Scholars@Duke
Joseph George Mammarappallil

Joseph George Mammarappallil

Associate Professor of Radiology
Radiology, Cardiothoracic Imaging

Selected Publications

Lung Tumors Marked Percutaneously with Indocyanine Green Dye-Soaked Embolization Coils: A Visual Beacon for Accurate Intraoperative Localization during Lung-Sparing Surgery.

Journal Article J Vasc Interv Radiol · January 2026 Thoracic surgeons using minimally invasive techniques for lung nodule resection often rely on localization markers to determine precise nodule location intraoperatively. Transbronchial or transthoracic injection of indocyanine green (ICG) dye has become a ... Full text Link to item Cite

Six-Month Local Control Rates and Immune Responses After Pulsed Electric Field Ablation in Metastatic Cancer

Journal Article Cancers · November 1, 2025 Background: The AFFINITY trial (NCT05890872) is a prospective, non-randomized, open-label, single-arm study evaluating the safety, immunological impact, and preliminary efficacy of Aliya pulsed electric field ablation in patients with solid tumors. Thirty- ... Full text Cite

Pulsed electric field ablation safety and characterization near sensitive structures in lung: a preclinical and clinical case series study.

Journal Article J Thorac Dis · June 30, 2025 BACKGROUND: Since pulsed electric fields (PEFs) can ablate tissue without reliance on ionizing radiation or thermal processes, there is potential for this technique to safely ablate near sensitive structures in the lung in a way that may be distinct from t ... Full text Link to item Cite

Airway Mucus Plugging in Chronic Bronchitis and the Impact of Bronchial Rheoplasty.

Journal Article Chest · June 24, 2025 BACKGROUND: Chronic bronchitis (CB) is characterized by excessive airway mucus production. Mucus plugs occluding the airway are common in CB, are associated with increased all-cause mortality, and can be identified on CT imaging. RESEARCH QUESTION: Does br ... Full text Link to item Cite

Safety and feasibility of percutaneous pulsed electrical field ablation in multiple organs: A multi-center retrospective study☆.

Journal Article Eur J Radiol · June 2025 PURPOSE: To assess the safety and feasibility of Pulsed Electrical Fields (PEF) ablation in various organs and patient populations. MATERIALS AND METHODS: This multi-center, retrospective study collected data from five academic medical centers on patients ... Full text Link to item Cite

Early experience with PEF in the setting of recalcitrant stage IV lung cancer.

Journal Article Lung Cancer · June 2025 BACKGROUND: Advanced-stage non-small cell lung cancer treatment has evolved with the introduction of molecularly targeted therapy, immunotherapy and combination frontline therapies. Despite these advancements, most patients experience treatment failure, re ... Full text Link to item Cite

Effect of Artificial Intelligence as a Second Reader on the Lung Nodule Detection and Localization Accuracy of Radiologists and Non-radiology Physicians in Chest Radiographs: A Multicenter Reader Study.

Journal Article Acad Radiol · March 2025 RATIONALE AND OBJECTIVES: Missed nodules in chest radiographs (CXRs) are common occurrences. We assessed the effect of artificial intelligence (AI) as a second reader on the accuracy of radiologists and non-radiology physicians in lung nodule detection and ... Full text Link to item Cite

Pulsed Electric Field Ablation versus Radiofrequency Thermal Ablation in Murine Breast Cancer Models: Anticancer Immune Stimulation, Tumor Response, and Abscopal Effects.

Journal Article J Vasc Interv Radiol · March 2024 PURPOSE: To compare the immune response and survival after size-matched radiofrequency (RF) ablation and a proprietary form of pulsed electric field (PEF) ablation in murine tumors. MATERIAL AND METHODS: Orthotopically inoculated EMT6 or 4T1 murine tumors ... Full text Link to item Cite

Computed Tomography Volumetrics for Size Matching in Lung Transplantation for Restrictive Disease.

Journal Article Ann Thorac Surg · February 2024 BACKGROUND: There is no consensus on the optimal allograft sizing strategy for lung transplantation in restrictive lung disease. Current methods that are based on predicted total lung capacity (pTLC) ratios do not account for the diminutive recipient chest ... Full text Link to item Cite

Functional gas exchange measures on 129Xe MRI and spectroscopy are associated with age, sex, and BMI in healthy subjects.

