Mohammad Reza Rouhezamin

All Publications

• Ultrasound-guided intraoperative liver ablation - retrospective review of indications and outcomes. Clinical radiology Rouhezamin, M. R., Iqbal, S. I., Qadan, M., Arellano, R. S., Uppot, R. N. 2024; 82: 106793

  Abstract

  To define the indications and outcomes of intraoperative ablation of hepatic malignancies.This retrospective study comprises 27 patients (male/female: 19/8; mean age: 56 ± 13) undergoing intraoperative ablation (IOA) of liver tumours between July 2001 and August 2021 for 42 tumours, including colorectal liver metastasis (CRLM) (n = 27), hepatocellular carcinoma (HCC)(n = 14), and ovarian cancer metastasis (n = 1). The mean tumour diameter was 2.1 cm ± 1.3 (range, 0.6-5.6 cm). The median imaging follow-up was 26.3 months ± 25.6 (range: 0.13-161.6). Technical success (TS), local tumour progression (LTP), and local progression-free survival (LPFS) were calculated leveraging the Kaplan-Meier method. Adverse events (AE) were categorised according to SIR guidelines.Indications for IOA include concurrent partial hepatectomy (n = 9), intraoperative detection of a new tumour (n = 4), lack of a safe percutaneous trajectory (n = 3) or clamp of hilum (n = 1). In 7 patients, surgeons made independent decisions for IOA not based on established criteria. Of 32 ablated tumours among 25 patients with available follow-up, TS was achieved for 31 tumours (97%). LTP was detected in 32% of cases at a median of 13.7 months. LPFS at 1,2,3,5 years were 82%, 60%, 51%, 51%. AE rate was 55.5% addressed with minimal or no interventions in 80% of cases. One patient with HCC died of liver failure.The indications for IOA are concurrent partial hepatectomy, intraoperative detection of a new tumour, and suboptimal percutaneous ablation. IOA is effective with high TS. LTP is high. AE rate is relatively high; however, no significant treatment is required in most cases.

  View details for DOI 10.1016/j.crad.2024.106793

  View details for PubMedID 39881460

• Adipose tissue around the knee; A pictorial review of normal anatomy and common pathologies. Current problems in diagnostic radiology Rouhezamin, M. R., Azhideh, A., Haseli, S., Pooyan, A., Hosseini, N., Chalian, M. 2024

  Abstract

  The periarticular adipose tissues play a crucial role in knee biomechanics, yet they are often overlooked in daily radiology practice. As the primary mechanical shock absorbers of the knee, intra-articular fat pads reduce the friction between intra-articular structures during joint movement. They also contribute to inflammatory regulation, endocrine secretion, and pain detection. Periarticular fat pads are susceptible to a spectrum of traumatic, degenerative, inflammatory, and neoplastic changes. MRI enables radiologists to assess the anatomy of periarticular fat pads and their related pathologies to make accurate diagnoses and to guide appropriate management. The MRI presentation of these pathologies can be categorized into three groups: (a) signal change and thickening of synovial lining, (b) edema-like change in fat pads, and (c) mass-like lesions. While degeneration and impingement appear as high signal edema-like intensity on fluid-sensitive sequences, inflammatory or infectious synovitis, hemosiderin deposition, and lipoma arborescens can change the signal intensity of the synovial lining. A mass-like lesion arising from these structures could be a true neoplastic lesion, or a variety of non-neoplastic pathologies. A comprehensive understanding of adipose tissues and their pathologies is fundamental for accurate diagnosis and interpretation. In this review, we aim to provide an in-depth assessment of the anatomy and common pathologies of these adipose tissues.

