Friday, 3 June 2016

Imaging in Thyroid Eye Disease - Role of CT, MRI, Isotope Scans

Imaging in Thyroid Eye Disease - Role of CT, MRI, Isotope Scans

invited presentation at NUH Eye International Congress 2016 held in conjunction with XII ISOT Meeting, III APOTS Meeting and NUH Ophthalmology Department 30th Anniversary Celebration at the NUHS Tower Block on 4th November 2016


https://themeetinglab.eventsair.com/QuickEventWebsitePortal/nuh-eye-international-congress-2016-xii-isot-iii-apots/ophthalmology/Agenda




Opening comments

"Thank you to Dr Ganga, and the members of the Scientific, and organising committee for inviting me to give this presentation.

Congratulations to the NUH Ophthalmology Department, which is celebrating a significant 30 year milestone this year. I feel a great sense of nostalgia, and happiness to participate in this conference, particularly since I spent a very happy 6 months as an ophthalmology MO 27 years ago during my first job in NUH, before joining the Radiology department; and subsequently have worked closely with members of the Ophthalmology Department at NUH on both academic projects, as well as during monthly clinical-radiology-pathology correlation education rounds over the last 15 years.

One big challenge for listeners in this session, which is jam packed with great content, from distinguished speakers and experienced subspecialty practitioners in this area, is "cognitive overload". In order to minimise this, I will give a "different" style presentation, highlighting one key slide first, the summary slide, and then the use of this presentation blog/website as a resource that participants can use to review, and study the subject further after this presentation. When given the invitation to speak on this topic, I took this as an opportunity to do an in depth literature, online resource, and textbook review of this topic, and the results of this journey has been documented within this presentation blog after the "presentation SlideDeck" embedded following these opening comments.

One of the key ideas we are most aware of as educators is that it is not what is presented, but what listeners take away from a presentation, and are able to recall, and make use of, which is most important.

To facilitate this, may I invite the audience to focus on the title of the presentation, selected by the Scientific Committee. In the title, "Imaging in TED", consider why Ultrasound was not included in the title, which was given to me to speak on. Furthermore, one might speculate why Isotope scans were included in the title, particularly since when asked, my senior Nuclear Medicine colleague tells me that there is no place for Isotope imaging in day to day, practical imaging and clinical practice. It turns out that Somatostatin receptor imaging does offer some information about disease activity, though for a variety of reasons, and from a practical point of view, isotope imaging is not used in day to day clinical practice. Reviewing some of the literature on isotope imaging however helps us understand TED better.

I will now put up the summary slide, and then illustrate some of the key points visually using the rest of the SlideDeck below. Please review the additional resources on this blog after the presentation. I hope you find them useful in your clinical practice.


                                       









































https://padlet.com/dnrgohps/ImagingInThyroidEyeDisease



Google search for "Imaging in thyroid eye disease"

https://radiopaedia.org/articles/thyroid-associated-orbitopathy

http://www.intechopen.com/books/thyroid-disorders-focus-on-hyperthyroidism/graves-ophthalmopathy-imaging-evaluation


https://www.google.com.sg/search?q=imaging+in+thyroid+eye+disease&espv=2&biw=1279&bih=677&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj-3ObV48zPAhXHtI8KHeKRD7UQ_AUIBigB&dpr=2
(Google image search for "Imaging in thyroid eye disease")







Pubmed /literature search (below) including review articles:



Review articles (Pubmed list) including several below

"Although the diagnosis of Graves' orbitopathy is primarily made clinically based on laboratory tests indicative of thyroid dysfunction and autoimmunity, imaging studies ...... play an important role both in the diagnosis and follow-up after clinical or surgical treatment of the disease. Imaging studies can be used to evaluate morphological abnormalities of the orbital structures during the diagnostic workup when a differential diagnosis versus other orbital diseases is needed. Imaging may also be useful to distinguish the inflammatory early stage from the inactive stage of the disease. Finally, imaging studies can be of great help in identifying patients prone to develop dysthyroid optic neuropathy and therefore enabling the timely diagnosis and treatment of the condition, avoiding permanent visual loss."
Abstract from
Gonçalves AC, Gebrim EM, Monteiro ML. Imaging studies for diagnosing Graves'
orbitopathy and dysthyroid optic neuropathy. Clinics (Sao Paulo). 2012
Nov;67(11):1327-34. Review. PubMed PMID: 23184212; PubMed Central PMCID:
PMC3488994.
https://www.ncbi.nlm.nih.gov/pubmed/23184212 (including open access link)

