Dr. Poullos is a native of Stockton California. He earned his B.S. at Santa Clara University and M.D. degree at the University of Texas Medical School at Houston, after which he did an Internal Medicine residency at the University of California-San Francisco, finishing in 2002. He stayed at UCSF as a Gastroenterology fellow until 2004. However, after a spinal cord injury, he decided to retrain in Radiology. He did his Radiology residency at Stanford University, where he also completed a fellowship In Body Imaging in 2009. Dr. Poullos is now faculty in both the departments of Radiology and Gastroenterology and Hepatology. His clinical practice is at the Stanford Medicine, where he specializes in CT, MRI, and ultrasound of the abdomen and pelvis. His interests include radiology of the acute abdomen, hepatobiliary imaging, and colorectal cancer screening.

Dr. Poullos is the Founder and Co-Chair of the Stanford Medicine Alliance for Disability Inclusion and Equity (SMADIE), a group composed of people with disabilities and their allies at Stanford Medicine. In that role, Dr. Poullos advocates for students and healthcare providers with disabilities and for health equity for disabled patients. He is a Faculty Advisor to the Stanford Medical Students with Disability and Chronic Illness (MSDCI) and the MSDCI National organizations. Dr. Poullos and SMADIE have made significant contributions to the disability community, including starting the Stanford Conference on Disability in Healthcare and Medicine, drawing over 1000 participants from 39 countries. He is the Co-Host of the popular “DocsWithDisabilities” podcast, has spoken internationally about disability access in medicine, and has written and researched in the field. One of his proudest achievements is co-creating the Disability in Medicine Mutual Mentorship Program, serving the needs of disabled medicine and healthcare students and practitioners. In 2022, Dr. Poullos received the Stanford President’s Award for Excellence through Diversity.

Clinical Focus

  • Body Imaging
  • virtual colonoscopy
  • Gastrointestinal Diseases
  • Hepatobiliary Imaging
  • Pancreatic imaging
  • Imaging of the acute abdomen
  • Acute appendicitis imaging

Academic Appointments

  • Clinical Professor, Radiology

Administrative Appointments

  • Founder and Co-Chair, Stanford Medicine Alliance for Disability Inclusion and Equity (SMADIE) (2018 - Present)
  • Board of Directors, Stanford Disability Initiative (SDI) (2019 - Present)
  • Member, School of Medicine Diversity Cabinet (2019 - Present)
  • Member, School of Medicine Faculty Senate (2017 - Present)
  • Associate Residency Program Director, Stanford University Radiology Residency (2009 - 2016)

Honors & Awards

  • President's Award for Excellence through Diversity, Stanford University (2022)
  • Certificate of Merit, Radiological Society of North America (2010)
  • Alpha Omega Alpha, University of Texas at Houston (1998)

Boards, Advisory Committees, Professional Organizations

  • Senator, School of Medicine Faculty Senate (2018 - Present)
  • Member, Stanford Radiology Diversity Committee (2018 - Present)
  • Member, Stanford Medicine Teaching and Mentoring Academy (2016 - Present)
  • Body Division Representative, Radiology Professional Practice Evaluation Committee (PPEC) (2011 - Present)
  • Member, Society of Abdominal Radiology (2010 - Present)
  • Member, American College of Radiology (2004 - Present)
  • Member, Radiological Society of North America (2004 - Present)
  • Member, Association of Program Directors in Radiology (2010 - 2015)
  • Member, Association of University Radiologists (2009 - 2015)
  • Member, Alliance of Clinician Educators in Radiology (2009 - 2015)

Professional Education

  • Fellowship: University of California San Francisco (2003) CA
  • Fellowship: Stanford University Medical Center (2009) CA
  • Residency: Stanford University Hospital (2008) CA
  • Residency: University of California at San Francisco School of Medicine (2002) CA
  • Medical Education: University of Texas Medical School at Houston Registrar (1999) TX
  • Board Certification: American Board of Radiology, Diagnostic Radiology (2008)
  • Board Certification, American Board of Internal Medicine, Internal Medicine (2002)

