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pulmonary nodule guidelines

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https://www.readbyqxmd.com/read/28331829/the-pulmonary-nodule-discovered-by-pneumonia-a-case-report
#1
Dong-Mei Yuan, Jian-Ya Zhang, Yan-Wen Yao, Hui-Ming Sun, Guan-Nan Wu, E-Hong Cao, Luca Bertolaccini, Tang-Feng Lv, Yong Song
The number of patients diagnosed with pulmonary nodules increased as more patients with high risk of lung cancer choose low-dose computed tomography (CT) scans for the screening of cancer. Clinicians might get two questions from the patients: what is the definite diagnosis of the nodule? What should we do? We have already got many guidelines trying to solve these problems. There are also several prediction models for pulmonary nodules. However, guidelines are not suitable for all types of patients, and the reality of patients is more complicated...
February 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28331823/small-pulmonary-nodules-in-baseline-and-incidence-screening-rounds-of-low-dose-ct-lung-cancer-screening
#2
REVIEW
Joan E Walter, Marjolein A Heuvelmans, Matthijs Oudkerk
Currently, lung cancer screening by low-dose computed tomography (LDCT) is widely recommended for high-risk individuals by US guidelines, but there still is an ongoing debate concerning respective recommendations for European countries. Nevertheless, the available data regarding pulmonary nodules released by lung cancer screening studies could improve future screening guidelines, as well as the clinical practice of incidentally detected pulmonary nodules on routine CT scans. Most lung cancer screening trials present results for baseline and incidence screening rounds separately, clustering pulmonary nodules initially found at baseline screening and newly detected pulmonary nodules after baseline screening together...
February 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28331822/risk-assessment-in-relation-to-the-detection-of-small-pulmonary-nodules
#3
REVIEW
John K Field, Michael W Marcus, Matthijs Oudkerk
The National Lung Cancer Screening trial (NLST) demonstrated that individuals assigned to the LDCT screening arm had a 20% lower mortality than those who were assigned to the conventional chest radiography. The NLST was thoroughly analyzed by the US Preventive Task Force on CT Screening and they recommended that lung cancer screening should be implemented. A number of other countries have also recommended implementation, whilst others are awaiting the outcome of the NELSON Trial. However, recommendations for the management of CT screen detected nodules have only recently had any clarity...
February 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28293773/malignancy-risk-estimation-of-screen-detected-nodules-at-baseline-ct-comparison-of-the-pancan-model-lung-rads-and-nccn-guidelines
#4
Sarah J van Riel, Francesco Ciompi, Colin Jacobs, Mathilde M Winkler Wille, Ernst Th Scholten, Matiullah Naqibullah, Stephen Lam, Mathias Prokop, Cornelia Schaefer-Prokop, Bram van Ginneken
OBJECTIVES: To compare the PanCan model, Lung-RADS and the 1.2016 National Comprehensive Cancer Network (NCCN) guidelines for discriminating malignant from benign pulmonary nodules on baseline screening CT scans and the impact diameter measurement methods have on performances. METHODS: From the Danish Lung Cancer Screening Trial database, 64 CTs with malignant nodules and 549 baseline CTs with benign nodules were included. Performance of the systems was evaluated applying the system's original diameter definitions: D(longest-C) (PanCan), D(meanAxial) (NCCN), both obtained from axial sections, and D(mean3D) (Lung-RADS)...
March 14, 2017: European Radiology
https://www.readbyqxmd.com/read/28278389/clinical-equipoise-and-shared-decision-making-in-pulmonary-nodule-management-a-survey-of-american-thoracic-society-clinicians
#5
Jonathan M Iaccarino, James Simmons, Michael K Gould, Christopher G Slatore, Steven Woloshin, Lisa M Schwartz, Renda Soylemez Wiener
RATIONALE: Guidelines for pulmonary nodule evaluation suggest a variety of strategies, reflecting the lack of high-quality evidence demonstrating the superiority of any one approach. It is unclear whether clinicians agree that multiple management options are appropriate at different levels of risk and whether this impacts their decision-making approaches with patients. OBJECTIVES: To assess clinicians' perceptions of the appropriateness of various diagnostic strategies, approach to decision-making, and perceived clinical equipoise in pulmonary nodule evaluation...
