Detection of small pulmonary nodules using direct digital radiography and picture archiving and communication systems.

Purpose: To evaluate the detection of small pulmonary nodules, in the diameter range of 5.4 to 15 mm, using direct digital chest imaging and soft copy interpretation on picture archiving and communication systems.

Materials And Methods: The results of clinical computed tomography (CT) scans of the thorax were retrospectively reviewed from our radiology information system and picture archiving and communication systems archives.

Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society.

Lung nodules are detected very commonly on computed tomographic (CT) scans of the chest, and the ability to detect very small nodules improves with each new generation of CT scanner. In reported studies, up to 51% of smokers aged 50 years or older have pulmonary nodules on CT scans. However, the existing guidelines for follow-up and management of noncalcified nodules detected on nonscreening CT scans were developed before widespread use of multi-detector row CT and still indicate that every indeterminate nodule should be followed with serial CT for a minimum of 2 years.

Lung nodule detection on chest CT: evaluation of a computer-aided detection (CAD) system.

Objective: To evaluate the capacity of a computer-aided detection (CAD) system to detect lung nodules in clinical chest CT.

Materials And Methods: A total of 210 consecutive clinical chest CT scans and their reports were reviewed by two chest radiologists and 70 were selected (33 without nodules and 37 with 1-6 nodules, 4-15.4 mm in diameter).

Reduced radiation for adult thoracic CT: a practical approach.

Purpose: To determine whether radiation dose to patients can be reduced for clinical thoracic CT scans without loss of diagnostic information.

Materials And Methods: One hundred consecutive patients having clinical CT examinations of the thorax were included. The patients were divided into 4 groups, and the mAs setting determined from the patient's weight as follows (max.

Picture archiving and communication systems (PACS).

Over the past 2 decades, groups of computer scientists, electronic design engineers, and physicians, in universities and industry, have worked to achieve an electronic environment for the practice of medicine and radiology. The radiology component of this revolution is often called PACS (picture archiving and communication systems). More recently it has become evident that the efficiencies and cost savings of PACS are realized when they are part of an enterprise-wide electronic medical record.

Automatic detection of small lung nodules on CT utilizing a local density maximum algorithm.

Increasingly, computed tomography (CT) offers higher resolution and faster acquisition times. This has resulted in the opportunity to detect small lung nodules, which may represent lung cancers at earlier and potentially more curable stages. However, in the current clinical practice, hundreds of such thin-sectional CT images are generated for each patient and are evaluated by a radiologist in the traditional sense of looking at each image in the axial mode.

A consensus statement of the Society of Thoracic Radiology: screening for lung cancer with helical computed tomography.

This consensus statement by the Society of Thoracic Radiology is a summary of the current understanding of low dose computed tomography (CT) for screening for lung cancer. Lung cancer is the most common fatal malignancy in the industrialized world. Unlike the next three most common cancers, screening for lung cancer is not currently recommended by cancer organizations.

Optimization of combined CT pulmonary angiography with lower extremity CT venography.

Objective: We wanted to determine the time delay for maximum enhancement of the deep venous system of the lower extremities after standard CT pulmonary angiography.

Subjects And Methods: In 20 patients who had undergone standard CT pulmonary angiography, we measured arterial and venous enhancement at the level of the greater trochanter. These measurements were obtained at 30-sec intervals immediately after completion of CT pulmonary angiography.

Parenchymal and pleural findings in patients with and patients without acute pulmonary embolism detected at spiral CT.

Purpose: To compare the frequencies of parenchymal abnormalities and pleural effusions in patients with and patients without acute pulmonary embolism (PE) detected at spiral computed tomography (CT).

Materials And Methods: Contrast material-enhanced spiral CT scans obtained in 92 patients clinically suspected of having acute PE were retrospectively reviewed. The presence or absence of parenchymal abnormalities and pleural effusions was noted.

High-resolution CT in the evaluation of clinically suspected Pneumocystis carinii pneumonia in AIDS patients with normal, equivocal, or nonspecific radiographic findings.

Objective: We prospectively studied AIDS patients with a high clinical pretest probability of Pneumocystis carinii pneumonia (PCP) in whom chest radiographic findings were normal, equivocal, or nonspecific with high-resolution CT (HRCT) to determine the incidence of PCP in these patients, to assess the diagnostic accuracy of HRCT for the presence or absence of PCP, to evaluate the role of HRCT in patient management, and to determine the clinical outcome of all patients 1 month after evaluation.

Subjects And Methods: All patients were referred to the Division of Pulmonary and Critical Care Medicine for diagnosis of clinically suspected PCP. Thirty-three patients were prospectively evaluated with HRCT within 24 hr of diagnostic bronchoalveolar lavage; 18 other patients who underwent HRCT were managed according to the HRCT interpretation and followed up clinically.

Causes of pulmonary impairment in asbestos-exposed individuals with diffuse pleural thickening.

