ACR Appropriateness Criteria® Tracheobronchial Disease.

A variety of thoracic imaging modalities and techniques have been used to evaluate diseases of the trachea and central bronchi. This document evaluates evidence for the use of thoracic imaging in the evaluation of tracheobronchial disease, including clinically suspected tracheal or bronchial stenosis, tracheomalacia or bronchomalacia, and bronchiectasis. Appropriateness guidelines for initial imaging evaluation of tracheobronchial disease and for pretreatment planning or posttreatment evaluation are included.

ACR Appropriateness Criteria® Sepsis.

Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. A search for the underlying cause of infection typically includes radiological imaging as part of this investigation. This document focuses on thoracic and abdominopelvic causes of sepsis.

Imaging of Large Airway Disorders.

Large airway disorders encompass a large variety of diseases and pathology, with broad categories including anatomic variants, congenital abnormalities, acquired abnormalities, inflammatory/infiltrative causes, infection, and tumors. The most common diseases in each category are discussed with a focus on the salient imaging findings. Pitfalls to beware of are discussed through the article, and concludes with a general method to approaching large airways pathology that should provide the reader with a basic framework and understanding of this complex topic.

Progressive Pulmonary Fibrosis and Interstitial Lung Abnormalities: Expert Panel Narrative Review.

Progressive pulmonary fibrosis (PPF) and interstitial lung abnormalities (ILA) are relatively new concepts in interstitial lung disease (ILD) imaging and clinical management. Recognition of signs of PPF, as well as identification and classification of ILA, are important tasks during chest high-resolution CT interpretation, to optimize management of patients with ILD and those at risk of developing ILD. However, following professional society guidance, the role of imaging surveillance remains unclear in stable patients with ILD, asymptomatic patients with ILA who are at risk of progression, and asymptomatic patients at risk of developing ILD without imaging abnormalities.

Prevalence of pulmonary artery dilation in non-cystic fibrosis bronchiectasis: a computed tomography analysis from a cohort of the US Bronchiectasis and Nontuberculous Mycobacteria Research Registry.

Although pulmonary artery (PA) dilation is independently associated with significant morbidity and mortality in patients with pulmonary diseases irrespective of diagnosed pulmonary hypertension, its relationship with nontuberculous mycobacteria (NTM) is unknown. The Bronchiectasis and NTM Research Registry is a multicenter registry created to foster research in non-cystic fibrosis (CF) bronchiectasis and NTM lung disease. The majority of patients with non-CF bronchiectasis at Oregon Health & Science University have NTM infections.

Pictorial Review of Fibrotic Interstitial Lung Disease on High-Resolution CT Scan and Updated Classification.

Topic Importance: Given the recently expanded approval of antifibrotics for various fibrotic interstitial lung diseases (ILDs), early and correct recognition of these diseases is imperative for physicians. Because high-resolution chest CT scan forms the backbone of diagnosis for ILD, this review will discuss evidence-based imaging findings of key fibrotic ILDs and an approach for differentiating these diseases.

Review Findings: (1) Imaging findings of nonspecific interstitial pneumonia may evolve over time and become indistinguishable from usual interstitial pneumonia.

ACR Appropriateness Criteria® Routine Chest Imaging.

Routine chest imaging has been used to identify unknown or subclinical cardiothoracic abnormalities in the absence of symptoms. Various imaging modalities have been suggested for routine chest imaging. We review the evidence for or against the use of routine chest imaging in different clinical scenarios.

Prevalence of pulmonary artery dilation in non-cystic fibrosis bronchiectasis: A CT analysis from a cohort of the US Bronchiectasis and Nontuberculous Mycobacteria Research Registry.

Although pulmonary artery (PA) dilation is independently associated with significant morbidity and mortality in patients with pulmonary diseases irrespective of diagnosed pulmonary hypertension, its relationship to nontuberculous mycobacteria (NTM) is unknown. To determine the prevalence of PA dilation in patients with NTM-predominant non-CF bronchiectasis, we evaluated the chest computed tomography (CT) scans from 321 patient in the United States based Bronchiectasis and NTM Research Registry. The majority of our cohort had NTM infection.

