Browsing by Author "Moosa, Sulaiman"

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    Abnormal diastolic and systolic septal motion following pericardiectomy demonstrated by cine DENSE MRI
    (Clinics Cardive, 2008) Spottiswoode, Bruce; Russell, James B; Moosa, Sulaiman; Meintjes, Ernesta M; Epstein, Frederick H; Mayosi, Bongani M
    Constrictive pericarditis can lead to paradoxical interventricular septal motion. Displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) provides a method for quantifying myocardial motion and strain. A case of constrictive pericarditis is presented and the diastolic ‘septal bounce’ is clearly evident in both anatomical and DENSE ciné MRI images. (See video link to full-text electronic article). The postoperative systolic septal wall-motion abnormality of cardiac surgery is portrayed with greater precision by DENSE than anatomical ciné MRI images.
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    Audit of the reporting adequacy of magnetic resonance enterograph performed in patients with Crohn's disease at Groote Schuur Hospital
    (2025) Smit, Elsabe Jacoba; Moosa, Sulaiman
    Background: CD is an idiopathic inflammatory bowel disease with a predilection for the terminal ileum and the colon. MRE is the cornerstone imaging modality for evaluating and monitoring CD. This audit aims to assess the adequacy of radiology reports for MRE in CD patients, performed at GSH. Objectives: Determine the proportion reporting elements included in MRE reports for patients with CD and compare it to international recommendations of essential elements to include in MRE reports, Evaluate the lexicon usage, Evaluate the structure and clarity. Method: Retrospective audit, assessing adequacy of radiology reports for patients with CD who underwent MRE examinations at GSH. This forms the first leg of an audit cycle assessing local practice standards and make recommendations for future improvements should target standards not be met. Results: Overall, none of the data points collected met our 70% cut-off for minimum requirements. Technical factors were particularly poorly reported (8%), with some improvement in Radiological factors (66%). There was suboptimal use of correct nomenclature and documentation of treatment response. Structured reporting was not correlated to improved documentation but did increase readability (p<0.01). Conclusion: This audit shows there is suboptimal documentation of essential elements in the MRE reports for patients with CD at GSH, including poor use of correct nomenclature and documentation of treatment response. Structured reporting has a role to play in increasing readability of reports. Contribution: The findings suggest a complete audit cycle should be implemented with targeted education on reporting of MRE studies, followed by reauditing of the findings.
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    Retrospective review: diagnostic performance of PI-RADS V2.1 4 and 5 lesions in predicting clinically significant prostate cancer at Groote Schuur Hospital, South Africa
    (2025) Wegner, Brett; Human, Gercois; Moosa, Sulaiman
    Background: Multiparametric MRI (mpMRI) prostate has become a fundamental part of prostate cancer primary diagnosis, active surveillance, and lesion localization. PI-RADS reporting lexicon is used to report mpMRI prostate examinations and is a risk- adjusted reporting structure designed by the European Society of Urogenital Radiology in combination with the American College of Radiology with the main aim to internationally standardized mpMRI prostate reporting into five risk categories, of which a higher PI-RADS category represents an increasing probability that the prostate pathology represents clinically significant cancer. Groote Schuur Hospital (GSH) radiology division has been reporting prostate mpMRI according to the updated PI-RADS v2.1 since its introduction in 2019, however no studies have been performed to assess the reliability of PI-RADS v2.1 at GSH for detecting clinically significant prostate cancer. This study aims to assess and validate the accurate use of PI-RADS v2.1 category 4 and 5 against internationally recognized standards of performance. The PI-RADS lexicon should be a reliable predictor of significant prostate cancer to promote confidence in its continued use and to justify the expenditure on mpMRI prostate examinations in the diagnostic pathway of prostate cancer at GSH. Objectives: The primary objective: To assess the diagnostic performance of PI-RADS v2.1 category 4 and 5 in predicting clinically significant prostate cancer confirmed on biopsy with appropriate histopathology. Secondary objective: - Correlate and validate the diagnostic performance of PI-RADS v2.1 category 4 and 5 lesions at GSH by comparing the outcomes with accepted international performance standards. - Identify problems with the use of PI-RADS v2.1 at GSH to improve prostate reporting with the ultimately goal of improving patient outcomes. Methods: Single institution retrospective study assessing mpMRI prostate PI-RADS (v2.1) category 4 and 5 reports performed at GSH between the dates of 01 June 2021 to 12 January 2024. Prostate reports categorised as PIRADS (v2.1) 4 or 5 are evaluated on PACS and correlated with the histological diagnosis on National Health Laboratory Service (NHLS). Prostate histology will be categorised into clinically significant prostate cancer or insignificant depending on the Gleason score. These outcomes will be measured against high powered international studies to assess the overall performance of the GSH radiology division when reporting PI-RADS 4 and 5 lesions. Results: This study incorporates a retrospective design structure and analysis where a grand total of 215 mpMRI prostate studies were considered for the period dated 01 June 2021 and 12 January 2024. From the 215 mpMRI prostate scans performed 89 studies met the strict inclusion and exclusion criteria: n=89. The sample size of 89 represented 37 PI-RADS category 4 and 52 PI-RADS category 5. The measures of sensitivity and specificity for the PI-RADS 4 and PI-RADS 5 categories in detecting clinically significant prostate cancer proven on biopsy are as follows: For PI-RADS 4: Sensitivity: 19.4, 95% CI: [5.4, 33.3] Specificity: 53.4, 95% CI: [40.6, 66.3] PPV : 16.2 95% CI:4.3-28.1 NPV: 51.9 95% CI:38.3-65.5 For PI-RADS 5: Sensitivity: 80.6, 95% CI: [66.7, 94.6] Specificity: 46.6, 95% CI: [33.7, 59.4] PPV: 48.1 95% CI:34.5- 61.7 NPV: 83.8 95% CI:71.9- 95.7 Conclusions: The findings in this study validates the accurate and reliable use of PI-RADS (v2.1) category at GSH when measured against the expected cancer detection rates reported in large high powered international studies. PI-RADS (v2.1) category 4 revealed a lower-than-expected correlation to international performance standards and is proposed to be the result of multiple interplaying factors such as reporting inexperience, inter-rater variability, suboptimal image acquisition and patient preparation and misrepresentative prostate biopsy. The Urology department, GSH management and patients can draw reserved confidence in the performance of the GSH radiology division reporting mpMRI prostate examinations according to PI-RADS v2.1 lexicon with a higher confidence in PI-RADS (v2.1) category 5 reports than PI-RADS (v2.1) category 4 reports. This study is not extrapolating to PI-RADS 1, 2 and 3 category lesions without further research.