Brian Patrick Pogatchnik

All Publications

• Volumetric Analysis: Effect on Diagnosis and Management of Indeterminate Solid Pulmonary Nodules in Routine Clinical Practice. Journal of computer assisted tomography Lim, R. S., Rosenberg, J., Willemink, M. J., Cheng, S. N., Guo, H. H., Hollett, P. D., Lin, M. C., Madani, M. H., Martin, L., Pogatchnik, B. P., Pohlen, M., Shen, J., Tsai, E. B., Berry, G. J., Scott, G., Leung, A. N. 2024

  Abstract

  To evaluate the effect of volumetric analysis on the diagnosis and management of indeterminate solid pulmonary nodules in routine clinical practice.This was a retrospective study with 107 computed tomography (CT) cases of solid pulmonary nodules (range, 6-15 mm), 57 pathology-proven malignancies (lung cancer, n = 34; metastasis, n = 23), and 50 benign nodules. Nodules were evaluated on a total of 309 CT scans (average number of CTs/nodule, 2.9 [range, 2-7]). CT scans were from multiple institutions with variable technique. Nine radiologists (attendings, n = 3; fellows, n = 3; residents, n = 3) were asked their level of suspicion for malignancy (low/moderate or high) and management recommendation (no follow-up, CT follow-up, or care escalation) for baseline and follow-up studies first without and then with volumetric analysis data. Effect of volumetry on diagnosis and management was assessed by generalized linear and logistic regression models.Volumetric analysis improved sensitivity (P = 0.009) and allowed earlier recognition (P < 0.05) of malignant nodules. Attending radiologists showed higher sensitivity in recognition of malignant nodules (P = 0.03) and recommendation of care escalation (P < 0.001) compared with trainees. Volumetric analysis altered management of high suspicion nodules only in the fellow group (P = 0.008). κ Statistics for suspicion for malignancy and recommended management were fair to substantial (0.38-0.66) and fair to moderate (0.33-0.50). Volumetric analysis improved interobserver variability for identification of nodule malignancy from 0.52 to 0.66 (P = 0.004) only on the second follow-up study.Volumetric analysis of indeterminate solid pulmonary nodules in routine clinical practice can result in improved sensitivity and earlier identification of malignant nodules. The effect of volumetric analysis on management recommendations is variable and influenced by reader experience.

  View details for DOI 10.1097/RCT.0000000000001630

  View details for PubMedID 38968327

• Pulmonary transplant complications: a radiologic review. Journal of cardiothoracic surgery Friedlander, S., Pogatchnik, B., Furuya, Y., Allen, T. 2024; 19 (1): 270

  Abstract

  Lung transplantation has become the definitive treatment for end stage respiratory disease. Numbers and survival rates have increased over the past decade, with transplant recipients living longer and with greater comorbidities, resulting in greater complexity of care. Common and uncommon complications that occur in the immediate, early, intermediate, and late periods can have significant impact on the course of the transplant. Fortunately, advancements in surgery, medical care, and imaging as well as other diagnostics work to prevent, identify, and manage complications that would otherwise have a negative impact on survivability. This review will focus on contextualizing complications both categorically and chronologically, with highlights of specific imaging and clinical features in order to inform both radiologists and clinicians involved in post-transplant care.

  View details for DOI 10.1186/s13019-024-02731-w

  View details for PubMedID 38702686

  View details for PubMedCentralID 5757055

• A case report of successful primary percutaneous coronary intervention to an occluded anomalous left main coronary artery arising from the right coronary sinus. European heart journal. Case reports Wong, C. C., Pogatchnik, B. P., Clark, D. E., Sharma, R. P. 2024; 8 (4): ytae192

  Abstract

  Background: Anomalous aortic origin of a coronary artery from the opposite sinus is a rare congenital abnormality that may be encountered during primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI).Case summary: A 65-year-old man presented with chest pain and signs of heart failure. Electrocardiogram demonstrated atrial fibrillation with ST elevation in the high lateral leads, and he was taken emergently to the cardiac catheterization laboratory for primary PCI. Coronary angiography identified the culprit to be an occluded anomalous left main coronary artery (LMCA) arising from the right coronary cusp, and primary PCI was successfully performed in the LMCA and the left anterior descending artery (LAD). Computed tomography angiography confirmed a benign retroaortic course of the anomalous LMCA with no additional high-risk features, as well as a new left atrial appendage thrombus. He subsequently developed deep venous thrombosis, acute pulmonary embolism, and acute kidney injury secondary to renal artery embolism with associated infarction. Workup for patent foramen ovale and thrombophilia were negative, and he was discharged in a stable condition. At 2-month follow-up, he was asymptomatic with no evidence of myocardial ischaemia on stress cardiac magnetic resonance imaging.Discussion: We present the first reported case of an occluded anomalous LMCA arising from the right coronary sinus in a patient presenting with STEMI. Rapid recognition of this congenital anomaly and selection of an appropriate guide catheter were keys to achieving timely reperfusion and a good outcome in this case.