Soeters MR, van Zeijl CJ, Boelen A, Kloos R, Saeed P, Vriesendorp TM, Mourits
MP. Optimal management of Graves orbitopathy: a multidisciplinary approach. Neth
J Med. 2011 Jul-Aug;69(7):302-8. Review. PubMed PMID: 21934174.
https://www.ncbi.nlm.nih.gov/pubmed/21934174 (including open access link)

Kirsch E, Hammer B, von Arx G. Graves' orbitopathy: current imaging
procedures. Swiss Med Wkly. 2009 Oct 31;139(43-44):618-23. doi: smw-12741.
Review. PubMed PMID: 19950023.
https://www.ncbi.nlm.nih.gov/pubmed/19950023 (including open access link)


from longer list below


1: Chuma-Bitcon V, Gruson D. The role of laboratory diagnostics in patient
management for Graves' disease. MLO Med Lab Obs. 2016 Jul;48(7):28, 30, 33.
Review. PubMed PMID: 27548921.


2: Walasik-Szemplińska D, Pauk-Domańska M, Sanocka U, Sudoł-Szopińska I. Doppler
imaging of orbital vessels in the assessment of the activity and severity of
thyroid-associated orbitopathy. J Ultrason. 2015 Dec;15(63):388-97. doi:
10.15557/JoU.2015.0036. Review. PubMed PMID: 26807296; PubMed Central PMCID:
PMC4710690.


3: Orlans HO, Bremner FD. Dysthyroid Orbitopathy Presenting with Gaze-Evoked
Amaurosis: Case Report and Review of the Literature. Orbit. 2015;34(6):324-6.
doi: 10.3109/01676830.2015.1078374. Review. PubMed PMID: 26505217.


4: Costello F. Inflammatory optic neuropathies. Continuum (Minneap Minn). 2014
Aug;20(4 Neuro-ophthalmology):816-37. doi: 10.1212/01.CON.0000453316.60013.52.
Review. PubMed PMID: 25099096.


5: Gonçalves AC, Gebrim EM, Monteiro ML. Imaging studies for diagnosing Graves'
orbitopathy and dysthyroid optic neuropathy. Clinics (Sao Paulo). 2012
Nov;67(11):1327-34. Review. PubMed PMID: 23184212; PubMed Central PMCID:
PMC3488994.


6: Tourbah A. Contribution of imaging to the diagnosis of optic neuropathies. Rev
Neurol (Paris). 2012 Oct;168(10):702-5. doi: 10.1016/j.neurol.2012.07.012.
Review. PubMed PMID: 22981271.


7: Müller-Forell W, Kahaly GJ. Neuroimaging of Graves' orbitopathy. Best Pract
Res Clin Endocrinol Metab. 2012 Jun;26(3):259-71. doi:
10.1016/j.beem.2011.11.009. Review. PubMed PMID: 22632363.


8: Soeters MR, van Zeijl CJ, Boelen A, Kloos R, Saeed P, Vriesendorp TM, Mourits
MP. Optimal management of Graves orbitopathy: a multidisciplinary approach. Neth
J Med. 2011 Jul-Aug;69(7):302-8. Review. PubMed PMID: 21934174.


9: Leong SC, White PS. Outcomes following surgical decompression for dysthyroid
orbitopathy (Graves' disease). Curr Opin Otolaryngol Head Neck Surg. 2010
Feb;18(1):37-43. doi: 10.1097/MOO.0b013e328335017c. Review. PubMed PMID:
19940769.


10: Kirsch E, Hammer B, von Arx G. Graves' orbitopathy: current imaging
procedures. Swiss Med Wkly. 2009 Oct 31;139(43-44):618-23. doi: smw-12741.
Review. PubMed PMID: 19950023.


11: Kirsch E, von Arx G, Hammer B. Imaging in Graves' orbitopathy. Orbit.
2009;28(4):219-25. Review. PubMed PMID: 19839878.


12: Bose S. Neuroimaging in neuroophthalmology. Neurosurg Focus. 2007;23(5):E9.
Review. PubMed PMID: 18004971.


