-
European Radiology Feb 2017To determine the presence and morphology of subsolid pulmonary nodules (SSNs) in a non-screening setting and relate them to clinical and patient characteristics.
OBJECTIVES
To determine the presence and morphology of subsolid pulmonary nodules (SSNs) in a non-screening setting and relate them to clinical and patient characteristics.
METHODS
A total of 16,890 reports of clinically obtained chest CT (06/2011 to 11/2014, single-centre) were searched describing an SSN. Subjects with a visually confirmed SSN and at least two thin-slice CTs were included. Nodule volumes were measured. Progression was defined as volume increase exceeding the software interscan variation. Nodule morphology, location, and patient characteristics were evaluated.
RESULTS
Fifteen transient and 74 persistent SSNs were included (median follow-up 19.6 [8.3-36.8] months). Subjects with an SSN were slightly older than those without (62 vs. 58 years; p = 0.01), but no gender predilection was found. SSNs were mostly located in the upper lobes. Women showed significantly more often persistent lesions than men (94 % vs. 69 %; p = 0.002). Part-solid lesions were larger (1638 vs. 383 mm; p < 0.001) and more often progressive (68 % vs. 38 %; p = 0.02), compared to pure ground-glass nodules. Progressive SSNs were rare under the age of 50 years. Logistic regression analysis did not identify additional nodule parameters of future progression, apart from part-solid nature.
CONCLUSIONS
This study confirms previously reported characteristics of SSNs and associated factors in a European, routine clinical population.
KEY POINTS
• SSNs in women are significantly more often persistent compared to men. • SSN persistence is not associated with age or prior malignancy. • The majority of (persistent) SSNs are located in the upper lung lobes. • A part-solid nature is associated with future nodule growth. • Progressive solitary SSNs are rare under the age of 50 years.
Topics: Age Factors; Aged; Europe; Female; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Sex Factors; Solitary Pulmonary Nodule; Tomography, X-Ray Computed
PubMed: 27255399
DOI: 10.1007/s00330-016-4429-9 -
Diagnostic and Interventional Imaging Apr 2021
Topics: Early Detection of Cancer; Humans; Lung; Lung Neoplasms; Multiple Pulmonary Nodules; Radiographic Image Interpretation, Computer-Assisted; Radiologists; Solitary Pulmonary Nodule
PubMed: 33642220
DOI: 10.1016/j.diii.2021.02.004 -
Der Radiologe Feb 2022Chest X‑ray is one of the most frequent examinations in radiology and its interpretation is considered part of the basic knowledge of every radiologist. (Review)
Review
BACKGROUND
Chest X‑ray is one of the most frequent examinations in radiology and its interpretation is considered part of the basic knowledge of every radiologist.
OBJECTIVES
The purpose of this article is to recognize common signs and patterns of pneumonias and pseudonodules in chest X‑rays and to provide a diagnostic guideline for young radiologists.
MATERIALS AND METHODS
Recent studies and data are analyzed and an overview of the most common signs and patterns in chest X‑ray is provided.
RESULTS
Knowledge about common signs and patterns in chest X‑ray is helpful in the diagnosis of pneumonias and can be indicative for the cause of an infection. However, those signs are often unspecific and should, therefore, be set in clinical content. Computed tomography is becoming increasingly important in the primary diagnosis of pulmonary lesions because of its much higher sensitivity.
CONCLUSION
Chest X‑ray is still the first-line modality in the diagnosis of pneumonia and pulmonary nodules; however, radiologists should be aware of its limitations.
Topics: Humans; Lung; Lung Neoplasms; Multiple Pulmonary Nodules; Pneumonia; Radiography, Thoracic; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 35020003
DOI: 10.1007/s00117-021-00953-w -
Respirology (Carlton, Vic.) May 2022
Topics: Bronchoscopy; Humans; Lung; Lung Neoplasms; Solitary Pulmonary Nodule
PubMed: 35315172
DOI: 10.1111/resp.14250 -
Computational and Mathematical Methods... 2022Lung nodules are the main lesions of the lung, and conditions of the lung can be directly displayed through CT images. Due to the limited pixel number of lung nodules in...