March 9, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28240562/guidelines-for-management-of-incidental-pulmonary-nodules-detected-on-ct-images-from-the-fleischner-society-2017
#6
Heber MacMahon, David P Naidich, Jin Mo Goo, Kyung Soo Lee, Ann N C Leung, John R Mayo, Atul C Mehta, Yoshiharu Ohno, Charles A Powell, Mathias Prokop, Geoffrey D Rubin, Cornelia M Schaefer-Prokop, William D Travis, Paul E Van Schil, Alexander A Bankier
The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences...
February 23, 2017: Radiology
https://www.readbyqxmd.com/read/28223153/evaluations-of-implementation-at-early-adopting-lung-cancer-screening-programs-lessons-learned
#7
Yaron B Gesthalter, Elisa Koppelman, Rendelle Bolton, Christopher G Slatore, Sue H Yoon, Hilary C Cain, Nichole T Tanner, David H Au, Jack A Clark, Renda Soylemez Wiener
BACKGROUND: Guidelines recommend lung cancer screening and it is currently being adopted nationwide. The American College of Chest Physicians advises inclusion of specific programmatic components to ensure high-quality screening. However, little is known about how lung cancer screening has been implemented in practice. We sought to evaluate the experience of early-adopting programs, characterize barriers faced, and identify strategies to achieve successful implementation. METHODS: We performed qualitative evaluations of lung cancer screening implementation at three Veterans Health Administration facilities, conducting semi-structured interviews with key staff (n=29)...
February 18, 2017: Chest
https://www.readbyqxmd.com/read/28222720/birt-hogg-dub%C3%A3-syndrome-a-literature-review-and-case-study-of-a-chinese-woman-presenting-a-novel-flcn-mutation
#8
Shengyu Hao, Fei Long, Fenglan Sun, Teng Liu, Daowei Li, Shujuan Jiang
BACKGROUND: The Birt-Hogg-Dubé (BHD) syndrome is a very rare autosomal dominant form of genodermatosis caused by germline mutations in the folliculin (FLCN) gene, which is mapped to the p11.2 region in chromosome 17. BHD commonly presents cutaneous fibrofolliculomas, pulmonary cysts, renal cell carcinoma, and recurrent pneumothoraxes. The disease is easily ignored or misdiagnosed as pneumothorax, pulmonary lymphangiomyomatosis (LAM), or emphysema. Follow-up and guidelines for managing recurrent pneumothoraxes in these patients are lacking...
February 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28135352/implementation-of-lung-cancer-screening-in-the-veterans-health-administration
#9
Linda S Kinsinger, Charles Anderson, Jane Kim, Martha Larson, Stephanie H Chan, Heather A King, Kathryn L Rice, Christopher G Slatore, Nichole T Tanner, Kathleen Pittman, Robert J Monte, Rebecca B McNeil, Janet M Grubber, Michael J Kelley, Dawn Provenzale, Santanu K Datta, Nina S Sperber, Lottie K Barnes, David H Abbott, Kellie J Sims, Richard L Whitley, R Ryanne Wu, George L Jackson
Importance: The US Preventive Services Task Force recommends annual lung cancer screening (LCS) with low-dose computed tomography for current and former heavy smokers aged 55 to 80 years. There is little published experience regarding implementing this recommendation in clinical practice. Objectives: To describe organizational- and patient-level experiences with implementing an LCS program in selected Veterans Health Administration (VHA) hospitals and to estimate the number of VHA patients who may be candidates for LCS...
