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Páez-Carpio A, Vollmer I, Zarco FX, Matute-González M, Domenech-Ximenos B, Serrano E, Barberà JA, Blanco I, Gómez FM. Imaging of chronic thromboembolic pulmonary hypertension before, during and after balloon pulmonary angioplasty. Diagn Interv Imaging 2024:S2211-5684(24)00040-8. [PMID: 38413273 DOI: 10.1016/j.diii.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
Balloon pulmonary angioplasty (BPA) has recently been elevated as a class I recommendation for the treatment of inoperable or residual chronic thromboembolic pulmonary hypertension (CTEPH). Proper patient selection, procedural safety, and post-procedural evaluation are crucial in the management of these patients, with imaging work-up playing a pivotal role. Understanding the diagnostic and therapeutic imaging algorithms of CTEPH, the imaging features of patients amenable to BPA, all imaging findings observed during and immediately after the procedure and the changes observed during the follow-up is crucial for all interventional radiologists involved in the care of patients with CTEPH. This article illustrates the imaging work-up of patients with CTEPH amenable to BPA, the imaging findings observed before, during and after BPA, and provides a detailed description of all imaging modalities available for CTEPH evaluation.
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Affiliation(s)
- Alfredo Páez-Carpio
- Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona 08036, Spain; Department of Medical Imaging, University of Toronto, Toronto M5T 1W7, ON, Canada; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain.
| | - Ivan Vollmer
- Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona 08036, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
| | - Federico X Zarco
- Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona 08036, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
| | | | | | - Elena Serrano
- Department of Radiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat 08907, Spain
| | - Joan A Barberà
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain; Department of Pulmonary Medicine, ICR, Hospital Clínic Barcelona, Barcelona 08036, Spain; Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Madrid 28029, Spain
| | - Isabel Blanco
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain; Department of Pulmonary Medicine, ICR, Hospital Clínic Barcelona, Barcelona 08036, Spain; Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Madrid 28029, Spain
| | - Fernando M Gómez
- Interventional Radiology Unit, Department of Radiology, Hospital Universitari i Politècnic La Fe, València 46026, Spain; Interventional Radiology Unit, Department of Radiology, The Netherlands Cancer Institute, Amsterdam 1066 CX, the Netherlands
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Sáenz de Argandoña O, Mestres J, Vollmer I. Langerhans Cell Sarcoma of the Lung: CT, PET-CT, US and CEUS Findings. Arch Bronconeumol 2023; 59:662-663. [PMID: 37541819 DOI: 10.1016/j.arbres.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/06/2023]
Affiliation(s)
| | - Judit Mestres
- Servicio de Radiodiagnóstico (CDI), Hospital Clínic, Barcelona, Spain
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico (CDI), Hospital Clínic, Barcelona, Spain.
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Cases C, Benegas M, Sánchez M, Vollmer I, Casas F, Gomà C, Mollà M. Corrigendum to "Biological effective dose is associated with radiological toxicity after lung stereotactic ablative radiation therapy" [Radiother. Oncol. 183 (2023) 109552]. Radiother Oncol 2023; 186:109776. [PMID: 37423000 DOI: 10.1016/j.radonc.2023.109776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Carla Cases
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mariana Benegas
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Translational Research in Pulmonary Vascular Diseases: Cell Proliferation and Apoptotic Mechanisms in Pulmonary Arterial Hypertension, Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Francesc Casas
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carles Gomà
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Meritxell Mollà
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Clinical Foundations, University of Barcelona, Barcelona Spain
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4
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Broncano J, Steinbrecher K, Marquis KM, Raptis CA, Royuela Del Val J, Vollmer I, Bhalla S, Luna A. Diffusion-weighted Imaging of the Chest: A Primer for Radiologists. Radiographics 2023; 43:e220138. [PMID: 37347699 DOI: 10.1148/rg.220138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Diffusion-weighted imaging (DWI) is a fundamental sequence not only in neuroimaging but also in oncologic imaging and has emerging applications for MRI evaluation of the chest. DWI can be used in clinical practice to enhance lesion conspicuity, tissue characterization, and treatment response. While the spatial resolution of DWI is in the order of millimeters, changes in diffusion can be measured on the micrometer scale. As such, DWI sequences can provide important functional information to MRI evaluation of the chest but require careful optimization of acquisition parameters, notably selection of b values, application of parallel imaging, fat saturation, and motion correction techniques. Along with assessment of morphologic and other functional features, evaluation of DWI signal attenuation and apparent diffusion coefficient maps can aid in tissue characterization. DWI is a noninvasive noncontrast acquisition with an inherent quantitative nature and excellent reproducibility. The outstanding contrast-to-noise ratio provided by DWI can be used to improve detection of pulmonary, mediastinal, and pleural lesions, to identify the benign nature of complex cysts, to characterize the solid portions of cystic lesions, and to classify chest lesions as benign or malignant. DWI has several advantages over fluorine 18 (18F)-fluorodeoxyglucose PET/CT in the assessment, TNM staging, and treatment monitoring of lung cancer and other thoracic neoplasms with conventional or more recently developed therapies. © RSNA, 2023 Quiz questions for this article are available in the supplemental material. Supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.
