Bio

Clinical Focus


  • Diagnostic Radiology

Academic Appointments


  • Clinical Assistant Professor, Radiology

Professional Education


  • Board Certification: Royal College of Physicians and Surgeons of Canada, Nuclear Medicine (2018)
  • Fellowship, University of Alberta, Canada (2018)
  • Board Certification: Royal College of Physicians and Surgeons of Canada, Diagnostic Radiology (2016)
  • Board Certification: American Board of Radiology, Diagnostic Radiology (2016)
  • Residency: Memorial University of Newfoundland (2016) Canada
  • Medical Education: Memorial University of Newfoundland School of Medicine (2011) Canada

Publications

All Publications


  • Impact of the COVID-19 Pandemic on Breast Imaging Education. Journal of breast imaging Chalfant, J. S., Pittman, S. M., Kothari, P. D., Chong, A., Grimm, L. J., Sohlich, R. E., Leung, J. W., Downey, J. R., Cohen, E. O., Ojeda-Fournier, H., Hoyt, A. C., Joe, B. N., Feig, S. A., Trinh, L., Rosen, E. L., Aminololama-Shakeri, S., Ikeda, D. M. 2021; 3 (3): 354-362

    Abstract

    Objective: To determine the impact of the COVID-19 pandemic on breast imaging education.Methods: A 22-item survey addressing four themes during the early pandemic (time on service, structured education, clinical training, future plans) was emailed to Society of Breast Imaging members and members-in-training in July 2020. Responses were compared using McNemar's and Mann-Whitney U tests; a general linear model was used for multivariate analysis.Results: Of 136 responses (136/2824, 4.8%), 96 U.S. responses from radiologists with trainees, residents, and fellows were included. Clinical exposure declined during the early pandemic, with almost no medical students on service (66/67, 99%) and fewer clinical days for residents (78/89, 88%) and fellows (48/68, 71%). Conferences shifted to remote live format (57/78, 73%), with some canceled (15/78, 19%). Compared to pre-pandemic, resident diagnostic (75/78, 96% vs 26/78, 33%) (P < 0.001) and procedural (73/78, 94% vs 21/78, 27%) (P < 0.001) participation fell, as did fellow diagnostic (60/61, 98% vs 47/61, 77%) (P = 0.001) and procedural (60/61, 98% vs 43/61, 70%) (P < 0.001) participation. Most thought that the pandemic negatively influenced resident and fellow screening (64/77, 83% and 43/60, 72%, respectively), diagnostic (66/77, 86% and 37/60, 62%), and procedural (71/77, 92% and 37/61, 61%) education. However, a majority thought that decreased time on service (36/67, 54%) and patient contact (46/79, 58%) would not change residents' pursuit of a breast imaging fellowship.Conclusion: The pandemic has had a largely negative impact on breast imaging education, with reduction in exposure to all aspects of breast imaging. However, this may not affect career decisions.

    View details for DOI 10.1093/jbi/wbab021

    View details for PubMedID 34056594

  • Multishot Diffusion-Weighted MRI of the Breast With Multiplexed Sensitivity Encoding (MUSE) and Shot Locally Low-Rank (Shot-LLR) Reconstructions. Journal of magnetic resonance imaging : JMRI Hu, Y., Ikeda, D. M., Pittman, S. M., Samarawickrama, D., Guidon, A., Rosenberg, J., Chen, S., Okamoto, S., Daniel, B. L., Hargreaves, B. A., Moran, C. J. 2020