All Publications

  • Who Are We Missing? Reporting of Transgender and Gender-Expansive Populations in Clinical Trials. Journal of the American Heart Association Rice, E. N., Lan, R. H., Nunes, J. C., Shah, R., Clark, K., Periyakoil, V. S., Chen, J. H., Lin, B., Echols, M., Awad, C., Idris, M. Y., Cruz, E. R., Poullos, P. D., Lewis, E. F., Brown-Johnson, C., Igwe, J., Shen, S., Palaniappan, L., Stefanick, M. L., Ritter, V., Pemu, P., Rodriguez, F., Deb, B., Pundi, K., Wang, P. J. 2023: e030209

    View details for DOI 10.1161/JAHA.123.030209

    View details for PubMedID 37947088

  • Prevalence of Diversity Statements and Disability Inclusion Among Radiology Residency Program Websites. Journal of the American College of Radiology : JACR Dhanani, Z., Doo, F. X., Spalluto, L. B., Yee, J., Flores, E. J., Meltzer, C. C., Poullos, P. D. 2023


    Radiology has widely acknowledged the need to improve inclusion of racial, ethnic, gender and sexual minorities, with recent discourse also underscoring the importance of disability diversity and inclusion efforts. Yet, studies have shown a paucity of diversity among radiology residents, despite increasing efforts to foster diversity and inclusion. Thus, the purpose of this study is to assess radiology residency program websites' diversity statements for inclusion of race/ethnicity, gender, sexual orientation, and disability as commonly underrepresented groups.A cross-sectional, observational study of websites of all diagnostic radiology programs in the ERAS (Electronic Residency Application Service®) directory was conducted. Program websites that met inclusion criteria were audited for presence of a diversity statement, if the statement was specific to the residency program, radiology department, or institution, and if it was presented or linked on the program or department website. All statements were evaluated for the inclusion of four diversity categories: race/ethnicity, gender, sexual orientation, and disability.192 radiology residencies were identified using ERAS. Programs with missing/malfunctioning hyperlinks (N=33) or required logins (N=1) were excluded. 158 websites met inclusion criteria for analysis. Two-thirds (N=103; 65.1%) had a diversity statement either within their residency, department, or institution, with only 28 (18%) having residency program specific statements and 22 (14%) having department-specific statements. Of the websites with diversity statements, inclusion of gender diversity was most frequent (43.0%), followed by race/ethnicity (39.9%), sexual orientation (32.9%) and disability (25.3%). Race/ethnicity was most-included in institution-level diversity statements.Less than 20% of radiology residency websites include a diversity statement, and disability is the least-included category among the diversity statements. As radiology continues to lead diversity and inclusion efforts in healthcare, a more comprehensive approach with equitable representation of different groups, including those with disabilities, would foster a broader sense of belonging. This comprehensive approach can help to overcome systemic barriers and bridge gaps in disability representation.

    View details for DOI 10.1016/j.jacr.2023.02.027

    View details for PubMedID 37028498

  • Validation of a Resectability Scoring System for Prediction of Pancreatic Adenocarcinoma Surgical Outcomes. Annals of surgical oncology Toesca, D. A., Susko, M., von Eyben, R., Baclay, J. R., Pollom, E. L., Jeffrey, R. B., Poullos, P. D., Poultsides, G. A., Fisher, G. A., Visser, B. C., Koong, A. C., Feng, M., Chang, D. T. 2023


    BACKGROUND: The most used pancreatic cancer (PC) resectability criteria are descriptive in nature or based solely on dichotomous degree of involvement (<180° or >180°) of vessels, which allows for a high degree of subjectivity and inconsistency.METHODS: Radiographic measurements of the circumferential degree and length of tumor contact with major peripancreatic vessels were retrospectively obtained from pre-treatment multi-detector computed tomography (MDCT) images from PC patients treated between 2001 and 2015 at two large academic institutions. Arterial and venous scores were calculated for each patient, then tested for a correlation with tumor resection and R0 resection.RESULTS: The analysis included 466 patients. Arterial and venous scores were highly predictive of resection and R0 resection in both the training (n=294) and validation (n=172) cohorts. A recursive partitioning tree based on arterial and venous score cutoffs developed with the training cohort was able to stratify patients of the validation cohort into discrete groups with distinct resectability probabilities. A refined recursive partitioning tree composed of three resectability groups was generated, with probabilities of resection and R0 resection of respectively 94 and 73% for group A, 61 and 35% for group B, and 4 and 2% for group C. This resectability scoring system (RSS) was highly prognostic, predicting median overall survival times of 27, 18.9, and 13.5 months respectively for patients in RSS groups A, B, and C (p<0.001).CONCLUSIONS: The proposed RSS was highly predictive of resection, R0 resection, and prognosis for patients with PC when tested against an external dataset.