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Affiliation(s)
- Jordi Broncano
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Kacie Steinbrecher
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Kaitlin M Marquis
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Constantin A Raptis
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Javier Royuela Del Val
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Ivan Vollmer
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Sanjeev Bhalla
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Antonio Luna
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
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Lucena CM, Martin-Deleon R, Boada M, Marrades RM, Sánchez D, Sánchez M, Vollmer I, Martínez D, Fontana A, Reguart N, Molins L, Agustí C. Integral mediastinal staging in patients with NON-SMALL cell lung cancer and risk factors for occult N2 disease. Respir Med 2023; 208:107132. [PMID: 36720323 DOI: 10.1016/j.rmed.2023.107132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND In patients with non-small cell lung cancer (NSCLC), the presence of abnormal hiliar lymph nodes (clinical N1; cN1), central tumor location and/or tumor size (diameter >3 cm) increases the risk of occult mediastinal metastasis (OMM). This study investigates prospectively the diagnostic value of an integral mediastinal staging (IMS) strategy that combines EndoBronchial Ultrasound-TransBronchial Needle Aspiration (EBUS-TBNA) and Video-Assisted Mediastinoscopy (VAM) in patients with NSCLC at risk of OMM. METHODS Patients with NSCLC and radiologically normal mediastinum assessed non-invasively by positron emission tomography and computed tomography of the chest (PET-CT), and OMM risk factors (cN1, central tumor and/or >3 cm) underwent EBUS-TBNA followed by VAM if the former was negative. Those with negative IMS underwent resection surgery of the tumor. RESULTS EBUS-TBNA identified OMM in 2 out of the 49 patients evaluated (4%) and VAM in 1 of the 47 patients with negative EBUS (2%). Two patients with a negative IMS had OMM at surgery. Overall, the prevalence of OMM was 10%. EBUS-TBNA has a sensitivity of 40%, a negative predictive value (NPV) of 93.6%, and negative likelihood ratio of 0.60 (95%CI:0.30-1.16). The risk of not diagnosing OMM after EBUS was 6% and after IMS was 4.4%. CONCLUSION Integral mediastinal staging in patients with NSCLC and clinical risk factors for OMM, does not seem to provide added diagnostic value to that of EBUS-TBNA, except perhaps in patients with cN1 disease who deserve further research.
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Affiliation(s)
- Carmen M Lucena
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | | | - Marc Boada
- Thoracic Surgery Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Ramon M Marrades
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - David Sánchez
- Thoracic Surgery Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Marcelo Sánchez
- Radiology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Ivan Vollmer
- Radiology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Daniel Martínez
- Pathology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Ainhoa Fontana
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Noemi Reguart
- Medical Oncology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Laureano Molins
- Thoracic Surgery Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Carlos Agustí
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain.
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Cases C, Benegas M, Sánchez M, Vollmer I, Casas F, Gomà C, Mollà M. Biological equivalent dose is associated with radiological toxicity after lung stereotactic ablative radiation therapy. Radiother Oncol 2023; 183:109552. [PMID: 36813167 DOI: 10.1016/j.radonc.2023.109552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/18/2023] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Stereotactic ablative radiation therapy (SABR) is the standard of care for inoperable early-stage non-small-cell lung cancer. Although the probability of grade ≥ II toxicities is low, many patients present radiological subclinical toxicities usually associated with long-term patient management challenges. We evaluated radiological changes and correlated them with the received Biological Equivalent Dose (BED). METHODS We retrospectively analyzed chest CT scans of 102 patients treated with SABR. An experienced radiologist evaluated the radiation-related changes 6 months and 2 years after SABR. The presence of consolidation, ground-glass opacities, organizing pneumonia pattern, atelectasis and the extent of affected lung were recorded. Dose-volume histograms of the lung healthy tissue were transformed to BED. Clinical parameters such as age, smoking habits, and previous pathologies were registered and correlations between BED and radiological toxicities were drawn. RESULTS We observed a positive and statistically significant correlation between lung BED over 300 Gy and the presence of organizing pneumonia pattern, the degree of lung affectation and the 2-year prevalence and/or increase of these radiological changes. Radiological changes in patients receiving BED > 300 Gy to a healthy lung volume ≥ 30 cc increased or remained in the 2 years follow-up scan. We found no correlation between radiological changes and the analyzed clinical parameters. CONCLUSIONS There seems to be a clear correlation between BEDs higher than 300 Gy and radiological changes both short and long term. If confirmed in an independent patient cohort, these findings could lead to the first radiotherapy dose constraints for grade I pulmonary toxicity.
