Advanced Technologies for Imaging and Visualization of the Tracheobronchial Tree: From Computed Tomography and MRI to Virtual Endoscopy.

Advanced imaging plays an increasingly important role in the evaluation of the trachea. The use of computed tomography (CT) has evolved to include multi-planar reconstructions and 3-dimensional reconstructions for the evaluation of benign and malignant disease of the trachea. Advanced applications of CT include dynamic expiratory imaging for the diagnosis of tracheomalacia and virtual endoscopy as a complementary or alternative examination to flexible bronchoscopy.

Low-dose computed tomography (LDCT) in workers previously exposed to asbestos: detection of parenchymal lung disease.

Objectives: To evaluate the lungs of asymptomatic asbestos-exposed workers who were screened for lung cancer and mesothelioma using low-dose computed tomography (LDCT) for parenchymal abnormalities.

Methods: Three hundred fifteen baseline LDCT studies of the chest of participants with at least 20 years' exposure to asbestos or presence of pleural plaques before enrollment on chest radiographs were analyzed.

Results: Three hundred fifteen subjects were studied.

Extending monetary values to broader performance and impact measures: Transportation applications and lessons for other fields.

This article examines recent progress at assigning monetary values to what are normally considered "hard to quantify" benefits of transportation projects. It focuses on three types of impacts - environmental quality, health and wider economic impacts - to examine how transportation project evaluation methods have evolved in recent years and how they compare to methods used for evaluation of non-transportation programs. Examples of recent practice are provided to show how transport agencies are continuing to refine performance measures to include broader impacts in project evaluation.

Tree-in-bud pattern on thoracic CT due to pulmonary intravascular metastases from pancreatic adenocarcinoma.

We report a case of pulmonary intravascular metastases from pancreatic adenocarcinoma manifesting as tree-in-bud pattern on thoracic computed tomography. Although infectious bronchiolitis is the most common cause of tree-in-bud pattern, this case emphasizes that the differential diagnoses include pulmonary intravascular metastases, particularly in patients with extrapulmonary adenocarcinomas.

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.

Imaging of lung transplantation: review.

OBJECTIVE Lung transplantation is an established treatment for end-stage pulmonary disease. Complications of lung transplantation include airway stenosis and dehiscence, reimplantation response, acute rejection, infection, posttransplantation lymphoproliferative disorder, and bronchiolitis obliterans syndrome. The incidence of graft rejection and airway anastomosis experienced in the early years of lung transplantation have been significantly reduced by advances in immunosuppression and surgical techniques.

CT-guided percutaneous fine-needle aspiration biopsy of pulmonary nodules measuring 10 mm or less.

Aim: To determine the value of computed tomography (CT)-guided fine-needle aspiration biopsy (FNAB) of small pulmonary nodules measuring 10 mm or less.

Material And Methods: CT-guided FNABs of 55 nodules, measuring 10mm or less, were performed between January 2003 and February 2006. A coaxial technique was used, with an outer 19 G Bard Truguide needle and inner 22 G disposable Greene biopsy needle.

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.

Pictorial review of the many faces of bronchioloalveolar cell carcinoma.

Bronchioloalveolar cell carcinoma (BAC) has a varied appearance on CT that often leads to an incorrect or delayed diagnosis. The purpose of this pictorial review is to define common CT characteristics that are specific to BAC. A retrospective review was undertaken of 20 CT scans of pathologically proven cases of BAC; tumours were categorized as focal or diffuse, single or multiple, and infiltrative or well defined.

Reversed halo sign in lymphomatoid granulomatosis.

Lymphomatoid granulomatosis is a rare lymphoproliferative disorder which affects extranodal sites, most commonly lung. Radiologically, it typically presents with multiple nodular opacities that may wax and wane. The reversed halo sign has previously been reported in cryptogenic organizing pneumonia and more recently in South American blastomycosis.

Epithelioid angiosarcoma of the lung: a rare late complication of Lucite plombage.

Epithelioid angiosarcoma of the lung is a rare late complication of Lucite plombage treatment of pulmonary tuberculosis. We describe the clinical, radiological and pathologic findings of a case of epithelioid angiosarcoma of the lung presenting with persistent haemoptysis who had undergone remote lung collapse therapy with Lucite plombage.

Bronchiolitis obliterans syndrome in lung transplant recipients: can thin-section CT findings predict disease before its clinical appearance?

Purpose: To determine whether there are thin-section computed tomographic (CT) features that predict bronchiolitis obliterans syndrome (BOS) in lung transplant recipients before the clinical appearance and during the early stages of the disease.

