Validating International Classification of Diseases Code 10th Revision algorithms for accurate identification of pulmonary embolism.

Background: Many research investigations for pulmonary embolism (PE) rely on the International Classification of Diseases 10th Revision (ICD-10) codes for analyses of electronic databases. The validity of ICD-10 codes in identifying PE remains uncertain.

Objectives: The objective of this study was to validate an algorithm to efficiently identify pulmonary embolism using ICD-10 codes.

Risk of Lung Cancer in Peripheral Pulmonary Nodules.

Purpose: To determine the risk of lung cancer and inter-observer agreement for small pulmonary nodules either touching or near the pleura.

Methods: Nodules were derived from two cohorts: patients from the National Lung Screening Trial with a solid nodule measuring 6-9.5 mm; and patients with incidental pulmonary nodules in our healthcare system with a solid nodule measuring 1-8 mm.

ACR Lung-RADS v2022: Assessment Categories and Management Recommendations.

The American College of Radiology created the Lung CT Screening Reporting and Data System (Lung-RADS) in 2014 to standardize the reporting and management of screen-detected pulmonary nodules. Lung-RADS was updated to version 1.1 in 2019 and revised size thresholds for nonsolid nodules, added classification criteria for perifissural nodules, and allowed for short-interval follow-up of rapidly enlarging nodules that may be infectious in etiology.

ACR Lung-RADS v2022: Assessment Categories and Management Recommendations.

The ACR created the Lung CT Screening Reporting and Data System (Lung-RADS) in 2014 to standardize the reporting and management of screen-detected pulmonary nodules. Lung-RADS was updated to version 1.1 in 2019 and revised size thresholds for nonsolid nodules, added classification criteria for perifissural nodules, and allowed for short-interval follow-up of rapidly enlarging nodules that may be infectious in etiology.

Developing Validated Tools to Identify Pulmonary Embolism in Electronic Databases: Rationale and Design of the PE-EHR+ Study.

Background:  Contemporary pulmonary embolism (PE) research, in many cases, relies on data from electronic health records (EHRs) and administrative databases that use International Classification of Diseases (ICD) codes. Natural language processing (NLP) tools can be used for automated chart review and patient identification. However, there remains uncertainty with the validity of ICD-10 codes or NLP algorithms for patient identification.

Strategies for Reducing False-Positive Screening Results for Intermediate-Size Nodules Evaluated Using Lung-RADS: A Secondary Analysis of National Lung Screening Trial Data.

Lung-RADS version 1.1 (v1.1) classifies all solid nodules less than 6 mm as category 2.

Loss of Pulmonary Vascular Volume as a Predictor of Right Ventricular Dysfunction and Mortality in Acute Pulmonary Embolism.

Background: In acute pulmonary embolism, chest computed tomography angiography derived metrics, such as the right ventricle (RV): left ventricle ratio are routinely used for risk stratification. Paucity of intraparenchymal blood vessels has previously been described, but their association with clinical biomarkers and outcomes has not been studied. We sought to determine if small vascular volumes measured on computed tomography scans were associated with an abnormal RV on echocardiography and mortality.

Quantification of Arterial and Venous Morphologic Markers in Pulmonary Arterial Hypertension Using CT Imaging.

Background: Pulmonary hypertension is a heterogeneous disease, and a significant portion of patients at risk for it have CT imaging available. Advanced automated processing techniques could be leveraged for early detection, screening, and development of quantitative phenotypes. Pruning and vascular tortuosity have been previously described in pulmonary arterial hypertension (PAH), but the extent of these phenomena in arterial vs venous pulmonary vasculature and in exercise pulmonary hypertension (ePH) have not been described.

Determinants of Chest X-Ray Sensitivity for COVID- 19: A Multi-Institutional Study in the United States.

Purpose: To evaluate the sensitivity, specificity, and severity of chest x-rays (CXR) and chest CTs over time in confirmed COVID-19+ and COVID-19- patients and to evaluate determinants of false negatives.

Methods: In a retrospective multi-institutional study, 254 RT-PCR verified COVID-19+ patients with at least one CXR or chest CT were compared with 254 age- and gender-matched COVID-19- controls. CXR severity, sensitivity, and specificity were determined with respect to time after onset of symptoms; sensitivity and specificity for chest CTs without time stratification.

Radiologist Reporting and Operational Management for Patients With Suspected COVID-19.

Purpose: The aim of this study was to evaluate the adoption and outcomes of locally designed reporting guidelines for patients with possible coronavirus disease 2019 (COVID-19).

Methods: A departmental guideline was developed for radiologists that specified reporting terminology and required communication for patients with imaging findings suggestive of COVID-19, on the basis of patient test status and imaging indication. In this retrospective study, radiology reports completed from March 1, 2020, to May 3, 2020, that mentioned COVID-19 were reviewed.