    View details for DOI 10.1245/s10434-023-13120-3

    View details for PubMedID 36792768

  • Disability Identity Among Diverse Learners and Employees at an Academic Medical Center. JAMA network open Jerome, B., Fassiotto, M., Altamirano, J., Sutha, K., Maldonado, Y., Poullos, P. 2022; 5 (11): e2241948


    This survey study evaluates representation of persons with disabilities across demographic characteristics at an academic medical center.

    View details for DOI 10.1001/jamanetworkopen.2022.41948

    View details for PubMedID 36355375

  • Design and Rationale for the Use of Magnetic Resonance Imaging Biomarkers to Predict Diabetes After Acute Pancreatitis in the Diabetes RElated to Acute Pancreatitis and Its Mechanisms Study: From the Type 1 Diabetes in Acute Pancreatitis Consortium. Pancreas Tirkes, T., Chinchilli, V. M., Bagci, U., Parker, J. G., Zhao, X., Dasyam, A. K., Feranec, N., Grajo, J. R., Shah, Z. K., Poullos, P. D., Spilseth, B., Zaheer, A., Xie, K. L., Wachsman, A. M., Campbell-Thompson, M., Conwell, D. L., Fogel, E. L., Forsmark, C. E., Hart, P. A., Pandol, S. J., Park, W. G., Pratley, R. E., Yazici, C., Laughlin, M. R., Andersen, D. K., Serrano, J., Bellin, M. D., Yadav, D., Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC) 2022; 51 (6): 586-592


    ABSTRACT: This core component of the Diabetes RElated to Acute pancreatitis and its Mechanisms (DREAM) study will examine the hypothesis that advanced magnetic resonance imaging (MRI) techniques can reflect underlying pathophysiologic changes and provide imaging biomarkers that predict diabetes mellitus (DM) after acute pancreatitis (AP). A subset of participants in the DREAM study will enroll and undergo serial MRI examinations using a specific research protocol. The aim of the study is to differentiate at-risk individuals from those who remain euglycemic by identifying parenchymal features after AP. Performing longitudinal MRI will enable us to observe and understand the natural history of post-AP DM. We will compare MRI parameters obtained by interrogating tissue properties in euglycemic, prediabetic, and incident diabetes subjects and correlate them with metabolic, genetic, and immunological phenotypes. Differentiating imaging parameters will be combined to develop a quantitative composite risk score. This composite risk score will potentially have the ability to monitor the risk of DM in clinical practice or trials. We will use artificial intelligence, specifically deep learning, algorithms to optimize the predictive ability of MRI. In addition to the research MRI, the DREAM study will also correlate clinical computed tomography and MRI scans with DM development.

    View details for DOI 10.1097/MPA.0000000000002080

    View details for PubMedID 36206463

  • Deconstructing Ableism in Health Care Settings Through Case-Based Learning. MedEdPORTAL : the journal of teaching and learning resources Dhanani, Z., Huynh, N., Tan, L., Kottakota, H., Lee, R., Poullos, P. 2022; 18: 11253


    Introduction: Patients with disabilities face health disparities, and providers with disabilities confront professional roadblocks and institutional bias. Yet their experiences are often excluded from medical education, and few case studies address culturally humble care for those with disabilities.Methods: We created two 1-hour case-based modules on disability and ableism from patient and provider perspectives. Modules were piloted in June 2020 and presented at two conferences in April 2021. Modules included a prereading, introductory disability presentation, and facilitated case discussions. Sessions were evaluated with pre- and/or postsession surveys. Modules were rated on 5-point Likert scales for educational value, professional growth contribution, and interactive/engaging design.Results: Participants rated the patient and provider modules 4.5, 4.4, and 4.4 and 4.5, 4.4, and 4.5 for the three categories, respectively. Participants noted that the sessions were insightful and validating and improved their understanding of ableism and the importance of disability curricula. There were significant improvements in participants' perceptions of ability to discuss ableism's impacts, recognize barriers, identify resource/support gaps for trainees, and advocate. A total of 171 participants completed our modules, with survey response rates of 38% (60 out of 160) and 48% (77 out of 160) for one conference and a postsurvey response rate of 64% (seven out of 11) for the second.Discussion: Designed for health care trainees, providers, administration, and staff, our sessions introduced concepts of ableism, accommodation, and health care barriers. Our results suggest the modules can contribute to professional growth, understandings of ableism, and participants' disability advocacy tool kit.