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Affiliation(s)
- Carla Cases
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mariana Benegas
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Translational Research in Pulmonary Vascular Diseases: Cell Proliferation and Apoptotic Mechanisms in Pulmonary Arterial Hypertension, Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Francesc Casas
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carles Gomà
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Meritxell Mollà
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain; Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Clinical Foundations, University of Barcelona, Barcelona Spain
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Blazic I, Cogliati C, Flor N, Frija G, Kawooya M, Umbrello M, Ali S, Baranne ML, Cho YJ, Pitcher R, Vollmer I, van Deventer E, del Rosario Perez M. The use of lung ultrasound in COVID-19. ERJ Open Res 2023; 9:00196-2022. [PMID: 36628270 PMCID: PMC9548241 DOI: 10.1183/23120541.00196-2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/22/2022] [Indexed: 01/13/2023] Open
Abstract
This review article addresses the role of lung ultrasound in patients with coronavirus disease 2019 (COVID-19) for diagnosis and disease management. As a simple imaging procedure, lung ultrasound contributes to the early identification of patients with clinical conditions suggestive of COVID-19, supports decisions about hospital admission and informs therapeutic strategy. It can be performed in various clinical settings (primary care facilities, emergency departments, hospital wards, intensive care units), but also in outpatient settings using portable devices. The article describes typical lung ultrasound findings for COVID-19 pneumonia (interstitial pattern, pleural abnormalities and consolidations), as one component of COVID-19 diagnostic workup that otherwise includes clinical and laboratory evaluation. Advantages and limitations of lung ultrasound use in COVID-19 are described, along with equipment requirements and training needs. To infer on the use of lung ultrasound in different regions, a literature search was performed using key words "COVID-19", "lung ultrasound" and "imaging". Lung ultrasound is a noninvasive, rapid and reproducible procedure; can be performed at the point of care; requires simple sterilisation; and involves non-ionising radiation, allowing repeated exams on the same patient, with special benefit in children and pregnant women. However, physical proximity between the patient and the ultrasound operator is a limitation in the current pandemic context, emphasising the need to implement specific infection prevention and control measures. Availability of qualified staff adequately trained to perform lung ultrasound remains a major barrier to lung ultrasound utilisation. Training, advocacy and awareness rising can help build up capacities of local providers to facilitate lung ultrasound use for COVID-19 management, in particular in low- and middle-income countries.
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Affiliation(s)
- Ivana Blazic
- Radiology Department, Clinical Hospital Center Zemun, Belgrade, Serbia
| | - Chiara Cogliati
- Internal Medicine, L. Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Nicola Flor
- Unità Operativa di Radiologia, Luigi Sacco University Hospital, Milan, Italy
| | - Guy Frija
- Université de Paris, International Society of Radiology, Paris, France
| | - Michael Kawooya
- Ernest Cook Ultrasound Research and Education Institute (ECUREI), Kampala, Uganda
| | - Michele Umbrello
- SC Anestesia e Rianimazione II, Ospedale San Carlo Borromeo, ASST Santi Paolo e Carlo – Polo Universitario, Milan, Italy
| | - Sam Ali
- ECUREI, Mengo Hospital, Kampala, Uganda
| | - Marie-Laure Baranne
- Assistance Publique – Hôpitaux de Paris, Paris Institute for Clinical Ultrasound, Paris, France
| | - Young-Jae Cho
- South Korea/Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Richard Pitcher
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Páez-Carpio A, Zarco F, Martin C, Vollmer I, García A, Serrano E, Corominas D, Carrero E, Freixa X, Gómez F, Blanco I, Barberà J. Abstract No. 273 Balloon pulmonary angioplasty in patients with non-operable or residual chronic thromboembolic hypertension: initial 5-year experience in a national referral center. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Guerrero C, Martínez D, Vollmer I, Gómez-Caro A. [Translated article] Iatrogenic Segmental Pulmonary Artery Pseudoaneurysm Due to Necrotizing Pneumonia After Intrapulmonary Nasogastric Tube Placement. Arch Bronconeumol 2022. [PMID: 35513941 DOI: 10.1016/j.arbres.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Carlos Guerrero
- Servicio de Cirugía Torácica, Instituto Clínico Respiratorio, Hospital Clínic, Barcelona, Spain.
| | - Daniel Martínez
- Servicio de Anatomía Patológica, Centro de Diagnóstico Biomédico, Hospital Clínic, Barcelona, Spain
| | - Ivan Vollmer
- Servicio de Radiología, Centro de Diagnóstico por la Imagen, Hospital Clínic, Barcelona, Spain
| | - Abel Gómez-Caro
- Servicio de Cirugía Torácica, Instituto Clínico Respiratorio, Hospital Clínic, Barcelona, Spain
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Matute-González M, Vollmer I. Usefulness of contrast ultrasound in ruling out local recurrence after radiation therapy for lung cancer. Arch Bronconeumol 2022. [DOI: 10.1016/j.arbres.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vollmer I, Páez-Carpio A, Sánchez-Lorente D, Boada M, Martínez D, Sánchez M, Sánchez-Izquierdo N, Tormo-Ratera M, Ribera-Perianes J, Vidal-Sicart S, Carrero-Cardenal E, Paredes P. Preoperative localization of lung nodules: a comparative analysis of hookwire and radio-guided procedures. J Thorac Dis 2022; 14:4329-4340. [PMID: 36524098 PMCID: PMC9745529 DOI: 10.21037/jtd-22-552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/09/2022] [Indexed: 11/29/2022]
Abstract
Background Histological diagnosis of pulmonary nodules requires surgical resection on many occasions. There are multiple localization strategies each with their own benefits and complications. The objective of this study is to compare preoperative lung nodule localization with hookwire and radiotracer injection (radioguided occult lesion localization, ROLL). To compare results, complications, and volume of the sample resected with both techniques. Methods Patients undergoing resection of pulmonary nodules with video-assisted thoracoscopy and pre-surgical localization with hookwire or ROLL were studied. Eighty-eight pulmonary nodules were resected in 76 patients: 52 with a hook wire and 36 with a radiotracer. The localization rate, the shortest distance between the nodule and the pleura, the intrapulmonary distance of the locator, the complications, the volume of the resection piece, and the histological result were all assessed. In addition, the factors that influence the volume of the surgical piece were analyzed. Results All the nodules were resected with both techniques. The intrapulmonary path of the locator is longer for the ROLL group (23.91 vs. 16.28 mm; P=0.04), with no differences in the distance from the nodule to the pleura. The rate of pneumothorax was significantly higher after the placement of a hook wire (69.2% vs. 24.2%; P<0.0001), while there were no differences in the presence of hemorrhage. The volume of the pieces resected using ROLL was more minor than with hookwire, although not statistically significant (20.19 vs. 34.26 cc; P=0.07). Conclusions Preoperative localization with the ROLL technique is safer than the placement of hookwire. In addition, the ROLL technique shows a tendency to obtain a smaller volume of resected tissue since the marking is not affected by the intrapulmonary route used during marker placement. ROLL technique allows to locate lung nodules with fewer complications than hookwire and probably gets smaller resection samples.