Radiologic-Pathologic Correlation for Nondiagnostic CT-Guided Lung Biopsies Performed for the Evaluation of Lung Cancer.

For nondiagnostic CT-guided lung biopsies, we tested whether radiologicpathologic correlation could identify patients who may benefit from repeat biopsy. In this retrospective study, 1525 lung biopsies were performed between July 2013 and June 2017, 243 of which were nondiagnostic. Of these 243 lung biopsies, 98 were performed to evaluate for lung malignancy; 17 were excluded because of insufficient follow-up, leaving a total of 81 cases.

Cancer Risk in Subsolid Nodules in the National Lung Screening Trial.

Background Subsolid pulmonary nodules, comprising pure ground-glass nodules (GGNs) and part-solid nodules (PSNs), have a high risk of indolent malignancy. Lung Imaging Reporting and Data System (Lung-RADS) nodule management guidelines are based on expert opinion and lack independent validation. Purpose To evaluate Lung-RADS estimates of the malignancy rates of subsolid nodules, using nodules from the National Lung Screening Trial (NLST), and to compare Lung-RADS to the NELSON trial classification as well as the Brock University calculator.

Predictive Features for Anterior Mediastinal Mass Diagnoses.

Objective: We set out to evaluate a set of demographic and computed tomography imaging features for diagnosing anterior mediastinal masses.

Methods: We identified 223 patients with anterior mediastinal masses, which we divided into training and validation sets. One radiologist evaluated computed tomography imaging features on the training set.

Cardiothoracic Applications of 3-dimensional Printing.

Medical 3-dimensional (3D) printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties and will therefore likely lead to interdisciplinary collaboration between engineers, radiologists, and surgeons. Data from standard imaging modalities such as computed tomography, magnetic resonance imaging, echocardiography, and rotational angiography can be used to fabricate life-sized models of human anatomy and pathology, as well as patient-specific implants and surgical guides. Cardiovascular 3D-printed models can improve diagnosis and allow for advanced preoperative planning.

Frequency and Severity of Pulmonary Hemorrhage in Patients Undergoing Percutaneous CT-guided Transthoracic Lung Biopsy: Single-Institution Experience of 1175 Cases.

Purpose: To evaluate the frequency and severity of pulmonary hemorrhage after transthoracic needle lung biopsy (TTLB) and assess possible factors associated with pulmonary hemorrhage.

Materials And Methods: This retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived.

Association Between Confidence Level of Acute Pulmonary Embolism Diagnosis on CTPA images and Clinical Outcomes.

Rationale And Objectives: The purpose was to evaluate clinical characteristics associated with low confidence in diagnosis of acute pulmonary embolism (PE) as expressed in computed tomography pulmonary angiography (CTPA) reports and to evaluate the effect of confidence level in PE diagnosis on patient clinical outcomes.

Materials And Methods: This study included radiology reports from 1664 consecutive CTPA considered positive for acute PE (8/2003-5/2010). All reports were retrospectively assessed for the level of confidence in diagnosis.

Classification of CT pulmonary angiography reports by presence, chronicity, and location of pulmonary embolism with natural language processing.

In this paper we describe an efficient tool based on natural language processing for classifying the detail state of pulmonary embolism (PE) recorded in CT pulmonary angiography reports. The classification tasks include: PE present vs. absent, acute PE vs.

Incidental findings detection using low tube potential for CT pulmonary angiography.

While lowering the radiation dose using a reduced tube potential (kVp) strategy for CT pulmonary angiography (CTPA) maintains accuracy for pulmonary embolism detection, there is no data regarding the effect of increased noise from lower kVp on both the accuracy of lung and mediastinum lesion detection in the same patient cohort. This study compares the accuracy and diagnostic confidence of lung nodules and enlarged mediastinal lymph nodes detection between low and standard kVp CTPA. The study cohort included 272 CTPA studies acquired at low kVp and 274 studies at standard kVp.

Computed tomography and echocardiography in patients with acute pulmonary embolism: part 2: prognostic value.

Purpose: The aim of the study was to compare the prognostic value of right ventricular (RV) dysfunction detected on computed tomography pulmonary angiography (CTPA) and transthoracic echocardiography (TTE) in patients with acute pulmonary embolism (PE).

Materials And Methods: From all consecutive CTPAs performed between August 2003 and May 2010 that were positive for acute PE (n=1744), those with TTE performed within 48 hours of CTPA (n=785) were selected as the study cohort. Multivariate logistic regression analysis was performed to assess the association of CTPA RV/left ventricular (LV) diameter ratio and TTE RV strain with PE-related 30-day mortality, including other associated factors as covariates.