  View details for DOI 10.1067/j.cpradiol.2024.11.001

  View details for PubMedID 39627041

• Limited Effectiveness in Early Human Clinical Experience with Pulsed Electrical Field Ablation. Journal of vascular and interventional radiology : JVIR Rouhezamin, M. R., Fintelmann, F. J., Huang, A. J., Arellano, R. S., Smolinski-Zhao, S., Patel, D. M., Wehrenberg-Klee, E. P., Uppot, R. N. 2024

  Abstract

  To evaluate oncological outcomes, abscopal effect, and adverse events of pulsed electrical field (PEF) ablation of tumors in the chest, abdomen, and pelvis.PEF ablations performed at an academic medical center between May 2023 - January 2024 were retrospectively analyzed . 11 patients (male/female: 4/7, age:58 ± 19) underwent 11 PEF sessions targeting 13 tumors (lung metastasis from solitary fibrous tumor (n=3) and colorectal carcinoma(CA) (n=1), osteosarcoma pleural metastases (n=2), hepatocellular CA (n=2),liver metastasis from colorectal CA (n=1)and leiomyosarcoma (n=1), metastatic melanoma to pancreas (n=1), metastatic retroperitoneal lymph node from endometrial CA(n=1), recurrence of endometrial CA in vaginal cuff(n=1)) with the goal of complete coverage (n=11/13) or debulking (n=2/13). The mean tumor diameter was 1.9 ± 1.0 cm (range, 0.4 - 3.3 cm). Cross-sectional imaging follow-up was 5.3 ± 2.2 months (range, 1.9 - 7.9 months). Oncological outcomes, abscopal effect, and adverse events categorized according to SIR guidelines were reported.Of 11 tumors underwent ablation for complete coverage, complete coverage was achieved for 1 (9%) and residual detected in 9 (81%). 10 of 11 patients (91%) showed either residual, local or distant progression within a median of 3 months. No abscopal effect was observed. There were 2 mild and 2 severe adverse events.PEF ablation showed a low rate of complete coverage (9%) and a high rate (91%) of residual, local or distant progression. No abscopal effect was observed within a median of 5.1 months after the ablation.

  View details for DOI 10.1016/j.jvir.2024.10.033

  View details for PubMedID 39522867

• Medical Extended Reality for Radiology Education and Training. Journal of the American College of Radiology : JACR Lang, M., Ghandour, S., Rikard, B., Balasalle, E. K., Rouhezamin, M. R., Zhang, H., Uppot, R. N. 2024; 21 (10): 1583-1594

  Abstract

  Medical extended reality (MXR), encompassing augmented reality, virtual reality, and mixed reality (MR), presents a novel paradigm in radiology training by offering immersive, interactive, and realistic learning experiences in health care. Although traditional educational tools in the field of radiology are essential, it is necessary to capitalize on the innovative and emerging educational applications of extended reality (XR) technologies. At the most basic level of learning anatomy, XR has been extensively used with an emphasis on its superiority over conventional learning methods, especially in spatial understanding and recall. For imaging interpretation, XR has fostered the concepts of virtual reading rooms by enabling collaborative learning environments and enhancing image analysis and understanding. Moreover, image-guided interventions in interventional radiology have witnessed an uptick in XR utilization, illustrating its effectiveness in procedural training and skill acquisition for medical students and residents in a safe and risk-free environment. However, there remain several challenges and limitations for XR in radiology education, including technological, economic, and ergonomic challenges and and integration into existing curricula. This review explores the transformative potential of MXR in radiology education and training along with insights on the future of XR in radiology education, forecasting advancements in immersive simulations, artificial intelligence integration for personalized learning, and the potential of cloud-based XR platforms for remote and collaborative training. In summation, MXR's burgeoning role in reshaping radiology education offers a safer, scalable, and more efficient training model that aligns with the dynamic healthcare landscape.

  View details for DOI 10.1016/j.jacr.2024.05.006

  View details for PubMedID 38866067

• The tipping point: Key oncologic imaging findings resulting in critical changes in the management of malignant genitourinary and gynecological tumors. Current problems in diagnostic radiology Rouhezamin, M. R., Lee, S. I., Harisinghani, M., Uppot, R. N. 2024

  Abstract

  The purpose of this article is to review the staging systems for common malignant genitourinary and gynecological tumors, including renal cell carcinoma, urinary bladder carcinoma, as well as cervical, endometrial, and ovarian carcinoma, and to highlight the key imaging findings ("tipping points") that may alter patient management algorithms based on radiological staging.There are identifiable imaging features for the common genitourinary and gynecological malignancies, including the size of the primary tumor, tumor extension, invasion of adjacent structures, lymph node involvement, and distant metastasis, which provide important prognostic information and determine patient management. Radiologists must be aware of these imaging findings ("tipping points") when interpreting staging examinations.