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Matute-González M, Vollmer I. Utilidad de la ecografía con contraste para descartar recurrencia local tras radioterapia sobre cáncer de pulmón. Arch Bronconeumol 2022; 58:438. [DOI: 10.1016/j.arbres.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/02/2022]
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13
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Muñoz-Guglielmetti D, Sanchez-Lorente D, Reyes R, Martinez D, Lucena C, Boada M, Paredes P, Parera-Roig M, Vollmer I, Mases J, Martin-Deleon R, Castillo S, Benegas M, Muñoz S, Mayoral M, Cases C, Mollà M, Casas F. Pathological response to neoadjuvant therapy with chemotherapy vs chemoradiotherapy in stage III NSCLC-contribution of IASLC recommendations. World J Clin Oncol 2021; 12:1047-1063. [PMID: 34909399 PMCID: PMC8641007 DOI: 10.5306/wjco.v12.i11.1047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/22/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neoadjuvant treatment (NT) with chemotherapy (Ch) is a standard option for resectable stage III (N2) NSCLC. Several studies have suggested benefits with the addition of radiotherapy (RT) to NT Ch. The International Association for the Study of Lung Cancer (IASLC) published recommendations for the pathological response (PHR) of NSCLC resection specimens after NT.
AIM To contribute to the IASLC recommendations showing our results of PHR to NT Ch vs NT chemoradiotherapy (ChRT).
METHODS We analyzed 67 consecutive patients with resectable stage III NSCLC with positive mediastinal nodes treated with surgery after NT Ch or NT ChRT between 2013 and 2020. After NT, all patients were evaluated for radiological response (RR) according to Response Evaluation Criteria in Solid Tumours criteria and evaluated for surgery by a specialized group of thoracic surgeons. All histological samples were examined by the same two pathologists. PHR was evaluated by the percentage of viable cells in the tumor and the resected lymph nodes.
RESULTS Forty patients underwent NT ChRT and 27 NT Ch. Fifty-six (83.6%) patients underwent surgery (35 ChRT and 21 Ch). The median time from ChRT to surgery was 6 wk (3-19) and 8 wk (3-21) for Ch patients. We observed significant differences in RR, with disease progression in 2.5% and 14.8% of patients with ChRT and Ch, respectively, and partial response in 62.5% ChRT vs 29.6% Ch (P = 0.025). In PHR we observed ≤ 10% viable cells in the tumor in 19 (54.4%) and 2 cases (9.5%), and in the resected lymph nodes (RLN) 30 (85.7%) and 7 (33.3%) in ChRT and Ch, respectively (P = 0.001). Downstaging was greater in the ChRT compared to the Ch group (80% vs 33.3%; P = 0.002). In the univariate analysis, NT ChRT had a significant impact on partial RR [odds ratio (OR) 12.5; 95% confidence interval (CI): 1.21 - 128.61; P = 0.034], a decreased risk of persistence of cancer cells in the tumor and RLN and an 87.5% increased probability for achieving downstaging (OR 8; 95%CI: 2.34-27.32; P = 0.001).
CONCLUSION We found significant benefits in RR and PHR by adding RT to Ch as NT. A longer follow-up is necessary to assess the impact on clinical outcomes.
