Scholars@Duke
Nicholas Befera

Nicholas Befera

Assistant Professor of Radiology
Radiology, Interventional Radiology
nicholas.befera@duke.edu
Dept of Radiology, Box 3808, Durham, NC 27710
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Selected Publications

Correlation of Ablation Volume with Renal Function Loss after Cryoablation in Solitary Functioning Kidneys.

Journal Article J Vasc Interv Radiol · October 2024 PURPOSE: To determine the degree of renal function deterioration after renal cryoablation in patients with a solitary functioning kidney on the basis of ablation volume. MATERIALS AND METHODS: Over a 15-year period, 81 percutaneous cryoablations were perfo ... Full text Link to item Cite

Long term impact of transjugular intrahepatic portosystemic shunt (TIPS) creation on hepatic morphology.

Journal Article Clin Imaging · June 2024 PURPOSE: The purpose of this study was to evaluate long-term morphologic changes occurring in the liver after TIPS creation with correlation with hepatic function to gain insight on the physiologic impact of TIPS on the liver. METHODS: This retrospective s ... Full text Link to item Cite

Yttrium-90 Radioembolization of a Large Hepatic Hemangioma.

Journal Article Cardiovasc Intervent Radiol · January 2024 Full text Link to item Cite

Tumor size and survival in intrahepatic cholangiocarcinoma treated with surgical resection or ablation.

Journal Article J Surg Oncol · December 2023 OBJECTIVES: We performed a retrospective analysis within a national cancer registry on outcomes following resection or ablation for intrahepatic cholangiocarcinoma (iCCA). METHODS: The National Cancer Database was queried for patients with clinical stage I ... Full text Link to item Cite

Comparing Survival After Resection, Ablation, and Radiation in Small Intrahepatic Cholangiocarcinoma.

Journal Article Ann Surg Oncol · October 2023 BACKGROUND: Hepatectomy is the cornerstone of curative-intent treatment for intrahepatic cholangiocarcinoma (ICC). However, in patients unable to be resected, data comparing efficacy of alternatives including thermal ablation and radiation therapy (RT) rem ... Full text Open Access Link to item Cite

Utility of CBCT and AVD for intraprocedural diagnosis and treatment of lower GI bleeding.

Journal Article Clin Imaging · February 2023 BACKGROUND: Intraprocedural Cone Beam CT (CBCT) is assessed to examine if use improves diagnosis and embolization rates of acute lower GI bleed (LGIB) and if automatic vessel detection (AVD) software can identify feeding vessels (FV) for embolization. METH ... Full text Link to item Cite

Coaxial Stent Graft inside a Constraining Stent for Transjugular Intrahepatic Portosystemic Shunt Reduction.

Journal Article J Vasc Interv Radiol · December 2022 A technique to create a coaxial, self-expanding stent graft inside a constraining, bare-metal, balloon-expandable stent for transjugular intrahepatic portosystemic shunt (TIPS) reduction is described. The key steps are performed on a back table rather than ... Full text Link to item Cite

Safety Profile of Particle Embolization for Treatment of Acute Lower Gastrointestinal Bleeding.

Journal Article J Vasc Interv Radiol · March 2022 PURPOSE: To assess ischemic adverse events following particle embolization when used as a second-line embolic to coil embolization for the treatment of acute lower gastrointestinal bleeding (LGIB). MATERIALS AND METHODS: The single-institution retrospectiv ... Full text Link to item Cite

Diagnostic accuracy of clinically reported adenomyosis on pelvic ultrasound and MRI compared to surgical pathology.

Journal Article Clin Imaging · February 2022 BACKGROUND: Adenomyosis is a common gynecologic pathology that relies on diagnostic imaging to guide treatment. Accuracy of both pelvic ultrasound and magnetic resonance imaging (MRI) when specifically evaluating for the presence of adenomyosis is high. Ho ... Full text Link to item Cite

Patient-Friendly Radiology Reporting-Implementation and Outcomes.

Journal Article J Am Coll Radiol · February 2022 OBJECTIVE: To evaluate patient use and experience with patient-centered radiology reports provided via a radiology-specific patient portal in an outpatient setting. METHODS: Patient-centered interactive radiology reports were made available to all patients ... Full text Link to item Cite

Proton pump inhibitor use is associated with increased rates of post-TIPS hepatic encephalopathy: Replication in an independent patient cohort.

