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Indeterminate pulmonary

Faming Jiang, Weiwei Huang, Ye Wang, Panwen Tian, Xuerong Chen, Zongan Liang
BACKGROUND: Smear-negative pulmonary tuberculosis (PTB) is common and difficult to diagnose. In this study, we investigated the diagnostic value of nucleic acid amplification testing and sequencing combined with acid-fast bacteria (AFB) staining of needle biopsy lung tissues for patients with suspected smear-negative PTB. METHODS: Patients with suspected smear-negative PTB who underwent percutaneous transthoracic needle biopsy between May 1, 2012, and June 30, 2015, were enrolled in this retrospective study...
2016: PloS One
Jie Ma, Maria A Guarnera, Wenxian Zhou, HongBin Fang, Feng Jiang
Lung cancer early detection by low-dose computed tomography (LDCT) can reduce the mortality. However, LDCT increases the number of indeterminate pulmonary nodules (PNs), whereas 95% of the PNs are ultimately false positives. Modalities for specifically distinguishing between malignant and benign PNs are urgently needed. We previously identified a panel of peripheral blood mononucleated cell (PBMC)-miRNA (miRs-19b-3p and -29b-3p) biomarkers for lung cancer. This study aimed to evaluate efficacy of integrating biomarkers and clinical and radiological characteristics of smokers for differentiating malignant from benign PNs...
November 24, 2016: Translational Oncology
Sohaib Munir, Sahil Koppikar, Wilma M Hopman, Alexander H Boag, Gurmohan Dhillon, Shafeequr Rahman Salahudeen, Robert L Nolan, Justin Flood
PURPOSE: We aimed to determine the diagnostic yield for cancer and diagnostic accuracy of computed tomography-guided core needle biopsy (CTNB) in subsolid pulmonary lesions. MATERIALS AND METHODS: Fifty-two biopsies of 52 subsolid lesions in 51 patients were identified from a database of 912 lung biopsies and analyzed for the diagnostic yield for cancer and diagnostic accuracy of core CTNB diagnosis as well as complication rates. RESULTS: When indeterminate biopsy results were included in the analysis, the diagnostic yield for cancer was 80...
November 18, 2016: Journal of Thoracic Imaging
Esther Pompe, Eva M van Rikxoort, Onno M Mets, Jean-Paul Charbonnier, Jan-Martin Kuhnigk, Harry J de Koning, Matthijs Oudkerk, Rozemarijn Vliegenthart, Pieter Zanen, Jan-Willem J Lammers, Bram van Ginneken, Pim A de Jong, Firdaus A A Mohamed Hoesein
OBJECTIVES: Airway wall thickness (AWT) is affected by changes in lung volume. This study evaluated whether correcting AWT on computed tomography (CT) for differences in inspiration level improves measurement agreement, reliability, and power to detect changes over time. METHODS: Participants of the Dutch-Belgian lung cancer screening trial who underwent 3-month repeat CT for an indeterminate pulmonary nodule were included. AWT on CT was calculated by the square root of the wall area at a theoretical airway with an internal perimeter of 10mm (Pi10)...
November 2016: European Journal of Radiology
Igor Barjaktarevic, Doug Arenberg, Brandon S Grimes, Kathleen Ruchalski, Denise R Aberle
Each year, more than 1 million persons worldwide are found to have a lung nodule that carries a risk of being malignant. In reality, the vast majority of lung nodules are benign, whether identified by screening or incidentally. The consequences of delaying or missing the diagnosis of lung cancer can be substantial, as can be the consequences of invasive procedures on patients with benign lung nodules. The challenge for the clinician caring for these patients is to differentiate between benign and malignant nodules with the least harm possible...
October 2016: Seminars in Respiratory and Critical Care Medicine
Zihao Yan, Ivan K Ip, Ali S Raja, Anurag Gupta, Joshua M Kosowsky, Ramin Khorasani
Purpose To determine the frequency of, and yield after, provider overrides of evidence-based clinical decision support (CDS) for ordering computed tomographic (CT) pulmonary angiography in the emergency department (ED). Materials and Methods This HIPAA-compliant, institutional review board-approved study was performed at a tertiary care, academic medical center ED with approximately 60 000 annual visits and included all patients who were suspected of having pulmonary embolism (PE) and who underwent CT pulmonary angiography between January 1, 2011, and August 31, 2013...