  View details for DOI 10.1093/ehjcr/ytae192

  View details for PubMedID 38665427

• Editorial for "4D Flow Cardiac MR in Primary Mitral Regurgitation". Journal of magnetic resonance imaging : JMRI Ma, L., Pogatchnik, B. 2024

  View details for DOI 10.1002/jmri.29356

  View details for PubMedID 38485209

• Computed Tomography Planning for Transcatheter Tricuspid Valve Interventions. Seminars in roentgenology Yang, I. Y., Pogatchnik, B. P. 2024; 59 (1): 87-102

  View details for DOI 10.1053/j.ro.2023.11.001

  View details for PubMedID 38388101

• Percutaneous Treatment of an Aorto-Right Ventricular Fistula FollowingBalloon-Expandable Transcatheter Aortic Valve Replacement. JACC. Case reports Dowling, C., Haeffele, C., Pogatchnik, B. P., Sharma, R. P. 2023; 18: 101906

  Abstract

  We present the case of a 71-year-old man who experienced congestive cardiac failure after transcatheter aortic valve replacement with a balloon-expandable transcatheter heart valve. Echocardiography and cardiac computed tomography demonstrated an aorto-right ventricular fistula, and successful percutaneous closure was performed with a vascular plug. (Level of Difficulty: Advanced.).

  View details for DOI 10.1016/j.jaccas.2023.101906

  View details for PubMedID 37545680

• Immediate and Follow-up Imaging Findings after Cone-Beam CT-guided Transbronchial Lung Cryobiopsy. Radiology. Cardiothoracic imaging Pogatchnik, B. P., Swenson, K. E., Duong, D. K., Shaller, B., Bedi, H., Guo, H. H. 2023; 5 (2): e220149

  Abstract

  To evaluate findings after transbronchial lung cryobiopsy (TBLC) using intraprocedural cone-beam CT (CBCT) and follow-up chest CT examinations.A single-center, prospective cohort study was performed with 14 participants (mean age, 65 years ± 13 [SD]; eight male participants) undergoing CBCT-guided TBLC between August 2020 and February 2021 who underwent follow-up chest CT imaging. Intraprocedural CBCT and follow-up chest CT images were interpreted for changes compared with baseline CT images. Statistical analyses were performed using independent samples t test and analysis of variance.A total of 62 biopsies were performed, with 48 in the field of view of CBCT immediately after biopsy. All 48 biopsy sites had evidence of postprocedural hemorrhage, and 17 (35%) had pneumatoceles at the biopsy site. Follow-up CT images showed resolution of these findings. Solid nodules developed at 18 of the 62 (29%) biopsy sites.Postbiopsy hemorrhage and pneumatoceles on intraprocedural CBCT images (which were clinically occult and resolved spontaneously) and new solid nodules on follow-up chest CT images were commonly observed after TBLC. These findings may help alleviate unnecessary follow-up imaging and tissue sampling.Keywords: Biopsy/Needle Aspiration, CT, Lungs, Lung Biopsy, Interventional Bronchoscopy© RSNA, 2023.

  View details for DOI 10.1148/ryct.220149

  View details for PubMedID 37124647

  View details for PubMedCentralID PMC10141444

• Lung abscess and empyema in a heart transplant recipient from Thailand. Transplant infectious disease : an official journal of the Transplantation Society Bruminhent, J., Lopez-Medrano, F., Pogatchnik, B. P., Nascimento, E., Namsiripongpan, W., Yingchoncharoen, T., Ngodngamthaweesuk, M., Sukprapruet, A., Naratreekoon, B., Rodriguez-Goncer, I., Hernandez, A., Polanco, N., Aguado, J. M., Pouch, S., Clemente, W. T. 2022

  Abstract

  The case discussed involves a 69-year-old Thai woman who underwent orthotopic heart transplantation nine months before this event. She presented with fever without localizing signs or symptoms. However, her chest images revealed mass-like consolidation in the left upper lobe. Blood culture and lung tissue identifiedRhodococcus equi.She was successfully treated with a combination of antimicrobial therapy, optimization of immunosuppressants, and surgical resection. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1111/tid.13984