Lung nodules are the main lesions of the lung, and conditions of the lung can be directly displayed through CT images. Due to the limited pixel number of lung nodules in the lung, doctors have the risk of missed detection and false detection in the detection process. In order to reduce doctors' work intensity and assist doctors to make accurate diagnosis, a lung nodule segmentation and recognition algorithm is proposed by simulating doctors' diagnosis process with computer intelligent methods. Firstly, the attention mechanism model is established to focus on the region of lung parenchyma. Then, a pyramid network of bidirectional enhancement features is established from multiple body positions to extract lung nodules. Finally, the morphological and imaging features of lung nodules are calculated, and then, the signs of lung nodules can be identified. The experiments show that the algorithm conforms to the doctor's diagnosis process, focuses the region of interest step by step, and achieves good results in lung nodule segmentation and recognition.
Topics: Algorithms; Humans; Lung; Lung Neoplasms; Radiographic Image Interpretation, Computer-Assisted; Tomography, X-Ray Computed
PubMed: 35371290
DOI: 10.1155/2022/5112867 -
Medicina 2022Diffuse idiopathic hyperplasia of neuroendocrine cells is an extremely rare condition. It is a widespread proliferation of neuroendocrine cells, without primary process...
Diffuse idiopathic hyperplasia of neuroendocrine cells is an extremely rare condition. It is a widespread proliferation of neuroendocrine cells, without primary process justifying it. Usually symptomatic in most cases, asymptomatic forms are also described. We describe three cases, 2 women and 1 man, average age 63 years (range 57-71) who presented with bilateral pulmonary nodules. Average follow-up: one year and three months (range 1 month-3 years). The two women had cough, progressive dyspnea and airflow obstruction in the spirometry, and were treated for asthma and chronic obstructive pulmonary disease, respectively, with little relief of symptoms. The remaining patient consulted for diagnosis of pulmonary nodules of unknown cause and a suspicion of metastatic disease. The biopsies diagnostic were: in the first and third case diffuse idiopathic hyperplasia of euroendocrine cells - tumorlets; and in the second case typical carcinoid tumor and diffuse idiopathic hyperplasia of neuroendocrine cells. The first patient controlled the symptoms with maximum bronchodilator therapy. The second patient presented immediate postoperative severe bronchospasm and respiratory failure which required ventilatory assistance, atrial fibrillation with rapid ventricular response (both signs interpreted as paraneoplastic syndromes) which responded favorably to the empirical octeotride management. The third patient is asymptomatic and in control. The diffuse neuroendocrine cell hyperplasia represents a diagnostic challenge because of the rarity of this condition. Lung biopsy in patients with multiple, bilateral pulmonary nodules and clinical history of cough and progressive dyspnea should be considered to confirm this entity.
Topics: Aged; Carcinoid Tumor; Female; Humans; Hyperplasia; Lung; Lung Neoplasms; Male; Middle Aged; Multiple Pulmonary Nodules; Neuroendocrine Cells; Neuroendocrine Tumors
PubMed: 35037876
DOI: No ID Found -
BioMed Research International 2022Helical CT plain scan has high spatial and area resolution, which is beneficial to the extraction of CT features of pulmonary nodules, and is of great significance for...
