Lynne M. Hurwitz Koweek, M.D.

  • Professor of Radiology
  • Director, Non-Invasive Cardiovascular Imaging
  • Medical Director CT, Duke Hospital
  • Medical Physics Faculty Member
Department/Division
  • Cardiothoracic Imaging
Address DUMC Box 3808
Durham, NC 27710
Telephone 919-684-7538
Training
  • MD, Duke University School of Medicine, 1997
Residency
  • Internal Medicine, University of Washington Medical Center Seattle, 1997-1998
  • Diagnostic Radiology, Duke University Medical Center, 1998-2002
Fellowship
  • Cardiothoracic Radiology, Duke University Medical Center, 2002-2003
National Roles
  • Chair, ARRS Scientific Program Task Force (Thoracic section), ARRS 2011-2016 Annual Meeting
  • ACR Body Imaging Committee on Cardiovascular Imaging 2011-2015
  • RSNA Exhibit Panel, Cardiac
  • ACR Appropriateness Criteria Expert Panel on Cardiac Imaging 2, June 2015- 2018
  • Fellow, Society of Computed Body Tomography and MR
  • Fellow, Society of Cardiac Computed Tomography
Clinical Interests
  • Imaging of acquired and congenital cardiac disease
  • Imaging of acquired and congenital vascular disease
  • Cardiac CT for structural heart disease
  • Non-invasive imaging of lymphatic disease
  • Radiation Dose and CT protocol design
  • Research Interests
  • Reduced contrast volume CTA for cardiovascular imaging
  • Radiation dose reduction techniques for MDCT imaging: Thoracic and Cardiac
  • Cardiac CT for aortic valve treatment
    • Dolar R, Hurwitz LM, Mizra Z, Strauss H, Wharton AR.  Regulation of extracellular calcium entry in endothelial cells: role of intracellular calcium pool. AJ Physiology 1992; 262:172-181.
    • Hurwitz LM and Casey, PJ. Can prenylcysteines be exploited as ligands for mammalian multi-drug resistance transporters? Chemistry and Biology 1997;4(10):711-715.
    • Eastwood JD, Provenzale JM, Hurwitz LM, Lee TY.  Practical injection-rate CT perfusion imaging: deconvolution-derived hemodynamics in a case of stroke. Neuroradiology 2001;43:223-226.
    • Hurwitz LM and Thompson W. Calcified arteriovenous fistula, an unusual etiology for right upper quadrant calcification. AJR 2002; 179:1293-1295.
    • Hurwitz LM and Goodman PC. Intra-aortic balloon pump location and aortic dissection.  AJR 2005;184:1245-1246
    • Hurwitz LM, Sporn T, and McAdams PM. A 73 Year-Old Woman With a Cough.  Roentgenogram of the Month. Chest 2005;128:1018-1021.
    • Hurwitz LM, Yoshizumi TT, Reiman RE, Goodman PC, Paulson EK, Frush DP, Toncheva G, Nguyen G, Barnes L.  Radiation dose to the fetus from current body MDCT in early gestation. AJR 2006; 186:1-9.
    • Hurwitz LM, Yoshizumi TT, Reiman RE, Paulson EK, Frush DP, Nguyen GT, Toncheva GI, Goodman PC.  Absorbed breast dose from current body MDCT imaging protocols. AJR 2006; 186:1718-22.
    • *Seivers B, Elliot MD, Hurwitz LM, Albert TS, Klem I, Rehwald WG, Parker MA, Judd RM, Kim RJ. Rapid detection of myocardial infarction by subsecond, free-breathing delayed contrast-enhancement cardiovascular magnetic resonance. Circulation 2007; Jan 16;115(2):236-44.
    • *Patel MR, Hurwitz LM , Orland L, McCrory DC, Sander GD, Matcher DB, Marks D; Medicare Coverage Advisory Commission, Non-invasive imaging for coronary artery disease: A technology assessment for the Medicare Coverage Advisory Commission. Am Heart J 2007; Feb, 153(2):161-174.
    • Hollingsworth C, Chan FP, Yoshizumi TT, Frush DP, Nguyen G, Lowry CR, Hurwitz LM.  Pediatric gated cardiac CT angiography: What is the radiation dose? AJR 2007; 189(1):12-8.
    • Hurwitz LM, Yoshizumi TT, Frush DP, Goodman PC. Effective dose determinant using an anthropmorphic phantom and MOSFET technology for clinical body MDCT protocols. J Comput Assist Tomogr 2007; 31(4):544-9.
