Browsing by Author "Katwal, S"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication Comparison of Ultrasonography with Computed Tomography in Diagnosis and Staging of Lung Cancer(Kathmandu University, 2024) Paudel, S; Kayastha, P; Suwal, S; Nepal, B; Bhusal, KR; Bhusal, KR; Katwal, S; Regmi, PRABSTRACT Background Ultrasound (US) can aid in lung cancer diagnosis and staging in peripheral-based lesions by demonstrating chest wall invasion, aiding as a guide to biopsy, and detecting supraclavicular lymph nodes which are often missed by computed tomography (CT). Objective This study is to compare the ultrasound with computed tomography in the diagnosis and staging of lung cancer. Method This was an observational prospective study conducted from October 2020 to April 2023 in patients with or suspected lung cancer sent for imaging assessment to the Department of Radiology and Imaging. Out of 306 patients who underwent computed tomography scan, a total of 234 patients with proven lung cancer were subjected to ultrasound of the chest, liver, bilateral adrenal, and supraclavicular regions for the evaluation of lung mass, pleural effusion, and metastasis in lung, adrenal, and supraclavicular lymph nodes. Diagnostic values of ultrasound to detect peripheral lung lesions, chest wall invasion, pleural effusion, liver and adrenal metastasis, and supraclavicular lymph nodes were compared with contrast-enhanced computed tomography scans. Ultrasound’s performance was evaluated against computed tomography scans as the gold standard, using the chi-square test, z-test, and area under the curve for comparison (p < 0.05 for significance). Result The majority of patients (53.8%, n=126) were aged 61-75, with 53% being male and 89% smokers. Ultrasound was superior in detecting pleural effusion (sensitivity 80.3%, NPV 92.2%, AUC 0.860) and supraclavicular lymph nodes (sensitivity 72.2%, NPV 91.6%, AUC 0.817). Conclusion In resource-constrained settings like Nepal, where advanced imaging may be limited, integrating ultrasound with contrast-enhanced computed tomography significantly improves lung cancer diagnosis. This non-radiation approach is particularly beneficial for peripheral lesions, patients with renal function impairment and aiding effective staging of lung cancer. KEY WORDS Computed tomography, Lung cancer, Role, UltrasoundPublication Correlation between Computed Tomography and Ultrasonography Findings in Patients with Fatty Liver(Kathmandu University, 2024) Kayastha, P; Paudel, S; Chapagain, P; Shingh, SS; Adhikari, B; Joshi, S; Katwal, SABSTRACT Background Fatty liver disease, linked to obesity, alcohol consumption, and insulin resistance, is characterized by pathological fat deposition exceeding 5%. Its rising global prevalence, particularly in Southeast Asia, highlights the need for effective diagnostic modalities. Objective To find the correlation between computed tomography and ultrasonography findings in patients with fatty liver. Method A prospective cross-sectional study was conducted on 211 patients from December 2016 to October 2017. Patients referred for computed tomography chest and abdomen were included, excluding those with diffuse or focal liver disease other than fatty liver. Computed tomography attenuation values were measured using non- contrast sequences, with participants showing mean hepatic attenuation less than +48 Hounsfield units subjected to further ultrasound and shear wave elastography examinations. Data were analyzed using Microsoft Excel and SPSS, with associations examined through Pearson correlation, ANOVA and Shapiro-Wilk test. Result The study included 100 males and 111 females, aged 21 to 65 years. The mean computed tomography attenuation was +40.31 Hounsfield units. A moderately strong negative correlation was found between Computed Tomography attenuation and ultrasound grades of fatty liver (Spearman’s coefficient = -0.775, p = 0.005). No significant correlation was observed between computed tomography attenuation and shear wave elastography values, nor between patient age and hepatic attenuation. Conclusion This study demonstrates a significant correlation between computed tomography attenuation and ultrasound grades of fatty liver, highlighting their complementary roles in diagnosing fatty liver disease. However, no significant correlation was found between computed tomography attenuation and shear wave elastography values. KEY WORDS Attenuation, Computed tomography, Elastography, Fatty liver, UltrasoundPublication Correlation between Femoral Intercondylar Notch Width and Anterior Cruciate and Posterior Cruciate Ligament Widths on MRI of Knee Joint(Kathmandu University, 2023) Ghimire, P; Kayastha, P; Suwal, S; Katwal, S; Dhakal, P; Lamichhane, S; Lohani, BABSTRACT Background Anatomic variations have been implicated as one of the intrinsic causes of injuries to the cruciate ligaments which can induce a functional deficiency to the knee. Narrow cruciate ligament widths as well as narrow femoral intercondylar notch widths can increase the risk of these ligaments rupturing. Objective To correlate the width of the femoral intercondylar notch (ICN) with anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) widths on MRI of the knee joint. Method A total of 46 patients who met the inclusion criteria were evaluated. Intercondylar notch was identified on coronal T1W images while anterior cruciate ligament and posterior cruciate ligament were identified on proton density coronal images. All the widths were measured in the same plane at a mid-coronal level where anterior cruciate ligament and posterior cruciate ligament cross each other. Result Our result showed a significant correlation between the widths of intercondylar notch and anterior cruciate ligament (r = 0.68, p < 0.001) and between intercondylar notch width (INW) and posterior cruciate ligament width (r = 0.65, p < 0.001). Overall, the mean intercondylar notch width measured was 17.5 ±2.5 mm (range 11.8 to 21.8 mm), the mean anterior cruciate ligament width was 5.9 ±1.3 mm (range 3.3 to 8.6 mm), and the mean posterior cruciate ligament width was 8.9 ±1.5 mm (range 5.9 to 11.8 mm). A statistically significant difference was observed between males and females for mean widths of intercondylar notch (p < 0.001) and posterior cruciate ligament (p=0.01). However, no statistically significant difference was seen for anterior cruciate ligament width (p=0.07) between the two genders. Conclusion Measurement of the femoral intercondylar notch width can be used as an indicator of anterior cruciate ligament and posterior cruciate ligament widths which can further assist to identify the individuals who are more susceptible to cruciate ligament injuries. KEY WORDS Anterior cruciate ligament, Cruciate ligament injury, Intercondylar notch width, MRI, posterior cruciate ligament