scispace - formally typeset
Search or ask a question
Author

Ruth P. Lim

Bio: Ruth P. Lim is an academic researcher from Harvard University. The author has contributed to research in topics: Magnetic resonance imaging & Magnetic resonance angiography. The author has an hindex of 31, co-authored 145 publications receiving 4420 citations. Previous affiliations of Ruth P. Lim include University of Melbourne & NorthShore University HealthSystem.


Papers
More filters
Journal ArticleDOI
TL;DR: ENB-0040, an enzyme-replacement therapy, was associated with improved findings on skeletal radiographs and improved pulmonary and physical function in infants and young children with life-threatening hypophosphatasia.
Abstract: Background Hypophosphatasia results from mutations in the gene for the tissue-nonspecific isozyme of alkaline phosphatase (TNSALP). Inorganic pyrophosphate accumulates extracellularly, leading to rickets or osteomalacia. Severely affected babies often die from respiratory insufficiency due to progressive chest deformity or have persistent bone disease. There is no approved medical therapy. ENB-0040 is a bone-targeted, recombinant human TNSALP that prevents the manifestations of hypophosphatasia in Tnsalp knockout mice. Methods We enrolled infants and young children with life-threatening or debilitating perinatal or infantile hypophosphatasia in a multinational, open-label study of treatment with ENB-0040. The primary objective was the healing of rickets, as assessed by means of radiographic scales. Motor and cognitive development, respiratory function, and safety were evaluated, as well as the pharmacokinetics and pharmacodynamics of ENB-0040. Results Of the 11 patients recruited, 10 completed 6 months of...

425 citations

Journal ArticleDOI
01 Feb 1999-Cancer
TL;DR: In this paper, a single-institution review of clinical presentation, treatment, and outcome of male breast carcinoma was conducted, where the patients were analyzed both as a single cohort and as four cohorts grouped according to decade of diagnosis.
Abstract: BACKGROUND A single-institution review of clinical presentation, treatment, and outcome of male breast carcinoma was conducted. METHODS Data obtained by chart review of 229 cases were analyzed with respect to clinical presentation, treatment choice, significant prognostic factors, and survival. The patients were analyzed both as a single cohort and as four cohorts grouped according to decade of diagnosis. RESULTS Presentation occurred at a median age of 63 years, most often with a self-detected lump. Pathology consisted of subtypes similar to those of female breast carcinoma. The majority of tumors were larger than 2 cm in greatest dimension. Lymph node status, hormone receptors, and histologic and nuclear grade were underreported. Primary, adjuvant, and advanced disease treatment practices were reviewed over time. The 5-year disease free survival (DFS), overall survival (OS), and local control were 47%, 53%, and 91%, respectively. No difference in outcome by decade of diagnosis was observed. Negative lymph nodes and adjuvant hormone treatment predicted for better DFS and OS. Younger age and Stage 0 also predicted for better OS. CONCLUSIONS Compared with data from female breast carcinoma patients, 5-year OS for this series was low; however, when these patients were separated by lymph node status, survival was similar for those with axillary lymph node metastases. Despite a change in standard primary surgical treatment and an increased use of chemotherapy and hormone therapy over the study period, no difference in outcome was observed among these males. In the absence of prospective, randomized clinical trials, collection of comprehensive data on the presentation and management of male breast carcinoma may help to optimize clinical care. Cancer 1999;85:629–39. © 1999 American Cancer Society.

318 citations

Journal ArticleDOI
TL;DR: Radiologists performed well with both PI-RADS and Likert scales for tumor localization, although, in the TZ, performance was better with the Lkert scale than the PI- RADS scale.
Abstract: Three experienced radiologists from our institution performed well with both the Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales in tumor localization, with radical prostatectomy as the reference standard, and performance was better in the peripheral zone than in the transition zone (TZ); however, performance with the PI-RADS scale was lower than with the Likert scale in the TZ and interreader agreement was poor in the TZ, thereby indicating the need for continued development of the PI-RADS scale, particularly in the TZ.

251 citations

Journal ArticleDOI
TL;DR: Free-breathing radially sampled 3D fat suppressed T1-weighted gradient-echo acquisitions with breath-hold and conventional VIBE acquisitions for postcontrast imaging of the liver can be performed during free breathing for contrast-enhanced imaging ofThe liver with comparable image quality to BH V IBE.
Abstract: Objective:To compare free-breathing radially sampled 3D fat suppressed T1-weighted gradient-echo acquisitions (radial volumetric interpolated breath-hold examination [VIBE]) with breath-hold (BH) and free-breathing conventional (rectilinearly sampled k-space) VIBE acquisitions for postcontrast imagi