    View details for DOI 10.15766/mep_2374-8265.11253

    View details for PubMedID 35601662

  • The Performance and Trajectory of Medical Students With Disabilities: Results From the Pathways Project. Academic medicine : journal of the Association of American Medical Colleges Meeks, L. M., Plegue, M., Swenor, B. K., Moreland, C. J., Jain, S., Grabowski, C. J., Westervelt, M., Case, B., Eidtson, W. H., Patwari, R., Angoff, N. R., LeConche, J., Temple, B. M., Poullos, P., Sanchez-Guzman, M., Coates, C., Low, C., Henderson, M. C., Purkiss, J., Kim, M. H. 2021; 96 (11S): S209-S210

    View details for DOI 10.1097/ACM.0000000000004271

    View details for PubMedID 34705710

  • The Performance and Trajectory of Medical Students With Disabilities: Results From the Pathways Project ACADEMIC MEDICINE Meeks, L. M., Plegue, M., Swenor, B. K., Moreland, C. J., Jain, S., Grabowski, C. J., Westervelt, M., Case, B., Eidtson, W. H., Patwari, R., Angoff, N. R., LeConche, J., Temple, B. M., Poullos, P., Sanchez-Guzman, M., Coates, C., Low, C., Henderson, M. C., Purkiss, J., Kim, M. H. 2021; 96 (11S): S209-S210
  • The Performance and Trajectory of Medical Students With Disabilities: Results From a Multisite, Multicohort Study. Academic medicine : journal of the Association of American Medical Colleges Meeks, L. M., Plegue, M., Swenor, B. K., Moreland, C. J., Jain, S., Grabowski, C. J., Westervelt, M., Case, B., Eidtson, W. H., Patwari, R., Angoff, N. R., LeConche, J., Temple, B. M., Poullos, P., Sanchez-Guzman, M., Coates, C., Low, C., Henderson, M. C., Purkiss, J., Kim, M. H. 2021


    To conduct a post-Americans with Disabilities Act Amendments Act multisite, multicohort study called the Pathways Project to assess the performance and trajectory of medical students with disabilities (SWD).From June to December 2020, the authors conducted a matched cohort study of SWD and nondisabled controls from 2 graduating cohorts (2018 and 2019) across 11 U.S. MD-granting medical schools. Each SWD was matched with 2 controls, one from their institution and, whenever possible, one from their cohort for Medical College Admission Test score and self-reported gender. Outcome measures included final attempt Step 1 and Step 2 Clinical Knowledge scores, time to graduation, leave of absence, matching on first attempt, and matching to primary care.A total of 171 SWD and 341 controls were included, the majority of SWD had cognitive/learning disabilities (118/171, 69.0%). Compared to controls, SWD with physical/sensory disabilities had similar time to graduation (88.6%, 95% confidence interval [CI]: 77.0, 100.0 vs 95.1%, 95% CI: 90.3, 99.8; P = .20), Step 1 scores (229.6 vs 233.4; P = .118), and matched on first attempt (93.9%, 95% CI: 86.9, 100.0 vs 94.6%, 95% CI: 91.8, 97.4; P = .842), while SWD with cognitive/learning disabilities had lower Step 1 scores (219.4; P < .001) and were less likely to graduate on time (81.2%, 95% CI: 69.2, 93.2; P = .003) and match on first attempt (85.3%, 95% CI: 78.0, 92.7; P = .009). Accommodated SWD had Step 1 scores that were 5.9 points higher than nonaccommodated SWD (95% CI: -0.7, 12.5; P = .08).Structural barriers remain for SWD with cognitive/learning disabilities, which could be partially mitigated by accommodations on high-stakes exams.