March 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28115167/physician-assessment-of-pre-test-probability-of-malignancy-and-adherence-with-guidelines-for-pulmonary-nodule-evaluation
#10
Nichole T Tanner, Alexander Porter, Michael Gould, Xiao-Jun Li, Anil Vachani, Gerard A Silvestri
BACKGROUND: The annual incidence of pulmonary nodules is estimated at 1.57 million. Guidelines recommend utilizing an initial assessment of nodule probability for malignancy (pCA). A previous study found that despite this recommendation, physicians did not follow guidelines. METHODS: Physician (n= 337) and two previously validated risk model assessment of cancer pre-test probability were evaluated for performance in 337 patients with pulmonary nodules based on final diagnosis and compared...
January 20, 2017: Chest
https://www.readbyqxmd.com/read/27904816/an-unusual-presentation-of-nocardiosis-in-an-allogeneic-transplant-recipient
#11
Uroosa Ibrahim, Amina Saqib, Farhan Mohammad, Terenig Terjanian
Nocardiosis is a rare cause of opportunistic infection post hematopoietic stem cell transplant (HSCT) occurring in about 0.3% of patients. The risk factors include delayed immune reconstitution, prolonged neutropenia, and graft-versus-host disease. The most common site of infection is the lung, followed by the brain and the skin. Concomitant pulmonary and central nervous system (CNS) nocardiosis is an extremely rare entity as presented in our case. We present the case of a 72-year-old male at 137 days post transplant presenting with complaints of headache and slurred speech...
October 17, 2016: Curēus
https://www.readbyqxmd.com/read/27793580/addition-of-the-fleischner-society-guidelines-to-chest-ct-examination-interpretive-reports-improves-adherence-to-recommended-follow-up-care-for-incidental-pulmonary-nodules
#12
Jennifer S McDonald, Chi Wan Koo, Darin White, Thomas E Hartman, Claire E Bender, Anne-Marie G Sykes
RATIONALE AND OBJECTIVES: The study aimed to determine whether the addition of the Fleischner Society guidelines to chest computed tomography (CT) reports identifying incidental pulmonary nodules affects follow-up care. PATIENTS AND METHODS: Beginning in 2008, a template containing the Fleischner Society guidelines was added at the interpreting radiologist's discretion to chest CT reports describing incidental solid pulmonary nodules at our institution. The records of all medical centers in Olmsted county were used to capture the complete medical history of local patients >35 years old diagnosed with a pulmonary nodule from April 1, 2008 to October 1, 2011...
March 2017: Academic Radiology
https://www.readbyqxmd.com/read/27743211/evaluation-of-a-flexible-nota-rgd-kit-solution-using-gallium-68-from-different-68-ge-68-ga-generators-pharmacokinetics-and-biodistribution-in-nonhuman-primates-and-demonstration-of-solitary-pulmonary-nodule-imaging-in-humans
#13
Thomas Ebenhan, Isabel Schoeman, Daniel D Rossouw, Anne Grobler, Biljana Marjanovic-Painter, Judith Wagener, Hendrik G Kruger, Mike M Sathekge, Jan Rijn Zeevaart
PURPOSE: Radiopharmaceuticals containing the motive tripeptide arginyl-glycyl-asparatic acid (RGD) are known to target ανβ3 integrins during tumor angiogenesis. A more generic kit radiolabeling procedure accommodating Ga-68 from different generators was developed for NOTA-RGD and evaluated for its versatile use and safety in subsequent in vivo applications. The [(68)Ga]NOTA-RGD kit was further verified for its expected biodistribution and pharmacokinetics in nonhuman primates and its clinical sensitivity to detect solitary pulmonary nodules (SPN) in cancer patients...
October 14, 2016: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/27631108/multicenter-external-validation-of-two-malignancy-risk-prediction-models-in-patients-undergoing-18f-fdg-pet-for-solitary-pulmonary-nodule-evaluation
#14
Simone Perandini, G A Soardi, A R Larici, A Del Ciello, G Rizzardi, A Solazzo, L Mancino, F Zeraj, M Bernhart, M Signorini, M Motton, S Montemezzi
OBJECTIVES: To achieve multicentre external validation of the Herder and Bayesian Inference Malignancy Calculator (BIMC) models. METHODS: Two hundred and fifty-nine solitary pulmonary nodules (SPNs) collected from four major hospitals which underwent 18-FDG-PET characterization were included in this multicentre retrospective study. The Herder model was tested on all available lesions (group A). A subgroup of 180 SPNs (group B) was used to provide unbiased comparison between the Herder and BIMC models...