    • *Cooke AL, Hurwitz LM, Valente AM, and Herlong R. Right heart enlargement: congenital causes AJR 2007; 189(3):592-601.
    • Hurwitz LM, Reiman RE, Yoshizumi TT, Goodman PC, Toncheva G, Nguyen G, Lowry C. Radiation dose from contemporary cardiothoracic multidetector CT protocols with an anthropomorphic phantom: Implications for cancer induction. Radiology 2007; 245(3):742-50.
    • Jaffe TA, Yoshizumi TT, Toncheva G, Nguyen G, Hurwitz LM, Nelson RC.  Early first trimester fetal dose estimation method in 16 -MDCT without and with automated tube current modulation mode.  AJR 2008; 190(4):860-4.
    • Ho LM, Hodulik KL, Suhocki PV, Paulson EK, Hurwitz LM.  New classes of anticoagulation and anti-platelet agents: Pre-procedure management and safety guidelines for imaging-guided intervention.  J Comput Assist Tomogr. 2008; May-Jun;32(3):475-9.
    • *Adams GL, Trimble MA, Brosnan RB, Russo CA, Rusband D, Honeycutt EF, Shaw LK, Hurwitz LM, Turkington TG, Hanson MW, Pagnanelli RA, Borges-Neto S. Evaluation of combined cardiac positron emission tomography and coronary computed tomography angiography for the detection of coronary artery disease. Nucl Med Commun. 2008; Jul;29(7):593-8.
    • Huda, W, Yoshizumi TT, Hurwitz LM, Goodman PC.  Computing effective dose from Dose-Length Product in CT.  Radiology 2008; 248:321-322.
    • Hurwitz LM, Yoshizumi TT, Goodman PC, Nelson RC, Toncheva G, Nguyen GB, Lowry C, Anderson-Evans C.  Radiation dose savings for adult pulmonary embolus 64-MDCT imaging using bismuth breast shields, lower kVp and automatic tube current modulation. AJR Am J Roentgenol. 2009; Feb; 192(2):515-24.
    • Shrimpton PC, Wall BF, Yoshizumi TT, Hurwitz LM, Goodman PC. Effective dose and dose-length product in CT.  Radiology. 2009; Feb; 250(2):604-5.
    • *Hoang J, Martinez-Jimenez S, Hurwitz LM. Imaging of the postoperative thoracic aorta: The spectrum of normal and abnormal findings. Semin Roentgenol. 2009; Jan; 44(1):52-62.
    • *Hoang JK, Martinez-Jimenez S, Hurwitz LM.  MDCT angiography of thoracic aorta endovascular stent-grafts: Pearls and pitfalls. Am J Roentgenol. 2009; Feb; 192(2):515-24.
    • *Hoang JK, Martinez-Jimenez S, Hurwitz LM.  MDCT angiography of open aortic surgery: Pearls and pitfalls. Am J Roentgenol. 2009; Jan; 192(1): W20-7.
    • Hoang, JK, Hurwitz LM, Bolls, D.  Optimization of tube current in coronary MDCT angiography: Assessment of a standardized method to individualize current selection based on body habitus.  J Comput Assist Tomogr 2009; Jul-Aug;33(4):498-504.
    • Margossian R, Schwartz M, Prakash A, Wruck L, Colan S, Atz A, Bradley T, Fogel M, Herlong R, Hurwitz LM, Marcus E, Powell A, Printz B, Puchalski M, Rychik J, Shirali G, Williams R, Yoo S, Geva T. Comparison of echocardiographic and cardiac magnetic resonance imaging measurements of functional single ventricle volumes, masses and ejection fraction (from the Pediatric Heart Network Fontan Cross-Sectional Study) Am J Cardiol 2009; Aug 104(3):419-428.
    • Ho LM, Yoshizumi TT, Hurwitz LM, Nelson RC, Marin D, Toncheva G, Schindera ST. Dual energy versus single energy MDCT: Measurement of radiation dose using adult abdominal imaging protocols.  Acad Radiol 2009; 33(4):498-504.
    • Prakash A, Travison TG, Fogel MA, Hurwitz LM, Powell AJ, Printz BF, Puchalski MD, Shirali GS, Yoo SJ, Geva T. Pediatric Heart Network Investigators. Relation of size of secondary ventricle to exercise performance in children after Fontan operation. AM J Cardiol 2010; 106:1652-1656.
