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Ackman JB, Chung JH, Walker CM, Bang TJ, Carter BW, Hobbs SB, Kandathil A, Lanuti M, Madan R, Moore WH, Shah SD, Verde F, Kanne JP. ACR Appropriateness Criteria® Imaging of Mediastinal Masses. J Am Coll Radiol 2021; 18:S37-S51. [PMID: 33958117 DOI: 10.1016/j.jacr.2021.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/25/2022]
Abstract
Mediastinal masses can present with symptoms, signs, and syndromes or incidentally. Selecting the appropriate diagnostic imaging study for mediastinal mass evaluation requires awareness of the strengths and weaknesses of the various imaging modalities with regard to tissue characterization, soft tissue contrast, and surveillance. This publication expounds on the differences between chest radiography, CT, PET/CT, ultrasound, and MRI in terms of their ability to decipher and surveil mediastinal masses. Making the optimal imaging choice can yield diagnostic specificity, avert unnecessary biopsy and surgery, guide the interventionist when necessary, and serve as a means of surveillance for probably benign, but indeterminate mediastinal masses. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Jeanne B Ackman
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| | | | | | - Tami J Bang
- University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Brett W Carter
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen B Hobbs
- University of Kentucky, Lexington, Kentucky, Councilor, ACR Kentucky Chapter, Vice Chair, Informatics and Integrated Clinical Operations, University of Kentucky
| | | | - Michael Lanuti
- Massachusetts General Hospital, Boston, Massachusetts, The Society of Thoracic Surgeons, Director, Thoracic Oncology, Division of Thoracic Surgery, Massachusetts General Hospital
| | - Rachna Madan
- Brigham & Women's Hospital, Boston, Massachusetts
| | - William H Moore
- New York University Langone Medical Center, New York, New York
| | - Sachin D Shah
- University of Chicago, Chicago, Illinois, Primary care physician. Associate Chief Medical Information Officer, University of Chicago Medicine
| | - Franco Verde
- Johns Hopkins University School of Medicine, Baltimore, Maryland, Director, Diagnostic Imaging, Johns Hopkins Bayview Medical Center
| | - Jeffrey P Kanne
- Specialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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UNLU EN, ALTINSOY HB, GÜLEÇ BALBAY E, SUNGUR MA, BORAN M, ÖNAL B. Shear Wave Ultrasound Elastography And Dıffusıon-Weıghted Magnetıc Resonance Imagıng Fındıngs Of Pleural-Based Masses Wıth Hıstopathologıc Correlatıon. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.880329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Infectious and Non-Infectious Diseases Causing the Air Crescent Sign: A State-of-the-Art Review. Lung 2017; 196:1-10. [PMID: 29143119 DOI: 10.1007/s00408-017-0069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/05/2017] [Indexed: 01/15/2023]
Abstract
Aspergilloma, also known as mycetoma or fungus ball, is characterized by a round or oval mass with soft-tissue attenuation within a preexisting lung cavity. The typical computed tomography (CT) aspect of an aspergilloma is a mass separated from the wall of the cavity by an airspace of variable size and shape, resulting in the air crescent sign, also known as the meniscus sign. This CT feature is non-specific and can be simulated by several other entities that result in intracavitary masses. This review describes the main clinical and imaging aspects of the infectious and non-infectious diseases that may present with fungus-ball appearance, including pulmonary hydatid cyst, Rasmussen aneurysm, pulmonary gangrene, intracavitary clot, textiloma, lung cancer, metastasis, and teratoma, focusing on the differential diagnosis.
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Ribeiro BNDF, Marchiori E. Chordoma of the posterior mediastinum accompanied by synchronous lesion. Radiol Bras 2017; 50:340-341. [PMID: 29085171 PMCID: PMC5656078 DOI: 10.1590/0100-3984.2016.0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Belém LC, Souza CA, Souza AS, Escuissato DL, Hochhegger B, Nobre LF, Rodrigues RS, Gomes ACP, Silva CS, Guimarães MD, Zanetti G, Marchiori E. Metastatic pulmonary calcification: high-resolution computed tomography findings in 23 cases. Radiol Bras 2017; 50:231-236. [PMID: 28894330 PMCID: PMC5586513 DOI: 10.1590/0100-3984.2016-0123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective The aim of this study was to evaluate the high-resolution computed tomography
(HRCT) findings in patients diagnosed with metastatic pulmonary
calcification (MPC). Materials and Methods We retrospectively reviewed the HRCT findings from 23
cases of MPC [14 men, 9 women; mean age, 54.3 (range, 26-89) years]. The
patients were examined between 2000 and 2014 in nine tertiary hospitals in
Brazil, Chile, and Canada. Diagnoses were established by histopathologic
study in 18 patients and clinical-radiological correlation in 5 patients.
