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Walter Wiggins

Walter Wiggins

Adjunct Assistant Professor in the Department of Radiology
Radiology, Neuroradiology
walter.wiggins@duke.edu
DUMC 3808, Durham, NC 27710
DUMC 3808, Durham, NC 27710

Selected Publications

The Brain Tumor Segmentation - Metastases (BraTS-METS) Challenge 2023: Brain Metastasis Segmentation on Pre-treatment MRI.

Journal Article ArXiv · December 9, 2024 The translation of AI-generated brain metastases (BM) segmentation into clinical practice relies heavily on diverse, high-quality annotated medical imaging datasets. The BraTS-METS 2023 challenge has gained momentum for testing and benchmarking algorithms ... Link to item Cite

The Brain Tumor Segmentation (BraTS) Challenge 2023: Brain MR Image Synthesis for Tumor Segmentation (BraSyn).

Journal Article ArXiv · November 24, 2024 Automated brain tumor segmentation methods have become well-established and reached performance levels offering clear clinical utility. These methods typically rely on four input magnetic resonance imaging (MRI) modalities: T1-weighted images with and with ... Link to item Cite

Automated selection of abdominal MRI series using a DICOM metadata classifier and selective use of a pixel-based classifier.

Journal Article Abdom Radiol (NY) · October 2024 Accurate, automated MRI series identification is important for many applications, including display ("hanging") protocols, machine learning, and radiomics. The use of the series description or a pixel-based classifier each has limitations. We demonstrate a ... Full text Link to item Cite

Using Novel Segmentation Technology to Define Safe Corridors for Minimally Invasive Posterior Lumbar Interbody Fusion.

Journal Article Oper Neurosurg (Hagerstown) · July 1, 2024 BACKGROUND AND OBJECTIVES: There has been a rise in minimally invasive methods to access the intervertebral disk space posteriorly given their decreased tissue destruction, lower blood loss, and earlier return to work. Two such options include the percutan ... Full text Open Access Link to item Cite

The Brain Tumor Segmentation (BraTS) Challenge 2023: Focus on Pediatrics (CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs).

Journal Article ArXiv · May 23, 2024 Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20%. Due to their rarity, the diagnosis of these entities is often del ... Link to item Cite

Using Augmented Reality Technology to Optimize Transfacet Lumbar Interbody Fusion: A Case Report.

Journal Article J Clin Med · March 6, 2024 The transfacet minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a novel approach available for the management of lumbar spondylolisthesis. It avoids the need to manipulate either of the exiting or traversing nerve roots, both protect ... Full text Open Access Link to item Cite

Incidence and imaging characteristics of difficult to detect retrospectively identified brain metastases in patients receiving repeat courses of stereotactic radiosurgery.

Journal Article J Neurooncol · March 2024 PURPOSE: During stereotactic radiosurgery (SRS) planning for brain metastases (BM), brain MRIs are reviewed to select appropriate targets based on radiographic characteristics. Some BM are difficult to detect and/or definitively identify and may go untreat ... Full text Link to item Cite

Severe CNS involvement in a subset of long-term treated children with infantile-onset Pompe disease.

Journal Article Mol Genet Metab · February 2024 INTRODUCTION: The standard of care for patients with infantile-onset Pompe disease (IOPD) is enzyme replacement therapy (ERT), which does not cross the blood brain barrier. While neuromuscular manifestations of IOPD are well-described, central nervous syst ... Full text Link to item Cite

Two-Year Clinical and Radiographic Outcomes for Percutaneous Lumbar Interbody Fusion With an Expandable Titanium Cage Through Kambin's Triangle Without Facetectomy.

Journal Article Int J Spine Surg · December 26, 2023 BACKGROUND: There has been heightened interest in performing percutaneous lumbar interbody fusions (percLIFs) through Kambin's triangle, an anatomic corridor allowing entrance into the disc space. However, due to its novelty, there are limited data regardi ... Full text Open Access Link to item Cite

Duke Liver Dataset: A Publicly Available Liver MRI Dataset with Liver Segmentation Masks and Series Labels.

Journal Article Radiol Artif Intell · September 2023 The Duke Liver Dataset contains 2146 abdominal MRI series from 105 patients, including a majority with cirrhotic features, and 310 image series with corresponding manually segmented liver masks. ... Full text Link to item Cite

Novel Approach to Percutaneous Lumbar Surgeries via Kambin's Triangle-Radiographic and Surgical Planning Analysis with Nerve Segmentation Technology.