13: Morax S, Ben Ayed H. [Orbital decompression for dysthyroid orbitopathy: a
review of techniques and indications]. J Fr Ophtalmol. 2004 Sep;27(7):828-44.
Review. French. PubMed PMID: 15499287.


14: Boncoeur MP. [Dysthyroid orbitopathy: imaging]. J Fr Ophtalmol. 2004
Sep;27(7):815-8. Review. French. PubMed PMID: 15499283.


15: Camezind P, Robert PY, Adenis JP. [Clinical signs of dysthyroid orbitopathy].
J Fr Ophtalmol. 2004 Sep;27(7):810-4. Review. French. PubMed PMID: 15499282.


16: Szúcs-Farkas Z, Galuska L, Nagy VE. [Current imaging methods in Graves'
ophthalmopathy]. Orv Hetil. 2004 Apr 25;145(17):891-9. Review. Hungarian. PubMed
PMID: 15170966.


17: Pérez Moreiras JV, Coloma Bockos JE, Prada Sánchez MC. [Thyroid orbitopathy
(pathogenesis, diagnosis and treatment)]. Arch Soc Esp Oftalmol. 2003
Aug;78(8):407-31. Review. Spanish. PubMed PMID: 12955622.


18: Fung S, Malhotra R, Selva D. Thyroid orbitopathy. Aust Fam Physician. 2003
Aug;32(8):615-20. Review. PubMed PMID: 12973869.


19: Kazim M, Goldberg RA, Smith TJ. Insights into the pathogenesis of
thyroid-associated orbitopathy: evolving rationale for therapy. Arch Ophthalmol.
2002 Mar;120(3):380-6. Review. PubMed PMID: 11879144.


20: Ebner R. Dysthyroid optic neuropathy (DON). Semin Ophthalmol. 2002
Mar;17(1):18-21. Review. PubMed PMID: 15513451.


21: Kahaly GJ. Imaging in thyroid-associated orbitopathy. Eur J Endocrinol. 2001
Aug;145(2):107-18. Review. PubMed PMID: 11454505.


22: Weber AL, Romo LV, Sabates NR. Pseudotumor of the orbit. Clinical,
pathologic, and radiologic evaluation. Radiol Clin North Am. 1999
Jan;37(1):151-68, xi. Review. PubMed PMID: 10026735.


23: Kendall-Taylor P, Perros P. Clinical presentation of thyroid associated
orbitopathy. Thyroid. 1998 May;8(5):427-8. Review. PubMed PMID: 9623736.


24: Domenjôd M, Merle H, Gerard M, Ayeboua L, Poman G. [Dysthyroid optic
neuropathy. Apropos of 2 cases]. J Fr Ophtalmol. 1996;19(8-9):543-50. Review.
French. PubMed PMID: 8944137.


25: Bartley GB, Gorman CA. Diagnostic criteria for Graves' ophthalmopathy. Am J
Ophthalmol. 1995 Jun;119(6):792-5. Review. PubMed PMID: 7785696.


26: Jorissen M, Feenstra L. Dysthyroid orbitopathy and orbital decompression. A
review. Acta Otorhinolaryngol Belg. 1992;46(3):303-9. Review. PubMed PMID:
1414313.



A longer list of recent publications on topics in orbital imaging below (PubMed link - then select by year of publication):

1: Purohit BS, Vargas MI, Ailianou A, Merlini L, Poletti PA, Platon A, Delattre
BM, Rager O, Burkhardt K, Becker M. Orbital tumours and tumour-like lesions:
exploring the armamentarium of multiparametric imaging. Insights Imaging. 2016
Feb;7(1):43-68. doi: 10.1007/s13244-015-0443-8. PubMed PMID: 26518678; PubMed
Central PMCID: PMC4729705.
https://www.ncbi.nlm.nih.gov/pubmed/26518678

2: Narvid J, Talbott JF, Glastonbury CM. The caverno-apical triangle:
anatomic-pathological considerations and pictorial review. Clin Imaging. 2016
Jan-Feb;40(1):23-32. doi: 10.1016/j.clinimag.2015.08.005. Review. PubMed PMID:
26481233.


3: Hoch M, Win W, Hagiwara M, Fatterpekar G, Patel S. Orbital lesions with low
signal intensity on T2-weighted imaging. Clin Radiol. 2016 Jan;71(1):e88-95. doi:
10.1016/j.crad.2015.10.011. Review. PubMed PMID: 26602937.