Two chest radiologists analyzed the images and reached decisions by
consensus. Results The predominant HRCT findings were centrilobular ground-glass nodules
(n = 14; 60.9%), consolidation with high attenuation
(n = 10; 43.5%), small dense nodules
(n = 9; 39.1%), peripheral reticular opacities
associated with small calcified nodules (n = 5; 21.7%), and
ground-glass opacities without centrilobular ground-glass nodular opacity
(n = 5; 21.7%). Vascular calcification within the chest
wall was found in four cases and pleural effusion was observed in five
cases. The abnormalities were bilateral in 21 cases. Conclusion MPC manifested with three main patterns on HRCT, most commonly centrilobular
ground-glass nodules, often containing calcifications, followed by dense
consolidation and small solid nodules, most of which were calcified. We also
described another pattern of peripheral reticular opacities associated with
small calcified nodules. These findings should suggest the diagnosis of MPC
in the setting of hypercalcemia.
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Affiliation(s)
| | - Carolina A Souza
- MD, PhD, Ottawa Hospital Research Institute, University of Ottawa, Canada
| | - Arthur Soares Souza
- MD, PhD, Faculdade de Medicina de São José do Rio Preto (Famerp) and Ultra X, São José do Rio Preto, SP, Brazil
| | | | - Bruno Hochhegger
- MD, PhD, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Luiz Felipe Nobre
- MD, PhD, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Rosana Souza Rodrigues
- MD, PhD, Universidade Federal do Rio de Janeiro (UFRJ) and Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
| | | | - Claudio S Silva
- MD, MSc, Facultad de Medicina Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Marcos Duarte Guimarães
- MD, PhD, A.C.Camargo Cancer Center, São Paulo, SP, and Universidade Federal do Vale do São Francisco (Univasf), Petrolina, PE, Brazil
| | - Gláucia Zanetti
- MD, PhD, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Edson Marchiori
- MD, PhD, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Hochhegger B, Baldisserotto M. Chest computed tomography in bronchiolitis obliterans after bone marrow transplantation. Radiol Bras 2017; 50:IX. [PMID: 28670041 PMCID: PMC5487226 DOI: 10.1590/0100-3984.2017.50.3e3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Bruno Hochhegger
- Adjunct Professor of Radiology at the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil. E-mail:
| | - Matteo Baldisserotto
- Professor in the Graduate Program of the Faculdade de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil. E-mail:
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Boaventura CS, Rodrigues DP, Silva OAC, Beltrani FH, de Melo RAB, Bitencourt AGV, Mendes GG, Chojniak R. Evaluation of the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer, according to the American College of Radiology criteria. Radiol Bras 2017; 50:1-6. [PMID: 28298725 PMCID: PMC5347495 DOI: 10.1590/0100-3984.2015.0123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective To evaluate the indications for performing magnetic resonance imaging of the
female pelvis at a referral center for cancer. Materials and Methods This was a retrospective, single-center study, conducted by reviewing medical
records and imaging reports. We included 1060 female patients who underwent
magnetic resonance imaging of the pelvis at a cancer center between January
2013 and June 2014. The indications for performing the examination were
classified according to the American College of Radiology (ACR)
criteria. Results The mean age of the patients was 52.6 ± 14.8 years, and 49.8% were
perimenopausal or postmenopausal. The majority (63.9%) had a history of
cancer, which was gynecologic in 29.5% and nongynecologic in 34.4%. Of the
patients evaluated, 44.0% had clinical complaints, the most common being
pelvic pain (in 11.5%) and bleeding (in 9.8%), and 34.7% of patients had
previously had abnormal findings on ultrasound. Most (76.7%) of the patients
met the criteria for undergoing magnetic resonance imaging, according to the
ACR guidelines. The main indications were evaluation of tumor recurrence
after surgical resection (in 25.9%); detection and staging of gynecologic
neoplasms (in 23.3%); and evaluation of pelvic pain or of a mass (in
17.1%). Conclusion In the majority of the cases evaluated, magnetic resonance imaging was
clearly indicated according to the ACR criteria. The main indication was
local recurrence after surgical treatment of pelvic malignancies, which is
consistent with the routine protocols at cancer centers.
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Affiliation(s)
| | | | | | | | | | | | | | - Rubens Chojniak
- PhD, MD, Head of the Imaging Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
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Affiliation(s)
| | | | | | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Saadatpour Z, Bjorklund G, Chirumbolo S, Alimohammadi M, Ehsani H, Ebrahiminejad H, Pourghadamyari H, Baghaei B, Mirzaei HR, Sahebkar A, Mirzaei H, Keshavarzi M. Molecular imaging and cancer gene therapy. Cancer Gene Ther 2016:cgt201662. [PMID: 27857058 DOI: 10.1038/cgt.2016.62] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/21/2016] [Accepted: 09/23/2016] [Indexed: 12/30/2022]
Abstract
Gene therapy is known as one of the most advanced approaches for therapeutic prospects ranging from tackling genetic diseases to combating cancer. In this approach, different viral and nonviral vector systems such as retrovirus, lentivirus, plasmid and transposon have been designed and employed. These vector systems are designed to target different therapeutic genes in various tissues and cells such as tumor cells. Therefore, detection of the vectors containing therapeutic genes and monitoring of response to the treatment are the main issues that are commonly faced by researchers. Imaging techniques have been critical in guiding physicians in the more accurate and precise diagnosis and monitoring of cancer patients in different phases of malignancies. Imaging techniques such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are non-invasive and powerful tools for monitoring of the distribution of transgene expression over time and assessing patients who have received therapeutic genes. Here, we discuss most recent advances in cancer gene therapy and molecular approaches as well as imaging techniques that are utilized to detect cancer gene therapeutics and to monitor the patients' response to these therapies worldwide, particularly in Iranian Academic Medical Centers and Hospitals.Cancer Gene Therapy advance online publication, 18 November 2016; doi:10.1038/cgt.2016.62.
