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pulmonary nodule guidelines

A Skiada, C Lass-Floerl, N Klimko, A Ibrahim, E Roilides, G Petrikkos
The diagnosis and treatment of mucormycosis are challenging. The incidence of the disease seems to be increasing. Hematological malignancies are the most common underlying disease in countries with high income and uncontrolled diabetes in developing countries. Clinical approach to diagnosis lacks sensitivity and specificity. Radiologically, multiple (≥10) nodules and pleural effusion are reportedly associated with pulmonary mucormycosis. Another finding on computerized tomography (CT) scan, which seems to indicate the presence of mucormycosis, is the reverse halo sign...
April 1, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
B Julie He, Brian J Malm, Michelle Carino, Mehran M Sadeghi
BACKGROUND: Myocardial perfusion imaging (MPI) often employs attenuation-correction computed tomography (CTAC) to reduce attenuation artifacts and improve specificity. While there is no specific guideline on how they should be reported, incidental noncardiac findings identified on these scans may be clinically significant. The prevalence of these findings in veterans is not currently known. In addition, variability in reporting these findings may depend on the interpreting physician's specialty...
February 28, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Takaomi Hanaoka, Makoto Kurai, Mitsuyo Okada, Satoshi Ishizone, Fumitoshi Karasawa, Akira Iizuka
BACKGROUNDS: Chest low-dose CT screening (LDCTS) has been finding unprecedented numbers of peripheral non-small cell lung cancers (NSCLC) at an early stage and increased the number of patients with surgical indication. It is important to explore the influence of preoperative watchful-waiting time (WWT) on surgical outcomes. Objective is to clarify relationship between WWT and surgical outcomes of LDCTS-finding NSCLC from the view point of treatment delay. METHODS: Total 283 cases of NSCLC, found by LDCTS and consecutively resected, were surveyed for preoperative WWT and surgical outcomes...
February 28, 2018: World Journal of Surgery
Alvin So, Owen Pointon, Richard Hodgson, John Burgess
CONTEXT: Bronchopulmonary neuroendocrine tumours (bpNETs) and thymic carcinoid (ThC) are features of Multiple Endocrine Neoplasia Type 1 (MEN 1) and surveillance guidelines recommend periodic thoracic imaging. The optimal thoracic imaging modality and screening frequency remains uncertain as does the prognosis of small lung nodules when identified. OBJECTIVES: To evaluate fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) for identification and prognostic assessment of thoracic lesions in MEN 1...
February 15, 2018: Clinical Endocrinology
Timothy F Mott
Low-dose computed tomography (CT) scan is the only modality currently considered acceptable for lung cancer screening in high-risk populations. Screening recommendations vary. The US Preventive Services Task Force recommends annual low-dose CT scan to screen high-risk patients (ie, asymptomatic patients ages 55 to 80 years with a 30 pack-year smoking history and who currently smoke or have quit within the previous 15 years). The American Academy of Family Physicians recommends a shared decision-making discussion between the clinician and patient regarding the benefits and potential harms of screening...
January 2018: FP Essentials
Amelia W Maiga, Stephen A Deppen, Pierre P Massion, Carol Callaway-Lane, Rhonda Pinkerman, Robert S Dittus, Eric S Lambright, Jonathan C Nesbitt, Eric L Grogan
Importance: Clinical guidelines recommend that clinicians estimate the probability of malignancy for patients with indeterminate pulmonary nodules (IPNs) larger than 8 mm. Adherence to these guidelines is unknown. Objectives: To determine whether clinicians document the probability of malignancy in high-risk IPNs and to compare these quantitative or qualitative predictions with the validated Mayo Clinic Model. Design, Setting, and Participants: Single-institution, retrospective cohort study of patients from a tertiary care Department of Veterans Affairs hospital from January 1, 2003, through December 31, 2015...
December 20, 2017: JAMA Surgery
Sebastian E Beyer, Brady J McKee, Shawn M Regis, Andrea B McKee, Sebastian Flacke, Gilan El Saadawi, Christoph Wald
Background: Our aim was to train a natural language processing (NLP) algorithm to capture imaging characteristics of lung nodules reported in a structured CT report and suggest the applicable Lung-RADS™ (LR) category. Methods: Our study included structured, clinical reports of consecutive CT lung screening (CTLS) exams performed from 08/2014 to 08/2015 at an ACR accredited Lung Cancer Screening Center. All patients screened were at high-risk for lung cancer according to the NCCN Guidelines® ...
