Richard Adam Leder | Scholars@Duke

Richard Adam Leder
Associate Professor of Radiology

Current and ongoing research activities include evaluation of contrast reactions in patients who have received a steroid preparation. This endeavor will aim to evaluate common risk factors shared by patients who have so called breakthrough reactions. This may help to further redefine premedications regiments in high risk patients. Additional research activities include clinical CT scanning of the kidneys with the use of a compression device. The aim of this work will help to establish whether compression CT improves visualization of the collecting system and ureters over conventional urography. Other ongoing projects include CT descriptions of idiopathic retroperitoneal fibrosis causing renal and perirenal masses, post traumatic pseudopneumoperitoneum and continued work on extravastion injuries and extravasation detection.

Current Appointments & Affiliations

Associate Professor of Radiology, Radiology, Abdominal Imaging, Radiology 2006
Clinical Associate in the Department of Surgery, Surgery, Section of Surgical Disciplines 1999

Contact Information

1417 Hosp North, Durham, NC 27710
Box 3808 Med Ctr, Durham, NC 27710
leder963@mc.duke.edu (919) 684-7310

Background
Education, Training, & Certifications
- M.D., Boston University 1984
Duke Appointment History
- Associate Clinical Professor of Radiology, Radiology, Abdominal Imaging, Radiology 2000 - 2006
- Associate Clinical Professor of Radiology, Radiology, Clinical Science Departments 1999 - 2000
- Associate Professor of Radiology, Radiology, Abdominal Imaging, Radiology 1995 - 1999
- Assistant Professor of Radiology, Radiology, Abdominal Imaging, Radiology 1989 - 1995
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Patel, Bhavik N., Alex Bibbey, Kingshuk R. Choudhury, Richard A. Leder, Rendon C. Nelson, and Daniele Marin. “Characterization of Small (< 4 cm) Focal Renal Lesions: Diagnostic Accuracy of Spectral Analysis Using Single-Phase Contrast-Enhanced Dual-Energy CT.” Ajr Am J Roentgenol 209, no. 4 (October 2017): 815–25. https://doi.org/10.2214/AJR.17.17824.
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  - Lungren, Matthew P., Eshan Samei, Huiman Barnhart, H Page McAdams, Richard A. Leder, Jared D. Christensen, John D. Wylie, Jin W. Tan, Xiang Li, and Lynne M. Hurwitz. “Gray-scale inversion radiographic display for the detection of pulmonary nodules on chest radiographs.” Clin Imaging 36, no. 5 (September 2012): 515–21. https://doi.org/10.1016/j.clinimag.2012.01.009.
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  - Davenport, M. S., A. M. Neville, J. H. Ellis, R. H. Cohan, and R. A. Leder. “Response.” Radiology 262, no. 1 (January 1, 2012): 371–72. https://doi.org/10.1148/radiol.11111592.
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  - Davenport, Matthew S., Amy M. Neville, James H. Ellis, Richard H. Cohan, and Richard A. Leder. “Diagnosis of Renal Angiomyolipoma with CT Hounsfield Unit Thresholds Response.” Radiology 262, no. 1 (January 1, 2012): 371–72.
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  - Davenport, Matthew S., Amy M. Neville, James H. Ellis, Richard H. Cohan, Humaira S. Chaudhry, and Richard A. Leder. “Diagnosis of renal angiomyolipoma with hounsfield unit thresholds: effect of size of region of interest and nephrographic phase imaging.” Radiology 260, no. 1 (July 2011): 158–65. https://doi.org/10.1148/radiol.11102476.
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  - Stewart, Suzanne Biehn, Richard A. Leder, and Brant A. Inman. “Imaging tumors of the penis and urethra.” Urol Clin North Am 37, no. 3 (August 2010): 353–67. https://doi.org/10.1016/j.ucl.2010.04.014.
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  - Scales, Charles D., W Patrick Springhart, Matthew D. Young, Jennifer T. Anger, Richard A. Leder, and Glenn M. Preminger. “Lymphangioleiomyomatosis presenting as bladder outlet obstruction.” Urology 65, no. 3 (March 2005): 589–90. https://doi.org/10.1016/j.urology.2004.11.039.
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  - Heneghan, Joan P., Keith A. McGuire, Richard A. Leder, David M. DeLong, Terry Yoshizumi, and Rendon C. Nelson. “Helical CT for nephrolithiasis and ureterolithiasis: comparison of conventional and reduced radiation-dose techniques.” Radiology 229, no. 2 (November 2003): 575–80. https://doi.org/10.1148/radiol.2292021261.