4: Vachha BA, Robson CD. Imaging of Pediatric Orbital Diseases. Neuroimaging Clin
N Am. 2015 Aug;25(3):477-501. doi: 10.1016/j.nic.2015.05.009. Review. PubMed
PMID: 26208421.


5: Reith W, Yilmaz U. [Orbit: Part 1: anatomy, imaging procedures and retrobulbar
lesions]. Radiologe. 2015 Aug;55(8):701-18; quiz 719-20. doi:
10.1007/s00117-015-2868-y. Review. German. PubMed PMID: 26296805.


6: Guo P, Xian J, Chen G, Liang X, Yang B, Wang Z, Yan F. [Features of clinical
presentation, pathology and magnetic resonance or computed tomography imaging for
ocular lymphoma]. Zhonghua Yi Xue Za Zhi. 2015 Mar 24;95(11):814-8. Chinese.
PubMed PMID: 26080911.


7: Langner S. [Optimized imaging of the midface and orbits].
Laryngorhinootologie. 2015 Mar;94 Suppl 1:S248-71. doi: 10.1055/s-0034-1398513.
Review. German. PubMed PMID: 25860492.


8: Meltzer DE. Orbital imaging: a pattern-based approach. Radiol Clin North Am.
2015 Jan;53(1):37-80. doi: 10.1016/j.rcl.2014.09.004. Review. PubMed PMID:
25476173.


9: Dharsono F, van Heerden J, Mesbah Ardakani N, Franconi C, Honeybul S, Lind CR,
McAuliffe W. Vanishing bone disease of the orbital roof: now you see it, now you
don't. J Med Imaging Radiat Oncol. 2014 Oct;58(5):582-4. doi:
10.1111/1754-9485.12199. PubMed PMID: 24976008.


10: McNab AA, Selva D, Hardy TG, O'Donnell B. The anatomical location and
laterality of orbital cavernous haemangiomas. Orbit. 2014 Oct;33(5):359-62. doi:
10.3109/01676830.2014.915329. PubMed PMID: 24831510.


11: Tiegs-Heiden CA, Eckel LJ, Hunt CH, Diehn FE, Schwartz KM, Kallmes DF,
Salomão DR, Witzig TE, Garrity JA. Immunoglobulin G4-related disease of the
orbit: imaging features in 27 patients. AJNR Am J Neuroradiol. 2014
Jul;35(7):1393-7. doi: 10.3174/ajnr.A3865. PubMed PMID: 24627453.


12: Panda A, Sharma S, Jana M, Arora A, Sharma SK. Ophthalmic manifestations of
systemic diseases--part 2: metabolic, infections, granulomatoses, demyelination,
and skeletal dysplasias. Curr Probl Diagn Radiol. 2014 Sep-Oct;43(5):242-53. doi:
10.1067/j.cpradiol.2014.02.003. Review. PubMed PMID: 25088219.


13: Burns NS, Iyer RS, Robinson AJ, Chapman T. Diagnostic imaging of fetal and
pediatric orbital abnormalities. AJR Am J Roentgenol. 2013 Dec;201(6):W797-808.
doi: 10.2214/AJR.13.10949. Review. PubMed PMID: 24261386.


14: Salchow DJ. [Orbital disorders in childhood]. Klin Monbl Augenheilkd. 2013
Oct;230(10):1047-65; quiz 1066-7. doi: 10.1055/s-0033-1346702. German. PubMed
PMID: 24146426.


15: Ginat DT, Freitag SK, Kieff D, Grove A, Fay A, Cunnane M, Moonis G.
Radiographic patterns of orbital involvement in IgG4-related disease. Ophthal
Plast Reconstr Surg. 2013 Jul-Aug;29(4):261-6. doi: 10.1097/IOP.0b013e31829165ad.
PubMed PMID: 23645355.


16: Avetisov SE, Kharlap SI, Eksarenko OV, Sheremet NL, Razumova IIu,
Vashkulatova EA, Fedorova VE. [Basics of spatial diagnostic acoustic analysis of
ocular and orbital tissues by the example of a study on local changes in systemic
sarcoidosis]. Vestn Oftalmol. 2013 Sep-Oct;129(5):136-46. Russian. PubMed PMID:
24261290.