    Abstract

    BACKGROUND: Diffusion-weighted imaging (DWI) has shown promise to screen for breast cancer without a contrast injection, but image distortion and low spatial resolution limit standard single-shot DWI. Multishot DWI methods address these limitations but introduce shot-to-shot phase variations requiring correction during reconstruction.PURPOSE: To investigate the performance of two multishot DWI reconstruction methods, multiplexed sensitivity encoding (MUSE) and shot locally low-rank (shot-LLR), compared to single-shot DWI in the breast.STUDY TYPE: Prospective.POPULATION: A total of 45 women who consented to have multishot DWI added to a clinically indicated breast MRI.FIELD STRENGTH/SEQUENCES: Single-shot DWI reconstructed by parallel imaging, multishot DWI with four or eight shots reconstructed by MUSE and shot-LLR, 3D T2 -weighted imaging, and contrast-enhanced MRI at 3T.ASSESSMENT: Three blinded observers scored images for 1) general image quality (perceived signal-to-noise ratio [SNR], ghosting, distortion), 2) lesion features (discernment and morphology), and 3) perceived resolution. Apparent diffusion coefficient (ADC) of the lesion was also measured and compared between methods.STATISTICAL TESTS: Image quality features and perceived resolution were assessed with a mixed-effects logistic regression. Agreement among observers was estimated with a Krippendorf's alpha using linear weighting. Lesion feature ratings were visualized using histograms, and correlation coefficients of lesion ADC between different methods were calculated.RESULTS: MUSE and shot-LLR images were rated to have significantly better perceived resolution (P<0.001), higher SNR (P<0.005), and a lower level of distortion (P<0.05) with respect to single-shot DWI. Shot-LLR showed reduced ghosting artifacts with respect to both MUSE (P<0.001) and single-shot DWI (P<0.001). Eight-shot DWI had improved perceived SNR and perceived resolution with respect to four-shot DWI (P<0.005).DATA CONCLUSION: Multishot DWI enables increased resolution and improved image quality with respect to single-shot DWI in the breast. Shot-LLR reconstructs multishot DWI with minimal ghosting artifacts. The improvement of multishot DWI in image quality increases with an increased number of shots.LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.

    View details for DOI 10.1002/jmri.27383

    View details for PubMedID 33067849

  • Diffusion-weighted double-echo steady-state with a three-dimensional cones trajectory for non-contrast-enhanced breast MRI. Journal of magnetic resonance imaging : JMRI Moran, C. J., Cheng, J. Y., Sandino, C. M., Carl, M. n., Alley, M. T., Rosenberg, J. n., Daniel, B. L., Pittman, S. M., Rosen, E. L., Hargreaves, B. A. 2020

    Abstract

    The image quality limitations of echo-planar diffusion-weighted imaging (DWI) are an obstacle to its widespread adoption in the breast. Steady-state DWI is an alternative DWI method with more robust image quality but its contrast for imaging breast cancer is not well-understood. The aim of this study was to develop and evaluate diffusion-weighted double-echo steady-state imaging with a three-dimensional cones trajectory (DW-DESS-Cones) as an alternative to conventional DWI for non-contrast-enhanced MRI in the breast. This prospective study included 28 women undergoing clinically indicated breast MRI and six asymptomatic volunteers. In vivo studies were performed at 3ā€‰T and included DW-DESS-Cones, DW-DESS-Cartesian, DWI, and CE-MRI acquisitions. Phantom experiments (diffusion phantom, High Precision Devices) and simulations were performed to establish framework for contrast of DW-DESS-Cones in comparison to DWI in the breast. Motion artifacts of DW-DESS-Cones were measured with artifact-to-noise ratio in volunteers and patients. Lesion-to-fibroglandular tissue signal ratios were measured, lesions were categorized as hyperintense or hypointense, and an image quality observer study was performed in DW-DESS-Cones and DWI in patients. Effect of DW-DESS-Cones method on motion artifacts was tested by mixed-effects generalized linear model. Effect of DW-DESS-Cones on signal in phantom was tested by quadratic regression. Correlation was calculated between DW-DESS-Cones and DWI lesion-to-fibroglandular tissue signal ratios. Inter-observer agreement was assessed with Gwet's AC. Simulations predicted hyperintensity of lesions with DW-DESS-Cones but at a 3% to 67% lower degree than with DWI. Motion artifacts were reduced with DW-DESS-Cones versus DW-DESS-Cartesian (pā€‰<ā€‰0.05). Lesion-to-fibroglandular tissue signal ratios were not correlated between DW-DESS-Cones and DWI (r = 0.25, p = 0.38). Concordant hyperintensity/hypointensity was observed between DW-DESS-Cones and DWI in 11/14 lesions. DW-DESS-Cones improved sharpness, distortion, and overall image quality versus DWI. DW-DESS-Cones may be able to eliminate motion artifacts in the breast allowing for investigation of higher degrees of steady-state diffusion weighting. Malignant breast lesions in DW-DESS-Cones demonstrated hyperintensity with respect to surrounding tissue without an injection of contrast. LEVEL OF EVIDENCE: 2. TECHNICAL EFFICACY STAGE: 1.

    View details for DOI 10.1002/jmri.27492

    View details for PubMedID 33382171

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