Senior Professor with over two decades of expertise in clinical radiodiagnosis, medical education, and academic administration. An alumnus of Christian Medical College, Vellore (MBBS ’96, MD ’07), I furthered my academic credentials with a PhD from JSS Medical College, JSSAHER (2025), focusing on neuroimaging in neonatal hypoxia. With a clinical career spanning leadership roles at CSI Holdsworth Memorial Hospital and CMC Vellore where I served as Clinical Lead for Head & Neck Imaging and Mammography, my field of expertise is also in thoracoabdominal imaging. A pioneer in digital pedagogy, I founded and served as Executive Editor of the JSS Radiology teaching website for over decade before passing the baton to the upcoming generation. My administrative contributions include spearheading the transition of BSc MIT curricula in sync with NEO. Currently with over 50 publications in indexed journals, i have also authored two chapters and currently Heading Radiology at JSSMC.
EDUCATION
MBBS, DMRD, MD, PhD
RESEARCH, TEACHING, or OTHER INTERESTS
Radiology, Nuclear Medicine and imaging, Pediatrics, Perinatology and Child Health, Cognitive Neuroscience, Cardiology and Cardiovascular Medicine
Sinonasal Fibro-osseous Lesions: Our Experience Kavya Sivapuram, Bharathi M Basavaraj, Rakesh Bambore, Sudha K Das, Vijaya Basavaraj, Jaishree Pitchaimani Otorhinolaryngology Clinics, 2024 Introduction: Osseous lesions of the nose and paranasal sinuses are rare and slow-growing tumors that can be benign or malignant.Benign lesions share similarities in clinical, radiological, and histological presentations, yet they exhibit different behaviors.The most frequent benign osseous lesion type is osteoma; others are fibrous dysplasia (FD) and ossifying fibroma.Ewing's sarcoma of the head and neck region constitutes 1-4% of all Ewing's sarcoma, mandible and skull base being the most common and primary sinonasal location being rare.Methods: A retrospective study was done reviewing the records of patients diagnosed with osseous lesions of the nose and PNS over 7 years from August 2013 to August 2020 in our tertiary care center.Results: A total of 16 osseous lesions were noted of which 12 (75%) patients were diagnosed with benign lesions and 4 (25%) with malignant lesions.Of the benign lesions, osteomas constituted 58% (7 patients), FD 17% (2 patients), ossifying fibroma 17% (2 patients), and chondromesenchymal hamartoma 8% (1 patient).Of the malignant lesions, we experienced 75% (3 patients) Ewing's sarcoma and 25% chondrosarcoma (1 patient).All the cases were managed with a transnasal endoscopic approach except for one with ossifying fibroma that required an external approach.Conclusion: An early diagnosis and appropriate intervention with long-term surveillance will help to increase the quality of life.Observation and regular imaging with surgical intervention, when required, remain the mainstay of treatment for benign lesions.Our patients are under regular follow-up with no evidence of recurrence to date.
Renal resistive index as a marker of histopathological damage in diabetic and non-diabetic chronic kidney disease Theertha Kuttancheri, Sudha Kiran Das, Manjunath Sanjeeva Shetty, Suchitha Satish, B. Bathrenathh Egyptian Journal of Radiology and Nuclear Medicine, 2023 Background Chronic kidney disease is a worldwide public health problem with diabetes being the leading cause. Renal resistive index derived by Duplex Doppler sonography, has been in use clinically to examine intrarenal hemodynamic abnormalities. However, renal biopsy remains the gold standard for the evaluation of intrarenal damage. In this study we correlated the renal resistive index in diabetic and non-diabetic kidney disease patients with the established parameters of renal dysfunction i.e. histopathological changes. Results The conducted study was a cross-sectional comparative study on 114 patients (58 diabetic and 56 non-diabetic patients) over a period of 18 months. Evaluated histopathological indices and renal resistive index had a statistically significant positive correlation (glomerulosclerosis, arterial damage and tubulo-interstitial damage scores) in both diabetic and non-diabetic patients. The highest correlation was observed with tubulo-interstitial score in our study. Conclusions Renal resistive index could be considered a marker of histological damage in both diabetic and non-diabetic kidney disease. Inclusion of resistive index in the routine diagnostic protocol of chronic kidney disease can help in the accurate assessment of intrarenal damage. Hence, it is of utmost importance as a radiologist to determine resistive index in chronic kidney disease patients and guide the clinicians for efficient management.
Case series of identity: renal lymphangiectasia mistaken for non-functional hydronephrotic kidney Sai Siddartha Kosinepalli, Sudha Kiran Das, Balasubramanian Gurumurthy, T. Sachin, Swathi Hassan Dharmaraju Egyptian Journal of Radiology and Nuclear Medicine, 2023 Background Renal lymphangiectasia also referred to as renal lymphangiomatosis is a rare, but benign condition is characterized by the ectatic of lymphatic channels and is characterized by ectasia of peripelvic, perirenal and/or intrarenal lymphatic vessels. It can mimic the appearance of hydronephrosis or cystic renal lesions on imaging. As radiologists, to avoid therapeutic misadventure, it becomes critical to make an accurate diagnosis. Case presentation The clinical presentation of renal lymphangiectasia is typically asymptomatic, but it can be complicated by infection or bleeding. We report two cases, who presented with loin pain, diagnosed as hydronephrosis on ultrasound, one of whom had a nephrectomy done for a hydronephrotic and non-functioning right kidney. Conclusions Hence, this case series brings to light a short review of the literature on renal lymphangiectasia, including its pathophysiology, clinical presentation, imaging findings, complications and differential diagnosis.