18: Roy AA, Davagnanam I, Evanson J. Abnormalities of the globe. Clin Radiol.
2012 Oct;67(10):1011-22. doi: 10.1016/j.crad.2012.03.006. Review. PubMed PMID:
22647655.


19: Vignal Clermont C, Héran F, Morax S. [How to deal with orbital syndrome:
diagnostic approach]. Rev Neurol (Paris). 2012 Oct;168(10):729-33. doi:
10.1016/j.neurol.2012.08.004. Review. French. PubMed PMID: 22986080.


20: Kralik SF, Kersten R, Glastonbury CM. Evaluation of orbital disorders and
cranial nerve innervation of the extraocular muscles. Magn Reson Imaging Clin N
Am. 2012 Aug;20(3):413-34. doi: 10.1016/j.mric.2012.05.005. Review. PubMed PMID:
22877949.


21: Kim E, Kim HJ, Kim YD, Woo KI, Lee H, Kim ST. Subconjunctival fat prolapse
and dermolipoma of the orbit: differentiation on CT and MR imaging. AJNR Am J
Neuroradiol. 2011 Mar;32(3):465-7. doi: 10.3174/ajnr.A2313. PubMed PMID:
21163882.


22: Vohra ST, Escott EJ, Stevens D, Branstetter BF. Categorization and
characterization of lesions of the orbital apex. Neuroradiology. 2011
Feb;53(2):89-107. doi: 10.1007/s00234-010-0712-7. Review. PubMed PMID: 20449579.


23: Swanger RS, Crum AV, Klett ZG, Bokhari SA. Postsurgical imaging of the globe.
Semin Ultrasound CT MR. 2011 Feb;32(1):57-63. doi: 10.1053/j.sult.2010.09.004.
Review. PubMed PMID: 21277492.


24: Rose GE, Verity DH. Neuro-ophthalmology of orbital disease. Handb Clin
Neurol. 2011;102:467-91. doi: 10.1016/B978-0-444-52903-9.00023-6. Review. PubMed
PMID: 21601077.


25: Dastgir G, Gutman J, Nakra T, Shinder R. Re: "Indications for orbital imaging
by the oculoplastic surgeon". Ophthal Plast Reconstr Surg. 2011
Nov-Dec;27(6):469; author reply 469-70. doi: 10.1097/IOP.0b013e318236495b. PubMed
PMID: 22072208.


26: Wu AY, Jebodhsingh K, Le T, Law C, Tucker NA, DeAngelis DD, Oestreicher JH,
Harvey JT. Indications for orbital imaging by the oculoplastic surgeon. Ophthal
Plast Reconstr Surg. 2011 Jul-Aug;27(4):260-2. doi: 10.1097/IOP.0b013e31820b0365.
PubMed PMID: 21326128.


27: Yoon MK, McCulley TJ. Orbital disease in neuro-ophthalmology. Neurol Clin.
2010 Aug;28(3):679-99. doi: 10.1016/j.ncl.2010.03.008. PubMed PMID: 20637996.


28: Bell RB, Markiewicz MR. Computer-assisted planning, stereolithographic
modeling, and intraoperative navigation for complex orbital reconstruction: a
descriptive study in a preliminary cohort. J Oral Maxillofac Surg. 2009
Dec;67(12):2559-70. doi: 10.1016/j.joms.2009.07.098. PubMed PMID: 19925972.


29: Spira D, Ernemann U, Schulze M, Horger M. [Imaging of orbital tumors]. Rofo.
2009 Oct;181(10):925-7. doi: 10.1055/s-0029-1238263. German. PubMed PMID:
19795346.



31: Pelton RW. The anterior eyelid crease approach to the orbit. Curr Opin
Ophthalmol. 2009 Sep;20(5):401-5. doi: 10.1097/ICU.0b013e32832ec3f7. Review.
PubMed PMID: 19620865.


32: Zampa V, Bargellini I, Ortori S, Faggioni L, Cioni R, Bartolozzi C. Osteoid
osteoma in atypical locations: the added value of dynamic gadolinium-enhanced MR
imaging. Eur J Radiol. 2009 Sep;71(3):527-35. doi: 10.1016/j.ejrad.2008.05.010.
PubMed PMID: 18599238.