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Affiliation(s)
| | - David Sanchez-Lorente
- Thoracic Surgery Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Roxana Reyes
- Medical Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Daniel Martinez
- Pathology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Carmen Lucena
- Pneumology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Marc Boada
- Thoracic Surgery Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Pilar Paredes
- Nuclear Medicine Department, Faculty of Medicine of University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Cataluña, Spain
| | - Marta Parera-Roig
- Medical Oncology Department, Hospital Comarcal de Vic, Vic 08500, Cataluña, Spain
| | - Ivan Vollmer
- Radiology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Joel Mases
- Radiation Oncology Department, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Roberto Martin-Deleon
- Pneumology Department, Hospital Universitario Reina Sofia, Córdoba 14004, Andalucía, Spain
| | - Sergi Castillo
- Medical Oncology Department, Hospital de Mollet, Mollet 08100, Cataluña, Spain
| | - Mariana Benegas
- Radiology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Silvia Muñoz
- Medical Oncology Department, Hospital General de Granollers, Granollers 08402, Cataluña, Spain
| | - Maria Mayoral
- Nuclear Medicine Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Carla Cases
- Radiation Oncology Department, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Meritxell Mollà
- Radiation Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Francesc Casas
- Radiation Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
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Isus G, Vollmer I. Ultrasound-guided interventional radiology procedures in the chest. Radiologia (Engl Ed) 2021; 63:536-546. [PMID: 34801188 DOI: 10.1016/j.rxeng.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/19/2021] [Indexed: 10/19/2022]
Abstract
Ultrasonography is a very good tool for guiding different interventional procedures in the chest. It is the ideal technique for managing conditions involving the pleural space, and it makes it possible to carry out procedures such as thoracocentesis, biopsies, or drainage. In the lungs, only lesions in contact with the costal pleura are accessible to ultrasound-guided interventions. In this type of lung lesions, ultrasound is as effective as computed tomography to guide interventional procedures, but the rate of complications and time required for the intervention are lower for ultrasound-guided procedures.
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Affiliation(s)
- G Isus
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain
| | - I Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain.
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Aya F, Benegas M, Viñolas N, Reyes R, Vollmer I, Arcocha A, Sánchez M, Reguart N. A Pilot Study to Evaluate Early Predictive Value of Thorax Perfusion-CT in Advanced NSCLC. Cancers (Basel) 2021; 13:cancers13215566. [PMID: 34771728 PMCID: PMC8583202 DOI: 10.3390/cancers13215566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The use of targeted drugs has brought about the development of new imaging techniques which are able to assess in vivo processes and changes in vascularization parameters can be captured as part of the antitumor response to antiangiogenic therapies. This pilot study (IMPACT trial, NCT02316327) aimed to explore the capacity of Perfusion-Computed Tomography (pCT) to detect early changes in tumor vascularization in non-small cell lung cancer (NSCLC) patients treated with an antiangiogenic-based therapy. Our results confirm the feasibility of pCT to capture early changes in tumor vasculature and suggest the potential of blood volume (BV) to early identify differential tumor responses to antiangiogenic therapy. Abstract Background: The role of perfusion computed tomography (pCT) in detecting changes in tumor vascularization as part of a response to antiangiogenic therapy in non-small cell lung cancer (NSCLC) remains unclear. Methods: In this prospective pilot study (IMPACT trial, NCT02316327), we aimed to determine the ability of pCT to detect early changes in blood flow (BF), blood volume (BV), and permeability (PMB), and to explore whether these changes could predict the response at day +42 in patients with advanced, treatment-naive, non-squamous NSCLC treated with cisplatin and gemcitabine plus bevacizumab. Results: All of the perfusion parameters showed a consistent decrease during the course of treatment. The BV difference between baseline and early assessment was significant (p = 0.013), whereas all perfusion parameters showed significant differences between baseline and day +42 (p = 0.003, p = 0.049, and p = 0.002, respectively). Among the 16 patients evaluable for efficacy, a significant decline in BV at day +7 from baseline was observed in tumors with no response (p = 0.0418). Conclusions: Our results confirm that pCT can capture early changes in tumor vasculature. A substantial early decline of BV from baseline might identify tumors less likely responsive to antiangiogenic-drugs.
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Affiliation(s)
- Francisco Aya
- Department of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (F.A.); (N.V.); (R.R.); (A.A.)
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, 08003 Barcelona, Spain
- Pompeu Fabra University, 08002 Barcelona, Spain
| | - Mariana Benegas
- Department of Radiology, Hospital Clínic, 08036 Barcelona, Spain; (M.B.); (I.V.); (M.S.)
- Thoracic Oncology Unit, Hospital Clínic, 08036 Barcelona, Spain
| | - Nuria Viñolas
- Department of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (F.A.); (N.V.); (R.R.); (A.A.)
- Thoracic Oncology Unit, Hospital Clínic, 08036 Barcelona, Spain
| | - Roxana Reyes
- Department of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (F.A.); (N.V.); (R.R.); (A.A.)
- Thoracic Oncology Unit, Hospital Clínic, 08036 Barcelona, Spain
| | - Ivan Vollmer
- Department of Radiology, Hospital Clínic, 08036 Barcelona, Spain; (M.B.); (I.V.); (M.S.)
- Thoracic Oncology Unit, Hospital Clínic, 08036 Barcelona, Spain
| | - Ainara Arcocha
- Department of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (F.A.); (N.V.); (R.R.); (A.A.)
- Thoracic Oncology Unit, Hospital Clínic, 08036 Barcelona, Spain
| | - Marcelo Sánchez
- Department of Radiology, Hospital Clínic, 08036 Barcelona, Spain; (M.B.); (I.V.); (M.S.)
- Thoracic Oncology Unit, Hospital Clínic, 08036 Barcelona, Spain
| | - Noemi Reguart
- Department of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (F.A.); (N.V.); (R.R.); (A.A.)