Lemierre’s syndrome variant with inferior vena cava and right common iliac vein thrombosis secondary to emphysematous pyelonephritis Anupama Chandrappa, Sudha Kiran Das, Sachin P. Shetty, Balasubramanian Gurumurthy, Rudresh Hiremath, Vikram Patil Egyptian Journal of Radiology and Nuclear Medicine, 2023 Background Emphysematous pyelonephritis (EPN) is a potentially life-threatening disease with Escherichia coli (E. coli) being the most common aetiology. Infection can involve the renal parenchyma, collecting system and perinephric tissues, and is commonly encountered in patients with uncontrolled diabetes mellitus. EPN complicated by suppurative thrombophlebitis of the inferior vena cava is a rare occurrence. Our case had thrombosis of the right common iliac vein as well, which is first of its kind reported with EPN. Case presentation We describe a case of a 59-year-old male patient, with uncontrolled diabetes mellitus, who presented to the emergency department with a history of high-grade fever and left loin pain. Clinico-laboratory findings were diagnostic for diabetes mellitus, complicated by upper urinary tract infection with sepsis. A preliminary ultrasound of the abdomen was indicative of left hydronephrosis with features of emphysematous pyelonephritis. Abdominal computed tomography (CT) was done to ascertain the cause of hydronephrosis. Left ureteric calculus complicated by emphysematous pyelonephritis (type 3a) with intraluminal air in the left renal vein and inferior vena cava (IVC). Culture grew E. coli. Patient was started on insulin and intravenous (IV) antibiotics, and bilateral DJ stenting was done. Patient was symptomatically better and was discharged. A month later, he was readmitted with relapse of symptoms; repeat CT showed left perinephric abscess, with left renal vein, inferior vena cava and right common iliac vein thrombosis. Repeat culture grew E. coli, stent was replaced, and subsequently he underwent ultrasound-guided aspiration for left perinephric abscess. Haemodialysis along with IV antibiotics and anticoagulant therapy was started. Conclusion Suppurative thrombophlebitis of the inferior vena cava in association with EPN is rare; however, the same is associated with higher morbidity and mortality. Prompt diagnosis, drainage procedure, antibiotics coupled with anticoagulants are the mainstay of treatment for deep venous thrombophlebitis.
Imaging Recommendations for Diagnosis, Staging, and Management of Lung Cancer Aparna Irodi, Ashu Seith Bhalla, Leena Robinson Vimala, Taruna Yadav, Subathra Adithan, Harish Bhujade, Parang Sanghavi, Alok Kale, Mandeep Garg, Abhishek Mahajan, Yvette Kirubha Jaykar David Livingstone, Sudha Kiran Das, Geethi M. H., Balukrishna Sasidharan, Balamugesh Thangakunam, Simon Pavamani, Rajesh Isiah, Anjana Joel, Tameem Ahmad Bhat Indian Journal of Medical and Paediatric Oncology, 2023 Globally and in India, lung cancer is one of the leading malignancies in terms of incidence and mortality. Smoking and environmental pollution are the common risk factors for developing lung cancer. Traditionally, lung cancer is divided into small cell and nonsmall cell types, with nonsmall cell carcinomas including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.In this review article, we describe the imaging recommendations and findings in the diagnosis, staging, and management of lung cancer, including the imaging of treatment-related complications.
Shear wave elastography: usefulness in chronic kidney disease Theertha Kuttancheri, Kavitha Krishnan, Sudha Kiran Das, Manjunath Sanjeeva Shetty Polish Journal of Radiology, 2023 PurposeChronic kidney disease (CKD) is recognized as a major worldwide health problem. For all CKD, intra-renal fibrosis is a final common pathway that can be correlated with disease severity. Tissue stiffness can be measured non-invasively using shear wave elastography. This study evaluates the use of Young’s modulus derived by SWE as a biomarker that can distinguish normal from diseased kidneys. Also, Young’s modulus was correlated with Doppler findings and estimated glomerular filtration rate (eGFR).Material and methodsThis prospective study was performed in 2 phases, in which initially 50 CKD patients and 50 controls were studied to arrive at a median Young’s modulus value in both the groups. In the later phase, a cross-sectional comparative study was conducted on 58 diabetic and 56 non-diabetic patients with SWE and renal Doppler, and the findings were correlated in various stages of CKD.ResultsUsing Young’s modulus, the renal cortex elasticity of CKD patients was shown to be considerably reduced as compared to normal kidneys. There was significant correlation between Young’s modulus, eGFR, and renal resistive index. Young’s modulus values did not show significant differences between diabetic and non-diabetic groups, revealing its inability to arrive at the aetiopathogenesis of CKD.ConclusionsCorrelation of renal tissue Young’s modulus with eGFR suggests that SWE may be used as an indicator of renal tissue injuries in CKD patients. SWE can never replace the gold standard biopsy, but it can be used for staging of CKD. Even though SWE cannot predict the aetiopathogenesis of CKD, it may be a low-cost way to provide additional diagnostic information in CKD.