Materials And Methods: Two hundred ninety-eight thin-section CT scans obtained in 26 lung transplant recipients who did (study group) and 26 lung transplant recipients who did not (control group) develop BOS were reviewed for the presence of mosaic perfusion, bronchiectasis, bronchial wall thickening, and air trapping. BOS was defined by using the recently revised definition of the International Society for Heart and Lung Transplantation.

Radiologic pattern of disease in patients with severe acute respiratory syndrome: the Toronto experience.

Severe acute respiratory syndrome (SARS) is a transmissible febrile respiratory illness caused by a recently discovered coronavirus. Various patterns of disease progression may be observed that have different implications for the prognosis in those affected by SARS. The appearance of the lungs on chest radiographs of patients with this condition may be normal or may include focal airspace opacity or multifocal or diffuse opacities.

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).

Fibrosis of the upper lobes: a newly identified late-onset complication after lung transplantation?

Objective: The objective of this study was to describe the high-resolution CT findings of a previously unreported rare complication observed in seven patients who had undergone lung transplantation.

Conclusion: High-resolution CT findings suggestive of gradual progressive lung fibrosis, predominantly in the upper lobes with relative sparing of the basal segments, may represent a specific and rare type of rejection of still unknown cause in lung transplant recipients.

Mycobacterium avium complex lung disease in immunocompetent patients: radiography-CT correlation.

This study aimed to describe and correlate the chest radiography and CT findings of Mycobacterium avium complex (MAC) lung disease in immunocompetent patients. 26 patients fulfilled The American Thoracic Society criteria for MAC lung disease and underwent chest radiography and CT within 6 weeks of positive cultures. All abnormalities and predominant lobar involvement were recorded and abnormalities on chest radiography were correlated with those on CT.

Correlation of chest radiographic findings with biopsy-proven acute lung rejection.

The purpose of this study was to determine the chest radiographic findings of acute rejection and the accuracy of chest radiography in making this diagnosis in patients undergoing lung transplantation. For each of 100 transbronchial biopsies performed on 25 lung transplant recipients (single lung in three, double lung in 22), chest radiographs obtained within 24 hours before the biopsy were reviewed retrospectively without knowledge of clinical or biopsy information. Transbronchial biopsy revealed 42 instances of acute rejection in 17 patients and 58 instances of no acute rejection (normal, n = 43; other processes, n = 15).

Mycobacterium xenopi pulmonary infection: evaluation with CT.

Purpose: Our goal was to describe the CT appearances of Mycobacterium xenopi pulmonary infection.

Method: A retrospective study period of 75 months was used. Eight immunocompetent patients fulfilled the American Thoracic Society criteria for M.

Cystic change (pseudocavitation) associated with bronchioloalveolar carcinoma: a report of four patients.

Cavitation in bronchioloalveolar carcinoma is uncommon, but apparent radiologic cavitation may be produced by other causes of abnormal air collections in and around the tumor. We report four patients whose plain films and computed tomography scans were interpreted as showing cavitary masses. Paracicatricial emphysema, fibrosis with honeycombing, and localized bronchiectasis were present pathologically to explain the abnormal air collections.

Congenital bronchopulmonary diseases in adults: CT findings.

Congenital lung disease is divided into two types: lesions that arise from the primitive foregut (i.e., bronchopulmonary malformations) and lesions that originate in the pulmonary vasculature.

Pulmonary manifestations of coccidioidomycosis.

Pulmonary coccidioidomycosis is a fungal disease seen primarily in the southwestern United States and Mexico. However, with the advent of mass travel it is being seen increasingly in countries outside the zone where it is endemic. Pulmonary coccidioidomycosis, which has a high infectivity, is acquired by inhalation of fungal arthrospores.

Mediastinal invasion by bronchogenic carcinoma: CT signs.

Purpose: To determine the accuracy of computed tomographic (CT) signs in assessment of direct mediastinal invasion by primary bronchogenic carcinoma.

Materials And Methods: In 90 patients with primary bronchogenic carcinoma who underwent CT with thoracic surgical staging and thoracotomy, the pathologic and CT findings in 14 mediastinal structures were compared retrospectively. The degree of contact of the primary tumor with each structure and whether the structure was distorted or contained intraluminal tumor were recorded.

Bronchioloalveolar carcinoma and the air bronchogram sign: a new pathologic explanation.

Bronchioloalveolar carcinoma (BAC) is one of the few lung tumors known to demonstrate the air bronchogram sign. Production of this valuable radiologic sign by this tumor has been ascribed to an "alveolar" filling process in which tumor grows along alveolar walls with preservation of the architecture and secretes copious amounts of mucus. Thus, aerated bronchi are surrounded by alveoli that are filled with mucus and tumor.