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain
- Thoracic Oncology Unit, Hospital Clínic, 08036 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-227-54-02
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Cabedo-Esteve L, Pérez-Serrano C, Vollmer I. Migrating pleuropericardial cyst: A case report. Arch Bronconeumol 2021; 57:648. [PMID: 35702905 DOI: 10.1016/j.arbr.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/15/2020] [Indexed: 06/15/2023]
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17
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Isus Olivé G, Páez Carpio A, Martínez D, Vollmer I. Role of contrast-enhanced ultrasound in the differentiation between pneumonia and neoplasia within a lung consolidation. Arch Bronconeumol 2021; 57:605-607. [PMID: 35702919 DOI: 10.1016/j.arbr.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/29/2021] [Indexed: 06/15/2023]
Affiliation(s)
- Gemma Isus Olivé
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain
| | | | - Daniel Martínez
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain.
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18
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León L, Vollmer I, Sánchez-Lorente D, Sánchez-Izquierdo N, Vidal-Sicart S, Paredes P. Biopsia pleural mediante técnica ROLL: primer caso en la literatura. Rev Esp Med Nucl Imagen Mol 2021. [DOI: 10.1016/j.remn.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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León LF, Vollmer I, Sánchez-Lorente D, Sánchez-Izquierdo N, Vidal-Sicart S, Paredes P. Pleural biopsy by ROLL technique: the first case report. Rev Esp Med Nucl Imagen Mol 2021; 40:332-333. [PMID: 34425978 DOI: 10.1016/j.remnie.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/05/2020] [Indexed: 11/27/2022]
Affiliation(s)
- L F León
- Servicio de Medicina Nuclear, Hospital Rey Juan Carlos, Madrid, Spain
| | - I Vollmer
- Servicio de Radiodiagnóstico, Hospital Clínic de Barcelona, Barcelona, Spain
| | - D Sánchez-Lorente
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain
| | - N Sánchez-Izquierdo
- Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, Spain
| | - S Vidal-Sicart
- Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, Spain
| | - P Paredes
- Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, Spain; Facultad de Medicina, Universitat de Barcelona (UB), Barcelona, Spain.
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20
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Vollmer I, Sánchez-Izquierdo N, Martínez D, Sánchez-Lorente D, Casanueva-Eliceiry S, Boada M, Guirao Á, Romero-Zayas I, Vidal-Sicart S, Paredes P. Role of a portable gamma-camera with optical view for margins assessment of pulmonary nodules resected by radioguided surgery. Eur J Nucl Med Mol Imaging 2021; 49:361-370. [PMID: 34185137 DOI: 10.1007/s00259-021-05466-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/16/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Radioguided occult lesion localization (ROLL) of pulmonary nodules is an alternative to hook-wire. Both required of a histological margin assessment. The activity emerging from the radiotracer allows to obtain an intraoperative scintigraphic image of the surgical specimen by a portable gamma-camera (PGC) fitted with an optical view, which provides information about the localization of the nodule in relation to the margins. The aim of this study was to evaluate the intraoperative use of a PGC for margin assessment of pulmonary nodules. METHODS ROLL technique was used in 38 nodules (36 pulmonary, 1 chest wall, and 1 pleural nodules). A PGC intraoperative image of the surgical specimen was obtained in 32. Scintigraphic results were compared to the histological assessment. Other factors, such as nodule size, distance from the pleural surface, or distance covered by the needle, were considered as possible factors for non-centered lesions. RESULTS PGC images showed that the lesion was in contact with the margins in 8/32 cases and centered in 24. In all cases in which the lesion was considered as centered by the PGC, the margins were free of involvement (NPV 100%), although the PPV is low. CONCLUSIONS The use of a PGC for margin assessment after pulmonary nodule resection is feasible and provides a high NPV in our series. In addition, the short intraoperative time required for its use makes the PGC a useful tool for providing supplementary information to histopathologic results. Further studies from different surgical teams are required for an external validation.
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Affiliation(s)
- Ivan Vollmer
- Radiology Department, Hospital Clínic Barcelona, Barcelona, Spain
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain
| | | | - Daniel Martínez
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain
- Pathology Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - David Sánchez-Lorente
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain
- Thoracic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Marc Boada
- Thoracic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - Ángela Guirao
- Thoracic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Sergi Vidal-Sicart
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Spain
| | - Pilar Paredes
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain.
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain.
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Spain.
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Molla M, Fernandez-Plana J, Albiol S, Fondevila C, Vollmer I, Cases C, Garcia-Criado A, Capdevila J, Conill C, Fundora Y, Fernandez-Martos C, Pineda E. Limited Liver or Lung Colorectal Cancer Metastases. Systemic Treatment, Surgery, Ablation or SBRT. J Clin Med 2021; 10:jcm10102131. [PMID: 34069240 PMCID: PMC8157146 DOI: 10.3390/jcm10102131] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/07/2021] [Indexed: 12/25/2022] Open
Abstract
The prognosis for oligometastatic colorectal cancer has improved in recent years, mostly because of recent advances in new techniques and approaches to the treatment of oligometastases, including new surgical procedures, better systemic treatments, percutaneous ablation, and stereotactic body radiation therapy (SBRT). There are several factors to consider when deciding on the better approach for each patient: tumor factors (metachronous or synchronous metastases, RAS mutation, BRAF mutation, disease-free interval, size and number of metastases), patient factors (age, frailty, comorbidities, patient preferences), and physicians' factors (local expertise). These advances have presented major challenges and opportunities for oncologic multidisciplinary teams to treat patients with limited liver and lung metastases from colorectal cancer with a curative intention. In this review, we describe the different treatment options in patients with limited liver and lung metastases from colorectal cancer, and the possible combination of three approaches: systemic treatment, surgery, and local ablative treatments.