Helical CT plain scan has high spatial and area resolution, which is beneficial to the extraction of CT features of pulmonary nodules, and is of great significance for the diagnosis and differential diagnosis of pulmonary diseases. In order to deeply study the role of visual sensor image algorithm in CT image, this paper adopts clinical simulation method, data fusion method, and image acquisition method to collect images, analyze CT image features, and simplify the algorithm and create a CT model that can better diagnose secondary tuberculosis and lung cancer. We selected 45 patients with lung disease in this group, with an average age of 38 years. At the same time, the consistency analysis results of the diameter and plain CT value data of the five groups of cases measured by two observers are between 0.82 and 0.88, which has a good consistency. We could find that the nodule diameters of the five groups of cases were different ( =16.99, < 0.01), and the difference was statistically significant ( < 0.06), indicating that our data are not only accurate but also very reliable. ROC was used to analyze the precise value of CT values in the pulmonary tuberculosis group and lung cancer group, intrapulmonary lymph node group, and pulmonary hamartoma group to determine the cutoff value. The results showed that the AUC values of the pulmonary tuberculosis group and the lung cancer group were 0.788, and the middle was the largest, indicating that the values were guaranteed. The basic realization starts with visual sensor technology and designs a clinical model that can more accurately identify CT images and differential diagnosis.
Topics: Adult; Diagnosis, Differential; Humans; Lung; Lung Diseases; Lung Neoplasms; Solitary Pulmonary Nodule; Tomography, Spiral Computed; Tuberculosis, Pulmonary
PubMed: 36046451
DOI: 10.1155/2022/7514898 -
Journal of Medical Radiation Sciences Jun 2021Early detection of malignant pulmonary nodules through screening has been shown to reduce lung cancer-related mortality by 20%. However, perceptual and cognitive factors... (Review)
Review
INTRODUCTION
Early detection of malignant pulmonary nodules through screening has been shown to reduce lung cancer-related mortality by 20%. However, perceptual and cognitive factors that affect nodule detection are poorly understood. This review examines the cognitive and visual processes of various observers, with a particular focus on radiologists, during lung nodule detection.
METHODS
Four databases (Medline, Embase, Scopus and PubMed) were searched to extract studies on eye-tracking in pulmonary nodule detection. Studies were included if they used eye-tracking to assess the search and detection of lung nodules in computed tomography or 2D radiographic imaging. Data were charted according to identified themes and synthesised using a thematic narrative approach.
RESULTS
The literature search yielded 25 articles and five themes were discovered: 1 - functional visual field and satisfaction of search, 2 - expert search patterns, 3 - error classification through dwell time, 4 - the impact of the viewing environment and 5 - the effect of prevalence expectation on search. Functional visual field reduced to 2.7° in 3D imaging compared to 5° in 2D radiographs. Although greater visual coverage improved nodule detection, incomplete search was not responsible for missed nodules. Most radiological errors during lung nodule detection were decision-making errors (30%-45%). Dwell times associated with false-positive (FP) decisions informed feedback systems to improve diagnosis. Interruptions did not influence diagnostic performance; however, it increased viewing time by 8% and produced a 23.1% search continuation accuracy. Comparative scanning was found to increase the detection of low contrast nodules. Prevalence expectation did not directly affect diagnostic accuracy; however, decision-making time increased by 2.32 seconds with high prevalence expectations.
CONCLUSION
Visual and cognitive factors influence pulmonary nodule detection. Insights gained from eye-tracking can inform advancements in lung screening. Further exploration of eye-tracking in lung screening, particularly with low-dose computed tomography (LDCT), will benefit the future of lung cancer screening.
Topics: Cognition; Early Detection of Cancer; Humans; Lung; Lung Neoplasms; Solitary Pulmonary Nodule
PubMed: 33556995
DOI: 10.1002/jmrs.456 -
Multimedia Manual of Cardiothoracic... Jun 2020Anatomic segmentectomy is a form of sublobar resection that can be both diagnostic and therapeutic in the context of an indeterminate pulmonary nodule, suspected...
Anatomic segmentectomy is a form of sublobar resection that can be both diagnostic and therapeutic in the context of an indeterminate pulmonary nodule, suspected metastasis, or small peripheral cancer. This video tutorial demonstrates our technique for an apicoposterior anatomical segmentectomy performed by video-assisted thoracoscopy, using two ports, for resection of an undiagnosed pulmonary nodule. The steps performed by the surgical team are shown, and we pay particular attention to the recognition of vascular anatomy. To perform this type of sublobar resection, it is necessary to understand both the normal anatomy and the different variants. This tutorial will provide a thorough grounding in the anatomy of the apicoposterior segment as well as demonstrating the optimal approach for this type of resection.
