Desencia E. Thomas, MD, Author at Grand Rounds in Urology

Desencia E. Thomas, MD

Dr. Desencia Thomas is an Assistant Professor of Radiology and the Abdominal Radiology Section Chief at Baylor College of Medicine in Houston, TX. A native Texan, she earned a B.A. in Biology at Johns Hopkins University before returning to Dallas to complete her M.D. at The University of Texas Southwestern Medical Center. She completed an internship in Internal Medicine at the Johns Hopkins University/Sinai Hospital of Baltimore and her residency in Diagnostic Radiology at Drexel University College of medicine. After serving as Chief Resident in her senior year, she joined the Brigham and Women’s Hospital at Harvard Medical School as a Diagnostic Radiology Fellow in the section of Abdominal Imaging and Intervention. Dr. Thomas’ first academic appointment was at Eastern Virginia Medical School where she served for 12 years. Her dedication to resident education was evident through her multiple awards in teaching. While at EVMS, she also worked with the Medical Center Radiologists, Inc. where she served as the Director of Operations/ Chief Quality Officer, Partner, and member of the Board of Directors. She continued her professional development, completing formal education in Coronary CTA, CT Colonography and Practice Leadership while in Virginia. In 2017, Dr. Thomas joined the Baylor College of Medicine in Houston, continuing her dedication to leadership, education and clinical care.

Talks by Desencia E. Thomas, MD

Updates on the Imaging for Urothelial Carcinoma

Posted by Desencia E. Thomas, MD | Nov 2024

Desencia E. Thomas, MD, presents an update on imaging techniques for urothelial carcinoma (UC), emphasizing advancements in diagnosis and staging.

In this 18-minute presentation, Dr. Thomas highlights the diagnostic accuracy of CT urography. MR urography provides an alternative for patients unable to tolerate iodine-based contrast or when CT findings are inconclusive. PET imaging, including 18-F FDG PET, excels in detecting distant metastases, but tracers like 11-C acetate and choline help minimize false positives in the urinary tract due to reduced excretion.

Dr. Thomas discusses the role of MRI in bladder cancer staging, where VI-RADS scoring helps distinguish between muscle-invasive and non-invasive cancers. This system, using T2-weighted, diffusion-weighted, and contrast-enhanced sequences, enables precise preoperative staging. Dual-energy CT (DECT) is also emerging, allowing reduced radiation exposure while retaining diagnostic value.

Key challenges include limited imaging sensitivity for early-stage UC and difficulty assessing tumor invasion depth. Dr. Thomas emphasizes that contrast-enhanced ultrasound may assist patients with contraindications to CT or MRI, although it remains less sensitive for upper tract tumors. She stresses that imaging advancements hold promise for improving UC management and minimizing invasive procedures like TURBT.

mpMRI of the Prostate and Correlation with CT +/- PSMA PET findings: Prostate Imaging Lessons for the Urologist

Posted by Desencia E. Thomas, MD | Oct 2024

Desencia E. Thomas, MD, covers the advancements in imaging techniques for prostate cancer, focusing on integrating multiparametric MRI (mpMRI) and PSMA PET imaging, and their evolving roles in diagnosis, prognosis, and management.

In this 24-minute presentation, Thomas discusses the standardized PI-RADS scoring system, which aids in assessing the likelihood of significant cancer and has undergone revisions (PI-RADS 2.1) to address limitations in lesion evaluation. She also discusses the PI-QUAL score, which assesses MRI quality, and the PRECISE scoring system, which evaluates radiologic stability for patients undergoing active surveillance. She shares several images illustrating the advantages of the scoring systems, ultimately showing the benefits of advanced imaging techniques.

The presentation highlights the role of PSMA PET. FDA-approved PSMA PET agents have shown superior sensitivity in detecting biochemical recurrence and metastasis compared to conventional imaging. The integration of PSMA PET with MP-MRI, exemplified by the new P-score system, aims to refine diagnostic accuracy and reduce the need for invasive biopsies.