  View details for DOI 10.1067/j.cpradiol.2024.08.009

  View details for PubMedID 39183071

• Retrieval of a Greenfield Inferior Vena Cava Filter Indwelling for 29 Years. Vascular and endovascular surgery Patel, D. M., Di Capua, J. F., Rouhezamin, M. R., Uppot, R. N., Kalva, S. P. 2024; 58 (6): 640-644

  Abstract

  Inferior vena cava (IVC) filters are used to prevent fatal and nonfatal pulmonary embolism in patients who otherwise cannot receive anticoagulation for venous thrombosis. While generally safe and effective, complications can arise, especially after prolonged implantation. Timely retrieval is essential once the indication for insertion has resolved. However, encountering patients with long-standing embedded filters is not uncommon. This case report discusses the successful retrieval of a permanent Greenfield IVC filter after 29 years.

  View details for DOI 10.1177/15385744241231134

  View details for PubMedID 38279905

• A technical review of percutaneous sclerotherapy with bleomycin for giant hepatic venous malformation. CVIR endovascular Ghaemi, O., Mehrabi Nejad, M. M., Rouhezamin, M. R., Ayoobi Yazdi, N., Pourghorban, R., Rokni Yazdi, H. 2023; 6 (1): 46

  Abstract

  Hepatic venous malformation (HVM), traditionally called liver haemangioma, is considered the most common benign hepatic lesion. Treatment might be indicated in large and symptomatic HVMs. We aim to describe stepwise technical aspects of trans-hepatic percutaneous sclerotherapy of hepatic venous malformation (HVM).Patients with symptomatic HVM larger than 5 cm are selected after discussion in hepatobiliary multidisciplinary team. After prophylactic antibiotic and corticosteroid administration, local anaesthesia and conscious sedation are applied. A 22-gauge spinal or Chiba needle is used to obtain percutaneous access to the HVM through normal liver parenchyma under ultrasound guidance. To ensure proper needle placement and to prevent accidental delivery of sclerosant into unintended areas, about 5-10 mL iodine contrast is injected under fluoroscopy. Then, 45-60 IU bleomycin is mixed with 10 mL distilled water and 10 mL lipiodol and is slowly injected under fluoroscopy over a period of 20-30 s. After the needle is removed, manual pressure is applied over the puncture site for a period of 5 min followed by placement of a sandbag. Patients are monitored for 6-8 h post-procedure.In this technical review, we described our institutional technique of percutaneous sclerotherapy, which could be regarded as an alternative to TAE in the management of HVM.

  View details for DOI 10.1186/s42155-023-00394-7

  View details for PubMedID 37755623

  View details for PubMedCentralID PMC10533756

• Predictors of Death in the Liver Transplantation Adult Candidates: An Artificial Neural Networks and Support Vector Machine Hybrid-Based Cohort Study. Journal of biomedical physics & engineering Bagheri Lankarani, K., Honarvar, B., Shafi Pour, F., Bagherpour, M., Erjaee, A., Rouhezamin, M. R., Khorrami, M., Amiri Zadeh Fard, S., Seifi, V., Geramizadeh, B., Salahi, H., Nikeghbalian, S., Shamsaeefar, A., Malek-Hosseini, S. A., Shirzadi, S. 2022; 12 (6): 591-598

