The Lung Reporting and Data System (LU-RADS): a proposal for computed tomography screening.

Despite the positive outcome of the recent randomized trial of computed tomography (CT) screening for lung cancer, substantial implementation challenges remain, including the clear reporting of relative risk and suggested workup of screen-detected nodules. Based on current literature, we propose a 6-level Lung-Reporting and Data System (LU-RADS) that classifies screening CTs by the nodule with the highest malignancy risk. As the LU-RADS level increases, the risk of malignancy increases.

Restrictive allograft syndrome post lung transplantation is characterized by pleuroparenchymal fibroelastosis.

We previously described restrictive allograft syndrome as a form of chronic lung allograft dysfunction, demonstrating restrictive pulmonary function decline. However, the histopathological correlates of restrictive allograft syndrome have yet to be satisfactorily described. We hypothesized that pulmonary pleuroparenchymal fibroelastosis, as has recently been described in bone marrow transplant recipients, may also be present in the lungs of patients with restrictive allograft syndrome.

CT screening for lung cancer: implication of lung biopsy recommendations.

Objective: The purpose of this article is to address the implications of invasive diagnostic procedures recommended by a lung cancer screening protocol. In particular, we assess how many invasive procedures were recommended for benign nodules.

Materials And Methods: Between 2003 and 2009, 4782 high-risk current and former smokers were enrolled in a lung cancer screening study.

Screen-detected lung cancer: a retrospective analysis of CT appearance.

Rationale And Objectives: The aim of this study was to retrospectively evaluate characteristics of lung cancers diagnosed in a low-dose computed tomographic lung cancer screening study.

Materials And Methods: As part of the International Early Lung Cancer Action Program, a cohort of 4782 at-risk participants were screened. A total of 86 cancers in 84 individuals were detected and evaluated for location, morphology (density, border), size, histology, stage at diagnosis, treatment, and survival.

Restrictive allograft syndrome (RAS): a novel form of chronic lung allograft dysfunction.

Background: Bronchiolitis obliterans syndrome (BOS) with small-airway pathology and obstructive pulmonary physiology may not be the only form of chronic lung allograft dysfunction (CLAD) after lung transplantation. Characteristics of a form of CLAD consisting of restrictive functional changes involving peripheral lung pathology were investigated.

Methods: Patients who received bilateral lung transplantation from 1996 to 2009 were retrospectively analyzed.

Repeated low-dose computed tomography in current and former smokers for quantification of emphysema.

Objective: To quantify different emphysema evolution in current and former smokers.

Methods: We retrospectively analyzed low-dose computed tomography scans from a lung cancer screening study of 59 current and 75 former smokers. The quantitative emphysema analysis was performed using a home-built software (YACTA version 0.

Assessing the impact of incidental findings in a lung cancer screening study by using low-dose computed tomography.

Purpose: To assess the prevalence and nature of incidental findings (IF) seen in low-dose computed tomographies (LDCT) from a lung cancer screening study for at-risk individuals.

Materials And Methods: Radiology reports from LDCTs of 4073 participants of a lung cancer screening study were retrospectively reviewed for findings other than lung nodules, that is, IFs, which were regarded as actionable. The frequency, nature, and expected cost of these IFs, and their anticipated follow-up were estimated.

Imaging the diaphragm.

This article describes the normal and abnormal position, motion and morphology of the diaphragm, on chest radiography and fluoroscopy, as well as on computed tomography and magnetic resonance imaging.

Dynamic airway evaluation with volume CT: initial experience.

Purpose: The purpose of the study was to prospectively establish the use of a novel multidetector computed tomography unit (MDCT) with 320 x 0.5 detector rows for the evaluation of tracheomalacia by using a dynamic expiratory low-dose technique.

Methods: Six adult patients (5 men, 1 woman; mean age, 53.

Lung cancer screening using low-dose computed tomography in at-risk individuals: the Toronto experience.

Objective: The Department of Medical Imaging at the University Health Network in Toronto is performing a lung cancer screening study, utilizing low-dose computed tomography (LDCT) as the modality. Baseline and annual repeat results are reported on the first 3352 participants, enrolled between June 2003 and May 2007.

Methods: Enrollment was limited to those aged 50 years or older, with a smoking history of at least 10 pack-years, no previous cancer and general good health.

Computer-aided detection for the identification of pulmonary nodules in pediatric oncology patients: initial experience.

Background: Computer-aided detection (CAD) has been shown to increase the sensitivity for detection of pulmonary nodules in adults. This study reports initial findings utilizing a CAD system for the detection of pediatric pulmonary nodules.

Objective: To assess the performance of CAD and pediatric radiologists in the detection of pediatric pulmonary nodules.

Screening for malignant pleural mesothelioma and lung cancer in individuals with a history of asbestos exposure.