To examine whether diffuse pleural thickening (DPT) causes impairment of pulmonary function independent of other manifestations of asbestos-related disease, we studied individuals selected from 1,150 men with occupational asbestos exposure who had undergone pulmonary function testing and computed tomographic (CT) scanning. The CT scans revealed 84 subjects with DPT as defined for CT. Of these 84 subjects, 53 eligible study cases were matched by age with a referent group without DPT from the same exposed group.

Temporal image database design for outcome analysis of lung nodule.

This paper presents the design of a temporal image database system and its application in thoracic imaging. The design of this information system is based on the client/server architecture. The system consists of a chest imaging database server, a library of image processing modules, a link to the picture archiving and communication system (PACS) archive, and a low end client workstation with motif-based graphic user interface (GUI).

Tree-in-bud pattern: frequency and significance on thin section CT.

Purpose: Our goal was to describe those diseases of the airways that manifest the tree-in-bud (TIB) pattern on CT scan and to establish a differential diagnosis for this CT scan finding.

Method: We prospectively collected cases with the TIB pattern on CT and reviewed the scans of patients with histories pertaining to small airway disease. CT scans were performed at 1 to 3 mm collimation.

High-resolution computed tomography of airway changes after induced bronchoconstriction and bronchodilation in asthmatic volunteers.

Rationale And Objectives: We examined whether high-resolution computed tomography (HRCT) would detect and quantify induced airway changes in asthmatic volunteers.

Methods: We performed pulmonary function tests and HRCT on eight asthmatic adults and two nonasthmatic control adults under three conditions: baseline, after methacholine inhalation, and after albuterol inhalation. Changes in pulmonary function, airway internal luminal diameter (AILD), and airway wall thickness (AWT) in the three conditions were compared.

Pulmonary tuberculosis: comparison of CT findings in HIV-seropositive and HIV-seronegative patients.

Purpose: To determine the differences in the computed tomographic (CT) appearance of pulmonary tuberculosis (TB) between patients with and patients without human immunodeficiency virus (HIV) infection.

Materials And Methods: CT scans and chest radiographs of 42 HIV-seropositive and 42 HIV-seronegative patients with pulmonary TB were reviewed. CD4 T-lymphocyte counts, measured in 40 seropositive patients, were at least 200 cells per microliter in 10 patients and were less that 200 cells per microliter in 30.

Artifacts in chest radiographs with a third-generation computed radiography system.

Photostimulable phosphor computed radiography (CR) is a developing and increasingly widespread technology. The purpose of this pictorial essay is to familiarize readers with the appearance and cause of image artifacts that can occur in a third-generation computed radiographic system. Artifacts are described that relate to imaging plates, image readers, image processing, and film processing.

AIDS-related Kaposi sarcoma of the lung: radiographic findings and staging system with bronchoscopic correlation.

Purpose: To determine the chest radiographic findings in patients with tracheobronchial Kaposi sarcoma (KS) and to develop a radiographic staging system that allows comparison of radiographic to bronchoscopic findings and allows assessment of the typical temporal progression of pulmonary KS.

Materials And Methods: The chest radiographs and medical records of 76 male patients, aged 23-60 years (mean, 36 years 4 months) with bronchoscopically proved KS were retrospectively reviewed. Tumor extent at bronchoscopy (grade 1-3) was compared with severity of parenchymal disease (radiographic stage 0-3).

Dyspnea in ambulatory patients with SLE: prevalence, severity, and correlation with incremental exercise testing.

Objective: We sought to determine the prevalence and severity of dyspnea, and to correlate dyspnea with clinical features and exercise limitation in ambulatory patients with systemic lupus erythematosus (SLE).

Methods: Twenty-five consecutive patients were evaluated with a validated pulmonary questionnaire, chest radiograph, 2-dimensional echocardiography, resting pulmonary function tests, and incremental exercise testing.

Results: Dyspnea was reported by 60% (95% CI 39-79) of patients; 20% (95% CI 7-40) had severe dyspnea (inability to dress without dyspnea) and 12% (95% CI 3-31) had moderate dyspnea (dyspnea after walking 100 yards).

High-resolution computed tomography sampling for detection of asbestos-related lung disease.

Rationale And Objectives: We determined whether a limited number of high-resolution computed tomography (HRCT) scans will effectively screen for interstitial lung disease (ILD) in a population of individuals exposed to asbestos.

Methods: We retrospectively reviewed the computed tomography studies of 49 patients exposed to asbestos. HRCT in the supine and prone positions had been performed at specifically preselected levels.

CT quantification of interstitial fibrosis in patients with asbestosis: a comparison of two methods.

Objective: The likelihood of interstitial lung disease being detected on high-resolution CT scans and having functional significance is often related to the severity of the disease. The extent and severity of the abnormalities seen on high-resolution CT are usually assessed subjectively. This study was undertaken to investigate whether a subjective semiquantitative scoring method or a method using a cumulation of the different high-resolution CT features of asbestosis were comparable in suggesting asbestosis in a group of patients with histopathologic confirmation of disease.