Efficacy of bronchoscopic thermal vapor ablation and lobar fissure completeness in patients with heterogeneous emphysema.

Background: Bronchoscopic thermal vapor ablation (BTVA) ablates emphysematous tissue through a localized inflammatory response followed by contractive fibrosis and tissue shrinkage leading to lung volume reduction that should not be influenced by collateral ventilation.

Objectives: To determine the correlation of clinical data from a trial of BTVA with fissure integrity visually assessed by computed tomography (CT).

Methods: We conducted a single-arm study of patients with upper lobe-predominant emphysema (n = 44).

[Dyspnea, cough and tachycardia].

Pneumopericardium is known as a rare complication following cardiothoracic surgery or intravenous line placement. Baseline examination including chest x-ray may lead to diagnosis. To prevent cardiac tamponade, pericardiotomy or adaequate pericardial drainage is crucial.

[Moving pleural mass].

A 74-year-old man with bronchial carcinoma underwent radiofrequency ablation (RFA) due to poor pulmonary function. Therefore non-enhanced computed tomography (CT) of the chest was performed on two subsequent days. Besides the tumor, the CT scans showed a moving calcification in the pleural cavity.

Detection and size of pulmonary lesions: how accurate is MRI? A prospective comparison of CT and MRI.

Background: Although CT is the modality of choice for morphological lung imaging, an increasing proportion of chest imaging is performed by MRI due to the utilization of whole-body MRI. Therefore, the diagnostic performance of MRI in reliably detecting pulmonary lesions should be established.

Purpose: To investigate the detection rate of pulmonary lesions by MRI that can be expected in a clinical setting and to assess the accuracy of lesion measurement by MRI compared to CT.

ECIL-3 classical diagnostic procedures for the diagnosis of invasive fungal diseases in patients with leukaemia.

Invasive fungal diseases (IFDs) continue to cause considerable morbidity and mortality in patients with haematological malignancy. Diagnosis of IFD is difficult, with the sensitivity of the gold standard tests (culture and histopathology) often reported to be low, which may at least in part be due to sub-optimal sampling or subsequent handling in the routine microbiological laboratory. Therefore, a working group of the European Conference in Infections in Leukaemia was convened in 2009 with the task of reviewing the classical diagnostic procedures and providing recommendations for their optimal use.

[Corynebacterium pseudodiphtheriticum causing severe pneumonia in secondary immunoglobulin deficiency].

Background: Corynebacterium pseudodiphtheriticum is of increasing importance because of the rising number of immunocompromised patients. Pneumonia, but also endocarditis, urinary tract infections or keratitis can be caused by this bacteria in case of immunosuppression. Taking corynebacterium pseudodiphtheriticum into consideration as causitive agent provides for a fast onset of targeted antibiotic therapy.

Diagnosis of invasive fungal infections in hematology and oncology--guidelines from the Infectious Diseases Working Party in Haematology and Oncology of the German Society for Haematology and Oncology (AGIHO).

Invasive fungal infections (IFIs) are a primary cause of morbidity and mortality in patients with hematological malignancies. Establishing a definite diagnosis of IFI in immunocompromised patients is particularly challenging and time consuming, but delayed initiation of antifungal treatment increases mortality. The limited overall outcome has led to the strategy of initiating either 'empirical' or 'preemptive' antifungal therapy before the final diagnosis.

Phase II dose escalation study of caspofungin for invasive Aspergillosis.

Our objective was to evaluate the maximum tolerated dose of caspofungin for invasive aspergillosis (IA). The safety and pharmacokinetics of escalating dosages of caspofungin were investigated in IA. Eight patients each received caspofungin 70, 100, 150, or 200 mg once a day (QD).

Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation.

Antifungal prophylaxis for allogeneic haematopoietic stem-cell transplant (alloHCT) recipients should prevent invasive mould and yeast infections (IFIs) and be well tolerated. This prospective, randomized, open-label, multicentre study compared the efficacy and safety of voriconazole (234 patients) versus itraconazole (255 patients) in alloHCT recipients. The primary composite endpoint, success of prophylaxis, incorporated ability to tolerate study drug for ≥ 100 d (with ≤ 14 d interruption) with survival to day 180 without proven/probable IFI.

