Elijah Richard Sommer
MD Student with Scholarly Concentration in Clinical Research / Surgery, expected graduation Spring 2027
All Publications
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Limitations of ultrasound compared with computed tomography for kidney stone surveillance.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada
2025
Abstract
Renal ultrasound (US) offers less radiation exposure than computed tomography (CT) for kidney stone surveillance but has lower sensitivity and specificity for nephrolithiasis diagnosis. Additionally, US may overestimate stone size, leading to unnecessary surgical interventions. Evidence on US performance for kidney stone surveillance is variable, making its clinical utility unclear. We aimed to assess US accuracy against CT and identify factors influencing US performance.We performed a retrospective review of patients with known nephrolithiasis seen in urology clinic at Stanford who underwent both renal US and CT within 90 days for surveillance from January to December 2022. Patients with spontaneous stone passage or interventions were excluded. Stone characteristics were recorded, and statistical analysis compared the diagnostic accuracy of US and CT.A total of 107 patients and 128 stones were included, with a mean time difference of 25.7 days between US and CT. US sensitivity was 77%, with a positive predictive value (PPV) of 75% for stone detection. The PPV was only 59% for stones >4 mm by CT. Mean stone size was 8.7 mm on US vs. 5.5 mm on CT (p=0.02), with more pronounced overestimation in smaller stones and higher body mass index (BMI) (p<0.05). No significant differences in US performance were found by stone location, laterality, or time between scans. Differences in stone detection (p=0.01) and size (p=0.03) were associated with the individual performing the ultrasound.US performance is limited compared to CT and is influenced by stone size, BMI, and sonographer. Overestimation by US may lead to unnecessary interventions in up to 40% of patients with stones >4 mm.
View details for DOI 10.5489/cuaj.9043
View details for PubMedID 40116666
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ProCUSNet: Prostate Cancer Detection on B-mode Transrectal Ultrasound Using Artificial Intelligence for Targeting During Prostate Biopsies.
European urology oncology
2025
Abstract
To assess whether conventional brightness-mode (B-mode) transrectal ultrasound images of the prostate reveal clinically significant cancers with the help of artificial intelligence methods.This study included 2986 men who underwent biopsies at two institutions. We trained the PROstate Cancer detection on B-mode transrectal UltraSound images NETwork (ProCUSNet) to determine whether ultrasound can reliably detect cancer. Specifically, ProCUSNet is based on the well-established nnUNet frameworks, and seeks to detect and outline clinically significant cancer on three-dimensional (3D) examinations reconstructed from 2D screen captures. We compared ProCUSNet against (1) reference labels (n = 515 patients), (2) eight readers that interpreted B-mode ultrasound (n = 20-80 patients), and (3) radiologists interpreting magnetic resonance imaging (MRI) for clinical care (n = 110 radical prostatectomy patients).ProCUSNet found 82% clinically significant cancer cases with a lesion boundary error of up to 2.67 mm and detected 42% more lesions than ultrasound readers (sensitivity: 0.86 vs 0.44, p < 0.05, Wilcoxon test, Bonferroni correction). Furthermore, ProCUSNet has similar performance to radiologists interpreting MRI when accounting for registration errors (sensitivity: 0.79 vs 0.78, p > 0.05, Wilcoxon test, Bonferroni correction), while having the same targeting utility as a supplement to systematic biopsies.ProCUSNet can localize clinically significant cancer on screen capture B-mode ultrasound, a task that is particularly challenging for clinicians reading these examinations. As a supplement to systematic biopsies, ProCUSNet appears comparable with MRI, suggesting its utility for targeting suspicious lesions during the biopsy and possibly for screening using ultrasound alone, in the absence of MRI.
View details for DOI 10.1016/j.euo.2024.12.012
View details for PubMedID 39880746
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Career Trajectory After General Surgery Residency: Do Academic Program Graduates Pursue Academic Surgery?
Annals of surgery
2024
Abstract
Determine the proportion of contemporary US academic general surgery residency program graduates who pursue academic careers and identify factors associated with pursuing academic careers.Many academic residency programs aim to cultivate academic surgeons, yet the proportion of contemporary graduates who choose academic careers is unclear. The potential determinants that affect graduates' decisions to pursue academic careers remain underexplored.We collected program and individual-level data on 2015 and 2018 graduates across 96 US academic general surgery residency programs using public resources. We defined those pursuing academic careers as faculty within US allopathic medical school-affiliated surgery departments who published two or more peer-reviewed publications as the first or senior author between 2020-2021. After variable selection using sample splitting LASSO regression, multivariable regression evaluated association with pursuing academic careers among all graduates, and graduates of top-20 residency programs. Secondary analysis using multivariable ordinal regression explored factors associated with high research productivity during early faculty years.Among 992 graduates, 166 (17%) were pursuing academic careers according to our definition. Graduating from a top-20 ranked residency program (OR[95%CI]: 2.34[1.40-3.88]), working with a longitudinal research mentor during residency (OR[95%CI]: 2.21[1.24-3.95]), holding an advanced degree (OR[95%CI]: 2.20[1.19-3.99]), and the number of peer-reviewed publications during residency as first or senior author (OR[95%CI]: 1.13[1.07-1.20]) were associated with pursuing an academic surgery career, while the number of peer-reviewed publications before residency was not (OR[95%CI]: 1.08[0.99-1.20]). Among top 20 program graduates, working with a longitudinal research mentor during residency (OR[95%CI]: 0.95[0.43-2.09]) was not associated with pursuing an academic surgery career. The number of peer-reviewed publications during residency as first or senior author was the only variable associated with higher productivity during early faculty years (OR[95%CI]: 1.12[1.07-1.18]).Our findings suggest programs that aim to graduate academic surgeons may benefit from ensuring trainees receive infrastructural support and demonstrate sustained commitment to research throughout residency. Our results should be interpreted cautiously as the impact of unmeasured confounders is unclear.
View details for DOI 10.1097/SLA.0000000000006307
View details for PubMedID 38652655
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MIC-CUSP: Multimodal Image Correlations for Ultrasound-Based Prostate Cancer Detection
SPRINGER INTERNATIONAL PUBLISHING AG. 2023: 121-131
View details for DOI 10.1007/978-3-031-44521-7_12
View details for Web of Science ID 001115849400012