September 30, 2016: Radiology
Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi
The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computer-aided diagnosis (CAD) vs human judgment alone in characterizing solitary pulmonary nodules (SPNs) at computed tomography (CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator (BIMC) model predictions...
August 28, 2016: World Journal of Radiology
Binghu Jiang, Huaijun Liu, Dan Zhou
OBJECTIVE: This study aims to perform a metaanalysis to assess the diagnostic performance and clinical utility of the dynamic magnetic resonance imaging (MRI) in discrimination of benign and malignant pulmonary nodules. MATERIALS AND METHODS: We searched PubMed, EMBASE, and Cochrane Library from January 1995 to May 2015 for studies evaluating the diagnostic accuracy of dynamic MRI in discriminating benign from malignant pulmonary nodules. Methodological quality was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2...
August 26, 2016: Clinical Imaging
Pierre P Massion, Graham F Healey, Laura J Peek, Lynn Fredericks, Herb F Sewell, Andrea Murray, John F R Robertson
INTRODUCTION: The incidence of pulmonary nodules is increasing with the movement toward screening for lung cancer by low-dose computed tomography. Given the large number of benign nodules detected by computed tomography, an adjunctive test capable of distinguishing malignant from benign nodules would benefit practitioners. The ability of the EarlyCDT-Lung blood test (Oncimmune Ltd., Nottingham, United Kingdom) to make this distinction by measuring autoantibodies to seven tumor-associated antigens was evaluated in a prospective registry...
September 8, 2016: Journal of Thoracic Oncology
Agustín Ruiz-González, Laia Utrillo, Silvia Bielsa, Miquel Falguera, José M Porcel
Background. The clinical diagnosis of pneumonia is sometimes difficult since chest radiographs are often indeterminate. In this study, we aimed to assess whether serum C-reactive protein (CRP) could assist in identifying patients with pneumonia. Methods. For one winter, all consecutive patients with acute respiratory symptoms admitted to the emergency ward of a single center were prospectively enrolled. In addition to chest radiographs, basic laboratory tests, and microbiology, serum levels of CRP were measured at entry...
2016: Journal of Biomarkers
Sonali Sethi, Scott Parrish
Indeterminate pulmonary nodules are commonly encountered and often result in costly and invasive procedures that eventually turn out to be unnecessary. Current prediction models can help to estimate the pretest probability of cancer and assist in determining a strategy of observation with serial imaging for a low pretest probability of cancer, and a more aggressive approach for those patients with a high pretest probability. However, the majority of patients will have an intermediate pretest probability which becomes complex...
July 2016: Journal of Thoracic Disease
Sara C Auld, Scott H Lee, Eleanor S Click, Roque Miramontes, Cheryl L Day, Neel R Gandhi, Charles M Heilig
RATIONALE: The IFN-γ release assays and tuberculin skin tests are used to support the diagnosis of both latent and active tuberculosis. However, we previously demonstrated that a negative tuberculin test in active tuberculosis is associated with disseminated disease and death. It is unknown whether the same associations exist for IFN-γ release assays. OBJECTIVES: To determine the association between these tests and site of tuberculosis and death among persons with active tuberculosis...
December 2016: Annals of the American Thoracic Society
Piotr Widlak, Monika Pietrowska, Joanna Polanska, Michal Marczyk, Malgorzata Ros-Mazurczyk, Rafał Dziadziuszko, Jacek Jassem, Witold Rzyman
OBJECTIVES: Circulating molecular biomarkers of lung cancer may allow the pre-selection of candidates for computed tomography screening or increase its efficacy. We aimed to identify features of serum mass profile distinguishing individuals with early lung cancer from healthy participants of the lung cancer screening program. METHODS: Blood samples were collected during a low-dose computed tomography (LD-CT) screening program performed by one institution (Medical University of Gdansk, Poland)...