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Affiliation(s)
- Z Saadatpour
- Bozorgmehr Imaging Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - G Bjorklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - S Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - M Alimohammadi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Ehsani
- Department of Periodontology, School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Ebrahiminejad
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - H Pourghadamyari
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - B Baghaei
- Department of Endodontics, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - H R Mirzaei
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Mirzaei
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Keshavarzi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
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Qiu B, Wang D, Yang H, Xie W, Liang Y, Cai P, Chen Z, Liu M, Fu J, Xie C, Liu H. Combined modalities of magnetic resonance imaging, endoscopy and computed tomography in the evaluation of tumor responses to definitive chemoradiotherapy in esophageal squamous cell carcinoma. Radiother Oncol 2016; 121:239-245. [DOI: 10.1016/j.radonc.2016.09.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 08/31/2016] [Accepted: 09/11/2016] [Indexed: 11/26/2022]
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Lopes AJ. Is computed tomography the ideal method for the identification and management of lung disease in systemic sclerosis? Radiol Bras 2016; 49:VII-VIII. [PMID: 27818558 PMCID: PMC5094831 DOI: 10.1590/0100-3984.2016.49.5e2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Agnaldo José Lopes
- MD, Adjunct Professor of Pulmonology at the Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil. E-mail:
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Alves UD, Lopes AJ, Maioli MCP, Soares AR, de Melo PL, Mogami R. Changes seen on computed tomography of the chest in mildly symptomatic adult patients with sickle cell disease. Radiol Bras 2016; 49:214-219. [PMID: 27777473 PMCID: PMC5073386 DOI: 10.1590/0100-3984.2015.0111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To describe and quantify the main changes seen on computed tomography of the chest in mildly symptomatic adult patients with sickle cell disease, as well as to evaluate the radiologist accuracy in determining the type of hemoglobinopathy. MATERIALS AND METHODS A prospective study involving 44 adult patients with sickle cell disease who underwent inspiration and expiration computed tomography of the chest. The frequency of tomography findings and the extent of involvement are reported. We also calculated radiologist accuracy in determining the type of hemoglobinopathy by analyzing the pulmonary alterations and morphology of the spleen. RESULTS The changes found on computed tomography scans, in descending order of frequency, were as follows: fibrotic opacities (81.8%); mosaic attenuation (56.8%); architectural distortion (31.8%); cardiomegaly (25.0%); lobar volume reduction (18.2%); and increased caliber of peripheral pulmonary arteries (9.1%). For most of the findings, the involvement was considered mild, five or fewer lung segments being affected. The accuracy in determining the type of hemoglobinopathy (HbSS group versus not HbSS group) was 72.7%. CONCLUSION In adult patients with sickle cell disease, the main tomography findings reflect fibrotic changes. In addition, computed tomography can be helpful in differentiating among hemoglobinopathies.
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Affiliation(s)
- Ursula David Alves
- MD, Radiologist at the Hospital Universitário Pedro Ernesto (HUPE), Student in the Graduate Program in Medical Sciences at the Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Agnaldo José Lopes
- PhD, Adjunct Professor of Pulmonology at the Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Maria Christina Paixão Maioli
- PhD, Adjunct Professor of Hematology at the Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Andrea Ribeiro Soares
- PhD, Adjunct Professor of Hematology at the Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Pedro Lopes de Melo
- PhD, Associate Professor, Head of the Biomedical Instrumentation Laboratory, Head of the Laboratory for Clinical and Experimental Research in Vascular Biology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Roberto Mogami
- PhD, Adjunct Professor of Radiology at the Universidade do Estado do Rio de Janeiro (UERJ), Head of the Radiology Department of the Hospital Universitário Pedro Ernesto (HUPE), Rio de Janeiro, RJ, Brazil
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Hochhegger B. PET/CT used in the evaluation of pulmonary nodules suspicious for lung cancer in regions where infectious lung disease is endemic: to be or not to be? Radiol Bras 2016; 49:199. [PMID: 27403022 PMCID: PMC4938452 DOI: 10.1590/0100-3984.2016.49.3.ce1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Bruno Hochhegger
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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Affiliation(s)
- Bruno Hochhegger
- Professor of Radiology at Universidade Federal de Ciências da
Saúde de Porto Alegre (UFCSPA) and at Pontifícia Universidade
Católica do Rio Grande do Sul (PUC/ RS), Porto Alegre, RS, Brazil
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