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Affiliation(s)
- Meritxell Molla
- Department of Radiation Oncology, Hospital Clinic Barcelona, Barcelona 08036, Spain; (M.M.); (C.C.); (C.C.)
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona 08036, Spain
| | | | - Santiago Albiol
- Department of Medical Oncology, Hospital Clinic de Barcelona, Barcelona 08036, Spain;
| | - Constantino Fondevila
- Department of General and Digestive Surgery, Hospital Clinic de Barcelona, Barcelona 08036, Spain; (C.F.); (Y.F.)
| | - Ivan Vollmer
- Department of Radiology, Hospital Clinic Barcelona, Barcelona 08036, Spain; (I.V.); (A.G.-C.)
| | - Carla Cases
- Department of Radiation Oncology, Hospital Clinic Barcelona, Barcelona 08036, Spain; (M.M.); (C.C.); (C.C.)
| | - Angeles Garcia-Criado
- Department of Radiology, Hospital Clinic Barcelona, Barcelona 08036, Spain; (I.V.); (A.G.-C.)
| | - Jaume Capdevila
- Department of Medical Oncology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona 08035, Spain;
| | - Carles Conill
- Department of Radiation Oncology, Hospital Clinic Barcelona, Barcelona 08036, Spain; (M.M.); (C.C.); (C.C.)
| | - Yliam Fundora
- Department of General and Digestive Surgery, Hospital Clinic de Barcelona, Barcelona 08036, Spain; (C.F.); (Y.F.)
| | | | - Estela Pineda
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona 08036, Spain
- Department of Medical Oncology, Hospital Clinic de Barcelona, Barcelona 08036, Spain;
- Correspondence:
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Vollmer I. Thoracic ultrasound in viral infections. Radiología (English Edition) 2021. [DOI: 10.1016/j.rxeng.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Páez-Carpio A, Gómez FM, Isus Olivé G, Paredes P, Baetens T, Carrero E, Sánchez M, Vollmer I. Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art. Insights Imaging 2021; 12:57. [PMID: 33914187 PMCID: PMC8085189 DOI: 10.1186/s13244-021-00997-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/09/2021] [Indexed: 12/25/2022] Open
Abstract
Image-guided percutaneous lung ablation has proven to be a valid treatment alternative in patients with early-stage non-small cell lung carcinoma or oligometastatic lung disease. Available ablative modalities include radiofrequency ablation, microwave ablation, and cryoablation. Currently, there are no sufficiently representative studies to determine significant differences between the results of these techniques. However, a common feature among them is their excellent tolerance with very few complications. For optimal treatment, radiologists must carefully select the patients to be treated, perform a refined ablative technique, and have a detailed knowledge of the radiological features following lung ablation. Although no randomized studies comparing image-guided percutaneous lung ablation with surgery or stereotactic radiation therapy are available, the current literature demonstrates equivalent survival rates. This review will discuss image-guided percutaneous lung ablation features, including available modalities, approved indications, possible complications, published results, and future applications.
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Affiliation(s)
- Alfredo Páez-Carpio
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain.
| | - Fernando M Gómez
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gemma Isus Olivé
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Pilar Paredes
- Department of Nuclear Medicine, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Tarik Baetens
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Enrique Carrero
- Department of Anesthesiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
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Martin-Deleon R, Teixido C, Lucena CM, Martinez D, Fontana A, Reyes R, García M, Viñolas N, Vollmer I, Sanchez M, Jares P, Pérez FM, Vega N, Marin E, Marrades RM, Agustí C, Reguart N. EBUS-TBNA Cytological Samples for Comprehensive Molecular Testing in Non-Small Cell Lung Cancer. Cancers (Basel) 2021; 13:2084. [PMID: 33923116 PMCID: PMC8123471 DOI: 10.3390/cancers13092084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Clinical guidelines promote the identification of several targetable biomarkers to drive treatment decisions in advanced non-small cell lung cancer (NSCLC), but half of all patients do not have a viable biopsy. Specimens from endobronchial-ultrasound transbronchial needle aspiration (EBUS-TBNA) are an alternative source of material for the initial diagnosis of NSCLC, however their usefulness for a complete molecular characterization remains controversial. EBUS-TBNA samples were prospectively tested for several biomarkers by next-generation sequencing (NGS), nCounter, and immunohistochemistry (PD-L1). The primary objectives were to assess the sensitivity of EBUS-TBNA samples for a comprehensive molecular characterization and to compare its performance to the reference standard of biopsy samples. Seventy-two EBUS-TBNA procedures were performed, and 42 NSCLC patients were diagnosed. Among all cytological samples, 92.9% were successfully genotyped by NGS, 95.2% by nCounter, and 100% by immunohistochemistry. There were 29 paired biopsy samples; 79.3% samples had enough tumor material for genomic genotyping, and 96.6% for PD-L1 immunohistochemistry. A good concordance was found between both sources of material: 88.9% for PD-L1, 100% for NGS and nCounter. EBUS-TBNA is a feasible alternative source of material for NSCLC genotyping and allows the identification of patient candidates for personalized therapies with high concordance when compared with biopsy.