    • Christensen JD, Meyer LT, Hurwitz LM, Boll DT.  Assessment of iodine concentration comparing iopamidol-370 vs. iodixanol-320in dual source coronary MDCT angiography: Impact on heart rate variability, coronary contrast and vessel conspicuity. AJR 2011; Sep 197(3): W445-51.
    • Hoang JK, Yoshizumi TT, Toncheva G, Gray L, Gafton AR, Huh BK, Eastwood JD, Lascola CD, Hurwitz LM.  Radiation dose exposure for lumbar spine epidural steroid injections: A comparison of conventional fluoroscopy and computed tomographic fluoroscopy techniques. AJR 2011; Oct 197(4);778-82
    • Hoang JA, Gafton AR, Eastwood JD, Chen LF, Hurwitz LM. Correlation of cross-sectional width with image quality and radiation exposure for multi-detector computed tomography neck examinations. AJR 2011; Nov 197(5): W904-9.
    • *James O, Christensen JD, Wong T, Borges-Neto S, Koweek LM. Cardiac FDG-PET/CT:  Utility in inflammatory and infectious cardiovascular disease. RadioGraphics 2011; Sept-Oct; 31(5):1271-86.
    • Hoang JK, Yoshizumi TT, Nguyen G, Toncheva G, Grafton A, Eastwood JD, Lowry C, Hurwitz LM.  Variation in tube voltage for adult neck MDCT: Effect on radiation dose and image quality. AJR 2012; Mar; 198(3):621-7.
    • Hoang JA, Yoshizumi, TT, Nguyen G, Grafton A, Eastwood J, Lowry C and Hurwitz LM.  Organ based tube current modulation and thyroid shields: Techniques of radiation dose reduction for neck CT. AJR 2012; May; 198(5):1132-8.
    • *Lungren M, Samei E, Mcadams HP, Christensen K, Wylie JD, Heyneman LE, Leder RA, Hurwitz LM. Grey-scale inversion radiographic display in the detection of pulmonary nodules on chest radiographs. Clin Imaging 2012; Sep; 36(5):515-21
    • *Lungren MP, Yoshizumi TT, Brady SL, Toncheva G, Anderson-Evans C, Lowry C, Zhou X, Frush D, Hurwitz LM.  Evaluation of radiation exposure to the thorax using anterior/posterior beam tube current modulation. AJR 2012; Jul; 199(1): W65-73.
    • Pollard BJ, Samei E, Chawla AS, Beam C, Heyneman LE, Hurwitz Koweek LM, Martinez-Jimenez S, Washington EL, Hashimoto N, McAdams HP. The effect of ambient light in chest radiology reading rooms. J Digit Imaging, 2012; Aug: 25(4):520-6.
    • Boyce SJ, McAdams HP, Ravin CE, Patz EF, Hurwitz LM, Martinez S Samei E.  Preliminary evaluation of bi-plane correlation (BCI) stereoscopic imaging for lung nodule detection.  J Digit Imaging, 2013; 26(1):109-14.
    • *Prescott-Focht JA, Martinez-Jimenez S, Hurwitz LM, Hoang JK, Christensen JD, Ghoshhajra BB, Abbara S. Ascending thoracic aorta: postoperative imaging evaluation. RadioGraphics. 2013; Jan-Feb; 33(1):73-85. doi: 10.1148/rg.331125090.
    • *Halim SA, Kiefer TL, Hughes GC, Hurwitz LM, Harrison JK.  Transcatheter aortic valve replacements: An update.  Current Cardiology Reports 2013; Jun; 15(6) 367.
    • Kiefer TL, Vavalle J, Halim S, Kaul P, Klein JL, Hurwitz LH, Gaca JG, Harrison JK. Anterograde percutaneous coronary-cameral fistula closure employing a guide-in-guide technique. JACC Cardiovasc Interv. 2013; Oct; 6(10):1105-7.
    • *Ganapathi AM, Englum BR, Hanna JM, Schechter MA, Gaca JG, Hurwitz LM, Hughes GC. Frailty and risk in proximal aortic surgery.J Thorac Cardiovasc Surg. 2014; Jan; 147(1):186-191.
    • Christensen JD, Seaman DM, Lungren MP, Hurwitz LM, Boll DT.  Assessment of vascular contrast and wall motion of the aortic root and ascending aorta on MDCT angiography: Dual-source high-pitch vs non-gated single-source acquisition schemes. Eur Radiol. 2014; 24(5):990-7.