  Abstract

  Model for end-stage liver disease (MELD) is currently used for liver transplantation (LT) allocation, however, it is not a sufficient criterion.This current study aims to perform a hybrid neural network analysis of different data, make a decision tree and finally design a decision support system for improving LT prioritization.In this cohort follow-up-based study, baseline characteristics of 1947 adult patients, who were candidates for LT in Shiraz Organ Transplant Center, Iran, were assessed and followed for two years and those who died before LT due to the end-stage liver disease were considered as dead cases, while others considered as alive cases. A well-organized checklist was filled for each patient. Analysis of the data was performed using artificial neural networks (ANN) and support vector machines (SVM). Finally, a decision tree was illustrated and a user friendly decision support system was designed to assist physicians in LT prioritization.Between all MELD types, MELD-Na was a stronger determinant of LT candidates' survival. Both ANN and SVM showed that besides MELD-Na, age and ALP (alkaline phosphatase) are the most important factors, resulting in death in LT candidates. It was cleared that MELD-Na <23, age <53 and ALP <257 IU/L were the best predictors of survival in LT candidates. An applicable decision support system was designed in this study using the above three factors.Therefore, Meld-Na, age and ALP should be used for LT allocation. The presented decision support system in this study will be helpful in LT prioritization by LT allocators.

  View details for DOI 10.31661/jbpe.v0i0.2010-1212

  View details for PubMedID 36569570

  View details for PubMedCentralID PMC9759643

• A Rare Case of Peripheral Pulmonary Artery Aneurysm and Cavitating Pneumonia in a Patient with COVID-19 Managed with an Endovascular Method. Radiology case reports Rokni, H., Nourizadeh, A. M., Sarmadi, B., Rouhezamin, M. R. 2022; 17 (10): 3694-3698

  Abstract

  Peripheral pulmonary artery aneurysm (PAA), being a rare condition, is considered extremely rare following coronavirus disease 2019 (COVID-19). We present a 58-year-old male who presented with fever, malaise, and dry cough. SARS-CoV-RNA transcription-mediated amplification test was positive for the patient. After 2 days, he developed hemoptysis and back pain, and a CT scan revealed a pulmonary aneurysm, evidence of alveolar hemorrhage, and Necrotizing pneumonia. He was scheduled for pulmonary artery angiography. The angiography confirmed a fusiform aneurysm and partial coiling of the aneurysmal sac, and indoor and backdoor embolization was performed. In the follow-up, a CT scan showed complete thrombosis of the aneurysmal sac, and the patient was free of symptoms. Peripheral PAAs can show a variety of symptoms. They can even be asymptomatic. The infectious pathologies of this condition are less common than the other. COVID-19 is an extremely rare pathology. To the best of our knowledge, this is the first case of necrotizing pneumonia and peripheral PPA in an adult. Moreover, it was followed by COVID-19. A vital takeaway note for physicians is to consider PAAs as a complication when treating COVID-19 patients who don't show signs of improvement or even show signs of exacerbation.

  View details for DOI 10.1016/j.radcr.2022.06.087

  View details for PubMedID 35936879

  View details for PubMedCentralID PMC9342831

• Immunoglobulin G Immunity to Hepatitis A Virus in Liver Transplant Candidates: A Serosurvey from Iran HEPATITIS MONTHLY Lankarani, K. B., Honarvar, B., Zahedroozegar, M., Dehghan, A., Rouhezamin, M., Khorrami, M., Fard, S., Seifi, V., Geramizadeh, B., Salahi, H., Nikeghbalian, S., Shamsaeefar, A., Malek-Hosseini, S. 2021; 21 (2)

  View details for DOI 10.5812/hepatmon.113001

  View details for Web of Science ID 000751891600002

• COVID-19 or Pulmonary Contusion? A Diagnostic Dilemma. Academic radiology Rouhezamin, M. R., Paydar, S., Haseli, S. 2020; 27 (6): 894-895

  View details for DOI 10.1016/j.acra.2020.04.008

  View details for PubMedID 32327295

  View details for PubMedCentralID PMC7158835

• Diagnosing Pulmonary Thromboembolism in COVID-19: A Stepwise Clinical and Imaging Approach. Academic radiology Rouhezamin, M. R., Haseli, S. 2020; 27 (6): 896-897