Topics: Diagnosis, Differential; Hamartoma; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Neoplasms, Multiple Primary; Pneumonectomy; Solitary Pulmonary Nodule; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 32597052
DOI: 10.1510/mmcts.2020.037 -
Danish Medical Journal Nov 2012Pulmonary nodules are of high clinical importance, as they may prove to be an early manifestation of lung cancer. Pulmonary nodules are small, focal opacities that may... (Review)
Review
Pulmonary nodules are of high clinical importance, as they may prove to be an early manifestation of lung cancer. Pulmonary nodules are small, focal opacities that may be solitary or multiple. A solitary pulmonary nodule (SPN) is a single, small (= 30 mm in diameter) radiographic opacity. Larger opacities are called masses and are often malignant. As imaging techniques improve and more nodules are detected, the optimal management of SPNs remains unclear. Current strategies include tissue sampling or CT follow-up. The aim of this PhD was to examine current non-invasive methods used to characterise pulmonary nodules and masses in patients with suspected lung cancer and to stage NSCLC. In doing so, this PhD helps to validate the existing methods used to diagnose and stage lung cancer correctly and, hopefully, aids in the development of new methods. In the first study, 213 participants with pulmonary nodules on CT were examined with an additional HRCT. In this study, it was concluded that HRCT of a solitary pulmonary nodule, assessed using attenuation and morphological criteria is a fast, widely available and effective method for diagnosing lung cancer correctly, and especially for ruling out cancer. In the second study, 168 patients with pulmonary lesions on CT were examined with an additional F-18-FDG PET/CT. It was concluded that when used early in the work-up of the lesions, CT raised the prevalence of lung cancer in the population to the point at which further diagnostic imaging examination could be considered redundant. Standard contrast-enhanced CT seems better suited to identify patients with lung cancer than to rule out cancer. Finally, the overall diagnostic accuracy as well as the classification probabilities and predictive values of the two modalities were not significantly different. The reproducibility of the above results was substantial. In the third study, 59 patients with pulmonary nodules or masses on chest radiography were examined with an additional DCE-CT. A qualitative as well as a quantitative assessment method was examined. It was concluded that although the results of the qualitative approach were acceptable in their own right, they did not, however, add anything new when compared to standard CT. The quantitative approach gave rise to several conclusions concerning DCE-CT analysis as well as the use of DCE-CT in the diagnosis of lung cancer: First, that DCE-CT is best analysed using logarithmic scale data transformation; second, that irrespective of the ROI method applied, it was not possible to discriminate malignant and benign; and, third, that the lack of reproducibility should be addressed. These results show us that DCE-CT is currently not a clinically feasible method for analysing pulmonary lesions. This does not necessarily mean that DCE-CT should be abandoned, but it does signify the need for further development of the current DCE-CT methods. Finally, in the fourth study, 114 patients with NSCLC were examined with both a CT and with an additional F-18-FDG PET/CT. It was concluded that there was no significant difference in the overall diagnostic accuracy of the two modalities when imaging the mediastinum for staging purposes. In conclusion, although standard contrast-enhanced CT has brought us far in the characterisation of pulmonary nodules and masses, the last decade has seen a constant move away from strictly anatomical approaches to imaging, towards more functional or analytical approaches. The desire is, of course, to be able to safely distinguish between malignant and benign nodules without the need for invasive procedures.
Topics: Area Under Curve; Cohort Studies; Early Detection of Cancer; False Positive Reactions; Fluorodeoxyglucose F18; Humans; Lung; Lung Neoplasms; Neoplasm Metastasis; Perfusion Imaging; Positron-Emission Tomography; ROC Curve; Radiography, Thoracic; Reproducibility of Results; Tomography, X-Ray Computed; Ultrasonography, Interventional
PubMed: 23171752
DOI: No ID Found