Journal Article World Neurosurg · June 22, 2023 OBJECTIVE: While Kambin's Triangle has become an ever more important anatomic window given its proximity to the exiting nerve root, there have been limited studies examining the effect of disease on the corridor. Our goal was to better understand how patho ... Full text Open Access Link to item Cite

The Brain Tumor Segmentation (BraTS) Challenge 2023: Glioma Segmentation in Sub-Saharan Africa Patient Population (BraTS-Africa).

Journal Article ArXiv · May 30, 2023 Gliomas are the most common type of primary brain tumors. Although gliomas are relatively rare, they are among the deadliest types of cancer, with a survival rate of less than 2 years after diagnosis. Gliomas are challenging to diagnose, hard to treat and ... Link to item Cite

Systematic Analysis of Common Factors Impacting Deep Learning Model Generalizability in Liver Segmentation.

Journal Article Radiology. Artificial intelligence · May 2023 PurposeTo investigate the effect of training data type on generalizability of deep learning liver segmentation models.Materials and methodsThis Health Insurance Portability and Accountability Act-compliant retrospective study included 860 ... Full text Cite

A Deep Learning-Based Computer Aided Detection (CAD) System for Difficult-to-Detect Brain Metastases.

Journal Article Int J Radiat Oncol Biol Phys · March 1, 2023 PURPOSE: We sought to develop a computer-aided detection (CAD) system that optimally augments human performance, excelling especially at identifying small inconspicuous brain metastases (BMs), by training a convolutional neural network on a unique magnetic ... Full text Link to item Cite

Novel Merging of CT and MRI to Allow for Safe Navigation into Kambin's Triangle for Percutaneous Lumbar Interbody Fusion-Initial Case Series Investigating Safety and Efficacy.

Journal Article Oper Neurosurg (Hagerstown) · March 1, 2023 BACKGROUND: For percutaneous lumbar fusion (percLIF), magnetic resonance imaging and computed tomography are critical to defining surgical corridors. Currently, these scans are performed separately, and surgeons then use fluoroscopy or neuromonitoring to g ... Full text Open Access Link to item Cite

Head CT deep learning model is highly accurate for early infarct estimation.

Journal Article Sci Rep · January 5, 2023 Non-contrast head CT (NCCT) is extremely insensitive for early (< 3-6 h) acute infarct identification. We developed a deep learning model that detects and delineates suspected early acute infarcts on NCCT, using diffusion MRI as ground truth (3566 NCCT/MRI ... Full text Link to item Cite

How dimensions can guide surgical planning and training: a systematic review of Kambin's triangle.

Journal Article Neurosurg Focus · January 2023 OBJECTIVE: The authors sought to analyze the current literature to determine dimensional trends across the lumbar levels of Kambin's triangle, clarify the role of imaging techniques for preoperative planning, and understand the effect of inclusion of the s ... Full text Link to item Cite

Implementation of Clinical Artificial Intelligence in Radiology: Who Decides and How?

Journal Article Radiology · December 2022 As the role of artificial intelligence (AI) in clinical practice evolves, governance structures oversee the implementation, maintenance, and monitoring of clinical AI algorithms to enhance quality, manage resources, and ensure patient safety. In this artic ... Full text Link to item Cite

A Deep Learning-Based Computer Aided Detection (CAD) System for Difficult-to-Detect Brain Metastases (BM)

Conference INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS · 2022 Cite

Imaging of Traumatic Brain Injury

Chapter · January 1, 2022 Traumatic injury to the brain and head has several manifestations, including primary brain parenchymal injuries, secondary brain injury, extra-axial hemorrhage, and vascular injury. In this chapter, we review the mechanisms and imaging appearance of trauma ... Full text Cite

Robotic-Assisted Trajectory Into Kambin's Triangle During Percutaneous Transforaminal Lumbar Interbody Fusion-Initial Case Series Investigating Safety and Efficacy.

Journal Article Oper Neurosurg (Hagerstown) · November 15, 2021 BACKGROUND: Minimally invasive spine surgery (MISS) has the potential to further advance with the use of robot-assisted (RA) techniques. While RA pedicle screw placement has been extensively investigated, there is a lack of literature on the use of the rob ... Full text Link to item Cite

Imaging AI in Practice: A Demonstration of Future Workflow Using Integration Standards.

Journal Article Radiol Artif Intell · November 2021 Artificial intelligence (AI) tools are rapidly being developed for radiology and other clinical areas. These tools have the potential to dramatically change clinical practice; however, for these tools to be usable and function as intended, they must be int ... Full text Link to item Cite

The Composite Severity Score for Lumbar Spine MRI: a Metric of Cumulative Degenerative Disease Predicts Time Spent on Interpretation and Reporting.