Journal Article Clin Imaging · September 2021 PURPOSE: Proton pump inhibitor (PPI) use is a potential risk factor for hepatic encephalopathy (HE), but few studies have examined the effect on post-TIPS HE. The purpose of this study was to determine whether PPIs are associated with increased rates of po ... Full text Link to item Cite

Intravascular Ultrasound-Guided Transvenous Biopsy of Abdominal and Pelvic Targets Difficult to Access by Percutaneous Needle Biopsy: Technique and Initial Clinical Experience.

Journal Article J Vasc Interv Radiol · September 2021 PURPOSE: To report initial clinical experience with intravascular ultrasound (US)-guided transvenous biopsy (TVB) for perivascular target lesions in the abdomen and pelvis using side-viewing phased-array intracardiac echocardiography catheters. MATERIALS A ... Full text Link to item Cite

Spinal Arterial Blood Supply Does Not Arise from the Bronchial Arteries: A Detailed Analysis of Angiographic Studies Performed for Hemoptysis.

Journal Article J Vasc Interv Radiol · November 2019 PURPOSE: To determine the angiographic prevalence of spinal arteries originating directly from the bronchial arteries in the setting of embolization for hemoptysis. MATERIALS AND METHODS: Over a 14-year interval, 205 patients underwent angiography for hemo ... Full text Link to item Cite

Comprehensive Word-Level Classification of Screening Mammography Reports Using a Neural Network Sequence Labeling Approach.

Journal Article J Digit Imaging · October 2019 Radiology reports contain a large amount of potentially valuable unstructured data. Recently, neural networks have been employed to perform classification of radiology reports over a few classes at the document level. The success of neural networks in sequ ... Full text Link to item Cite

Endovascular repair of an acute symptomatic carotid artery dissection through the false dissecting carotid lumen.

Journal Article Interv Neuroradiol · February 2019 A 48-year-old woman presented with an acute ischemic stroke (National Institutes of Health Stroke Scale (NIHSS) 21) six hours after symptom onset. Workup revealed a left cervical internal carotid artery (ICA) occlusive dissection, which was emergently reco ... Full text Link to item Cite

Correlation of Ablation Volume with Renal Function Loss after Cryoablation in Solitary Functioning Kidneys.

Journal Article J Vasc Interv Radiol · October 2024 PURPOSE: To determine the degree of renal function deterioration after renal cryoablation in patients with a solitary functioning kidney on the basis of ablation volume. MATERIALS AND METHODS: Over a 15-year period, 81 percutaneous cryoablations were perfo ... Full text Link to item Cite

Long term impact of transjugular intrahepatic portosystemic shunt (TIPS) creation on hepatic morphology.

Journal Article Clin Imaging · June 2024 PURPOSE: The purpose of this study was to evaluate long-term morphologic changes occurring in the liver after TIPS creation with correlation with hepatic function to gain insight on the physiologic impact of TIPS on the liver. METHODS: This retrospective s ... Full text Link to item Cite

Yttrium-90 Radioembolization of a Large Hepatic Hemangioma.

Journal Article Cardiovasc Intervent Radiol · January 2024 Full text Link to item Cite

Tumor size and survival in intrahepatic cholangiocarcinoma treated with surgical resection or ablation.

Journal Article J Surg Oncol · December 2023 OBJECTIVES: We performed a retrospective analysis within a national cancer registry on outcomes following resection or ablation for intrahepatic cholangiocarcinoma (iCCA). METHODS: The National Cancer Database was queried for patients with clinical stage I ... Full text Link to item Cite

Comparing Survival After Resection, Ablation, and Radiation in Small Intrahepatic Cholangiocarcinoma.

Journal Article Ann Surg Oncol · October 2023 BACKGROUND: Hepatectomy is the cornerstone of curative-intent treatment for intrahepatic cholangiocarcinoma (ICC). However, in patients unable to be resected, data comparing efficacy of alternatives including thermal ablation and radiation therapy (RT) rem ... Full text Open Access Link to item Cite

Utility of CBCT and AVD for intraprocedural diagnosis and treatment of lower GI bleeding.

Journal Article Clin Imaging · February 2023 BACKGROUND: Intraprocedural Cone Beam CT (CBCT) is assessed to examine if use improves diagnosis and embolization rates of acute lower GI bleed (LGIB) and if automatic vessel detection (AVD) software can identify feeding vessels (FV) for embolization. METH ... Full text Link to item Cite

Coaxial Stent Graft inside a Constraining Stent for Transjugular Intrahepatic Portosystemic Shunt Reduction.