September 2017: Journal of Thoracic Disease
Hyungjin Kim, Chang Min Park, Eui Jin Hwang, Su Yeon Ahn, Jin Mo Goo
OBJECTIVES: We hypothesized that semi-automatic diameter measurements would improve the accuracy and reproducibility in discriminating preinvasive lesions and minimally invasive adenocarcinomas from invasive pulmonary adenocarcinomas appearing as subsolid nodules (SSNs) and increase the reproducibility in classifying SSNs. METHODS: Two readers independently performed semi-automatic and manual measurements of the diameters of 102 SSNs and their solid portions. Diagnostic performance in predicting invasive adenocarcinoma based on diameters was tested using logistic regression analysis with subsequent receiver operating characteristic curves...
December 1, 2017: European Radiology
Jan-Erik Scholtz, Michael T Lu, Sandeep Hedgire, Nina M Meyersohn, George R Oliveira, Anand M Prabhakar, Rajiv Gupta, Mannudeep K Kalra, Jo-Anne O Shepard, Udo Hoffmann, Brian B Ghoshhajra
BACKGROUND: Pulmonary nodules (PN) are frequently detected incidentally during coronary computed tomography angiography (CTA). We evaluated whether the 2017 Fleischner Society guidelines may result in a decrease of follow-up testing of incidental PN as compared to prior guidelines in patients undergoing coronary CTA. METHODS: We conducted a retrospective study of a registry of emergency department patients who underwent coronary CTA for acute coronary syndrome assessment between 2012 and 2017...
January 2018: Journal of Cardiovascular Computed Tomography
Matheus Zanon, Gabriel Sartori Pacini, Vinicius Valério Silveiro de Souza, Edson Marchiori, Gustavo Souza Portes Meirelles, Gilberto Szarf, Felipe Soares Torres, Bruno Hochhegger
OBJECTIVES: To assess whether an additional chest ultra-low-dose CT scan to the coronary CT angiography protocol can be used for lung cancer screening among patients with suspected coronary artery disease. METHODS: 175 patients underwent coronary CT angiography for assessment of coronary artery disease, additionally undergoing ultra-low-dose CT screening to early diagnosis of lung cancer in the same scanner (80kVp and 15mAs). Patients presenting pulmonary nodules were followed-up for two years, repeating low-dose CTs in intervals of 3, 6, or 12 months based on nodule size and growth rate in accordance with National Comprehensive Cancer Network guidelines...
December 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Sean P Stoy, Lauren Rosen, Jeffrey Mueller, Septimiu Murgu
BACKGROUND: Programmed death-ligand 1 (PD-L1) expression testing is recommended by guidelines for patients with advanced non-small cell lung cancer (NSCLC). The primary objective of the current study was to determine the success rate of PD-L1 testing from cytology cell block samples obtained by bronchoscopic needle aspiration. The secondary objective was the assessment of the difference in specimen adequacy acquired via needles of different gauges. METHODS: Patients with NSCLC who underwent bronchoscopic needle aspirations for which PD-L1 testing was requested between November 1, 2016, and February 6, 2017, were included in the current analysis...
February 2018: Cancer Cytopathology
Matthew Triplette, Erin K Kross, Blake A Mann, Joann G Elmore, Christopher G Slatore, Shahida Shahrir, Perrin E Romine, Paul D Frederick, Kristina Crothers
RATIONALE: Lung cancer screening (LCS) has a mortality benefit to high-risk smokers, but implementation remains suboptimal. Providers represent the key entry point to screening, and an understanding of provider perspectives on lung cancer screening is necessary to improve referral and overall implementation. OBJECTIVES: The objective of this study was to understand knowledge, beliefs, attitudes, barriers, and facilitators to screening in a diverse group of referring pulmonologists and primary care providers...