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  - Weizer, Alon Z., Ari D. Silverstein, Brian K. Auge, Fernando C. Delvecchio, Ganesh Raj, David M. Albala, Richard Leder, and Glenn M. Preminger. “Determining the incidence of horseshoe kidney from radiographic data at a single institution.” J Urol 170, no. 5 (November 2003): 1722–26. https://doi.org/10.1097/01.ju.0000092537.96414.4a.
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  - Freed, K. S., R. A. Leder, C. Alexander, D. M. DeLong, and M. A. Kliewer. “Breakthrough adverse reactions to low-osmolar contrast media after steroid premedication.” Ajr Am J Roentgenol 176, no. 6 (June 2001): 1389–92. https://doi.org/10.2214/ajr.176.6.1761389.
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  - Heneghan, J. P., D. H. Kim, R. A. Leder, D. DeLong, and R. C. Nelson. “Compression CT urography: a comparison with IVU in the opacification of the collecting system and ureters.” J Comput Assist Tomogr 25, no. 3 (May 2001): 343–47. https://doi.org/10.1097/00004728-200105000-00003.
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  - Leder, R. A., and E. K. Paulson. “Vaginitis emphysematosa: CT and review of the literature.” Ajr Am J Roentgenol 176, no. 3 (March 2001): 623–25. https://doi.org/10.2214/ajr.176.3.1760623.
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  - Leder, R. A., and R. C. Nelson. “Three-dimensional CT of the genitourinary tract.” J Endourol 15, no. 1 (February 2001): 37–46. https://doi.org/10.1089/08927790150500935.
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  - Leder, R. A. “The safe administration of intravenous contrast material for urologists and radiologists.” Curr Opin Urol 10, no. 2 (March 2000): 95–98. https://doi.org/10.1097/00042307-200003000-00008.
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  - Coulam, C. H., D. H. Sheafor, R. A. Leder, E. K. Paulson, D. M. DeLong, and R. C. Nelson. “Evaluation of pseudoenhancement of renal cysts during contrast-enhanced CT.” Ajr Am J Roentgenol 174, no. 2 (February 2000): 493–98. https://doi.org/10.2214/ajr.174.2.1740493.
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  - Heneghan, J. P., D. H. Kim, M. H. Howard, R. A. Leder, D. M. Delong, and R. C. Nelson. “Compression CT urography: Comparison of 3D volume rendered images with IVP in evaluation of the collecting system and ureters, and assessment of clinical acceptabilty by urologists.” Radiology 213P (November 1, 1999): 475–475.
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  - Patz, E. F., J. J. Erasmus, H. P. McAdams, J. E. Connolly, E. M. Marom, P. C. Goodman, R. A. Leder, M. T. Keogan, and J. E. Herndon. “Lung cancer staging and management: comparison of contrast-enhanced and nonenhanced helical CT of the thorax.” Radiology 212, no. 1 (July 1999): 56–60. https://doi.org/10.1148/radiology.212.1.r99jl1956.
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  - Iselin, C. E., R. A. Leder, J. Lacey, J. P. Gockerman, and D. F. Paulson. “Renal lymphoma in an azotemic patient--usefulness of magnetic resonance imaging.” Scand J Urol Nephrol 33, no. 2 (April 1999): 129–30. https://doi.org/10.1080/003655999750016131.
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  - Heyneman, L. E., M. T. Keogan, J. E. Tuttle-Newhall, R. J. Porte, R. A. Leder, and R. C. Nelson. “Pancreatic transplantation using portal venous and enteric drainage: the postoperative appearance of a new surgical procedure.” J Comput Assist Tomogr 23, no. 2 (March 1999): 283–90. https://doi.org/10.1097/00004728-199903000-00020.
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  - Leder, R. A. “Radiological approach to renal cysts and the Bosniak classification system.” Curr Opin Urol 9, no. 2 (March 1999): 129–33. https://doi.org/10.1097/00042307-199903000-00007.
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  - Hara, M., P. C. Goodman, and R. A. Leder. “FDG-PET finding in early-phase Takayasu arteritis.” J Comput Assist Tomogr 23, no. 1 (January 1999): 16–18. https://doi.org/10.1097/00004728-199901000-00004.
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  - Freed, K. S., E. K. Paulson, M. G. Frederick, G. M. Preminger, D. J. Shusterman, M. T. Keogan, J. Vieweg, et al. “Interobserver variability in the interpretation of unenhanced helical CT for the diagnosis of ureteral stone disease.” J Comput Assist Tomogr 22, no. 5 (September 1998): 732–37. https://doi.org/10.1097/00004728-199809000-00013.
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  - Vieweg, J., C. Teh, K. Freed, R. A. Leder, R. H. Smith, R. H. Nelson, and G. M. Preminger. “Unenhanced helical computerized tomography for the evaluation of patients with acute flank pain.” J Urol 160, no. 3 Pt 1 (September 1998): 679–84. https://doi.org/10.1097/00005392-199809010-00010.