  View details for PubMedID 36305598

• Coronary Artery Disease in a Young Adult With Unilateral Moyamoya Disease. Journal of the Society for Cardiovascular Angiography & Interventions Stathogiannis, K. E., Pogatchnik, B. P., Steinberg, G. K., Sharma, R. P. 2022; 1 (6): 100459

  View details for DOI 10.1016/j.jscai.2022.100459

  View details for PubMedID 39132340

  View details for PubMedCentralID PMC11307966

• Update on CT Imaging of Left Ventricular Assist Devices and Associated Complications CURRENT CARDIOVASCULAR IMAGING REPORTS Velangi, P. S., Agdamag, A. C., Nijjar, P. S., Pogatchnik, B., Nijjar, P. S. 2022

  View details for DOI 10.1007/s12410-022-09570-0

  View details for Web of Science ID 000860208200001

• The RSNA International COVID-19 Open Annotated Radiology Database (RICORD). Radiology Tsai, E. B., Simpson, S., Lungren, M., Hershman, M., Roshkovan, L., Colak, E., Erickson, B. J., Shih, G., Stein, A., Kalpathy-Cramer, J., Shen, J., Hafez, M., John, S., Rajiah, P., Pogatchnik, B. P., Mongan, J., Altinmakas, E., Ranschaert, E. R., Kitamura, F. C., Topff, L., Moy, L., Kanne, J. P., Wu, C. C. 2021: 203957

  Abstract

  The coronavirus disease 2019 (COVID-19) pandemic is a global healthcare emergency. Although reverse transcriptase polymerase chain reaction (RT-PCR) is the reference standard method to identify patients with COVID-19 infection, chest radiographs and CT chest play a vital role in the detection and management of these patients. Prediction models for COVID-19 imaging are rapidly being developed to support medical decision making. However, inadequate availability of a diverse annotated dataset has limited the performance and generalizability of existing models. To address this unmet need, the RSNA and Society of Thoracic Radiology (STR) collaborated to develop the RSNA International COVID-19 Open Radiology Database (RICORD). This database is the first multi-institutional, multi-national expert annotated COVID-19 imaging dataset. It is made freely available to the machine learning community as a research and educational resource for COVID-19 chest imaging. Pixel-level volumetric segmentation with clinical annotations were performed by thoracic radiology subspecialists for all COVID positive thoracic CTs. The labeling schema was coordinated with other international consensus panels and COVID data annotation efforts, European Society of Medical Imaging Informatics (EUSOMII), the American College of Radiology (ACR) and the American Association of Physicists in Medicine (AAPM). Study level COVID classification labels for chest radiographs were annotated by three radiologists with majority vote adjudication by board certified radiologists. RICORD consists of 240 thoracic CT scans and 1,000 chest radiographs contributed from four international sites. We anticipate that the RICORD database will ideally lead to prediction models that can demonstrate sustained performance across populations and healthcare systems. See also the editorial by Bai and Thomasian.

  View details for DOI 10.1148/radiol.2021203957

  View details for PubMedID 33399506

• Observational Supervision for Medical Image Classification Using Gaze Data Saab, K., Hooper, S. M., Sohoni, N. S., Parmar, J., Pogatchnik, B., Wu, S., Dunnmon, J. A., Zhang, H. R., Rubin, D., Re, C., DeBruijne, M., Cattin, P. C., Cotin, S., Padoy, N., Speidel, S., Zheng, Y., Essert, C. SPRINGER INTERNATIONAL PUBLISHING AG. 2021: 603-614

  View details for DOI 10.1007/978-3-030-87196-3_56

  View details for Web of Science ID 000712020700056

• Dramatic Case of Paradoxical Embolism. Radiology. Cardiothoracic imaging Pogatchnik, B. P., Fleischmann, D. 2020; 2 (4): e200360

  View details for DOI 10.1148/ryct.2020200360

  View details for PubMedID 33778615

• Radiology-pathology Correlation in Recovered COVID-19, Demonstrating Organizing Pneumonia. American journal of respiratory and critical care medicine Pogatchnik, B. P., Swenson, K. E., Sharifi, H. n., Bedi, H. n., Berry, G. J., Guo, H. H. 2020

  View details for DOI 10.1164/rccm.202004-1278IM

  View details for PubMedID 32609531