September 15, 2016: European Radiology
https://www.readbyqxmd.com/read/27620199/resected-small-cell-lung-cancer-time-for-more
#15
COMMENT
Alissa S Marr, Chi Zhang, Apar Kishor Ganti
Small cell lung cancer (SCLC) often presents with either regional or systemic metastases, but approximately 4% of patients present with a solitary pulmonary nodule. Surgical resection can be an option for these patients and is endorsed by the National Comprehensive Cancer Network (NCCN) guidelines. There are no prospective randomized clinical trials evaluating the role of adjuvant systemic therapy in these resected SCLC patients. A recent National Cancer Database analysis found that the receipt of adjuvant chemotherapy alone [hazard ratio (HR), 0...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27606078/incidental-nodule-management-should-there-be-a-formal-process
#16
REVIEW
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
https://www.readbyqxmd.com/read/27439324/multi-institutional-evaluation-of-digital-tomosynthesis-dual-energy-radiography-and-conventional-chest-radiography-for-the-detection-and-management-of-pulmonary-nodules
#17
James T Dobbins, H Page McAdams, John M Sabol, Dev P Chakraborty, Ella A Kazerooni, Gautham P Reddy, Jenny Vikgren, Magnus Båth
Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device...
January 2017: Radiology
https://www.readbyqxmd.com/read/27393550/solitary-pulmonary-nodules-due-to-non-tuberculous-mycobacteriosis-among-28-resected-cases
#18
N Ose, H Maeda, Y Takeuchi, Y Susaki, Y Kobori, S Taniguchi, R Maekura
BACKGROUND: In some patients, non-tuberculous mycobacteria (NTM) infections manifest in solitary nodules (solitary nodular [SN] type) generally caused by Mycobacterium avium complex (MAC). In patients treated using surgical resection, the American Thoracic Society guidelines state that postoperative chemotherapy is not necessary in the absence of lesions, although there have been a few reports of such cases. METHODS: Twenty-eight patients diagnosed with NTM who underwent solitary pulmonary nodule resection at Toneyama Hospital, Osaka, Japan, between January 2000 and October 2012 were enrolled...
August 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27270762/ct-dose-reduction-approaches-strategies-and-results-from-a-province-wide-program-in-quebec
#19
Moulay Ali Nassiri, Manon Rouleau, Philippe Després
Many studies have shown a statistically significant increase of life-time risk of radiation-induced cancer from CT examinations. In this context, in Canada, the Quebec's provincial clinical center of expertise in radiation safety (CECR) has led a province-wide tour of 180 CT installations in order to: (i) evaluate the technical and functional performance of CT scanners, (ii) evaluate and improve radiation safety practices and (iii) initiate, with local teams, a CT dose optimization process. The CT tour consisted of a two day visit of CT installations by a CECR multidisciplinary team of medical physicists, engineers and medical imaging technologists (MITs) carried out in close collaboration with local teams composed of MITs, radiologists, physicists, engineers and managers...
June 6, 2016: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/27210231/a-radiologist-s-primer-on-bundles-and-care-episodes
#20
David Seidenwurm, Frank James Lexa
Bundled or episode payments are among the most heavily emphasized approaches to aligning incentives and promoting care coordination, efficiency, and accountability in health care redesign. Bundled or episode payments price a market basket of services for an entire episode of care with both a clearly defined trigger and termination. Because the radiologist is "ancillary" in many bundles, the specialty is often unaware of the phenomenon. This is likely to change rapidly. Radiology is pivotal in high-prevalence, high-impact care areas such as low back pain and stroke that are focuses of widely used system performance metrics...
September 2016: Journal of the American College of Radiology: JACR
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