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  - Vieweg, J., C. Teh, K. Freed, R. A. Leder, R. H. A. Smith, R. H. Nelson, and G. M. Preminger. “Unenhanced helical computerized tomography for the evaluation of patients with acute flank pain.” Journal of Urology 160, no. 3 I (1998): 679–84. https://doi.org/10.1016/S0022-5347(01)62754-X.
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  - Leder, R. “How well does a history of seafood allergy predict the likelihood of an adverse reaction to i.v. contrast material?” Ajr Am J Roentgenol 169, no. 3 (September 1997): 906–7. https://doi.org/10.2214/ajr.169.3.9275919.
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  - Keogan, M. T., L. Carr, V. G. McDermott, R. A. Leder, and G. E. Webster. “Continent urinary diversion procedures: radiographic appearances and potential complications.” Ajr Am J Roentgenol 169, no. 1 (July 1997): 173–78. https://doi.org/10.2214/ajr.169.1.9207520.
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  - Hertzberg, B. S., M. A. Kliewer, R. A. Leder, and B. A. Carroll. “Primary megaureter mimicking hydrosalpinx on ultrasonography.” J Ultrasound Med 16, no. 6 (June 1997): 441–44. https://doi.org/10.7863/jum.1997.16.6.441.
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  - Keogan, M. T., L. K. Carr, V. G. McDermott, R. A. Leder, and G. D. Webster. “New continent urinary diversion procedures: Radiographic appearances and potential complications.” Radiology 201 (November 1, 1996): 220–220.
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  - Price, D. T., K. E. Maloney, G. K. Ibrahim, G. W. Cundiff, R. A. Leder, and E. E. Anderson. “Vesical endometriosis: report of two cases and review of the literature.” Urology 48, no. 4 (October 1996): 639–43. https://doi.org/10.1016/S0090-4295(96)00224-5.
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  - Cohan, R. H., R. A. Leder, and J. H. Ellis. “Treatment of adverse reactions to radiographic contrast media in adults.” Radiol Clin North Am 34, no. 5 (September 1996): 1055–76.
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  - Paulson, E. K., R. A. Leder, D. M. Delong, M. T. Keogan, A. R. Moore, and R. C. Nelson. “Use of time during body computed tomography scanning in a tertiary care teaching hospital: focus on patient throughput.” Acad Radiol 3, no. 3 (March 1996): 254–59. https://doi.org/10.1016/s1076-6332(96)80453-3.
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  - MCDERMOTT, V. G., R. C. NELSON, T. P. SMITH, M. T. KEOGAN, R. A. LEDER, and C. S. PAYNE. “VOLUME-RENDERED 3D HELICAL CT ANGIOGRAPHY OF ABDOMINAL AORTIC-ANEURYSMS.” Radiology 197 (November 1, 1995): 515–515.
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  - Leder, R. A. “Genitourinary case of the day. Renal lymphangiomatosis.” Ajr Am J Roentgenol 165, no. 1 (July 1995): 197–98. https://doi.org/10.2214/ajr.165.1.7785592.
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  - Leder, R. A. “Genitourinary case of the day. Angiomyolipoma of the kidney with fat thrombus in the inferior vena cava.” Ajr Am J Roentgenol 165, no. 1 (July 1995): 198–99. https://doi.org/10.2214/ajr.165.1.7785593.
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  - Leder, R. A., and V. H. Low. “Tuberculosis of the abdomen.” Radiol Clin North Am 33, no. 4 (July 1995): 691–705.
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  - Cohan, R. H., C. L. Siegel, M. Korobkin, J. C. Stanley, M. B. Alpern, D. L. Courneya, and R. A. Leder. “Abdominal aortic aneurysms: CT evaluation of renal artery involvement.” Radiology 194, no. 3 (March 1995): 751–56. https://doi.org/10.1148/radiology.194.3.7862974.
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  - Siegel, C. L., R. H. Cohan, M. Korobkin, M. B. Alpern, D. L. Courneya, and R. A. Leder. “Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms.” Ajr Am J Roentgenol 163, no. 5 (November 1994): 1123–29. https://doi.org/10.2214/ajr.163.5.7976888.
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  - Bree, R. L., Y. R. Parisky, M. E. Bernardino, P. Costello, R. Leder, and P. C. Brown. “Cost-effective use of low-osmolality contrast media for CT of the liver: evaluation of liver enhancement provided by various doses of iohexol.” Ajr Am J Roentgenol 163, no. 3 (September 1994): 579–83. https://doi.org/10.2214/ajr.163.3.8079849.
