CT imaging findings of invasive pulmonary fungal infections in hemato-oncologic children.

Hemato-oncologic children form a heterogeneous group with a wide spectrum of ages, malignancy types, and immunosuppression grades during the different phases of their treatment. Immunosuppression is caused by multiple factors, including the malignancy itself, bone marrow suppression secondary to therapy, and wide use of steroids and antibiotics, among others. At the same time, the risk of infections in these patients remains high because of prolonged hospitalizations or the need for long-timing implanted devices between other features.

Allergic bronchopulmonary aspergillosis in a lung transplant recipient treated with mepolizumab.

Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus spp. ABPA diagnosis may be challenging due to its non-specific presentation. Standard ABPA treatment consists of systemic corticosteroids and antifungal agents.

Atypical imaging patterns during lung invasive mould diseases: lessons for clinicians.

Imaging of pulmonary invasive mould diseases (IMDs), which represents a cornerstone in their work-up, is mainly based on computed tomography (CT). The purpose of this review is to discuss their CT features, mainly those related to aspergillosis and mucormycosis. We will especially focus on atypical radiological presentations that are increasingly observed among non-neutropenic emerging populations of patients at risk, such as those receiving novel anticancer therapies or those in the intensive care unit.

Lung CT stabilization with high-frequency non-invasive ventilation (HF-NIV) and breath-hold (BH) in lung nodule assessment by PET/CT.

Purpose: To evaluate the effect of lung stabilization using high-frequency non-invasive ventilation (HF-NIV) and breath-hold (BH) techniques on lung nodule detection and texture assessment in PET/CT compared to a free-breathing (FB) standard lung CT acquisition in PET/CT.

Materials And Methods: Six patients aged 65 ± 7 years, addressed for initial assessment of at least one suspicious lung nodule with F-FDG PET/CT, underwent three consecutive lung PET/CT acquisitions with FB, HF-NIV and BH. Lung nodules were assessed on all three CT acquisitions of the PET/CT and characterized for any size, volume and solid/sub-solid nature.

Lung and sinus fungal infection imaging in immunocompromised patients.

Background: Imaging is a key diagnostic modality for suspected invasive pulmonary or sinus fungal disease and may help to direct testing and treatment. Fungal diagnostic guidelines have been developed and emphasize the role of imaging in this setting. We review and summarize evidence regarding imaging for fungal pulmonary and sinus disease (in particular invasive aspergillosis, mucormycosis and pneumocystosis) in immunocompromised patients.

Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned?

Lung cancer screening (LCS) programs through low-dose Computed Tomography (LDCT) are being implemented in several countries worldwide. Radiation exposure of healthy individuals due to prolonged CT screening rounds and, eventually, the additional examinations required in case of suspicious findings may represent a concern, thus eventually reducing the participation in an LCS program. Therefore, the present review aims to assess the potential radiation risk from LDCT in this setting, providing estimates of cumulative dose and radiation-related risk in LCS in order to improve awareness for an informed and complete attendance to the program.

Comparison Between Magnetic Resonance Imaging and Computed Tomography in the Detection and Volumetric Assessment of Lung Nodules: A Prospective Study.

Rationale And Objectives: Computed tomography (CT) lung nodule assessment is routinely performed and appears very promising for lung cancer screening. However, the radiation exposure through time remains a concern. With the overall goal of an optimal management of indeterminate lung nodules, the objective of this prospective study was therefore to evaluate the potential of optimized ultra-short echo time (UTE) MRI for lung nodule detection and volumetric assessment.

[Pulmonary tularemia : a diagnosis not to be missed].

Tularemia (caused by the facultative intracellular Gram-negative bacillus Francisella tularensis) is an endemic zoonotic disease in Europe, which exhibits different clinical patterns. Following the glandular form, pneumonia is the second most frequent manifestation in Switzerland. Pulmonary tularemia often has a subacute course and fails to respond to beta-lactam antibiotics.

[Covid-19 respiratory sequelae : Screening and management].

Infection with SARS-CoV-2 can affect multiple organ systems with variable severity and is known to frequently have a major impact on the respiratory system. Symptoms may persist for several months after infection, and are associated with a reduction of lung function, diminished exercise capacity and anomalies on chest CT. Guidelines on the post-acute care of patients with SARS-CoV-2 are now available.

[Clinical approach to enlarged mediastinal and hilar lymph nodes other than the oncological causes].

Widespread use of CT-scans leads to increased discovery of mediastinal and hilar lymph node enlargement, a frequent motive for consulting a pulmonologist. The persistence or progression of such lymphadenopathies outside of an oncological context is most often associated with an infectious process or inflammatory disorders. The history will also point to possible occupational or environmental exposure.

Imaging Features of Pulmonary Immune-related Adverse Events.

Pulmonary immune-related adverse events represent rare but potentially severe side effects of immunotherapies. Diagnosis is often challenging, as symptoms and imaging features are not specific and may mimic other lung diseases, thus potentially delaying appropriate patient management. In this setting, an accurate imaging evaluation is essential for a prompt detection and correct management of these drug-induced lung diseases.