Journal Article Front Med (Lausanne) · 2024 INTRODUCTION: Hyperpolarized 129Xe MRI and spectroscopy is a rapidly growing technique for assessing lung function, with applications in a wide range of obstructive, restrictive, and pulmonary vascular disease. However, normal variations in 129Xe measures ... Full text Link to item Cite

Hyperpolarized 129Xe MRI and spectroscopy of gas exchange abnormalities in chronic hypersensitivity pneumonitis.

Journal Article Respir Med · 2024 PURPOSE: To evaluate 3D gas-exchange functional imaging characteristics using 129Xe MRI in a group of study participants with chronic hypersensitivity pneumonitis (CHP) as compared with healthy control participants. METHODS: In this prospective study, 11 p ... Full text Link to item Cite

MR Imaging for the Evaluation of Diffuse Lung Disease: Where Are We?

Journal Article Radiol Clin North Am · November 2022 Patients with diffuse lung diseases require thorough medical and social history and physical examinations, coupled with a multitude of laboratory tests, pulmonary function tests, and radiologic imaging to discern and manage the specific disease. This revie ... Full text Link to item Cite

Prediction of lung malignancy progression and survival with machine learning based on pre-treatment FDG-PET/CT.

Journal Article EBioMedicine · August 2022 BACKGROUND: Pre-treatment FDG-PET/CT scans were analyzed with machine learning to predict progression of lung malignancies and overall survival (OS). METHODS: A retrospective review across three institutions identified patients with a pre-procedure FDG-PET ... Full text Link to item Cite

Noninvasive diagnosis of pulmonary hypertension with hyperpolarised 129Xe magnetic resonance imaging and spectroscopy.

Conference ERJ Open Res · April 2022 BACKGROUND: The diagnosis of pulmonary hypertension (PH) remains challenging. Pre- and post-capillary PH have different signatures on noninvasive 129Xe gas-exchange magnetic resonance imaging (MRI) and dynamic MR spectroscopy (MRS). We tested the accuracy ... Full text Link to item Cite

Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia.

Journal Article Radiology · October 2021 Background Recent studies demonstrate that antifibrotic drugs previously reserved for idiopathic pulmonary fibrosis (IPF) may slow progression in other interstitial lung diseases (ILDs), creating an urgent need for tools that can sensitively assess disease ... Full text Link to item Cite

Missed Incidental Pulmonary Embolism: Harnessing Artificial Intelligence to Assess Prevalence and Improve Quality Improvement Opportunities.

Journal Article J Am Coll Radiol · July 2021 PURPOSE: Incidental pulmonary embolism (IPE) can be found on body CT. The aim of this study was to evaluate the feasibility of using artificial intelligence to identify missed IPE on a large number of CT examinations. METHODS: This retrospective analysis i ... Full text Link to item Cite

Using hyperpolarized 129Xe gas-exchange MRI to model the regional airspace, membrane, and capillary contributions to diffusing capacity.

Journal Article J Appl Physiol (1985) · May 1, 2021 Hyperpolarized 129Xe MRI has emerged as a novel means to evaluate pulmonary function via 3D mapping of ventilation, interstitial barrier uptake, and RBC transfer. However, the physiological interpretation of these measurements has yet to be firmly establis ... Full text Link to item Cite

Ferumoxytol-enhanced MR Venography of the Central Veins of the Thorax for the Evaluation of Stenosis and Occlusion in Patients with Renal Impairment.

Journal Article Radiol Cardiothorac Imaging · December 2020 PURPOSE: To assess the diagnostic performance of ferumoxytol-enhanced MR venography for the detection of thoracic central vein stenosis or occlusion with conventional venography as the reference standard. MATERIALS AND METHODS: In this retrospective study, ... Full text Link to item Cite

Generalized Linear Binning to Compare Hyperpolarized 129Xe Ventilation Maps Derived from 3D Radial Gas Exchange Versus Dedicated Multislice Gradient Echo MRI.

Journal Article Acad Radiol · August 2020 RATIONALE: Hyperpolarized 129Xe ventilation MRI is typically acquired using multislice fast gradient recalled echo (GRE), but interleaved 3D radial 129Xe gas transfer MRI now provides dissolved-phase and ventilation images from a single breath. To investig ... Full text Open Access Link to item Cite

Case 274: Cardiac Echinococcus.

Journal Article Radiology · February 2020 HistoryA 47-year-old Sudanese man without a known remarkable medical history presented to the emergency department for a syncopal episode. The patient denied chest pain, dyspnea, focal weakness, or prior similar episodes. He was originally from north Sudan ... Full text Link to item Cite

Utilization of 19F MRI for Identification of Iraq-Afghanistan War Lung Injury.