    View details for DOI 10.1097/ACM.0000000000004510

    View details for PubMedID 34817411

  • Reporting of acute pancreatitis by radiologists-time for a systematic change with structured reporting template. Abdominal radiology (New York) Khurana, A., Nelson, L. W., Myers, C. B., Akisik, F., Jeffrey, B. R., Miller, F. H., Mittal, P., Morgan, D., Mortele, K., Poullos, P., Sahani, D., Sandrasegaran, K., Tirkes, T., Zaheer, A., Patel, B. N. 2020


    Acute pancreatitis has a wide array of imaging presentations. Various classifications have been used in the past to standardize the terminology and reduce confusing and redundant terms. We aim to review the historical and current classifications of acute pancreatitis and propose a new reporting template which can improve communication between various medical teams by use of appropriate terminology and structured radiology template. The standardized reporting template not only conveys the most important imaging findings in a simplified yet comprehensive way but also allows structured data collection for future research and teaching purposes.

    View details for DOI 10.1007/s00261-020-02468-9

    View details for PubMedID 32189022

  • Creative approaches to the inclusion of medical students with disabilities AEM Education and Training Meeks , L., Poullos , P., Sweenor , B. 2019

    View details for DOI 10.1002/aet2.10425

  • Structured Reporting of Multiphasic CT for Hepatocellular Carcinoma: Effect on Staging and Suitability for Transplant. AJR. American journal of roentgenology Poullos, P. D., Tseng, J. J., Melcher, M. L., Concepcion, W. n., Loening, A. M., Rosenberg, J. n., Willmann, J. K. 2018: 1–9


    The purpose of this study is to evaluate whether use of a standardized radiology report template would improve the ability of liver transplant surgeons to diagnose stage T2 hepatocellular carcinoma (HCC) and determine patient suitability to undergo orthotopic liver transplant (OLT).In this retrospective study, a standardized template was devised, and its use was mandated for reporting of liver CT findings for patients with cirrhosis and HCC. Two surgeons analyzed 200 reports (100 before and 100 after template implementation) for descriptions of cirrhosis, portal hypertension, lesion enhancement characteristics, tumor thrombus, portal and superior mesenteric vein patency, and Organ Procurement Transplantation Network (OPTN) class. Ability to determine Milan criteria and surgeon satisfaction were also assessed. Data obtained before and after template implementation were statistically analyzed using the Cochran-Mantel-Haenszel test.Template implementation increased the percentage of reports documenting the presence or absence of portal hypertension (74% to 88% for surgeon 1 and 86% to 87% for surgeon 2; p = 0.042); lesion number (76% to 88% for surgeon 2 [no change for surgeon 1]; p = 0.038), size (95% to 96% for surgeon 1 and 82% to 93% for surgeon 2; p = 0.03), and enhancement (93% to 94% for surgeon 1 and 80% to 91% for surgeon 2; p = 0.049); presence of tumor thrombus (10% to 57% for surgeon 1 and 31% to 63% for surgeon 2; p < 0.001); and OPTN class (8% to 82% for surgeon 1 and 2% to 81% for surgeon 2; p < 0.001). The surgeons were significantly more able to determine the presence of T2 disease and qualification for exception points after implementation of the template (increasing from 80% to 94%; p = 0.025). Satisfaction with reports also improved (p < 0.0001).The reporting template improved determination of patient suitability to undergo transplant according to the Milan criteria.

    View details for PubMedID 29470153

  • Assessing local progression after stereotactic body radiation therapy for unresectable pancreatic adenocarcinoma: CT versus PET. Practical radiation oncology Toesca, D. A., Pollom, E. L., Poullos, P. D., Flynt, L., Cui, Y., Quon, A., von Eyben, R., Koong, A. C., Chang, D. T. 2017; 7 (2): 120-125