33: Mueller EB, Niethammer K, Rees D, Partsch CJ. Orbital compression syndrome in
sickle cell crisis. Klin Padiatr. 2009 Sep;221(5):308-9. doi:
10.1055/s-0029-1234077. PubMed PMID: 19707994.


34: Balci NC, Befeler AS, Bieneman BK, Fattahi R, Saglam S, Havlioglu N. Fat
containing HCC: findings on CT and MRI including serial contrast-enhanced
imaging. Acad Radiol. 2009 Aug;16(8):963-8. doi: 10.1016/j.acra.2009.02.010.
PubMed PMID: 19386514.



36: Dunn IF, Kim DH, Rubin PA, Blinder R, Gates J, Golby AJ. Orbitocranial wooden
foreign body: a pre-, intra-, and postoperative chronicle: case report.
Neurosurgery. 2009 Aug;65(2):E383-4; discussion E384. doi:
10.1227/01.NEU.0000347474.69080.A1. PubMed PMID: 19625895.


37: Karkos PD, Khoo LC, Leong SC, Lewis-Jones H, Swift AC. Computed tomography
and/or magnetic resonance imaging for pre-operative planning for inverted nasal
papilloma: review of evidence. J Laryngol Otol. 2009 Jul;123(7):705-9. doi:
10.1017/S0022215109004575. Review. PubMed PMID: 19216815.


38: Kösling S, Neumann K, Brandt S. [CT and MRI of intrinsic space-occupying
lesions of the bony skull base]. Radiologe. 2009 Jul;49(7):598-607. doi:
10.1007/s00117-008-1802-y. Review. German. PubMed PMID: 19436984.


39: Pang CE, Teoh SC. Anterior uveitis as a clinical presentation of orbital
inflammatory disease in an adult. Singapore Med J. 2009 Jul;50(7):e229-31. PubMed
PMID: 19644605.



41: De Wyngaert R, Casteels I, Demaerel P. Orbital and anterior visual pathway
infection and inflammation. Neuroradiology. 2009 Jun;51(6):385-96. doi:
10.1007/s00234-009-0505-z. Review. PubMed PMID: 19221728.




45: Fu CH, Huang SF, Jung SM, Chin SC, Liao CT, Chen IH. Radiology quiz case 2.
Extranodal Rosai-Dorfman disease involving the right orbit and nasal cavity. Arch
Otolaryngol Head Neck Surg. 2009 Mar;135(3):317, 319. doi:
10.1001/archoto.2008.552-a. PubMed PMID: 19289715.


46: Mawlawi O, Townsend DW. Multimodality imaging: an update on PET/CT
technology. Eur J Nucl Med Mol Imaging. 2009 Mar;36 Suppl 1:S15-29. doi:
10.1007/s00259-008-1016-6. Review. PubMed PMID: 19104808.



51: Kolk A, Stimmer H, Klopfer M, Wolff KD, Hohlweg-Majert B, Ploder O, Pautke C.
High resolution magnetic resonance imaging with an orbital coil as an alternative
to computed tomography scan as the primary imaging modality of pediatric orbital
fractures. J Oral Maxillofac Surg. 2009 Feb;67(2):348-56. doi:
10.1016/j.joms.2008.04.003. PubMed PMID: 19138609.


52: Szatmáry G. Imaging of the orbit. Neurol Clin. 2009 Feb;27(1):251-84, x. doi:
10.1016/j.ncl.2008.09.008. PubMed PMID: 19055983.


53: Lee TJ, Li SP, Fu CH, Huang CC, Chang PH, Chen YW, Chen CW. Extensive
paranasal sinus mucoceles: a 15-year review of 82 cases. Am J Otolaryngol. 2009
Jul-Aug;30(4):234-8. doi: 10.1016/j.amjoto.2008.06.006. PubMed PMID: 19563933.


57: Earl JB, Kramm L, Durairaj VD. Benign hamartoma masquerading as a deep
orbital hemangioma. J Pediatr Ophthalmol Strabismus. 2009 Jul-Aug;46(4):228-31.
doi: 10.3928/01913913-20090706-10. PubMed PMID: 19645403.


58: Sáenz-Madrazo N, Arribas-Garcia I, Tejada-Palacios P, Romance-Garcia A.
Spontaneous subperiosteal hematoma of the orbit. J Pediatr Ophthalmol Strabismus.
2009 May-Jun;46(3):175-7. PubMed PMID: 19496501.