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  - Newhouse, J. H., J. Landman, E. Lang, E. S. Amis, S. Goldman, R. Khazan, R. Leder, and M. Hedgcock. “Efficacy and safety of iopromide for excretory urography.” Invest Radiol 29 Suppl 1 (May 1994): S68–73. https://doi.org/10.1097/00004424-199405001-00013.
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  - Paulson, E. K., M. E. Baker, C. E. Spritzer, R. A. Leder, D. J. Gulliver, and W. C. Meyers. “Focal fatty infiltration: a cause of nontumorous defects in the left hepatic lobe during CT arterial portography.” J Comput Assist Tomogr 17, no. 4 (July 1993): 590–95.
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  - Baker, M. E., C. Beam, R. Leder, D. Gulliver, S. S. Paine, and N. R. Dunnick. “Contrast material for combined abdominal and pelvic CT: can cost be reduced by increasing the concentration and decreasing the volume?” Ajr Am J Roentgenol 160, no. 3 (March 1993): 637–41. https://doi.org/10.2214/ajr.160.3.8430570.
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  - Dunnick, N. R., G. S. Leight, M. A. Roubidoux, R. A. Leder, E. Paulson, and L. Kurylo. “CT in the diagnosis of primary aldosteronism: sensitivity in 29 patients.” Ajr Am J Roentgenol 160, no. 2 (February 1993): 321–24. https://doi.org/10.2214/ajr.160.2.8424342.
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  - Paulson, E. K., M. E. Baker, D. J. Hilleren, W. P. Jones, M. H. Knelson, S. N. Nadel, R. A. Leder, and W. C. Meyers. “CT arterial portography: causes of technical failure and variable liver enhancement.” Ajr Am J Roentgenol 159, no. 4 (October 1992): 745–49. https://doi.org/10.2214/ajr.159.4.1326885.
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  - Nemeroff, C. B., K. R. Krishnan, D. Reed, R. Leder, C. Beam, and N. R. Dunnick. “Adrenal gland enlargement in major depression. A computed tomographic study.” Arch Gen Psychiatry 49, no. 5 (May 1992): 384–87. https://doi.org/10.1001/archpsyc.1992.01820050048008.
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  - Friedland, G. W., P. A. deVries, M. Nino-Murcia, B. F. King, R. A. Leder, and S. Stevens. “Congenital anomalies of the inferior vena cava: embryogenesis and MR features.” Urol Radiol 13, no. 4 (1992): 237–48. https://doi.org/10.1007/BF02924631.
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  - Roubidoux, M. A., N. R. Dunnick, H. D. Sostman, and R. A. Leder. “Renal carcinoma: detection of venous extension with gradient-echo MR imaging.” Radiology 182, no. 1 (January 1992): 269–72. https://doi.org/10.1148/radiology.182.1.1727294.
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  - McDonnell, C. H., M. E. Baker, R. H. Cohan, S. N. Nadel, R. A. Leder, T. N. Pappas, and R. P. Rice. “CT of fundoplication.” J Comput Assist Tomogr 15, no. 5 (September 1991): 757–61. https://doi.org/10.1097/00004728-199109000-00006.
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  - Cohan, R. H., R. A. Leder, A. J. Herzberg, L. W. Hedlund, C. T. Wheeler, C. A. Beam, S. N. Nadel, and N. R. Dunnick. “Extravascular toxicity of two magnetic resonance contrast agents. Preliminary experience in the rat.” Invest Radiol 26, no. 3 (March 1991): 224–26. https://doi.org/10.1097/00004424-199103000-00005.
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  - Debatin, J. F., R. H. Cohan, R. A. Leder, C. B. Zakrzewski, and N. R. Dunnick. “Selective use of low-osmolar contrast media.” Invest Radiol 26, no. 1 (January 1991): 17–21. https://doi.org/10.1097/00004424-199101000-00004.
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  - Baker, M. E., R. H. Cohan, S. N. Nadel, R. A. Leder, and N. R. Dunnick. “Obliteration of the fat surrounding the celiac axis and superior mesenteric artery is not a specific CT finding of carcinoma of the pancreas.” Ajr Am J Roentgenol 155, no. 5 (November 1990): 991–94. https://doi.org/10.2214/ajr.155.5.2120970.
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  - Cohan, R. H., N. R. Dunnick, R. A. Leder, and M. E. Baker. “Computed tomography of renal lymphoma.” J Comput Assist Tomogr 14, no. 6 (November 1990): 933–38. https://doi.org/10.1097/00004728-199011000-00013.
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  - Leder, R. A., and N. R. Dunnick. “Transitional cell carcinoma of the pelvicalices and ureter.” Ajr Am J Roentgenol 155, no. 4 (October 1990): 713–22. https://doi.org/10.2214/ajr.155.4.2119098.
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  - Jacoby, W. T., R. H. Cohan, M. E. Baker, R. A. Leder, S. N. Nadel, and N. R. Dunnick. “Ovarian vein thrombosis in oncology patients: CT detection and clinical significance.” Ajr Am J Roentgenol 155, no. 2 (August 1990): 291–94. https://doi.org/10.2214/ajr.155.2.2115254.