    • *Yen H, Huang YC, Hurwitz LM, Miller MJ, Tsuang WM.  A pulmonary arteriovenous malformation growing for 35 years comes to an end. Am J Respir Crit Care Med. 2014; Feb 1;189(3):356-7.
    • Samei E, Richard S, Hurwitz L. Model-based CT performance assessment and optimization for iodinated and noniodinated imaging tasks as a function of kVp and body size. Med Phys. 2014; Aug; 41(8):081910-8.
    • *Lin C, Barrio G, Koweek LM and Kranz P. Cerebral air embolism from angio-invasive cavitary aspergillosis, Case Reports in Neurological Medicine, 2014, Article ID 406106, 4 pages Epub August 14.
    • Rubin GD, Roos JE, Tall M, Harrawood B, Bag S, Ly DL, Seaman DM, Hurwitz LM, Napal S, Choudhury KR. Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: Elucidation with eye tracking.  Radiology, 2015; 274(1):276-86.
    • *Lewis RK, Pokorney SD, Greenfield RA, Hranitzky PM, Hegland DD, Schroder JN, Lin SS, Milano CM, Daubert JP, Smith PK, Hurwitz LM and Piccini JP.  Pre-procedural gated commuted tomography for prevention of complications during lead extraction. Pacing Clin Electrophysiol. 2014; Oct; 37(10):1297-305.
    • *Caywood DT, Paxton BE, Boll DT, Nelson RC, Kim CY, Lowry C, Seaman DM, Roos J, Hurwitz LM.  Effects of model-based iterative reconstruction on image quality for low dose CT angiography of the thoracic aorta in a swine model. JCAT 2015; 39(2):196-201.
    • *Walker WL, Boll DT, Bueno JM, Kiefer TL, Vavalle J, Gaca JG, Harrison JK, Hughes GC, Wang A and Hurwitz LM.  Assessment of single-bolus contrast administration technique utilizing hybrid dual source ECG-gated thoracic and dual source non-ECG gated high-pitch abdominopelvic CT acquisitions for procedural planning prior to transcatheter aortic valve replacement. JCAT 2015; 39(2):207-12.
    • *Wang H, Hanna JM, Ganapathi A, Keenan JE, Hurwitz LM, Vavalle JP, Kiefer TL, Wang A, Harrison JK, Hughes GC. Comparison of aortic annulus size by transesophageal echocardiography and computed tomography angiography with direct surgical measurement. Am J Cardiol. 2015; Jun 1;115(11):1568-73.
    • Jackson LR, Piccini JP, Dauber JP, Hurwitz Koweek LM, Atwater BD.  Localization of pacing and defibrillator leads using standard x-ray views is frequently inaccurate and is not reproducible. J Interv Card Electrophysiol 2015; Jun 43(1): 5-12.
    • *Hard EW, Vavalle JP Kiefer TL, Halim S, Wang A, Hughes GC, Koweek LH, Gaca JG, Harrison JK. “Safe by a millimeter” tips and tricks to avoid coronary ostial occlusion with transcatheter aortic valve replacement in patients with effaced sinuses of Valsalva. Cardiology Open Lib 2015; 1(1): 1-3.
    • Kiefer TL, Vavalle J, Hurwitz LM, Hughes GC, Harrison JK. Resolution of severe hemolysis and paravalvular aortic regurgitation employing an amplatzer vascular plug: The importance of detailed pre-procedural planning using CT angiography. Cardiovasc Interv Ther. 2015; Oct 19. Doi:10.1007/s12928-015-0363-z.
    • *Mileto A, Ramirez-Giraldo JC, Nelson RC, Hurwitz LM, Choudhury KR, Seaman DM, Marin D.  High-pitch Dual-source MDCT for imaging the thoracoabdominal aorta: Relationships among radiation dose, noise, pitch and body size in a phantom experiment and clinical study.  AJR Am J Roentgenol. 2015; Oct; 2015(4):834-9
    • Vemulapalli S, Hurwitz Koweek LM, Kiefer TL, Jackson KP, Piccini JP.  Left atrial appendage to Great Cardiac Vein Fistula complicating watchman left atrial appendage closure.  Eur Heart J. 2016 May 21;37(20):1602.
    • *Davis B, Marin D, Hurwitz LM, Ronald J, Ellis MJ, Ravindra KV, Collins BH, Kim CY.  Application of a novel CT-based iliac artery calcification scoring system for predicting renal transplantation outcomes.  AJR 2016 February 2016; 206(2):436-41.