Purpose: We established a screening program for prior asbestos workers using low-dose computed tomography (LDCT).

Methods: Between March 2005 and October 2007 we performed LDCT (50-60 mA, 120 kV, 1.25 mm) in 516 asbestos-exposed individuals.

The use of computer-aided detection for the assessment of pulmonary arterial filling defects at computed tomographic angiography.

Purpose: To validate a computer-aided detection (CAD) tool for the detection of pulmonary arterial filling defects at computed tomographic pulmonary angiography (CTPA) and to assess its benefit for readers of different levels of experience.

Methods: One hundred consecutive CTPA studies were retrospectively evaluated by a chest radiologist for presence of emboli, serving as the reference standard. Subsequently, examinations were analyzed using commercially available second-generation CAD software (ImageChecker CT, version 2.

Computed tomography perfusion using first pass methods for lung nodule characterization.

Objective: To evaluate computed tomography (CT) perfusion using first pass methods for lung nodule characterization.

Methods: Fifty-seven patients with 51 malignant and 6 benign nodules underwent first-pass, dynamic contrast-enhanced-CT (50 mL, 3-5 mL/s.).

Radiology resident interpretation of on-call CT pulmonary angiograms.

Rationale And Objectives: To evaluate the interpretation of computed tomographic pulmonary angiograms performed outside of regular reporting hours, comparing the initial interpretation by the radiology resident to the attending radiologist.

Materials And Methods: Records for 840 consecutive computed tomographic pulmonary angiograms (CTPA) performed outside of regular reporting hours at two tertiary referral centers from January 1, 2004-December 31, 2005 were reviewed. The preliminary interpretation by the on-call radiology resident was compared to the subsequent final report issued by a subspecialty trained chest radiologist.

Lung cancer screening with low-dose computed tomography: Canadian experience.

Introduction: In 2003, the Department of Medical Imaging at the University Health Network in Toronto, Ontario, became the first Canadian site of the Intemational Early Lung Cancer Action Program (I-ELCAP). We report the results from the first 1000 baseline studies.

Methods: Between June 2003 and December 2005, we enrolled 1000 high-risk smokers (that is, smokers with a history of at least 10 pack years, or the equivalent of one pack daily for 10 years), aged 55 years or older.

Prognostic significance of the radiographic pattern of disease in patients with severe acute respiratory syndrome.

Objective: This study was performed to evaluate the prognostic significance of the radiographic pattern of disease in probable cases of severe acute respiratory syndrome (SARS).

Materials And Methods: A retrospective review of 439 radiographs was performed for 51 patients with a final diagnosis of probable SARS. Forty-nine patients were followed up for a mean interval of 23 days (range, 2-63 days).

Selection of acute ischemic stroke patients for intra-arterial thrombolysis with pro-urokinase by using ASPECTS.

Background: Previous studies have suggested that baseline computed tomographic (CT) scans might be a useful tool for selecting particular ischemic stroke patients who would benefit from thrombolysis. The aim of the present study was to assess whether the baseline CT scan, assessed with the Alberta Stroke Program Early CT Score (ASPECTS), could identify ischemic stroke patients who might particularly benefit from intra-arterial thrombolysis of middle cerebral artery occlusion.

Methods: Baseline and 24-hour follow-up CT scans of patients randomized within 6 hours of symptoms to intra-arterial thrombolysis with recombinant pro-urokinase or control in the PROACT-II study were retrospectively scored by using ASPECTS.

Safety and feasibility of a CT protocol for acute stroke: combined CT, CT angiography, and CT perfusion imaging in 53 consecutive patients.

By combining non-contrast-enhanced CT imaging, CT perfusion imaging, and cranial-to-chest CT angiography (CTA), the entire cerebrovascular axis can be imaged during acute stroke. To our knowledge, the safety and feasibility of this technique have not been previously reported. In a consecutive series of 53 patients with suspected acute stroke, renal failure was not observed.

Computed tomographic findings in patients undergoing intra-arterial thrombolysis for acute ischemic stroke due to middle cerebral artery occlusion: results from the PROACT II trial.

Background And Purpose: The purpose of this study was to evaluate the role of noncontrast CT in the selection of patients to receive thrombolytic therapy for acute ischemic stroke and to predict radiological and clinical outcomes.

Methods: One hundred eighty patients with stroke due to middle cerebral artery (MCA) occlusion were randomized 2:1 within 6 hours of onset to receive intra-arterial recombinant prourokinase plus intravenous heparin or intravenous heparin only. Four hundred fifty-four CT examinations were digitized to calculate early infarct changes, infarct volumes, and hemorrhagic changes among the 162 patients treated as randomized (108 recombinant prourokinase-treated patients and 54 control patients).