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  - Cohan, R. H., N. R. Dunnick, R. A. Leder, and M. E. Baker. “Extravasation of nonionic radiologic contrast media: efficacy of conservative treatment.” Radiology 176, no. 1 (July 1990): 65–67. https://doi.org/10.1148/radiology.176.1.2353113.
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  - Cohan, R. H., R. A. Leder, D. Bolick, A. J. Herzberg, L. W. Hedlund, C. T. Wheeler, M. J. Helms, and N. R. Dunnick. “Extravascular extravasation of radiographic contrast media. Effects of conventional and low-osmolar agents in the rat thigh.” Invest Radiol 25, no. 5 (May 1990): 504–10. https://doi.org/10.1097/00004424-199005000-00006.
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  - Dunnick, N. R., R. A. Leder, and M. A. Roubidoux. “Percutaneous biopsy of the kidney and adrenal glands.” Urol Radiol 12, no. 3 (1990): 125–29. https://doi.org/10.1007/BF02923987.
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  - Leder, R. A., and N. R. Dunnick. “Percutaneous drainage of abscesses in patients with Crohn disease.” Invest Radiol 24, no. 4 (April 1989): 334–36. https://doi.org/10.1097/00004424-198904000-00014.
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- Book Sections
  - Freed, K. S., M. T. Keogan, A. M. Foti, J. A. L. Lawrance, R. A. Leder, M. G. Frederick, D. Marin, et al. “Genitourinary imaging.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 175–234, 2012.
  - Leder, R. A. “Genitourinary imaging: Case 5.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 184–85, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 18.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 210–11, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 10.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 194–95, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 22.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 218–19, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 9.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 192–93, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 17.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 208–9, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 8.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 190–91, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 16.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 206–7, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 20.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 214–15, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 15.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 204–5, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 12.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 198–99, 2012.
  - Leder, R. A., and D. Marin. “Genitourinary imaging: Case 14.” In Duke Radiology Case Review: Imaging, Differential Diagnosis, and Discussion: 2nd Edition, 202–3, 2012.
- Other Articles
  - Peterson, L. J. “Re: Unenhanced helical computerized tomography for the evaluation of patients with acute flank pain.” J Urol, March 1999. https://doi.org/10.1016/s0022-5347(01)61820-2.
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  - Preminger, G. M., J. Vieweg, R. A. Leder, and R. C. Nelson. “Urolithiasis: detection and management with unenhanced spiral CT--a urologic perspective.” Radiology, May 1998. https://doi.org/10.1148/radiology.207.2.9577473.
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- Conference Papers
  - Thomas, J., L. M. Ho, G. Raj, R. A. Leder, and G. Webster. “Artificial urethral sphincter.” In American Journal of Roentgenology, 184:99–99. AMER ROENTGEN RAY SOC, 2005.
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  - Heneghan, J. P., K. A. McGuire, R. A. Leder, D. M. Delong, and R. C. Nelson. “Helical CT for nephrolithiasis: Comparison of the efficacy of standard and reduced radiation dose techniques.” In Radiology, 225:235–235. RADIOLOGICAL SOC NORTH AMERICA, 2002.
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Teaching & Mentoring
Recent Courses
- RADIOL 403C: Genitourinary Imaging 2020
- RADIOL 403C: Genitourinary Imaging 2019
- RADIOL 403C: Genitourinary Imaging 2018

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Education, Training, & Certifications

Duke Appointment History

Selected Publications

Academic Articles

Book Sections

Other Articles

Conference Papers

Recent Courses