Tumor volume measurement errors of RECIST studied with ellipsoids.

Purpose: The authors investigate the extent to which Response Evaluation Criteria in Solid Tumors (RECIST) can predict tumor volumes in ideal geometric settings and using clinical data.

Methods: The authors consider a hierarchy of models including uniaxial ellipsoids, general ellipsoids, and composites of ellipsoids, using both analytical and numerical techniques to show how well RECIST can predict tumor volumes in each case. The models have certain features that are compared to clinical data.

MRI in lung cancer: a pictorial essay.

Imaging studies play a critical role in the diagnosis and staging of lung cancer. CT and 18-fluorodeoxyglucose positron emission tomography CT (PET/CT) are widely and routinely used for staging and assessment of treatment response. Many radiologists still use MRI only for the assessment of superior sulcus tumours, and in cases where invasion of the spinal cord canal is suspected.

[Diagnostic value of transthoracic ultrasound compared to chest radiography in the detection of a post-interventional pneumothorax].

Purpose: Chest radiography is standard for the diagnosis of a pneumothorax. However, also ultrasound of the chest has considerable value in the detection of a pneumothorax. A typical sonographic feature is the lack of the lung gliding sign.

Lung sequestration: a rare cause for pulmonary symptoms in adulthood.

Background: Lung sequestration is a rare congenital pulmonary disorder and is usually diagnosed in children with recurrent pulmonary infections. Lung sequestrations are not commonly found to be a cause of respiratory symptoms in adults.

Objectives: It was the aim of this study to show that pulmonary sequestration is rare in advanced age and can be accompanied by severe pulmonary symptoms.

[Dyspnea in a 45-year-old man with liver cirrhosis].

History And Admission Findings: During evaluation for a liver transplantation in a 45-year-old man with alcoholic liver he complained of exertional dyspnea. He had grade 3 chronic obstructive pulmonary disease (COPD) after nicotine abuse of 50 pack-years. One and a half years earlier the patient had been treated for tuberculosis.

[Lung cancer staging].

Lung cancer is the third most frequent new cancer diagnosis in Germany. An elaborate clinical diagnosis is essential for successful therapy planning. The necessary examinations are defined in the current S3 guideline on lung cancer diagnosis and therapy.

[Diagnostic evaluation of lung cancer].

Lung cancer is the fourth rate cause of death in Germany. Symptoms are mainly unspecific and develop lately. Clinical history and examination come in first place of the diagnostic procedure.

The role of diagnostic imaging in the management of invasive fungal diseases--report from an interactive workshop.

Invasive fungal diseases are a significant cause of morbidity and mortality in the growing population of immunosuppressed patients. Appropriate early therapy is associated with a reduction in mortality, but relies on rapid diagnosis. Microbiological investigations are often a problem as it can take several days for a culture to mature.

Importance of pulmonary imaging diagnostics in the management of febrile neutropenic patients.

Early detection and characterisation of a pulmonary focus is a major goal in febrile neutropenic patients. Thus, an intensive interdisciplinary co-operation between radiologists and haemato-oncologists on a patient basis, as well as on a department basis is essential to develop a differential diagnosis. The radiologist can contribute much to a differential diagnosis if information about the patient's disease, status and medication is made available.

Polymorphisms in the apoptotic pathway gene BCL-2 and survival in small cell lung cancer.

Introduction: We investigated the single-nucleotide polymorphism C-938A in the apoptotic gene BCL-2 to assess the potential impact as a genetic marker for response to chemotherapy and outcome prediction in small cell lung cancer (SCLC) patients. Such a marker might help optimize lung cancer treatment in a tailored approach.

Methods: DNA derived from peripheral blood lymphocytes of 188 Caucasian SCLC patients treated at the Thoraxklinik Heidelberg was genotyped.

Computed tomography and magnetic resonance imaging in cystic fibrosis lung disease.

Computed tomography (CT) is the current "gold standard" for assessment of lung morphology and is so far the most reliable imaging modality for monitoring cystic fibrosis (CF) lung disease. CT has a much higher radiation exposure than chest x-ray. The cumulative radiation dose for life-long repeated CT scans has limited its use for CF patients as their life expectancy increases.

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.