59: Barry G, Khachikian S, Beck A, Belden C, Pearce J, Simon JW. Optic canal
diameter in infantile osteopetrosis. J Pediatr Ophthalmol Strabismus. 2009
Mar-Apr;46(2):112-4. PubMed PMID: 19343974.



61: Gündüz K, Kurt RA, Kaygusuz G, Kankaya D. Primary chondromesenchymal
hamartoma of the orbit. Ophthal Plast Reconstr Surg. 2009 Jul-Aug;25(4):324-7.
doi: 10.1097/IOP.0b013e3181ac77af. PubMed PMID: 19617800.


62: Heufelder MJ, Sterker I, Trantakis C, Schneider JP, Meixensberger J, Hemprich
A, Frerich B. Reconstructive and ophthalmologic outcomes following resection of
spheno-orbital meningiomas. Ophthal Plast Reconstr Surg. 2009
May-Jun;25(3):223-6. doi: 10.1097/IOP.0b013e3181a1f345. PubMed PMID: 19454936.


63: Sokol JA, Kazim M, Kelly KM, Lantos G, Leung LS, Baron E. Adult orbital
langerhans cell histiocytosis with frontal bone involvement. Ophthal Plast
Reconstr Surg. 2009 Mar-Apr;25(2):157-8. doi: 10.1097/IOP.0b013e31819ac2d9.
PubMed PMID: 19300172.


64: Yeniad B, Tuncer S, Peksayar G, Mete O, Minareci O. Primary orbital
leiomyosarcoma. Ophthal Plast Reconstr Surg. 2009 Mar-Apr;25(2):154-5. doi:
10.1097/IOP.0b013e31819aaef4. PubMed PMID: 19300170.


65: Price KM, Cummings TJ, Etter JR, Woodward JA. Ectopic brain in the orbit
presenting as disc edema in an adult. Orbit. 2009;28(1):74-7. doi:
10.1080/01676830802599150. PubMed PMID: 19229751.



68: Kamano H, Noguchi T, Yoshiura T, Mihara F, Togao O, Shono T, Iwaki T, Sasaki
T, Honda H. Intraorbital lobular capillary hemangioma (pyogenic granuloma).
Radiat Med. 2008 Dec;26(10):609-12. doi: 10.1007/s11604-008-0280-5. PubMed PMID:
19132492.


69: Cappabianca S, Colella G, Russo A, Pezzullo M, Reginelli A, Iaselli F,
Rotondo A. Maxillofacial fibrous dysplasia: personal experience with
gadoliniumenhanced magnetic resonance imaging. Radiol Med. 2008
Dec;113(8):1198-210. doi: 10.1007/s11547-008-0329-7. PubMed PMID: 18836864.


70: Papanagiotou P, Grunwald IQ, Politi M, Roth C, Körner H, Reith W. [Orbital
tumors]. Radiologe. 2008 Dec;48(12):1133-42. doi: 10.1007/s00117-008-1689-7.
Review. German. PubMed PMID: 19002664.


71: Zimmer A, Reith W. [Inflammatory diseases of the orbit]. Radiologe. 2008
Dec;48(12):1143-9. doi: 10.1007/s00117-008-1690-1. Review. German. PubMed PMID:
19002425.


72: Bossolesi P, Autelitano L, Brusati R, Castelnuovo P. The silent sinus
syndrome: diagnosis and surgical treatment. Rhinology. 2008 Dec;46(4):308-16.
PubMed PMID: 19146002.


74: Kolk A, Pautke C, Wiener E, Schott V, Wolff KD, Horch HH, Rummeny EJ.
Isotropic proton-density-weighted high-resolution MRI for volume measurement of
reconstructed orbital fractures--a comparison with multislice CT. Magn Reson
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From Amazon search below (Head and Neck Radiology)




From RSNA 2016:

https://meeting.rsna.org/virtual/program/

Blitz,A, Cranial Nerves: Perineural Spread and Primary Tumors. Radiological Society of North America 2016 Scientific Assembly and Annual Meeting, November 27 - December 2, 2016, Chicago IL. archive.rsna.org/2016/16000861.html Accessed December 5, 2016
http://abstract.rsna.org/uploads/2016/16000861/MSES33B%20Blitz%20RSNA%202016%20Tuesday%2029%20November%20cranial%20nerve%20handout.pdf