Journal Article J Vasc Interv Radiol · December 2022 A technique to create a coaxial, self-expanding stent graft inside a constraining, bare-metal, balloon-expandable stent for transjugular intrahepatic portosystemic shunt (TIPS) reduction is described. The key steps are performed on a back table rather than ... Full text Link to item Cite

Safety Profile of Particle Embolization for Treatment of Acute Lower Gastrointestinal Bleeding.

Journal Article J Vasc Interv Radiol · March 2022 PURPOSE: To assess ischemic adverse events following particle embolization when used as a second-line embolic to coil embolization for the treatment of acute lower gastrointestinal bleeding (LGIB). MATERIALS AND METHODS: The single-institution retrospectiv ... Full text Link to item Cite

Diagnostic accuracy of clinically reported adenomyosis on pelvic ultrasound and MRI compared to surgical pathology.

Journal Article Clin Imaging · February 2022 BACKGROUND: Adenomyosis is a common gynecologic pathology that relies on diagnostic imaging to guide treatment. Accuracy of both pelvic ultrasound and magnetic resonance imaging (MRI) when specifically evaluating for the presence of adenomyosis is high. Ho ... Full text Link to item Cite

Patient-Friendly Radiology Reporting-Implementation and Outcomes.

Journal Article J Am Coll Radiol · February 2022 OBJECTIVE: To evaluate patient use and experience with patient-centered radiology reports provided via a radiology-specific patient portal in an outpatient setting. METHODS: Patient-centered interactive radiology reports were made available to all patients ... Full text Link to item Cite

Proton pump inhibitor use is associated with increased rates of post-TIPS hepatic encephalopathy: Replication in an independent patient cohort.

Journal Article Clin Imaging · September 2021 PURPOSE: Proton pump inhibitor (PPI) use is a potential risk factor for hepatic encephalopathy (HE), but few studies have examined the effect on post-TIPS HE. The purpose of this study was to determine whether PPIs are associated with increased rates of po ... Full text Link to item Cite

Intravascular Ultrasound-Guided Transvenous Biopsy of Abdominal and Pelvic Targets Difficult to Access by Percutaneous Needle Biopsy: Technique and Initial Clinical Experience.

Journal Article J Vasc Interv Radiol · September 2021 PURPOSE: To report initial clinical experience with intravascular ultrasound (US)-guided transvenous biopsy (TVB) for perivascular target lesions in the abdomen and pelvis using side-viewing phased-array intracardiac echocardiography catheters. MATERIALS A ... Full text Link to item Cite

Spinal Arterial Blood Supply Does Not Arise from the Bronchial Arteries: A Detailed Analysis of Angiographic Studies Performed for Hemoptysis.

Journal Article J Vasc Interv Radiol · November 2019 PURPOSE: To determine the angiographic prevalence of spinal arteries originating directly from the bronchial arteries in the setting of embolization for hemoptysis. MATERIALS AND METHODS: Over a 14-year interval, 205 patients underwent angiography for hemo ... Full text Link to item Cite

Comprehensive Word-Level Classification of Screening Mammography Reports Using a Neural Network Sequence Labeling Approach.

Journal Article J Digit Imaging · October 2019 Radiology reports contain a large amount of potentially valuable unstructured data. Recently, neural networks have been employed to perform classification of radiology reports over a few classes at the document level. The success of neural networks in sequ ... Full text Link to item Cite

Endovascular repair of an acute symptomatic carotid artery dissection through the false dissecting carotid lumen.

Journal Article Interv Neuroradiol · February 2019 A 48-year-old woman presented with an acute ischemic stroke (National Institutes of Health Stroke Scale (NIHSS) 21) six hours after symptom onset. Workup revealed a left cervical internal carotid artery (ICA) occlusive dissection, which was emergently reco ... Full text Link to item Cite

Onyx embolization of a pial AV fistula with a giant venous varix using a flow-directed Scepter balloon catheter: Technical note.

Journal Article Interv Neuroradiol · December 2018 BACKGROUND AND IMPORTANCE: Pial arteriovenous fistulas (AVFs) of the brain are treacherous lesions that can be challenging to treat because of high risk of hemorrhage. We report on a rare case of a pial AVF with a giant venous varix as a draining vein trea ... Full text Link to item Cite

A Normal Thyroid by Any Other Name: Linguistic Analysis of Statements Describing a Normal Thyroid Gland from Noncontrast Chest CT Reports.

Journal Article J Am Coll Radiol · November 2018 PURPOSE: To determine the variability and readability of language used in chest CT reports to describe a "normal" thyroid gland. METHODS: Using a semi-automated process, we identified unique sentences or phrases describing a "normal" thyroid gland in 11,35 ... Full text Link to item Cite

Patient-Centered Radiology Reporting: Using Online Crowdsourcing to Assess the Effectiveness of a Web-Based Interactive Radiology Report.