Invasive infection in patients with acute myeloid leukemia: Report of two cases successfully treated and review of the literature.

is a rare cause of invasive mold infection, mostly described in patients with hematological malignancies. We describe two cases of invasive infections in patients with acute myeloid leukemia, successfully managed with complete surgical resection of the lesions and antifungal therapy of voriconazole alone or liposomal amphotericin B, followed by voriconazole, highlighting the key role of a multidisciplinary approach for the treatment of this rare and severe invasive mold infection.

Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery.

In these times of COVID-19 pandemic, concern has been raised about the potential effects of SARS-CoV-2 infection on immunocompromised patients, particularly on those receiving B-cell depleting agents and having therefore a severely depressed humoral response. Convalescent plasma can be a therapeutic option for these patients. Understanding the underlying mechanisms of convalescent plasma is crucial to optimize such therapeutic approach.

Endobronchial coil spring fiducial markers for CyberKnife® stereotactic body radiation therapy.

Background And Objective: SBRT is an alternative treatment for early-stage inoperable lung cancer. Metallic FM allow to increase tumour tracking precision by CyberKnife®. Currently used techniques for FM placement have many limitations; transthoracic insertion has a high risk for pneumothorax, endovascular insertion requires expertise and dedicated angiography infrastructure and endobronchial linear-gold FM dislocate frequently.

Monte Carlo Y PET/CT dosimetry of unexpected focal radiation-induced lung damage after hepatic radioembolisation.

Transarterial radioembolization (TARE) with Y-loaded microspheres is an established therapeutic option for inoperable hepatic tumors. Increasing knowledge regarding TARE hepatic dose-response and dose-toxicity correlation is available but few studies have investigated dose-toxicity correlation in extra-hepatic tissues. We investigated absorbed dose levels for the appearance of focal lung damage in a case of off-target deposition of Y microspheres and compared them with the corresponding thresholds recommended to avoiding radiation induced lung injury following TARE.

[Lung cancer screening in Switzerland : Who ? How ? When ?].

Professional societies encourage the establishment of coordinated national screening programs for lung cancer by « low-dose » chest CT scans. The interdisciplinary Swiss Lung Cancer Screening Implementation Group (CH-LSIG) is exploring the feasibility of such a project. However, several questions still remain unanswered, namely the -financing of such a program, the ideal « number-needed to screen », the definition and follow-up of « positive cases », as well as the role of smoking cessation measures.

[New developments in systemic sclerosis-associated interstitial lung disease].

Interstitial lung disease is a frequent complication of systemic sclerosis and has now become the leading cause of death in this disorder. It mainly occurs during the first five years after the diagnosis of systemic sclerosis. Various risk factors are associated with the occurrence of interstitial lung disease, including the presence of anti-topoisomerase I antibodies (Scl-70) and the diffuse cutaneous form of systemic sclerosis.

Pitfalls in diagnosis of infiltrative lung disease by CT.

The diagnosis of interstitial lung disease may be challenging, especially in atypical disease. Various factors must be considered when performing and reading a chest CT examination for interstitial lung disease, because each of them may represent a source of misinterpretation. Firstly, technical aspects must be mastered, including acquisition and reconstruction parameters as well as post-processing.

Imaging features and differential diagnoses of non-neoplastic diffuse mediastinal diseases.

Acute or chronic non-neoplastic diffuse mediastinal diseases have multiple causes, degrees of severity, and a wide range of management. Some situations require emergency care while others do not need specific treatment. Although the diagnosis may be suspected on chest X-ray, it is mainly based on CT.

Lung MRI assessment with high-frequency noninvasive ventilation at 3 T.

Purpose: To investigate three MR pulse sequences under high-frequency noninvasive ventilation (HF-NIV) at 3 T and determine which one is better-suited to visualize the lung parenchyma.

Methods: A 3D ultra-short echo time stack-of spirals Volumetric Interpolated Breath-hold Examination (UTE Spiral VIBE), without and with prospective gating, and a 3D double-echo UTE sequence with spiral phyllotaxis trajectory (3D radial UTE) were performed at 3 T in ten healthy volunteers under HF-NIV. Three experienced radiologists evaluated visibility and sharpness of normal anatomical structures, artifacts assessment, and signal and contrast ratio computation.

High prevalence of peribronchial focal lesions of airway invasive aspergillosis in hematological cancer patients with prolonged neutropenia.

Objective: The aim of this study is to characterize chest CT findings of neutropenic patients with proven/probable invasive pulmonary aspergillosis (IPA).

Methods: Hematological cancer patients admitted to our institution (2007-2017) were retrospectively enrolled if the diagnostic criteria of proven/probable IPA during the neutropenia were met (EORTC/MSG). Galactomannan (GM) was routinely measured in serum and chest CT-scan was routinely performed in case of recurrent/persistent fever.