245 citations

Journal ArticleDOI
TL;DR: Contrast-enhanced multiphase liver MRI of diagnostic quality can be performed during free breathing using a combination of compressed sensing, parallel imaging, and golden-angle radial sampling.
Abstract: Assessment of arterial and venous phases of enhancement is essential for liver lesion detection and characterization.1,2 Contrast-enhanced multiphase liver magnetic resonance (MR) examination is usually performed using a T1-weighted fat-saturated 3-dimensional (3D) volumetric interpolated sequence with cartesian k-space sampling in a breath hold (BH). However, this method is sensitive to respiratory motion and can result in suboptimal images in patients who cannot adequately hold their breath. Although parallel-imaging and partial-Fourier techniques are usually used for accelerating the examination, this may be insufficient in elderly patients, patients with debilitations, or pediatric patients who have severely limited breath-holding capacity.3,4 Furthermore, achievable in-plane spatial resolution and anatomic coverage remain limited because of the need to acquire data within a BH. Recently, a more motion-robust 3D gradient-echo sequence has been developed (radial VIBE) that uses the “stack-of-stars”scheme to acquire volumetric k-space data, where radial sampling is performed in-plane (along ky and kx) and cartesian sampling is used along the slice dimension (kz).5,6 Studies have shown that free-breathing acquisitions with the stack-of-stars radial VIBE sequence can yield images of comparable image quality with conventional BH examination at the expense of a longer acquisition time.7,8 This relatively long acquisition time limits its utility for dynamic liver imaging, which requires multiphase acquisitions with temporal resolution of 15 to 20 seconds. One potential solution to improve the temporal resolution is the application of the compressed sensing (CS) concept, which has recently emerged as a powerful tool for fast imaging by exploiting redundancies in the images.9 Successful application of CS requires sparsity, incoherence, and nonlinear reconstruction. Magnetic resonance images often can be represented using only few coefficients in an appropriate transform basis. Multiphase liver MRI is a perfect candidate for CS because of extensive spatiotemporal data correlations that result in sparse representations. Compressed sensing can be synergistically combined with parallel imaging to further increase imaging speed.10–12 High level of incoherence can be achieved by using irregular k-space sampling patterns. Radial sampling of k-space compares favorably with conventional cartesian schemes for CS because of the inherent presence of incoherent aliasing artifacts from undersampled radial trajectories,10 which are essential for application of the CS reconstruction. We have recently developed a reconstruction technique that combines CS with parallel imaging for radially acquired dynamic MRI.13 Two different types of radial acquisition schemes are investigated in this study: the interleaved angle-bisection scheme and the golden-angle scheme, which mainly differ in the temporal order of the k-space sampling. With the interleaved angle-bisection scheme, radial spokes are acquired at a regular angular distance (Fig. 1) in multiple interleaves, such that all spokes from 1 interleave intersect the spokes from the previously acquired interleave.14 With the recently proposed golden-angle acquisition scheme, on the other hand, the angle of the acquired spokes is continuously increased by 111.25 degrees during the acquisition, resulting in a series of complementary radial spokes with large angular distance that, for an arbitrary number of spokes, always add up to an approximately uniform angular coverage of the k-space15 (Fig. 1). FIGURE 1 Schematic of sampling scheme for interleaved angle-bisection and continuous golden-angle acquisitions. Temporal frames in the bisection scheme need to be predefined, whereas the golden-angle scheme provides freedom in defining temporal frames retrospectively ... The purposes of this study were to demonstrate the feasibility of performing free-breathing multiphase liver MRI using a combination of CS and parallel imaging with golden-angle (golden-angle radial sparse parallel [GRASP]) and interleaved-angle (interleaved-angle radial sparse parallel [IARASP]) radial sampling scheme and to compare image quality of GRASP and IARASP with conventional BH T1-weighted gradient-echo imaging with cartesian sampling (volumetric interpolate breath hold examination [BH-VIBE]) in healthy participants with normal breath-holding capacity.

215 citations


Cited by
More filters
Journal ArticleDOI
TL;DR: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors.
Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

6,968 citations

Journal ArticleDOI
TL;DR: The Prostate Imaging - Reporting and Data System Version 2 (PI-RADS™ v2) simplifies and standardizes terminology and content of reports, and provides assessment categories that summarize levels of suspicion or risk of clinically significant prostate cancer that can be used to assist selection of patients for biopsies and management.

2,210 citations

Journal ArticleDOI
01 Jul 2013
TL;DR: There is potentially a great upside to increasing the vitamin D status of children and adults worldwide for improving musculoskeletal health and reducing the risk of chronic illnesses, including some cancers, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, neurocognitive disorders and mortality.
Abstract: It is now generally accepted that vitamin D deficiency is a worldwide health problem that affects not only musculoskeletal health but also a wide range of acute and chronic diseases. However, there remains cynicism about the lack of randomized controlled trials to support the association studies regarding the nonskeletal health benefits of vitamin D. This review was obtained by searching English-language studies published up to April 1, 2013, in PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials (search terms: vitamin D and supplementation) and focuses on recent challenges regarding the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D concentrations from dietary sources, supplements, and sun exposure. The effect of vitamin D on fetal programming epigenetics and gene regulation could potentially explain why vitamin D has been reported to have such wide-ranging health benefits throughout life. There is potentially a great upside to increasing the vitamin D status of children and adults worldwide for improving musculoskeletal health and reducing the risk of chronic illnesses, including some cancers, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, neurocognitive disorders, and mortality.

994 citations

01 Jan 2013
TL;DR: The introduction of an effective blood test, prostate specific antigen (PSA), has made it possible to diagnose more and more men in an earlier stage where they can be offered potentially curative treatments, and this is the subject of the EAU guidelines on prostate cancer.
Abstract: The introduction of an effective blood test, prostate specific antigen (PSA), has made it possible to diagnose more and more men in an earlier stage where they can be offered potentially curative treatments. The other side of the coin is that if effective diagnostic procedures are used unselectively in elderly men with a short life expectancy, a problem with over diagnosis and over treatment might occur. Thus the same stage of prostate cancer may need different treatment strategies, pending on the patient’s life expectancy. This, and many other issues regarding the disease, is the subject of the EAU guidelines on prostate cancer. G UI DE LI N ES O N P RO ST AT E CA N CE R 10

968 citations