Journal Article J Am Coll Radiol · November 2017 PURPOSE: The aim of this study was to evaluate the effectiveness of a patient-centered web-based interactive mammography report. METHODS: A survey was distributed on Amazon Mechanical Turk, an online crowdsourcing platform. One hundred ninety-three US wome ... Full text Link to item Cite

Performance of a Machine Learning Classifier of Knee MRI Reports in Two Large Academic Radiology Practices: A Tool to Estimate Diagnostic Yield.

Journal Article AJR Am J Roentgenol · April 2017 OBJECTIVE: The purpose of this study is to evaluate the performance of a natural language processing (NLP) system in classifying a database of free-text knee MRI reports at two separate academic radiology practices. MATERIALS AND METHODS: An NLP system tha ... Full text Link to item Cite

CT Fluoroscopy-Guided Blood Patching of Ventral CSF Leaks by Direct Needle Placement in the Ventral Epidural Space Using a Transforaminal Approach.

Journal Article AJNR Am J Neuroradiol · October 2016 BACKGROUND AND PURPOSE: Epidural blood patch treatment of spontaneous intracranial hypotension arising from ventral CSF leaks can be difficult secondary to challenges in achieving ventral spread of patching material. The purpose of this study was to determ ... Full text Link to item Cite

Physician self-referral and imaging use appropriateness: negative cervical spine MRI frequency as an assessment metric.

Journal Article AJNR Am J Neuroradiol · December 2014 BACKGROUND AND PURPOSE: Imaging self-referral is increasingly cited as a contributor to diagnostic imaging overuse. The purpose of this study was to determine whether ownership of MR imaging equipment by ordering physicians influences the frequency of nega ... Full text Link to item Cite

A high-resolution cardiovascular magnetic resonance diffusion tensor map from ex-vivo C57BL/6 murine hearts.

Journal Article J Cardiovasc Magn Reson · October 16, 2014 BACKGROUND: The complex cardiac fiber structural organization and spatial arrangement of cardiomyocytes in laminar sheetlets contributes greatly to cardiac functional and contractile ejection patterns. This study presents the first comprehensive, ultra-hig ... Full text Link to item Cite

Comparison of 4D-microSPECT and microCT for murine cardiac function.

Journal Article Mol Imaging Biol · April 2014 PURPOSE: The objective of this study was to compare a new generation of four-dimensional micro-single photon emission computed tomography (microSPECT) with microCT for the quantitative in vivo assessment of murine cardiac function. PROCEDURES: Four-dimensi ... Full text Link to item Cite

Assessing cardiac injury in mice with dual energy-microCT, 4D-microCT, and microSPECT imaging after partial heart irradiation.

Journal Article Int J Radiat Oncol Biol Phys · March 1, 2014 PURPOSE: To develop a mouse model of cardiac injury after partial heart irradiation (PHI) and to test whether dual energy (DE)-microCT and 4-dimensional (4D)-microCT can be used to assess cardiac injury after PHI to complement myocardial perfusion imaging ... Full text Open Access Link to item Cite

Anatomical and functional imaging of myocardial infarction in mice using micro-CT and eXIA 160 contrast agent.

Journal Article Contrast Media Mol Imaging · 2014 Noninvasive small animal imaging techniques are essential for evaluation of cardiac disease and potential therapeutics. A novel preclinical iodinated contrast agent called eXIA 160 has recently been developed, which has been evaluated for micro-CT cardiac ... Full text Link to item Cite

Dual-energy micro-CT imaging of pulmonary airway obstruction: Correlation with micro-SPECT

Conference Progress in Biomedical Optics and Imaging - Proceedings of SPIE · January 1, 2014 To match recent clinical dual energy (DE) CT studies focusing on the lung, similar developments for DE micro-CT of the rodent lung are required. Our group has been actively engaged in designing pulmonary gating techniques for micro- CT, and has also introd ... Full text Cite

Abdominopelvic and lower extremity deep venous thrombosis: evaluation with contrast-enhanced MR venography with a blood-pool agent.

Journal Article AJR Am J Roentgenol · July 2013 OBJECTIVE: The purpose of this article is to evaluate contrast-enhanced (CE) MR venography (MRV) with a blood-pool agent for detection of abdominopelvic and lower extremity deep venous thrombosis (DVT) compared with a conventional unenhanced gradient-recal ... Full text Link to item Cite