  View details for DOI 10.1016/j.acra.2020.04.023

  View details for PubMedID 32331965

  View details for PubMedCentralID PMC7164893

• Water Only Sequence: An Accurate Method to Estimate Hepatic Siderosis in Patients with Thalassemia Major and Intermedia IRANIAN JOURNAL OF RADIOLOGY Lotfi, M., Rouhezamin, M., Bijan, B., Sefidbakht, S., Karimi, M., Dehdashtiyan, A. 2020; 17 (2)

  View details for DOI 10.5812/iranjradiol.96811

  View details for Web of Science ID 000533549200014

• Internal Jugular Vein Waveform; A New Insight to Detect Early Stage of Hemorrhagic Shock. Bulletin of emergency and trauma Rouhezamin, M. R., Shekarchi, B., Taheri Akerdi, A., Paydar, S. 2019; 7 (3): 263-268

  Abstract

  To evaluate the accuracy of internal jugular vein waveform to detect early stage of hemorrhagic shock.Forty-three volunteers enrolled in our study between November and December 2018. After blood donation of 450cc, the blood donors in the case group underwent color Doppler sonography of internal Jugular Vein. Besides, the clinical and laboratory indicators of shock were evaluated. The same clinical, laboratory and sonographic data was also obtained from the volunteers in the control group, then Chi-square and Student t-test were applied to make comparison between mentioned groups.After excluding five volunteers, eighteen subjects were included in the blood donor group (mean of age: 35.81±8.05) and 20 healthy volunteers enrolled in the control group (mean of age: 34.95± 6.86). The Jugular pulsatility index was significantly smaller in the case group (0.47 ± 0.27 vs. 0.77 ± 0.52). The jugular pulsatility index above 0.91 excluded blood loss (sensitivity=100%). The combination of clinical, laboratory and sonographic data were also represented as two other indices; Jugular Pulsatility-Shock index and Jugular Pulsatility-Shock-Base Deficit index (JPSBDI). These indices were also accurate enough to detect early blood loss (p=0.011 and <0.001, respectively). JPSBDI below 0.38 was highly accurate to rule out blood loss. (Area under the curve: 0.868, sensitivity=95% and specificity=76.47%).The internal Jugular vein waveform is accurate to detect early stages of shock. The combination of clinical, laboratory and sonographic data is more promising than each of them, separately.

  View details for DOI 10.29252/beat-070309

  View details for PubMedID 31392226

  View details for PubMedCentralID PMC6681873

• A Ten-Year Study of Prostate Cancer: A Southern Iranian Experience. Iranian journal of medical sciences Lotfi, M., Beheshti, R., Rouhezamin, M. R., Rezaianzadeh, A., Farhadi, P., Daneshi, Z. 2018; 43 (4): 372-379

  Abstract

  Prostate cancer is the most common malignancy among the male population in the United States and the 3rd most common non-skin cancer among men in Iran. Its prevalence has shown a rising trend in recent decades. The aim of this study was to report the epidemiological features of prostate cancer in patients referred for prostate biopsy in the south of Iran and to evaluate the accuracy of the levels of the prostate-specific antigen (PSA) and the PSA-density (PSAD) as well as the extension of the disease in the prediction of the biological behavior of prostate cancer.This is a retrospective study on the medical records of 1982 consecutive patients who underwent transrectal ultrasound-guided biopsy due to an abnormal digital rectal examination and/or an elevated PSA level following referral from the Urology Ward to the Radiology Department of Shahid Faghihi Hospital in Shiraz, southern Iran, between December 2003 and July 2014.The overall cancer detection rate was 33.1%. Although the cancer was more prevalent among the elderly patients, a significant fraction (7%) of the patients were aged < 55 years. The sensitivity and specificity of the PSA were 97.4% and 8.7% and those of the PSAD were 82.9% and 52%, respectively. Of the 637 patients with prostate cancer, 250 (39.2%) had unilateral disease, 378 (59.4%) had bilateral disease, and 9 (1.4%) had inner-gland involvement. Most of the patients with bilateral involvement had high-grade Gleason scores.Our study underlines the relationship between age and the frequency of cancer; the levels of the PSA and the PSAD and the Gleason score; and the extent of tumor involvement and the grade of prostate cancer and also highlights the significance of screening, especially in younger patients.