Journal Article Mil Med · January 7, 2020 INTRODUCTION: There is mounting evidence of respiratory problems related to military service in the Middle East in the past two decades due to environmental exposures during deployment (eg, sand storms and burn pits). This pilot study tests the hypothesis ... Full text Link to item Cite

Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures.

Journal Article Eur Respir J · December 2019 BACKGROUND: As an increasing number of patients exhibit concomitant cardiac and pulmonary disease, limitations of standard diagnostic criteria are more frequently encountered. Here, we apply noninvasive 129Xe magnetic resonance imaging (MRI) and spectrosco ... Full text Open Access Link to item Cite

Case 274.

Journal Article Radiology · October 2019 History A 47-year-old Sudanese man without a known remarkable medical history presented to the emergency department for a syncopal episode. The patient denied chest pain, dyspnea, focal weakness, or prior similar episodes. He was originally from north Suda ... Full text Link to item Cite

New Developments in Imaging Idiopathic Pulmonary Fibrosis With Hyperpolarized Xenon Magnetic Resonance Imaging.

Journal Article J Thorac Imaging · March 2019 Idiopathic pulmonary fibrosis (IPF) is a progressive pulmonary disease that is ultimately fatal. Although the diagnosis of IPF has been revolutionized by high-resolution computed tomography, this imaging modality still exhibits significant limitations, par ... Full text Link to item Cite

A protocol for quantifying cardiogenic oscillations in dynamic 129 Xe gas exchange spectroscopy: The effects of idiopathic pulmonary fibrosis.

Journal Article NMR Biomed · January 2019 The spectral parameters of hyperpolarized 129 Xe exchanging between airspaces, interstitial barrier, and red blood cells (RBCs) are sensitive to pulmonary pathophysiology. This study sought to evaluate whether the dynamics of 129 Xe spectroscopy provide ad ... Full text Link to item Cite

Lung cancer screening patient-provider discussion: Where do we stand and what are the associated factors?

Journal Article SAGE Open Med · 2019 OBJECTIVE: The primary objective of this study was to estimate the percentage of individuals possibly eligible for lung cancer screening that report having discussed screening with a health care provider. The secondary objective was to investigate the asso ... Full text Link to item Cite

Human-machine partnership with artificial intelligence for chest radiograph diagnosis.

Journal Article NPJ Digit Med · 2019 Human-in-the-loop (HITL) AI may enable an ideal symbiosis of human experts and AI models, harnessing the advantages of both while at the same time overcoming their respective limitations. The purpose of this study was to investigate a novel collective inte ... Full text Link to item Cite

Erratum: Author Correction: Human-machine partnership with artificial intelligence for chest radiograph diagnosis.

Journal Article NPJ Digit Med · 2019 [This corrects the article DOI: 10.1038/s41746-019-0189-7.]. ... Full text Link to item Cite

Hyperpolarized 129 Xe gas transfer MRI: the transition from 1.5T to 3T.

Journal Article Magn Reson Med · December 2018 PURPOSE: Hyperpolarized 129 Xe MRI depicting 3D ventilation, interstitial barrier uptake, and transfer to red blood cells (RBCs) has emerged as a powerful new means of detecting pulmonary disease. However, given the challenging susceptibility environment o ... Full text Link to item Cite

Impact of computed tomography (CT)-derived fractional flow reserve on reader confidence for interpretation of coronary CT angiography.

Journal Article Eur J Radiol · November 2018 PURPOSE: To assess the impact of computed tomography-derived fractional flow reserve (FFRCT) on reader confidence and reader time for interpretation of coronary computed tomography angiography (CCTA). MATERIAL AND METHODS: This IRB-approved, HIPAA-complian ... Full text Link to item Cite

Dendriform pulmonary ossification leading to bilateral lung transplant: a case report.

Journal Article Virchows Arch · September 2018 Metaplastic ossification within the lung is seen in a variety of diseases, usually as sequela of either a separate primary pulmonary parenchymal disease or an underlying cardiac disorder such as valvular disease. Primary intraalveolar ossification or ossif ... Full text Link to item Cite

Association Between Pseudotumor Formation and Patient Factors in Metal-on-Metal Total Hip Arthroplasty Population.

Journal Article J Arthroplasty · July 2018 BACKGROUND: Pseudotumor formation from metal-on-metal (MoM) hip implants is associated with implant revision. The relationship between pseudotumor type and patient outcomes is unknown. METHODS: We retrospectively reviewed patients with a MoM total hip arth ... Full text Link to item Cite

Pulmonary Delivery of Therapeutic and Diagnostic Gases.