    Evaluation of local tumor progression (LP) has typically been defined by contrast-enhanced computed tomography (CT) imaging after stereotactic body radiation therapy (SBRT) for locally advanced pancreatic cancer (PDAC). The purpose of this study is to determine the benefit of adding 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging to CT for LP assessment of PDAC after SBRT.We retrospectively reviewed pretreatment, follow-up images, and outcomes of all patients treated with definitive SBRT for unresectable PDAC between December 2002 and December 2015 at our institution. For each patient, we independently analyzed LP both by CT and by FDG-PET criteria, using the Response Evaluation Criteria In Solid Tumors version 1.1 and the FDG-PET Response Evaluation Criteria In Solid Tumors version 1.0, respectively.Among 206 patients treated with definitive SBRT for unresectable PDAC, we identified 30 with LP on follow-up. Four did not undergo follow-up FDG-PET. Median time to LP after SBRT was 7.5 months (range, 2-25 months). Of the 26 patients with LP who had follow-up FDG-PET, 21 were diagnosed by FDG-PET (80.7%), 14 by CT (53.8%), and 9 by both FDG-PET and CT (34.6%). Use of CT alone revealed only 53.8% of cases of LP detected when FDG-PET and CT were combined. The cumulative incidence of LP, based on competing risk of death, at 1 and 2 years after SBRT was 9.6% and 16.7% by CT and 11% and 29.1% by FDG-PET, respectively.FDG-PET increases the chance of detecting LP of unresectable PDAC after SBRT and can have an important impact on reported outcomes. We recommend obtaining FDG-PET to assess treatment response when evaluating efficacy of SBRT and taking its use into account when comparing clinical data.

    View details for DOI 10.1016/j.prro.2016.09.002

    View details for PubMedID 28274396

  • Factitious Disorder Presenting with Attempted Simulation of Fournier's Gangrene. Journal of radiology case reports Tseng, J., Poullos, P. 2016; 10 (9): 26-34


    Fournier's gangrene is a severe polymicrobial necrotizing fasciitis of the perineal, genital, or perianal regions. The classic presentation is severe pain and swelling with systemic signs. Crepitus and cutaneous necrosis are often seen. Characteristic CT findings include subcutaneous gas and inflammatory stranding. Unless treated aggressively, patients can rapidly become septic and die. Factitious Disorder is the falsification of one's own of medical or psychological signs and symptoms. Many deceptive methods have been described, from falsely reporting physical or psychological symptoms, to manipulating lab tests, or even injecting or ingesting foreign substances in order to induce illness. We present a case of a 35-year-old man with factitious disorder who attempted to simulate Fournier's gangrene by injecting his scrotum with air and fluid. We will review the clinical presentation and diagnosis of Factitious Disorder, as well as Fournier's gangrene.

    View details for PubMedID 27761196

  • Predictors of appendicitis on computed tomography among cases with borderline appendix size. Emergency radiology Thompson, A. C., Olcott, E. W., Poullos, P. D., Jeffrey, R. B., Thompson, M. O., Rosenberg, J., Shin, L. K. 2015; 22 (4): 385-394


    Confident diagnosis of appendicitis when the appendix is borderline (6 to 7 mm) in size can be challenging. This retrospective study assessed computed tomography (CT) findings that are most predictive of appendicitis when the appendix is borderline in diameter. Three radiologists conducted separate, blind retrospective reviews of 105 contrast-enhanced CTs with borderline appendices. Presence or absence of appendicitis was confirmed by chart review of clinical or surgical outcomes. Logistic regression was used to determine the odds ratio (OR) and the receiver operating characteristic for CT features predictive of appendicitis. Absence of intraluminal air (OR = 5.11, p < 0.001), wall hyperemia (OR = 3.92, p = 0.002), wall thickening (OR = 29.7, p < 0.001), and fat stranding (OR = 3.85, p = 0.003) were significant findings in univariate logistic regression. Using a multivariate model, we found that the absence of intraluminal air (OR = 6.04, p = 0.002) and wall thickening (OR = 24.6, p < 0.001) remained statistically significant and were unaffected by adjustment for gender and pediatric age. The area under the curve was significantly greater for the multivariate model than the initial, clinical CT impressions (p = 0.024). The combination of wall thickening and absence of intraluminal air was 92.6 % (95 % CI 75.7-99.1) sensitive and 82.4 % (95 % CI 65.5-93.2) specific for appendicitis. Wall thickening and the absence of intraluminal air are prominent predictors of appendicitis and, if present together, these features may aid in identifying appendicitis on CT when the appendix is borderline in size.