Journal Article J Digit Imaging · August 2021 Conventional measures of radiologist efficiency, such as the relative value unit, fail to account for variations in the complexity and difficulty of a given study. For lumbar spine MRI (LMRI), an ideal performance metric should account for the global sever ... Full text Link to item Cite

A Conference-Friendly, Hands-on Introduction to Deep Learning for Radiology Trainees.

Journal Article J Digit Imaging · August 2021 Artificial or augmented intelligence, machine learning, and deep learning will be an increasingly important part of clinical practice for the next generation of radiologists. It is therefore critical that radiology residents develop a practical understandi ... Full text Link to item Cite

Natural Language Processing of Radiology Text Reports: Interactive Text Classification.

Journal Article Radiol Artif Intell · July 2021 This report presents a hands-on introduction to natural language processing (NLP) of radiology reports with deep neural networks in Google Colaboratory (Colab) to introduce readers to the rapidly evolving field of NLP. The implementation of the Google Cola ... Full text Link to item Cite

Effects of age and sex on the distribution and symmetry of lumbar spinal and neural foraminal stenosis: a natural language processing analysis of 43,255 lumbar MRI reports.

Journal Article Neuroradiology · June 2021 PURPOSE: The purpose of this study is to investigate relationship of patient age and sex to patterns of degenerative spinal stenosis on lumbar MRI (LMRI), rated as moderate or greater by a spine radiologist, using natural language processing (NLP) tools. M ... Full text Link to item Cite

Lumbar MRI Reporting Efficiency for Trainees Over the Academic Year: An Opportunity for Improving Clinical Workflows in Academic Medical Centers.

Journal Article J Am Coll Radiol · March 2021 PURPOSE: Reporting efficiency is commonly used to measure performance and quality in diagnostic imaging. For academic centers, balancing the clinical demand for efficient reporting and educational obligation to trainees remains a major challenge. The objec ... Full text Link to item Cite

Preparing Radiologists to Lead in the Era of Artificial Intelligence: Designing and Implementing a Focused Data Science Pathway for Senior Radiology Residents.

Journal Article Radiol Artif Intell · November 2020 Artificial intelligence and machine learning (AI-ML) have taken center stage in medical imaging. To develop as leaders in AI-ML, radiology residents may seek a formative data science experience. The authors piloted an elective Data Science Pathway (DSP) fo ... Full text Link to item Cite

The "connecting vessel" sign: an imaging biomarker to differentiate ruptured infected (mycotic) intracranial aneurysm mimicking the CTA spot sign.

Journal Article Emerg Radiol · June 2020 PURPOSE: Infected (mycotic) intracranial aneurysms (IIA) are a prevalent source of morbidity in patients with systemic infection. Unlike saccular aneurysms, ruptured IIA frequently presents with intracerebral hemorrhage (ICH), and the appearance of rupture ... Full text Link to item Cite

Three-Dimensional Cinematic Rendering to Optimize Visualization of Cerebrovascular Anatomy and Disease in CT Angiography.

Journal Article Journal of neuroimaging : official journal of the American Society of Neuroimaging · May 2020 Three-dimensional cinematic rendering (3DCR) is an emerging postprocessing technique for computed tomography (CT) and CT angiography (CTA) that produces photorealistic, volumetric images. In contrast to conventional volume rendering techniques, 3DCR depict ... Full text Cite

Dual-Energy CT to Differentiate Small Foci of Intracranial Hemorrhage from Calcium.

Journal Article Radiology · January 2020 Background Diagnostic uncertainty in CT of possible intracranial hemorrhage requires short-interval follow-up imaging, resulting in reduced efficiency of care and higher costs. Purpose To quantify the diagnostic performance of dual-energy CT versus simulat ... Full text Link to item Cite

Imaging of Traumatic Brain Injury

Chapter · 2020 Traumatic injury to the brain and head has several manifestations, including primary brain parenchymal injuries, secondary brain injury, extra-axial hemorrhage, and vascular injury. In this chapter, we review the mechanisms and imaging appearance of trauma ... Full text Link to item Cite

Non-traumatic subdural hemorrhage: beware of ruptured intracranial aneurysm.

Journal Article Emerg Radiol · October 2019 Acute subdural hemorrhage (SDH) is commonly encountered by emergency radiologists in the setting of trauma. When history or imaging evidence of trauma is absent, the differential diagnosis for SDH should be expanded. Intracranial aneurysm rupture is a rare ... Full text Link to item Cite

Radiation Dose Considerations in Emergent Neuroimaging.

Journal Article Neuroimaging Clin N Am · August 2018 Computed tomography is often the first-line diagnostic imaging modality in the evaluation of patients with neurologic emergencies. A patient-centered approach to radiation dose management in emergent neuroimaging thus revolves around the appropriate use of ... Full text Link to item Cite

Hepatobiliary phase MRI: impact on planning image-guided liver tumor ablations.