Journal Article J Aerosol Med Pulm Drug Deliv · April 2018 The 21st Congress for the International Society for Aerosols in Medicine included, for the first time, a session on Pulmonary Delivery of Therapeutic and Diagnostic Gases. The rationale for such a session within ISAM is that the pulmonary delivery of gaseo ... Full text Open Access Link to item Cite

Impact of Fluoroscopically Guided Bone Biopsy on Antibiotic Management of Osteomyelitis in the Lower Extremity.

Journal Article J Surg Orthop Adv · 2018 This study evaluated the impact of fluoroscopically guided percutaneous bone biopsy on altering antibiotic regimens in lower extremity osteomyelitis. Eighty-eight patients who received fluoroscopically guided bone biopsies were identified. There was bacter ... Link to item Cite

Altered Nulling of Myocardium and Blood Pool.

Journal Article J Thorac Imaging · January 2017 Full text Link to item Cite

Abnormalities in hyperpolarized (129)Xe magnetic resonance imaging and spectroscopy in two patients with pulmonary vascular disease.

Journal Article Pulm Circ · March 2016 The diagnosis of pulmonary vascular disease (PVD) is usually based on hemodynamic and/or clinical criteria. Noninvasive imaging of the heart and proximal vasculature can also provide useful information. An alternate approach to such criteria in the diagnos ... Full text Link to item Cite

How accurate is the label "allergic to iodinated contrast agents"?

Journal Article Acta Radiol · January 2016 BACKGROUND: Iodinated contrast agents (ICAs) are crucial to the use of many imaging studies. Reported allergies to ICAs in the medical record can interfere with optimal diagnostic imaging workups. PURPOSE: To investigate the accuracy with which the label " ... Full text Link to item Cite

Estimation of Pleural Fluid Volumes on Chest Radiography Using Computed Tomography Volumetric Analysis: An Update of the Visual Prediction Rule.

Journal Article J Thorac Imaging · September 2015 PURPOSE: The purpose of the study was to determine the volumes of pleural fluid (PF) required to produce visible menisci in the lateral and posterior costophrenic angles (CPA) and obscure the hemidiaphragms (HD) on upright frontal and lateral chest radiogr ... Full text Link to item Cite

Computed tomography fluoroscopy versus conventional computed tomography guidance for biopsy of intrathoracic lesions: a retrospective review of 1143 consecutive procedures.

Journal Article J Thorac Imaging · November 2014 PURPOSE: To compare the success rates, complication rates, and radiation doses of conventional computed tomography (CCT) versus computed tomography with fluoroscopy (CTF) during image-guided percutaneous needle biopsies of intrathoracic lesions. MATERIALS ... Full text Link to item Cite

Semiautomatic method of quantifying pleural effusions using computed tomography scans - biomed 2013.

Journal Article Biomed Sci Instrum · 2013 Pleural effusion (PE) is a common and devastating manifestation of many pleural diseases. This complication can have dire effects by constricting breathing which increases the recovery time of the patient. Increased volumes of PE correspond with increased ... Link to item Cite

A semiautomatic method of quantifying pleural effusions using computed tomography scans

Journal Article Biomedical Sciences Instrumentation · January 1, 2013 Pleural effusion (PE) is a common and devastating manifestation of many pleural diseases. This complication can have dire effects by constricting breathing which increases the recovery time of the patient. Increased volumes of PE correspond with increased ... Cite

CT Angiography of the Aorta and Aortic Diseases

Journal Article Current Cardiovascular Imaging Reports · October 1, 2012 CT angiography (CTA) is a well established first line imaging modality used to assess diseases of the vasculature. In recent years new technologies, such as cardiac-gating, dual energy, high-pitch helical scanning, and iterative reconstruction have offered ... Full text Cite

Value of routine postoperative gastrographin contrast swallow studies after laparoscopic gastric banding.

Journal Article Arch Surg · August 2009 HYPOTHESIS: Laparoscopic adjustable gastric banding (LAGB) effectively treats morbid obesity and yields improved quality of life with low morbidity and mortality rates. The current standard of care is to perform a postoperative gastrographin study. This st ... Full text Link to item Cite

Epithelial cell adherence mediated by the enterotoxigenic Escherichia coli tia protein.

Journal Article Infect Immun · December 2000 In vitro studies have shown that enterotoxigenic Escherichia coli (ETEC) strains are capable of invading cultured epithelial cells derived from the human ileum and colon. Two separate invasion loci (tia and tib) have previously been isolated from the class ... Full text Link to item Cite