    View details for DOI 10.1007/s10140-015-1297-6

    View details for PubMedID 25687166

  • Ischemic colitis due to a mesenteric arteriovenous malformation in a patient with a connective tissue disorder. Journal of radiology case reports Poullos, P. D., Thompson, A. C., Holz, G., Edelman, L. A., Jeffrey, R. B. 2014; 8 (12): 9-21


    Ischemic colitis is a rare, life-threatening, consequence of mesenteric arteriovenous malformations. Ischemia ensues from a steal phenomenon through shunting, and may be compounded by the resulting portal hypertension. Computed tomographic angiography is the most common first-line test because it is quick, non-invasive, and allows for accurate anatomic characterization. Also, high-resolution three-dimensional images can be created for treatment planning. Magnetic resonance angiography is similarly sensitive for vascular mapping. Conventional angiography remains the gold standard for diagnosis and also allows for therapeutic endovascular embolization. Our patient underwent testing using all three of these modalities. We present the first reported case of this entity in a patient with a vascular connective tissue disorder.

    View details for DOI 10.3941/jrcr.v8i12.1843

    View details for PubMedID 25926912

    View details for PubMedCentralID PMC4394977

  • Ischemic Colitis Due to a Mesenteric Arteriovenous Malformation in a Patient with a Connective Tissue Disorder JOURNAL OF RADIOLOGY CASE REPORTS Poullos, P. D., Thompson, A. C., Holz, G., Edelman, L. A., Jeffrey, R. 2014; 8 (12): 9–21
  • Pancreatic neuroendocrine tumours: hypoenhancement on arterial phase computed tomography predicts biological aggressiveness. HPB Worhunsky, D. J., Krampitz, G. W., Poullos, P. D., Visser, B. C., Kunz, P. L., Fisher, G. A., Norton, J. A., Poultsides, G. A. 2014; 16 (4): 304-311


    Contrary to pancreatic adenocarcinoma, pancreatic neuroendocrine tumours (PNET) are commonly hyperenhancing on arterial phase computed tomography (APCT). However, a subset of these tumours can be hypoenhancing. The prognostic significance of the CT appearance of these tumors remains unclear.From 2001 to 2012, 146 patients with well-differentiated PNET underwent surgical resection. The degree of tumour enhancement on APCT was recorded and correlated with clinicopathological variables and overall survival.APCT images were available for re-review in 118 patients (81%). The majority had hyperenhancing tumours (n = 80, 68%), 12 (10%) were isoenhancing (including cases where no mass was visualized) and 26 (22%) were hypoenhancing. Hypoenhancing PNET were larger, more commonly intermediate grade, and had higher rates of lymph node and synchronous liver metastases. Hypoenhancing PNET were also associated with significantly worse overall survival after a resection as opposed to isoenhancing and hyperenhancing tumours (5-year, 54% versus 89% versus 93%). On multivariate analysis of factors available pre-operatively, only hypoenhancement (HR 2.32, P = 0.02) was independently associated with survival.Hypoenhancement on APCT was noted in 22% of well-differentiated PNET and was an independent predictor of poor outcome. This information can inform pre-operative decisions in the multidisciplinary treatment of these neoplasms.

    View details for DOI 10.1111/hpb.12139

    View details for PubMedID 23991643

  • Taller Haustral Folds in the Proximal Colon: A Potential Factor Contributing to Interval Colorectal Cancer? 78th Annual Scientific Meeting of the American-College-of-Gastroenterology Thompson, A., Jones, R., Banerjee, S., Poullos, P., Shin, L. NATURE PUBLISHING GROUP. 2013: S628–S628
  • Current techniques in the performance, interpretation, and reporting of CT colonography. Gastrointestinal endoscopy clinics of North America Poullos, P. D., Beaulieu, C. F. 2010; 20 (2): 169-192


    The technical objective of computed tomographic colonography (CTC) is to acquire high-quality computed tomography images of the cleansed, well-distended colon for polyp detection. In this article the authors provide an overview of the technical components of CTC, from preparation of the patient to acquisition of the imaging data and basic methods of interpretation. In each section, the best evidence for current practices and recommendations is reviewed. Each of the technical components must be optimized to achieve high sensitivity in polyp detection.