Journal Article Abdom Radiol (NY) · August 2017 PURPOSE: To assess the impact of hepatobiliary phase images obtained during intravenous gadoxetate disodium-enhanced liver MRI in the planning of image-guided liver tumor ablations. METHODS: This institutional review board-approved retrospective study incl ... Full text Link to item Cite

Angiotensin-(1-7) Attenuates Skeletal Muscle Fibrosis and Stiffening in a Mouse Model of Extremity Sarcoma Radiation Therapy.

Journal Article J Bone Joint Surg Am · January 6, 2016 BACKGROUND: Radiation-induced fibrosis (RIF) of musculoskeletal tissue is a common complication of radiation therapy for extremity soft-tissue sarcoma, with no standardized strategy for prevention and treatment. Angiotensin-(1-7) (Ang-[1-7]), a well-tolera ... Full text Link to item Cite

BCNU wafer placement with temozolomide (TMZ) in the immediate postoperative period after tumor resection followed by radiation therapy with TMZ in patients with newly diagnosed high grade glioma: final results of a prospective, multi-institutional, phase II trial.

Journal Article J Neurooncol · June 2015 Temozolomide (TMZ) and BCNU have demonstrated anti-glioma synergism in preclinical models. We report final data from a prospective, multi-institutional study of BCNU wafers and early TMZ followed by radiation therapy with TMZ in patients with newly diagnos ... Full text Link to item Cite

A new treatment paradigm: neoadjuvant radiosurgery before surgical resection of brain metastases with analysis of local tumor recurrence.

Journal Article International journal of radiation oncology, biology, physics · March 2014 PurposeResected brain metastases (BM) require radiation therapy to reduce local recurrence. Whole brain radiation therapy (WBRT) reduces recurrence, but with potential toxicity. Postoperative stereotactic radiosurgery (SRS) is a strategy without p ... Full text Cite

Ethosuximide reduces ethanol withdrawal-mediated disruptions in sleep-related EEG patterns.

Journal Article Alcohol Clin Exp Res · March 2013 BACKGROUND: Chronic ethanol (EtOH) leads to disruptions in resting electroencephalogram (EEG) activity and in sleep patterns that can persist into the withdrawal period. These disruptions have been suggested to be predictors of relapse. The thalamus is a k ... Full text Link to item Cite

Normal aging alters in vivo passive biomechanical response of the rat gastrocnemius-Achilles muscle-tendon unit.

Journal Article J Biomech · February 1, 2013 Predisposition to Achilles tendon (AT) ruptures in middle-aged individuals may be associated with age-related changes to inherent passive biomechanical properties of the gastrocnemius-Achilles (GC-AT) muscle-tendon unit, due to known muscle-tendon structur ... Full text Link to item Cite

Botulinum Neurotoxin A injections influence stretching of the gastrocnemius muscle-tendon unit in an animal model.

Journal Article Toxins (Basel) · August 2012 Botulinum Neurotoxin A (BoNT-A) injections have been used for the treatment of muscle contractures and spasticity. This study assessed the influence of (BoNT-A) injections on passive biomechanical properties of the muscle-tendon unit. Mousegastrocnemius mu ... Full text Link to item Cite

Contributions of neural tone to in vivo passive muscle--tendon unit biomechanical properties in a rat rotator cuff animal model.

Journal Article Ann Biomed Eng · July 2011 Passive viscoelastic properties of muscle-tendon units are key determinants of intra- and post-operative success. Atrophied, retracted, and stiff muscle-tendon units are technically challenging to manipulate and perform poorly after surgical repair. This s ... Full text Link to item Cite

Chemical denervation with botulinum neurotoxin a improves the surgical manipulation of the muscle-tendon unit: an experimental study in an animal model.

Journal Article J Hand Surg Am · February 2011 PURPOSE: The chemical denervation that results from botulinum neurotoxin A (BoNT-A) causes a temporary, reversible paresis that can result in easier surgical manipulation of the muscle-tendon unit in the context of tendon rupture and repair. The purpose of ... Full text Link to item Cite

An acquired channelopathy involving thalamic T-type Ca2+ channels after status epilepticus.

Journal Article The Journal of neuroscience : the official journal of the Society for Neuroscience · April 2009 Some epilepsies are linked to inherited traits, but many appear to arise through acquired alterations in neuronal excitability. Status epilepticus (SE) is associated with numerous changes that promote spontaneous recurrent seizures (SRS), and studies have ... Full text Cite