September 21, 2017: Annals of the American Thoracic Society
Evangelos Koliakos, Theodoros Thomopoulos, Ziad Abbassi, Christophe Duc, Michel Christodoulou
BACKGROUND Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disorder that is characterized by diffuse hyperplasia of bronchiolar and bronchial pulmonary neuroendocrine cells. In this condition, when no other pathological pulmonary condition is detected, DIPNECH is considered to be an idiopathic lung disease. DIPNECH is a rare condition that can be difficult to distinguish from other forms of reactive pulmonary neuroendocrine cell hyperplasia (NECH). We present a case of DIPNECH and describe the approach to diagnosis of this rare condition...
September 11, 2017: American Journal of Case Reports
Peng Huang, Seyoun Park, Rongkai Yan, Junghoon Lee, Linda C Chu, Cheng T Lin, Amira Hussien, Joshua Rathmell, Brett Thomas, Chen Chen, Russell Hales, David S Ettinger, Malcolm Brock, Ping Hu, Elliot K Fishman, Edward Gabrielson, Stephen Lam
Purpose To test whether computer-aided diagnosis (CAD) approaches can increase the positive predictive value (PPV) and reduce the false-positive rate in lung cancer screening for small nodules compared with human reading by thoracic radiologists. Materials and Methods A matched case-control sample of low-dose computed tomography (CT) studies in 186 participants with 4-20-mm noncalcified lung nodules who underwent biopsy in the National Lung Screening Trial (NLST) was selected. Variables used for matching were age, sex, smoking status, chronic obstructive pulmonary disease status, body mass index, study year of the positive screening test, and screening results...
September 5, 2017: Radiology
Anand Devaraj, Bram van Ginneken, Arjun Nair, David Baldwin
A consistent feature of many lung nodule management guidelines is the recommendation to evaluate nodule size by using diameter measurements and electronic calipers. Traditionally, the use of nodule volumetry applications has primarily been reserved for certain lung cancer screening trials rather than clinical practice. However, even before the first nodule management guidelines were published more than a decade ago, research has been ongoing into the use of nodule volumetry as a means of measuring nodule size, and this research has accelerated in recent years...
September 2017: Radiology
Jonathan M Iaccarino, Renda Soylemez Wiener
No abstract text is available yet for this article.
August 2017: Chest
Nasir Ali, Muhammad Atif Mansha, Ahmed Nadeem Abbasi, Bilal Mazhar Qureshi
Squamous cell carcinoma of uterine cervix is potentially a curable disease; however, many patients treated with definitive chemoradiotherapy develop distant metastases, with few of them having a single metastatic deposit. There are no guidelines for the treatment of patients with oligometastatic cervical cancer.We present a case of a patient with International Federation of Gynecology and Obstetrics (FIGO) Stage IIB squamous cell carcinoma of uterine cervix. She was successfully treated with concurrent chemoradiotherapy with definitive intent...
August 2, 2017: BMJ Case Reports
Richard Green, Mark T Macmillan, Theofano Tikka, Lorna Bruce, John T Murchison, Iain J Nixon
BACKGROUND: The management of pulmonary nodules is challenging; unfortunately, little is known about the incidence and significance of pulmonary nodules in patients with head and neck cancer. METHODS: A review was conducted of 400 consecutive patients with head and neck cancer. Imaging was reviewed to identify the incidence of nodules and patient, tumor, and radiological factors associated with the risk of malignancy. RESULTS: Nodules were found in 58% of patients, with a malignant rate of 6%...
July 25, 2017: Head & Neck
Chunquan Liu, Yong Cui
In the past 20 years, with the popularization of low-dose computed tomography (CT) screening, detection rate of lung nodules increased significantly. However, there are still many difficulties in making qualitative diagnosis for pulmonary nodules. The Lung nodule is a clinical common lung disease. The early onset for malignant nodules is quite hidden. Without early intervention, the course of disease can develop rapidly. For malignant nodules, the exacerbation can be very severe. Besides, the therapeutic effect can be unsatisfactory...
July 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Matthew Walker, Joy Borgaonkar, Daria Manos
PURPOSE: Technological advancements and the ever-increasing use of computed tomography (CT) have greatly increased the detection of incidental findings, including tiny pulmonary nodules. The management of many "incidentalomas" is significantly influenced by a patient's history of cancer. The study aim is to determine if CT requisitions include prior history of malignancy. METHODS: Requisitions for chest CTs performed at our adult tertiary care hospital during April 2012 were compared to a cancer history questionnaire, administered to patients at the time of CT scan...
November 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
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