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

Professor in the Department of Mechanical Engineering and Materials Science

Mechanical Engineering and Materials Science
Pratt School of Engineering

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

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

Publications:

Ultrasound-guided non-targeted liver core biopsy: comparison of the efficacy of two different core needle biopsy systems using an ex-vivo animal model and retrospective review of clinical experience.

PURPOSE: To compare the efficacy of two 18-gauge core needle biopsy systems, the Achieve® (Merit Medical) and the Marquee® (BD Bard), using an ex-vivo animal liver model and retrospective review of clinical experience. METHODS: Sixty ex-vivo liver biopsy samples were obtained using the Achieve® (n = 30) and the Marquee® (n = 30) needles. In addition, 20 liver biopsy samples from 20 patients obtained using the Achieve® (n = 10) and Marquee® (n = 10) were compared retrospectively. One pathologist, blinded to needle type, recorded total core length and the number of complete portal triads. Ex vivo measurements were compared using mixed effects linear, logistic, and ordinal regression. In vivo measurements were compared using Student's t-test. RESULTS: For the Achieve® and Marquee® needles, the mean(SD) total core length (mm) of ex vivo samples was 11.0(3.3) and 12.6(3.4), respectively (P = 0.069) and the adequacy rate was 23.3% and 50%, respectively (P = 0.04). Mean number of portal triads of ex vivo samples was 7.2(2.9) and 8.6(3.8), respectively (P = 0.13), and the adequacy rate was 73.3% and 83.3%, respectively (P = 0.32). For in vivo samples, the Achieve® and Marquee® needles demonstrates mean(SD) total core length (mm) of 24.6(7.1) and 32.0(4.6), respectively (P = 0.01), adequacy rate (P = 0.06). Mean number of portal triads was 14.9(4.8) and 19.6(4.1), respectively (P = 0.03), adequacy rate (P = 0.47). CONCLUSIONS: Slightly longer core biopsies were obtained with the Marquee® needle compared with the Achieve® needle. Early clinical experience demonstrates no significant difference in sample adequacy rates. Both needle types can be expected to provide adequate samples for pathologic assessment of liver tissue.
Authors
Ho, LM; Pendse, AA; Ronald, J; Luciano, M; Marin, D; Jaffe, TA; Nelson, RC
URI
https://scholars.duke.edu/individual/pub1427928
PMID
31954350
Source
pubmed
Published In
Clin Imaging
Volume
61
Published Date
Start Page
36
End Page
42
DOI
10.1016/j.clinimag.2020.01.005

Splenic venous flow exceeding portal venous flow at Doppler sonography: relationship to portosystemic varices.

OBJECTIVE: The purpose of this study was to determine if the Doppler sonographic finding of hepatopetal flow in the splenic vein that exceeds hepatopetal flow in the portal vein is associated with portosystemic varices. MATERIALS AND METHODS: Sixty-four patients with chronic liver disease were studied retrospectively. In 32 patients, splenic venous flow exceeded portal venous flow (S > P group); in 32 patients, portal venous flow exceeded splenic venous flow (P > S group). All patients were evaluated with Doppler sonography and CT of the upper part of the abdomen. Upper endoscopy was performed within 3 months of sonography in 44 of the 64 patients. RESULTS: In the S > P group, mean splenic volume was significantly larger (p = .02) than in the other group. The prevalence of varices as determined by CT in the esophageal, coronary, and peripancreatic regions was also higher in this group (p < or = .01). When esophageal varices were present, they were judged on the basis of their CT appearance to be massive in 50% of the S > P group and in 0% of the P > S group. Upper endoscopy revealed esophageal varices in 92% of the S > P group and in 55% of the P > S group (p < .005). Bleeding esophageal varices were noted in 75% of the S > P group and in 30% of the P > S group (p < .01). CONCLUSION: Patients with chronic liver disease and the Doppler sonographic finding of splenic venous flow that exceeds portal venous flow have an increased prevalence of portosystemic varices, which tend to be larger and more likely to bleed.
Authors
Nelson, RC; Sherbourne, GM; Spencer, HB; Chezmar, JL
MLA Citation
Nelson, R. C., et al. “Splenic venous flow exceeding portal venous flow at Doppler sonography: relationship to portosystemic varices.Ajr Am J Roentgenol, vol. 161, no. 3, Sept. 1993, pp. 563–67. Pubmed, doi:10.2214/ajr.161.3.8352105.
URI
https://scholars.duke.edu/individual/pub715254
PMID
8352105
Source
pubmed
Published In
Ajr. American Journal of Roentgenology
Volume
161
Published Date
Start Page
563
End Page
567
DOI
10.2214/ajr.161.3.8352105

Techniques for computed tomography of the liver.