September 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Zachary Ries, C Parker Gibbs, Mark T Scarborough, Benjamin J Miller
BACKGROUND: Pulmonary surveillance protocols following sarcoma excision based on clinical evidence and outcomes are limited in current literature. The purpose of this study was to determine the method, frequency, and reasoning behind pulmonary surveillance strategies in patients treated for sarcoma among members of the Musculoskeletal Tumor Society (MSTS). METHODS: SurveyMonkey, an online survey tool, was used to create and distribute a questionnaire to 211 members of the MSTS in 2011...
2016: Iowa Orthopaedic Journal
Matthew B Schabath, Pierre P Massion, Zachary J Thompson, Steven A Eschrich, Yoganand Balagurunathan, Dmitry Goldof, Denise R Aberle, Robert J Gillies
Lung cancer screening identifies cancers with heterogeneous behaviors. Some lung cancers will be identified among patients who had prior negative CT screens and upon follow-up scans develop a de novo nodule that was determined to be cancerous. Other lung cancers will be identified among patients who had one or more prior stable positive scans that were not determined to be lung cancer (indeterminate pulmonary nodules), but in follow-up scans was diagnosed with an incidence lung cancer. Using data from the CT arm of the National Lung Screening Trial, this analysis investigated differences in patient characteristics and survival endpoints between prevalence-, interval-, and screen-detected lung cancers, characterized based on sequence of screening results...
2016: PloS One
Zhe Shi, Chang Chen, Sen Jiang, Gening Jiang
Although uniportal video-assisted thoracic surgery (VATS) is becoming more popular, it's still very challenging to conduct a wedge resection of small pulmonary ground-glass opacities (GGOs), especially deeply situated subpleural GGOs, via uniportal VATS. We successfully performed thirteen uniportal VATS wedge resections through an approach that combines radiologically guided microcoil localization with palpation, and we encountered no complications related to the new approach. Based on our experience, a combination of CT-guided microcoil localization with palpation in uniportal VATS for deeply situated subpleural GGOs is a safe and effective procedure for accurate diag¬nosis and resection of indeterminate GGOs...
July 2016: Journal of Thoracic Disease
M Pilar Laguna
No abstract text is available yet for this article.
August 2016: Journal of Urology
Ju Hee Yeo, Lifeng Zhou, Remy Lim
INTRODUCTION: This study assessed the rate of indeterminate CT pulmonary angiogram (CTPA) in a general hospital and evaluated potential contributing factors to an indeterminate CTPA and patients' eventual clinical outcome. METHODS: Four hundred and three consecutive CTPA and their finalised report from 01/08/2012 to 05/12/2012 at Waitemata DHB were reviewed retrospectively. Patient demographics, scan parameters and average Hounsfield unit (HU) of the main pulmonary trunk (PT) and likely cause of indeterminate study were documented...
July 28, 2016: Journal of Medical Imaging and Radiation Oncology
Richa Kumari, Rajneesh Tripathi, Alok Prakash Pandey, Tuhina Banerjee, Pallavi Sinha, Shampa Anupurba
BACKGROUND: Drug resistance in tuberculosis is a major public health challenge in developing countries. The limited data available on drug resistance in extra pulmonary tuberculosis stimulated us to design our study on anti-tuberculosis drug resistance pattern in cases of extra pulmonary tuberculosis in a tertiary referral hospital of North India. We performed Geno Type MTBDRplus assay in comparison with conventional drug susceptibility testing by proportion method to study the mutation patterns in rpoB, katG and inhA genes...
2016: PloS One
Nagmi R Qureshi, Andrew Shah, Rosemary J Eaton, Ken Miles, Fiona J Gilbert
Incidental indeterminate solitary pulmonary nodules (SPN) that measure less than 3 cm in size are an increasingly common finding on computed tomography (CT) worldwide. Once identified there are a number of imaging strategies that can be performed to help with nodule characterization. These include interval CT, dynamic contrast enhanced computed tomography (DCE-CT), (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG-PET-CT). To date the most cost effective and efficient non-invasive test or combination of tests for optimal nodule characterization has yet to be determined...
July 18, 2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
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