Venous Thromboembolism During Pregnancy and the Postpartum Period: Risk Factors, Diagnostic Testing, and Treatment.

Importance: The risk of venous thromboembolism (VTE) increases during pregnancy and the postpartum period. Deep vein thrombosis is the most common VTE during pregnancy, but pulmonary embolism is typically of greater concern as it contributes to far higher morbidity and mortality. Diagnosis and treatment of VTE during pregnancy differ substantially from the general nonpregnant population.

Nonimaging Diagnostic Tests for Pneumonia.

This article reviews the various nonimaging diagnostic tests available for the diagnosis of pneumonia including the methods by which specimens are obtained and the speed at which certain tests are available. Because tests results may be available at the time of radiologic image interpretation, it is important for the radiologist to be aware of the type of specimens and diagnostic tests to search for in the electronic medical record in order to provide a more refined imaging report. Diagnostic tests for the most common bacterial, fungal, viral, and parasitic infections are discussed.

Dispelling myths: The case for women in radiology and radiation oncology.

Common misconceptions about radiology and radiation oncology exist and may dissuade women from pursuing these specialties. The American Association for Women in Radiology (AAWR) Medical Student Outreach Subcommittee began a multi-year social media campaign aimed at addressing these myths. Here, we outline several myths presented in this social media campaign and provide a combination of literature review and experts' opinions to deconstruct and dispel them.

Innovative Cardiac Devices on Chest Imaging: An Update.

Over the past decade, a rapidly increasing number of new cardiac devices have been created. Remaining current with these devices and how they appear on chest radiographs and other modalities used in chest imaging can be a challenge for the interpreting radiologist. This review is provides a concise summary of various common cardiac devices as well as recently developed devices that will be increasing in frequency over the coming years.

The efficacy of chest radiographs in detecting parapneumonic effusions.

Background And Objective: Current guidelines recommend parapneumonic effusions (PPEs) with a thickness of ≥ 10 mm be sampled via thoracentesis. We hypothesized that anteroposterior (AP) CXRs are not as sensitive as posteroanterior (PA) and lateral radiographs in identifying PPEs and should not be routinely used in patients with suspected pneumonia.

Methods: Sixty-one hospitalized patients with pneumonia and PPE were retrospectively studied, all of whom had a CXR and CT scan within 24 h of each other.

Pleural effusions occurring with right heart failure.

Purpose Of Review: Pleural effusions commonly occur in patients with left heart failure. However, there is increasing evidence that patients with pulmonary hypertension and isolated right heart failure frequently have pleural effusions.

Recent Findings: Three recent studies have evaluated the incidence of pleural effusions without an alternate explanation in patients with idiopathic/familial pulmonary arterial hypertension (14%), pulmonary arterial hypertension associated with connective tissue diseases (33%), and portopulmonary hypertension (30%).

Frequency of pleural effusions in patients with pulmonary arterial hypertension associated with connective tissue diseases.

Background: Pleural effusions frequently accumulate in patients with left-sided heart failure. However, our recent study in patients with idiopathic and heritable pulmonary arterial hypertension (PAH) demonstrated that pleural effusions frequently occur in patients with isolated right-sided heart failure (RHF). The objective of this study was to determine the frequency of pleural effusions in patients with PAH associated with connective tissue disease (CTD).

Pleural effusions due to dasatinib.

Purpose Of Review: Dasatinib is a novel tyrosine-kinase inhibitor approved for treatment of BCR-ABL positive chronic myeloid leukemia (CML) and Philadelphia chromosome positive acute lymphoblastic leukemia (ALL) after imatinib failure. Use of dasatinib is frequently complicated by pleural effusions. This review highlights the risk factors for development of effusions as well as characteristics of the pleural fluid.