We recommend that the CT technique of choice for routine screening of the liver, especially when there is potential for neoplasia, is dynamic CT using a single monophasic bolus of not less than 150 mL of a 60% iodinated contrast agent and a dynamic incremental package yielding at least 7 sections/minute. Routine use of noncontrast CT prior to dynamic CT is not indicated unless there is suspicion of a hypervascular tumor. We prefer to examine these particular patients with delayed CT 4 to 6 hours after receiving at least 60 g of iodine, as lesion to liver contrast is superior to noncontrast CT. Other indications for delayed CT include indeterminate lesions on dynamic CT or CTAP and perfusion defects on CTAP. In patients who are possible candidates for hepatic tumor resection, more invasive techniques such as CTAP are indicated as they yield the highest sensitivity to focal hepatic lesions, especially small lesions. A combination of CTAP and MR, however, demonstrates a superior lesion detection rate than either modality alone. CT-Lipiodol is a useful technique for detecting and palliating hepatocellular carcinomas, especially in patients with concomitant cirrhosis.
Authors
MLA Citation
Nelson, R. C. “Techniques for computed tomography of the liver.Radiol Clin North Am, vol. 29, no. 6, Nov. 1991, pp. 1199–212.
URI
https://scholars.duke.edu/individual/pub715321
PMID
1947041
Source
pubmed
Published In
Radiologic Clinics of North America
Volume
29
Published Date
Start Page
1199
End Page
1212

Gallstone extracorporeal shock-wave lithotripsy: time and treatment considerations.

We evaluated 30 gallstone lithotripsy procedures performed on 27 patients with the Dornier MPL-9000 Lithotripter to determine how time was spent in the lithotripsy suite and to evaluate the various technical reasons for interrupting the administration of shock waves during the treatment. The procedure averaged 98 +/- 32 min total time in the lithotripsy suite. This included an average of 22 +/- 6 min before the treatment, 70 +/- 28 min for administration of shock waves, and 6 +/- 2 min after the treatment. The time required to deliver the shock waves did not correlate with patient age, sex, or weight; the number of gallstones; or the number or date of the treatment. However, a trend was seen toward an association between shorter treatment times and larger stone volumes. On the average, the administration of shock waves was interrupted every 48 shock waves for various reasons. Electronically changing the imaging plane of the in-line sonographic transducer to retarget the stone in the focal zone was by far the most frequent reason for interrupting shock-wave delivery, averaging 56 shock waves between changes. We conclude that extracorporeal shock-wave lithotripsy of gallstones is a time consuming and technically demanding procedure that requires continuous monitoring and frequent interruption in order to optimize targeting and fragmentation of the stone(s) while maintaining the patient's comfort.
Authors
Nelson, RC; Rowland, GA; Torres, WE; Baumgartner, BR
MLA Citation
Nelson, R. C., et al. “Gallstone extracorporeal shock-wave lithotripsy: time and treatment considerations.Ajr Am J Roentgenol, vol. 154, no. 2, Feb. 1990, pp. 291–94. Pubmed, doi:10.2214/ajr.154.2.2105016.
URI
https://scholars.duke.edu/individual/pub715259
PMID
2105016
Source
pubmed
Published In
Ajr. American Journal of Roentgenology
Volume
154
Published Date
Start Page
291
End Page
294
DOI
10.2214/ajr.154.2.2105016

Role of computed tomography in screening for hepatocellular carcinoma in patients with cirrhosis.

One hundred patients with cirrhosis underwent abdominal computed tomography (CT) using a delayed contrast technique to determine liver and spleen volume. These scans were reviewed to screen this "at risk" population for hepatocellular carcinoma (HCC). Fifteen of the 100 screened patients had focal abnormalities suspicious for HCC. On biopsy, only 1 patient was shown to have HCC. The other 14 patients had either fatty infiltration or focal regeneration. In the same time interval, a total of 10 patients had histologically proven HCC. All presented with symptoms and died within 4 months of diagnosis. The results show that focal hepatic lesions can be detected by CT but in this population the lesions may not be due to HCC. The incidence of HCC was approximately 1%, probably reflecting a truly low incidence in this population.
Authors
Henderson, JM; Campbell, JD; Olson, R; Nelson, RC
MLA Citation
Henderson, J. M., et al. “Role of computed tomography in screening for hepatocellular carcinoma in patients with cirrhosis.Gastrointest Radiol, vol. 13, no. 2, 1988, pp. 129–34. Pubmed, doi:10.1007/BF01889041.
URI
https://scholars.duke.edu/individual/pub715247
PMID
2834256
Source
pubmed
Published In
Gastrointestinal Radiology
Volume
13
Published Date
Start Page
129
End Page
134
DOI
10.1007/BF01889041