    View details for DOI 10.1016/j.giec.2010.02.007

    View details for PubMedID 20451809

  • MR colonography and MR enterography. Gastrointestinal endoscopy clinics of North America Shin, L. K., Poullos, P., Jeffrey, R. B. 2010; 20 (2): 323-346


    The bowel is a common site for pathologic processes, including malignancies and inflammatory disease. Colorectal cancer accounts for 10% of all new cancers and 9% of cancer deaths. A significant decrease in the incidence of colorectal cancer and cancer death rates has been attributed to screening measures, earlier detection, and improved therapies. Virtual colonoscopy (VC), also known as computed tomography colonography, is an effective method for detecting polyps. However, in light of increasing concerns about ionizing radiation exposure from medical imaging and potential increased risk of future radiation-induced malignancies, magnetic resonance imaging (MRI) is seen as an increasingly attractive alternative. Improvements in MRI technology now permit three-dimensional volumetric imaging of the entire colon in a single breath hold at high spatial resolution, making VC with MRI possible.

    View details for DOI 10.1016/j.giec.2010.02.010

    View details for PubMedID 20451820

  • Gastrointestinal Amyloidosis: Approach to Treatment. Current treatment options in gastroenterology Poullos, P. D., Stollman, N. 2003; 6 (1): 17-25


    The main treatment goals in amyloidosis are twofold: 1) to diagnose the underlying disease state accurately to guide effective primary therapy (if available) and 2) to ameliorate symptoms. The correct diagnosis is essential because disease-modifying therapies vary widely according to the underlying primary pathology. Primary treatment options remain limited. The best evidence is for high-dose chemotherapy, followed by autologous stem cell transplantation in patients with primary systemic amyloidosis. High-flux hemodialysis (HD) may prevent HD-related amyloidosis. Liver transplantation may be an option for patients with familial amyloidotic polyneuropathy. Several novel specific therapies are under investigation, including small molecule drugs and vaccines. Their efficacy and safety in humans remain to be demonstrated. In the absence of specific cures, symptom-directed therapy assumes a paramount role and can improve quality of life by mitigating diarrhea or pain, for example.

    View details for PubMedID 12521568

  • Prediction of pancreatic cancer surgical outcomes and prognosis based on an objective resectability scoring system 2018 Gastrointestinal Cancers Sysmposium (GI-ASCO) Toesca, D. A., Jeffrey, B., von Eyben, R., Poullos, P. D., Poultsides, G. A., Fisher, G. A., Visser, B. C., Koong, A. C., Chang, D. T. 2018: 446
  • Predicting Pancreatic Cancer Resectability and Outcomes Based on an Objective Quantitative Scoring System. Pancreas Toesca, D. A., Jeffrey, R. B., von Eyben, R. n., Pollom, E. L., Poullos, P. D., Poultsides, G. A., Fisher, G. A., Visser, B. C., Koong, A. C., Chang, D. T. ; 48 (5): 622–28


    To quantitatively assess the probability of tumor resection based on measurements of tumor contact with the major peripancreatic vessels.This is a retrospective cohort study of pancreatic cancer patients treated between January 2001 and December 2015 in a single academic comprehensive cancer center. Radiographic measurements of the circumferential degree and length of solid tumor contact with major peripancreatic vessels were obtained from diagnostic pancreatic protocol computed tomography images and tested for correlation with tumor resection and margin status.Of 294 patients analyzed, 113 (38%) were resected, with 71 (63%) with negative margins. Based on the individual measurements of vascular involvement, a resectability scoring system (RSS) was created. The RSS correlated strongly with resection (P < 0.0001) and R0 resection (P < 0.0001) probabilities. Moreover, the RSS correlated with overall survival (P < 0.0001) and metastasis-free survival (P < 0.0001), being able to substratify resectable (P = 0.022) and unresectable patients (P = 0.014) into subgroups with different prognosis based on RSS scores.Based on a comprehensive and systematic quantitative approach, we developed a scoring system that demonstrated excellent accuracy to predict tumor resection, surgical margin status, and prognosis.

    View details for PubMedID 31091207