Unusual case of skull base adenoid cystic carcinoma presenting as skull base osteomyelitis: case report Sachin P. Shetty, Bala Seshank Akshit Reddy Mettu, Sudha Kiran Das, Rudresh Hiremath Egyptian Journal of Radiology and Nuclear Medicine, 2022 BackgroundAdenoid cystic carcinoma is a rare malignancy. Tumours of palatal region with minor salivary gland origin do not generally present at an early stage as the tumour is submucosal with symptoms prevalent only when there is evidence of perineural spread of the tumour. We report a case of adenoid cystic carcinoma of the palate with rare presentation of left ear discharge and diplopia on left lateral gaze. We discuss the case with emphasis on imaging evaluation mimicking a case of infective etiology with adjacent skull base osteomyelitis on initial presentation. However, on follow-up and further evaluation the patient was diagnosed as adenoid cystic carcinoma of hard palate on left side.Case presentationA 25-year-old male patient has presented to Jagadguru Sri Shivarathreeswara Hospital in August 2019 with complaints of left ear discharge and diplopia on left lateral gaze since 1 week. The clinical and imaging findings was suggestive of infective etiology and the patient was treated for the same with IV antibiotics. Repeat magnetic resonance imaging was then done which revealed definitive reduction in the severity of inflammation suggestive of response to therapy. Patient was then discharged and was followed up. Three months later, the patient came with complaints of mass in left nasal cavity. Patient was then referred for contrast enhanced computed tomography neck strongly suggestive of neoplastic etiology. The patient was then operated and histopathological examination of the biopsy revealed adenoid cystic carcinoma.ConclusionsTumours of palatal region with minor salivary gland origin do not generally present at an early stage as the tumour is submucosal with symptoms prevalent only when there is evidence of perineural spread of the tumour. In our case patient presented with lateral rectus palsy, involvement of meckel’s cave, trigeminal nerve involvement and cavernous sinus involvement which are strong indicators of the perineural and locoregional spread of the tumour. Hence, it is important for the radiologist and clinician to strongly suspect and evaluate for a primary lesion of the head and neck when such a radiological presentation has been demonstrated.
CT severity score: an imaging biomarker to estimate the severity of COVID-19 pneumonia in vaccinated and non-vaccinated population Balasubramanian Gurumurthy, Sudha Kiran Das, Sachin Shetty, Rakesh Chowkalli Veerabhadrappa, Sai Siddartha Kosinepalli, Swathi Hassan Dharamaraju Egyptian Journal of Radiology and Nuclear Medicine, 2022 Background In India, two vaccines received emergent use authorization, namely Covishield (a brand of the Oxford—Astra Zeneca vaccine manufactured by the Serum institute of India) and Covaxin (developed by Bharat Biotech) against COVID-19 disease. Chest CT is an objective way to assess the extent of pulmonary parenchymal involvement. This study aims to estimate the disease severity and outcome due to COVID-19 among vaccinated and non-vaccinated symptomatic patients and compare the same in Covishield versus Covaxin recipients using CT severity score. Results A total of 306 patients were retrospectively evaluated. The mean age was 62.56 ± 8.9 years, and males [n-208 (67.97%)] were commonly affected. Of 306 patients, 143 were non-vaccinated (47%), 124 were partially vaccinated (40%), and 39 were completely vaccinated (13%). CT severity scores were reduced in both Covishield and Covaxin recipients in comparison with the non-vaccinated group [χ2 (2) = 16.32, p < 0.001]. There is a reduction in LOS among the vaccinated group, predominantly among the Covishield recipients. Conclusion Vaccination confers protection from severe SARS-CoV2 infection and is associated with an overall reduction in mortality.
Case 301: Traumatic Subarachnoid-Pleural Fistula Vikram Patil, Divya Vishwanatha Kini, Sarah John, Sudha Kiran Das, Rudresh Hiremath, Nayanabai Shabadi Radiology, 2022 HISTORY: A 38-year-old man who had been in a motor vehicle collision was referred to our institute. He was suspected of having left-sided pneumothorax. This necessitated intercostal drainage with a chest tube, which had been placed elsewhere prior to his arrival. Paraparesis was noted at the initial clinical examination, with adequately maintained vital signs, while the blood work-up revealed a mildly reduced hemoglobin level of 10.1 mg/dL (normal range, 13.8-17.2 mg/dL); however, the rest of the laboratory values were within normal limits. The patient was then immediately referred for further evaluation with CT of the brain, cervical spine, and thorax. Thereafter, serial chest radiography was performed for follow-up.
