Papers by Michael Vannier
Pancreas, Mar 1, 2016
Objectives-In mouse models of pancreatic cancer, IPI-926, an oral Hedgehog inhibitor, increases c... more Objectives-In mouse models of pancreatic cancer, IPI-926, an oral Hedgehog inhibitor, increases chemotherapy delivery by depleting tumor-associated stroma. This multicenter phase Ib study evaluated IPI-926 in combination with FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, oxaliplatin) in patients with advanced pancreatic cancer. Methods-Patients were treated with once-daily IPI-926 plus FOLFIRINOX. A 3 + 3 dose escalation design was used, with cohort expansion at the maximum tolerated dose. A subset of patients underwent perfusion computed tomography to assess changes in tumor perfusion. Results-The maximum tolerated dose was identified 1 dose level below standard FOLFIRINOX. Common treatment-related adverse events included liver function test abnormalities, neuropathy, nausea/vomiting, and diarrhea. Objective response rate was high (67%), and patients receiving IPI-926 maintenance showed further declines in CA19-9 levels even after FOLFIRINOX discontinuation. Treatment did not result in consistent increases in tumor perfusion. The study closed early when a separate phase II trial of IPI-926 plus gemcitabine indicated detrimental effects of this combination. Conclusions-This is the first study to demonstrate the feasibility of using FOLFIRINOX as the chemotherapeutic backbone in a clinical trial design.
Computing in Cardiology Conference, Dec 1, 2013
Computed tomography (CT) is an emerging tool to detect stress-induced myocardial perfusion abnorm... more Computed tomography (CT) is an emerging tool to detect stress-induced myocardial perfusion abnormalities. We hypothesized that iterative reconstruction (IR) could improve the accuracy of the detection of significant coronary artery disease using quantitative 3D analysis of myocardial perfusion during vasodilator stress. We studied 39 patients referred for CT coronary angiography (CTCA) who agreed to undergo additional imaging with regadenoson (Astellas). Images were acquired using 256-channel scanner (Philips) and reconstructed using 2 different algorithms: filtered backprojection (FBP) and IR (iDose7, Philips). Custom software was used to analyze both FBP and IR images. Five patients with image artifacts were excluded. Ten patients with normal coronaries were used to obtain reference values, which were used to correct for x-ray attenuation differences among normal myocardial segments. Compared to the conventional FBP images, IR images had considerably lower noise levels, resulting in tighter histograms of x-ray attenuation. In the remaining 24 patients, IR improved the detection of perfusion abnormalities. Quantitative 3D analysis of MDCT images allows objective detection of stress-induced perfusion abnormalities, the accuracy of which is improved by IR.
Radiographics, Nov 1, 2014
Note: This copy is for your personal non-commercial use only. To order presentation-ready copies ... more Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. Computed tomography (CT) colonography is a screening modality used to detect colonic polyps before they progress to colorectal cancer. Computer-aided detection (CAD) is designed to decrease errors of detection by finding and displaying polyp candidates for evaluation by the reader. CT colonography CAD false-positive results are common and have numerous causes. The relative frequency of CAD false-positive results and their effect on reader performance on the basis of a 19-reader, 100-case trial shows that the vast majority of CAD false-positive results were dismissed by readers. Many CAD false-positive results are easily disregarded, including those that result from coarse mucosa, reconstruction, peristalsis, motion, streak artifacts, diverticulum, rectal tubes, and lipomas. CAD false-positive results caused by haustral folds, extracolonic candidates, diminutive lesions (<6 mm), anal papillae, internal hemorrhoids, varices, extrinsic compression, and flexural pseudotumors are almost always recognized and disregarded. The ileocecal valve and tagged stool are common sources of CAD falsepositive results associated with reader false-positive results. Nondismissable CAD soft-tissue polyp candidates larger than 6 mm are another common cause of reader false-positive results that may lead to further evaluation with follow-up CT colonography or optical colonoscopy. Strategies for correctly evaluating CAD polyp candidates are important to avoid pitfalls from common sources of CAD false-positive results. © RSNA, 2014 • radiographics.rsna.org
The Journal of Nuclear Medicine, Apr 1, 1982
arXiv (Cornell University), Oct 12, 2016
Academic leadership is essential for research innovation and impact. Until now, there has been no... more Academic leadership is essential for research innovation and impact. Until now, there has been no dedicated measure of leadership by bibliometrics. Popular bibliometric indices are mainly based on academic output, such as the journal impact factor and the number of citations. Here we develop an academic leadership index based on readily available bibliometric data that is sensitive to not only academic output but also research efficiency. Our leadership index was tested in two studies on peer-reviewed journal papers by extramurally-funded principal investigators in the field of life sciences from China and the USA, respectively. The leadership performance of these principal investigators was quantified and compared relative to university rank and other factors. As a validation measure, we show that the highest average leadership index was achieved by principal investigators at top national universities in both countries. More interestingly, our results also indicate that on an individual basis, strong leadership and high efficiency are not necessarily associated with those at top-tier universities nor with the most funding. This leadership index may become the basis of a comprehensive merit system, facilitating academic evaluation and resource management.
