Sadhna M. Verma, MD, MBA, FSAR

Sadhna M. Verma, MD, MBA, FSAR

University of Cincinnati

Cincinnati, Ohio

Sadhna Verma, MD, MBA, FSAR, is an Adjunct Professor-Affiliate of Radiology at the University of Cincinnati in Ohio. Dr. Verma established and continues to serve as the Director of the Prostate MRI Program at the University of Cincinnati and established the university’s CT imaging program for CT Urography and CT Enterography.  Dr. Verma is the associate Chair of Quality and Performance Improvement at the Prostate Cancer Midwest Center of Excellence and the Director of the Prostate Cancer Imaging Program for the U.S. Department of Veterans Affairs. She is an international expert in the fields of GI and GU Imaging.

Dr. Verma earned her medical degree from the University of Louisville in Kentucky. She then completed an internship in Internal Medicine at the University of Pittsburgh in Pennsylvania. Dr. Verma completed a residency in Diagnostic Radiology and a fellowship in Health Service and Outcomes Research at the University of Cincinnati and then completed a fellowship in Body Imaging/3D Imaging at Johns Hopkins University in Baltimore, Maryland. Dr. Verma earned her MBA from the University of Chicago Booth School of Business in Illinois.

Dr. Verma is a member of the International Prostate MRI Working Group. She conducts local and national workshops to help train radiologists and inform clinicians and patients about this test. Dr. Verma has over 100 published articles and book chapters in her field.

Talks by Sadhna M. Verma, MD, MBA, FSAR

PIRADS V2.1 – What a Urologist Needs to Know?

Sadhna Verma, MD, MBA, FSAR, begins this 20-minute presentation by emphasizing the exponential growth of prostate MRI usage and its critical role in prostate cancer detection. Before diving into PI-RADS, the multiparametric MRI approach is explained. T2-weighted sequences are highlighted as the best for anatomical visualization.

PI-RADS scoring, a standardized Likert-like system ranging from 1 to 5, assesses the likelihood of malignancy of a lesion based on size, location, and imaging characteristics. PI-RADS version 2.1 introduces refinements, particularly for transition zone lesions. The updated guidelines also incorporate templates to standardize reporting and emphasize quality assurance. Central zone tumors are recognized for their aggressive nature and specific imaging features.

Dr.Verma shares images to illustrate the scoring refinements of PI-RADS version 2.1. Despite advancements, quality variability in imaging and interpretation remains a concern. Collaborative initiatives led by the American College of Radiology aim to enhance diagnostic accuracy. Dr. Verma emphasizes the need for ongoing quality assurance and training to address current limitations and improve clinical outcomes.

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Interpretation of Post Focal Therapy Imaging Target and Pifab

Sadhna Verma, MD, MBA, FSAR, explores advancements in imaging and reporting for post-focal therapy in prostate cancer, highlighting the emergence of two scoring systems, TARGET and PI-FAB. This 16-minute presentation provides an overview of expected multiparametric MRI findings at different post-treatment intervals, describing immediate changes like coagulative necrosis and late findings such as fibrosis and scarring.

Dr. Verma introduces TARGET, a consensus-based system focusing on MRI timing, technical parameters, and interpretation. The PI-FAB system, developed from expert opinion, similarly prioritizes dynamic contrast imaging. Comparative examples illustrate their application.

Preliminary studies reveal moderate inter-reader agreement for both systems, though sensitivity and specificity vary, underscoring the importance of experience in interpretation. Despite promising results, the presenter stresses the need for validation through large, multicenter cohorts and integration with molecular imaging to enhance diagnostic accuracy.

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Prostate MRI for Dummies

Sadhna Verma, MD, FSAR, presents an overview of the use of multiparametric MRI in evaluating the prostate. Dr. Verma begins by reviewing the three elements of a multiparametric MRI in prostate cancer treatment: T2 Weighted Imaging (T2W), Diffusion Weighted Imaging (DWI), and Dynamic Contrast Enhanced (DCE) Imaging.

Dr. Verma presents examples of T1 and T2 Weighted (T2W) MRI images, which are used to illustrate the zonal anatomy of the prostate. She notes that T1 and T2 MRI is weak when it comes to identifying problems in the transition zone.

Dr. Verma then moves to Diffusion Weighted Imaging (DWI) to measure cell diffusion as a means of locating tumors. However, she notes that DWI is not very accurate for recently-biopsied patients.

Dr. Verma concludes by briefly touching on Dynamic Contrast Enhanced (DCE) Imaging to measure tumor vascularity, and how DCE combines with T2W and DWI to give each identified lesion a PI-RADS (Prostate Imaging Reporting and Data System) score. She emphasizes that a PI-RADS score should only be used in detection of clinically significant prostate cancer, and presents examples of how prostate cancer can be identified in peripheral zones, transition zones, and extra-prostatic locations through the use of multiparametric MRI.

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