Becker,M, Multiparametric Imaging of Orbital Lesions. Radiological Society of North America 2016 Scientific Assembly and Annual Meeting, November 27 - December 2, 2016, Chicago IL. archive.rsna.org/2016/16000860.html Accessed December 5, 2016
http://abstract.rsna.org/uploads/2016/16000860/Becker-Orbit_RSNA2016-handout.pdf

Casselman,J, MRI Congenital and Inflammatory Disorders of Middle and Inner Ear. Radiological Society of North America 2016 Scientific Assembly and Annual Meeting, November 27 - December 2, 2016, Chicago IL. archive.rsna.org/2016/16000859.htmlAccessed December 5, 2016
http://abstract.rsna.org/uploads/2016/16000859/MSES33D%20RSNA%20ME%20IE%202016.pdf




Articulating some educational theory below:

"Understanding basic theory using a few illustrative examples. Mastering a topic by exposure to and experience with many examples

Typical examples or real-life scenarios can be used to illustrate theory, and help students understand fundamental principles. Mastering a topic usually requires exposure to and experience with many examples, both typical and atypical, common to uncommon including subtle manifestations of a phenomenon. The traditional method of doing this is via a long apprenticeship, or many years of practice with feedback and experience. A digital collection of educational scenarios and cases can support and potentially shorten this educational and training process. Particularly if a systematic attempt is made to collect and curate a comprehensive collection of all possible educational scenarios and case-based examples, across the whole spectrum of professional practice. Online access to key elements, parts of and whole sections of these learning cases; used by students with guidance by instructors under a deliberate practice and mastery training framework, can potentially accelerate the educational process, and deepen learning."

above from
Goh, P.S. A series of reflections on eLearning, traditional and blended learning. MedEdPublish. 2016 Oct; 5(3), Paper No:19. Epub 2016 Oct 14.



Short Biography:

Dr Goh is a graduate of the Melbourne Medical School in Australia (1987), a Fellow of the Royal College of Radiologists in the UK (1993), Fellow of the Academy of Medicine in Singapore, and has obtained a Master of Heath Professions Education from Maastricht University (2012). He has been practicing as a clinical radiologist for the last 26 years, and teaching at the National University of Singapore (NUS) and National University Hospital (NUH) for the last 23 years. He has a special interest in Neuroradiology, and a long-standing association and collaboration with the Ophthalmology Department at NUH (with involvement as lead radiologist for the monthly clinical-radiology-pathology teaching case review session for the last 15 years, and role as curator of the digital teaching material from this meeting for the first 10 years - there are now over 650 indexed teaching cases of orbital disease in this digital teaching repository).

"Passions - Technology enhanced learning, Education, Radiology. Technology as a tool, platform and enabler to support and augment face to face customised teaching and learning; with educational principles as the foundation; and radiology as my academic and clinical focus."

http://learningheadandneckradiology.blogspot.sg/2016/06/imaging-in-thyroid-eye-disease-role-of.html
(above link to presentation website)



Selected publications:

Yong AM, Zhao DB, Siew SC, Goh PS, Liao J, Amrith S. “Assessment of bony nasolacrimal parameters among Asians.” Ophthal Plast Reconstr Surg. 2014 Jul-Aug;30(4):322-7.

Goh, P.S., Gi, M.T., Charlton, A., Tan, C., Gangadhara Sundar, J.K., Amrith, S. “Review of orbital imaging” (2008) European Journal of Radiology, 66 (3), pp. 387-395.

Amrith, S., Goh, P.S., Wang, S.-C. “Lacrimal sac volume measurement during eyelid closure and opening” (2007) Clinical and Experimental Ophthalmology, 35 (2), pp. 135-139.

Amrith, S., Goh, P.S., Wang, S.-C. “Tear flow dynamics in the human nasolacrimal ducts - A pilot study using dynamic magnetic resonance imaging (2005)” Graefe's Archive for Clinical and Experimental Ophthalmology, 243 (2), pp. 127-131.

Goh, P.S., Khoo, C.Y., Heng, L.K., Yeoh, R.L.S, Lim, A.S.M. “Pseudomonas keratitis with soft contact lenses.” Asia-Pacific Journal of Ophthalmology (1989) Oct; 1(1), pp. 12-13.


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