The Journal of Nuclear Medicine, Nov 1, 1983
The authors state their intent is to â€oedefine an epistemologythat allows one person or team to ... more The authors state their intent is to â€oedefine an epistemologythat allows one person or team to integrate the disciplines relevant to clinical application.― They distinguish the organization of this text as â€oetop-down,― where clinical applications are presented first, then the mathematical basis for the computer methods, and last the computer technology itself. Such an arrangement is distinctive from other introductory texts on computer methods in nuclear medicine that are organized in a â€oebottom-up― fashion, where computer technology is explained, mathematical methods derived, and clinical applications demonstrated. I do not believe this text can be characterized as introductory, since it begins with examples ofcomplex functional imagery, followed only much later with the methodology used to derive them. In general, the organization is betterdescribedas â€oemiddle-middle,― withverylittleintroductory or new material. An experiencednuclear medicinecomputer user can benefit from the first section, â€oeClinical Applications of Quantitative Scintigraphic Analysis,―especially to reveal the perspective of another experienced computer user in addressing scintigraphic approaches to the diagnosis of heart disease, renal, and pulmonary disorders. The second section, â€oeMathematical Derivations,― was disap pointing and cannot be recommended. Many familiar concepts, including digital filtering, convolution, and background correction, are not presented clearly. Integral formulations are widely used, despite the fact that nuclear medicine is a truly discrete imaging modality.
The Journal of Nuclear Medicine, 1984
all definitive and well written. Each chapter includes detailed steps for each laboratory procedu... more all definitive and well written. Each chapter includes detailed steps for each laboratory procedure, the clinical usefulness and alter native methods, and the radiation exposure involved.This book raises thequestion ofwhatprocedures areclinical andwhatpro cedures are purely for research purposes. The answer obviously differs, depending on your location. The tests of intestinal ab sorption using carbon-l4 labeled isotopes are not nearly as complex astheirlimitedusewould suggest. Theycanbeused byanyclinical laboratory equipped with a liquid scintillation counter. The ready availability of materials needed for these procedures is clearly documented. The measurement of theglomerularfiltration rate (GFR) by a singlesubcutaneousinjectionof ‘25I-Na iothalamate is so clearly presented and validated that it is surprising that this method is so infrequently used. Few clinical laboratories perform bone mineral measurements, but this review of the various tech niques andtheirresults makes fascinating reading. Thereisahost of goodreferences, includingthoseto official(government) reg ulatory guides. Ifyouareinterestedinanyoftheseareas,thenthisbookbelongs in your department for future reference. Much of the material is not really new, but it is difficult to locate, and this text provides a readily available, reliable, and convenient source book. It will have a longeractive shelf life than others on more â€oeclinical― levels, since the procedures described are less likely to change rapidly.
Clinical Nuclear Medicine, 1980
NDT international, Oct 1, 1990
A major purpose of the Technical Information Center is to provide the broadest dissemination poss... more A major purpose of the Technical Information Center is to provide the broadest dissemination possible of information contained in DOE's Research and Development Reports to business, industry, the academic community, and federal, state and local governments. Although a small portion of this report is not reproducible, it is being made available to expedite the availability of information on the research discussed herein. LIST OF FIGURES (Contd.
[Patent US5909476A] Iterative Process for Reconstructing Cone-beam Tomographic Images
The solutions to current diagnostic imaging problems will be found, at least in part, in digital ... more The solutions to current diagnostic imaging problems will be found, at least in part, in digital image processing technology developed by NASA. The adaptation of appropriate technology that can be applied clinically to improve the care of patients is a major concern of radiologists. We have considered ten problems with clinical significance in diagnostic medical imaging, and discuss the impact of NASA image processing technology presently and predict future developments in this area.
arXiv (Cornell University), Dec 16, 2011
In a recent study by Ginther et al., the probability of receiving a U.S. National Institutes of H... more In a recent study by Ginther et al., the probability of receiving a U.S. National Institutes of Health (NIH) RO1 award was related to the applicant's race/ethnicity. The results indicate black/African-American applicants were 10% less likely than white peers to receive an award, after controlling for background and qualifications. It has generated a widespread debate regarding the unfairness of the NIH grant review process and its correction. In this paper, the work by Ginther et al. was augmented by pairing analysis, axiomatically-individualized productivity and normalized funding success measurement. Although there are racial differences in R01 grant success rates, normalized figures of merit for funding success explain the discrepancy. The suggested "leverage points for policy intervention" are in question and require deeper and more thorough investigations. Further adjustments in policies to remove racial disparity should be made more systematically for equal opportunity, rather than being limited to the NIH review process. 
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Papers by Michael Vannier