    • *Mileto A, Heye T, Makar RA, Hurwitz LM, Marin D, Boll DT.  Regional mapping of aortic wall stress by using deformable, motion-coherent modeling based on Electrocardiography-gated multidetector CT angiography: Feasibility Study. Radiology 2016 Jul;280(1):230-6.
    • *Iribane A, Keenan J, Benrashid E, Wang H, Meza J, Ganapathi A, Gaca JG, Kim HW, Hurwitz LM, Hughes GC. Imaging Surveillance after proximal Aortic Surgery: Is it Necessary? Ann Thorac Surg. 2017 Mar;103(3):734-741. doi: 10.1016/ j.athoracsur.2016.06.085. Epub 2016 Sep 24.
    • *Bellini D, Ramirez-Giraldo JC, Bibey A, Solomon J, Hurwitz LM, Farjat A, Mileto A, Samei E, Marin D.  Dual-Source Single-Energy Multidetector CT Used to Obtain Multiple Radiation Exposure Levels within the Same Patient: Phantom Development and Clinical Validation.  Radiology 2017 May;283(2):526-537.
    • *Ehieli WL, Boll DT, Marin D, Lewis R, Piccini JP, Hurwitz LM. Use of Preprocedural MDCT for Cardiac Implantable Electric Device Lead Extraction: Frequency of Findings That Change Management.  AJR 2017 Apr;208(4):770-776.
    • *Ceponis PJ, Fox W, Tailor TD, Hurwitz LM, Amrhein TJ, Moon RE. Non-dysbaric arterial gas embolism associated with chronic nectrotizing pneumonia, bullae and coughing: a case report. Undersea Hyperb Med 2017 Jan-Feb; 44, (1) 73-76.
    • *Sander J, Hurwitz L, Samei E. Patient specific quantification of image quality: An automated method for measuring spatial resolution in clinical CT images. Med Phys. 2016 Oct;43(10):5330.
    • Rabbat MG, Berman DS, Kern M, Raff G, Chinnaiyan K, Koweek L, Shaw LJ, Blanke P, Scherer M, Jensen JM, Lesser J, Nørgaard BL, Pontone G, De Bruyne B, Bax JJ, Leipsic J.  Interpreting results of coronary computed tomography angiography-derived fractional flow reserve in clinical practice. J Cardiovasc Comput Tomogr. 2017 Jun 23. pii: S1934-5925(17)30161-2.  doi: 10.1016/j.jcct.2017.06.002.
    • *Griffin A, Navar AM, Crawford L, Mammarappallil J, Koweek LM.  A case of spontaneous coronary artery dissection diagnosed by coronary computed tomography angiography.  J Cardiovasc Comput Tomogr. 2017 Sep 11; 12:88-89.
    • *Schabel C, Sekaran NK, Wang A, Hurwitz L.  Metal Artifact Free and Dose Efficient CT Imaging of a Cardiac Prosthetic Valve Using Spectral Shaping of the X-ray Beam - a Case Report. J Comput Assist Tomogra. 2018 May/June; 42(3):467-468.
    • *Manneck S, Hurwitz LM, Seaman DM, Heye T, Boll DT.  Whole-Body High-Pitch CT Angiography: Strategies to Reduce Radiation Dose and Contrast Volume.  AJR 2017 Dec; 209:1396-1403.
    • *Fudim M, Thorpe MP, Chang LL, St Clair EW, Hurwitz Koweek LM, Wang ACardiovascular Imaging with 18F-FDG-PET/CTA in patients with Fibro-inflammatory Disorders.  JACC Imaging Feb; 2018:II(2);365-368.
    • *Richards T, Sturgeon GM, Ramirez-Giraldo JC, Rubin GD, Hurwitz Koweek LM, Segars WP, Samei E.  Quantification of uncertainty in the assessment of coronary plaque in CCTA through a dynamic cardiac phantom and 3D-printed plaque model.  Journal of Medical Imaging 2018 Jan; 5(1);013501-1-013501-9
    • Fairbairn T, Nieman K, Akasaka T, Norgaard BL, Berman DS, Raff G , Hurwitz-Koweek LM, Pontone G, Kawasaki T, Sand NP, Jensen J, Amano T, Poon M, Ovrehus K, Sonck J, Rabbat M, Mullen S, De Bruyne B, Rogers C, Matsuo H, Bax JJ, Leipsic J, Patel MR. Real-world clinical utility and impact on clinical decision making of FFRCT Lessons from the ADVANCE Registry Eur Heart J 2018;doi:10.1093/eurheart/ehy530.