and European Organization for Research and Treatment of Cancer (EORTC) PET criteria. DECT vital iodine TB criteria used the same percentage changes as RECIST 1.1 response categories. Progression-free survival was compared between responders and nonresponders for each response criterion by use of Cox proportional hazard ratios and Harrell C-indexes (i.e., concordance indexes). RESULTS. The phantom experiment identified a threshold of 0.5 mg/mL to differentiate vital from nonvital tissue. With use of the DECT vital iodine TB, median progression-free survival was significantly different between responders and nonresponders (623 vs 104 days; p < .001).. For nonresponders versus responders, the hazard ratio for disease progression for DECT vital iodine TB was 6.9 versus 7.6 for EORTC PET criteria, 3.3 for VTB criteria, 2.3 for RECIST 1.1, and 2.1 for mChoi criteria. The C-index was 0.74 for EORTC PET criteria, 0.73 for DECT vital iodine TB criteria, 0.67 for VTB criteria, 0.61 for RECIST 1.1, and 0.58 for mChoi criteria. The C-index was significantly greater for DECT vital iodine TB criteria than for RECIST 1.1 (p = .02) and mChoi criteria (p = .002), but it was not different from that for VTB and EORTC PET criteria (p > .05). CONCLUSION. DECT vital iodine TB criteria showed performance comparable to that of EORTC PET criteria and outperformed RECIST 1.1 and mChoi criteria for response assessment of metastatic GIST treated with TKI therapy. CLINICAL IMPACT. DECT vital iodine TB could help guide early management decisions in patients receiving TKI therapy.
Authors
Meyer, M; Hohenberger, P; Overhoff, D; Bartsch, A; Henzler, T; Haubenreisser, H; Ronald, J; Schmidt, B; Flohr, T; Sedlmair, M; Ota, H; Messiou, C; Schoenberg, SO; Riedel, RF; Nelson, RC; Marin, D
MLA Citation
Meyer, Mathias, et al. “Dual-Energy CT Vital Iodine Tumor Burden for Response Assessment in Patients With Metastatic GIST Undergoing TKI Therapy: Comparison With Standard CT and FDG PET/CT Criteria.Ajr Am J Roentgenol, vol. 218, no. 4, Apr. 2022, pp. 659–69. Pubmed, doi:10.2214/AJR.21.26636.
URI
https://scholars.duke.edu/individual/pub1499246
PMID
34668385
Source
pubmed
Published In
Ajr. American Journal of Roentgenology
Volume
218
Published Date
Start Page
659
End Page
669
DOI
10.2214/AJR.21.26636

HSP90-Specific nIR Probe Identifies Aggressive Prostate Cancers: Translation from Preclinical Models to a Human Phase I Study.

A noninvasive test to discriminate indolent prostate cancers from lethal ones would focus treatment where necessary while reducing overtreatment. We exploited the known activity of heat shock protein 90 (Hsp90) as a chaperone critical for the function of numerous oncogenic drivers, including the androgen receptor and its variants, to detect aggressive prostate cancer. We linked a near-infrared fluorescing molecule to an HSP90 binding drug and demonstrated that this probe (designated HS196) was highly sensitive and specific for detecting implanted prostate cancer cell lines with greater uptake by more aggressive subtypes. In a phase I human study, systemically administered HS196 could be detected in malignant nodules within prostatectomy specimens. Single-cell RNA sequencing identified uptake of HS196 by malignant prostate epithelium from the peripheral zone (AMACR+ERG+EPCAM+ cells), including SYP+ neuroendocrine cells that are associated with therapeutic resistance and metastatic progression. A theranostic version of this molecule is under clinical testing.
Authors
Osada, T; Crosby, EJ; Kaneko, K; Snyder, JC; Ginzel, JD; Acharya, CR; Yang, X-Y; Polascik, TJ; Spasojevic, I; Nelson, RC; Hobeika, A; Hartman, ZC; Neckers, LM; Rogatko, A; Hughes, PF; Huang, J; Morse, MA; Haystead, T; Lyerly, HK
MLA Citation
Osada, Takuya, et al. “HSP90-Specific nIR Probe Identifies Aggressive Prostate Cancers: Translation from Preclinical Models to a Human Phase I Study.Mol Cancer Ther, vol. 21, no. 1, Jan. 2022, pp. 217–26. Pubmed, doi:10.1158/1535-7163.MCT-21-0334.
URI
https://scholars.duke.edu/individual/pub1499234
PMID
34675120
Source
pubmed
Published In
Mol Cancer Ther
Volume
21
Published Date
Start Page
217
End Page
226
DOI
10.1158/1535-7163.MCT-21-0334

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, Katelyn, et al. “Occult Regions of Suppressed Coherence in Liver B-Mode Images.Ultrasound Med Biol, vol. 48, no. 1, Jan. 2022, pp. 47–58. Pubmed, doi:10.1016/j.ultrasmedbio.2021.09.007.
URI
https://scholars.duke.edu/individual/pub1500861
PMID
34702640
Source
pubmed
Published In
Ultrasound Med Biol
Volume
48
Published Date
Start Page
47
End Page
58
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