  View details for DOI 10.1093/annonc/mds024

  View details for PubMedID 30046205

  View details for PubMedCentralID PMC6055215

• The Spatiotemporal Pattern of Trauma in Victims of Violence Visited in Emergency Room of Rajaei Hospital, Shiraz, Iran. Bulletin of emergency and trauma Rouhezamin, M. R., Paydar, S., Hasirbaf, M., Bolandparvaz, S., Abbasi, H. R. 2013; 1 (4): 141-6

  Abstract

  To explain an important aspect of violence, the spatiotemporal pattern of trauma in victims of violence visited in emergency room of Rajaei hospital, Shiraz, Iran.This cross-sectional prospective study comprised 109 randomly selected victims of violence visited in emergency room of Rajaei hospital, a tertiary referral hospital affiliated to Shiraz University of Medical Sciences in winter 2013. We recorded the demographic information as well as data regarding the type and time of the injuries. The data collected for each victim was then entered in a data gathering form.The study included 88% males with mean age 27.8 ± 8.8 years, which encompassed more than 60% young adults. Our study showed a temporal pattern with triple peaks. Moreover, 64% of assault trauma occurred at night. Furthermore, our study showed the majority of our patients suffered from stab wounds and about 57% of patients studied lacked high school diploma. Moreover it was revealed that violence was more common in downtown Shiraz, especially in the Fifth city district with simultaneous presence of many risk factors for violence.The result of this study showed that age, gender, educational status and temporal peak of violence were shown to be similar to other investigations conducted  in other countries. Despite these similarities, stabbing were more prevalent in our study. Additionally, the Fifth city district of Shiraz seems to be the main city district where preventive intervention is needed to reduce violence- related injuries.

  View details for PubMedID 27162846

  View details for PubMedCentralID PMC4789448

• Modified Perihepatic Packing; A Creative and Beneficial Method for Management of High Grade Liver Injury. Bulletin of emergency and trauma Ebrahimi, S., Tahmasebi, S., Rouhezamin, M. R., Mousavi, S. M., Abbasi, H. R., Bolandparvaz, S., Paydar, S. 2013; 1 (1): 22-7

  Abstract

  To evaluate the efficacy of modified perihepatic packing (MPHP) in reducing the rate of re-bleeding rate after packing removal.This was an experimental study being performed in Shiraz animal laboratory. High grade liver parenchymal injury was induced in 30 transgenic Australian rabbits which were then divided into two groups. Group A (control) included 14 and group B (experimental) comprised 16 rabbits. The animals in group A underwent standard perihepatic packing (SPHP) and those in group B were subjected to MPHP. Re-bleeding was assessed and compared between the two groups, after removal of perihepatic packings.There was no significant difference between two study groups regarding baseline and perioperative characteristics. Rabbits in group A had significantly lower rate of postoperative re-bleeding compared to those in group A (57.1% vs. 12.5%; p=0.019). The mean bleeding volume was also significantly lower in group B compared to group A (76.88 ± 22.12 vs. 98.93 ± 33.8 mL; p<001). Although the survival rate was higher in group A compared to group B (93.8% vs. 78.6%) but the difference was not statistically significant (p=0.315).MPHP is a simple and safe procedure for surgical management of high grade liver parenchymal injury concomitant with severe loss of glisson's capsule. This procedure significantly decreases re-bleeding after packing removal in comparison with SPHP.

  View details for PubMedID 27162817

  View details for PubMedCentralID PMC4771238

• On-scene echocardiography and focused assessment with sonography for trauma (FAST), screening modalities to limit early prehospital thoracotomy, means to reduce the expenditure of resources. The Journal of trauma Paydar, S., Rouhezamin, M. R., Mousavi, M., Akerdi, A. T., Navaei, M. R., Bolandparvaz, S. 2011; 71 (4): 1096

  View details for DOI 10.1097/TA.0b013e31822f3515

  View details for PubMedID 21986763