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Affiliation(s)
- Roberto Martin-Deleon
- Department of Respiratory Medicine, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (R.M.-D.); (C.M.L.); (A.F.); (R.M.M.); (C.A.)
| | - Cristina Teixido
- Translational Genomic and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (C.T.); (R.R.); (N.V.); (E.M.)
- Department of Pathology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (D.M.); (M.G.); (P.J.); (F.M.P.); (N.V.)
| | - Carmen Mª Lucena
- Department of Respiratory Medicine, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (R.M.-D.); (C.M.L.); (A.F.); (R.M.M.); (C.A.)
| | - Daniel Martinez
- Department of Pathology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (D.M.); (M.G.); (P.J.); (F.M.P.); (N.V.)
| | - Ainhoa Fontana
- Department of Respiratory Medicine, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (R.M.-D.); (C.M.L.); (A.F.); (R.M.M.); (C.A.)
| | - Roxana Reyes
- Translational Genomic and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (C.T.); (R.R.); (N.V.); (E.M.)
- Department of Medical Oncology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Mireia García
- Department of Pathology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (D.M.); (M.G.); (P.J.); (F.M.P.); (N.V.)
| | - Nuria Viñolas
- Translational Genomic and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (C.T.); (R.R.); (N.V.); (E.M.)
- Department of Medical Oncology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Ivan Vollmer
- Department of Radiology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (I.V.); (M.S.)
| | - Marcelo Sanchez
- Department of Radiology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (I.V.); (M.S.)
| | - Pedro Jares
- Department of Pathology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (D.M.); (M.G.); (P.J.); (F.M.P.); (N.V.)
| | - Francisco Manuel Pérez
- Department of Pathology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (D.M.); (M.G.); (P.J.); (F.M.P.); (N.V.)
| | - Naiara Vega
- Department of Pathology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (D.M.); (M.G.); (P.J.); (F.M.P.); (N.V.)
| | - Elba Marin
- Translational Genomic and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (C.T.); (R.R.); (N.V.); (E.M.)
| | - Ramón Mª Marrades
- Department of Respiratory Medicine, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (R.M.-D.); (C.M.L.); (A.F.); (R.M.M.); (C.A.)
| | - Carlos Agustí
- Department of Respiratory Medicine, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; (R.M.-D.); (C.M.L.); (A.F.); (R.M.M.); (C.A.)
| | - Noemi Reguart
- Translational Genomic and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (C.T.); (R.R.); (N.V.); (E.M.)
- Department of Medical Oncology, Thoracic Oncology Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
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Vollmer I, Domènech-Ximenos B, Sánchez M. Contrast-Enhanced Lung Ultrasound: A New Horizon. Arch Bronconeumol 2021; 57:385-386. [PMID: 34088388 DOI: 10.1016/j.arbr.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/12/2020] [Indexed: 10/21/2022]
Affiliation(s)
- Ivan Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain.
| | | | - Marcelo Sánchez
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain
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26
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Jiménez Serrano S, Radalov I, Vollmer I. Split pleura sign diagnosis with contrast-enhanced ultrasound. Arch Bronconeumol 2021; 57:431. [PMID: 34088397 DOI: 10.1016/j.arbr.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/24/2020] [Indexed: 11/25/2022]
Affiliation(s)
| | - Igor Radalov
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain.
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González de Aledo-Castillo JM, Casanueva-Eliceiry S, Soler-Perromat A, Fuster D, Pastor V, Reguart N, Viñolas N, Reyes R, Vollmer I, Paredes P, Puig-Butillé JA. Cell-free DNA concentration and fragment size fraction correlate with FDG PET/CT-derived parameters in NSCLC patients. Eur J Nucl Med Mol Imaging 2021; 48:3631-3642. [PMID: 33797597 DOI: 10.1007/s00259-021-05306-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/07/2021] [Indexed: 01/26/2023]
Abstract
PURPOSE The aim of our study was to investigate the correlation between cfDNA concentration and fragment size fraction with FDG PET/CT- and CT-derived parameters in untreated NSCLC patient. METHODS Fifty-three patients diagnosed of locally advanced or metastatic NSCLC who had undergone FDG PET/CT, CT and cfDNA analysis prior to any treatment were included in this retrospective study. CfDNA concentration was measured by fluorometry and fragment size fractions were determined by microchip electrophoresis. [18F]F-FDG PET/CT was performed and standardised uptake values (SUV), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were calculated for primary, extrapulmonary and total disease. CT scans were evaluated according to RECIST 1.1 criteria. RESULTS CfDNA concentration showed a positive correlation with extrapulmonary MTV (r2 = 0.36, P = 0.009), and extrapulmonary TLG (r2 = 0.35, P = 0.009) and their whole-body (wb) ratios. Higher concentrations of total cfDNA were found in patients with liver lesions. Short fragments of cfDNA (100-250 bp) showed a positive correlation with extrapulmonary MTV (r2 = 0.49, P = 0.0005) and extrapulmonary TLG (r2 = 0.39, P = 0.006) and their respective wb ratios, and a negative correlation with SUVmean (r2 = -0.31, P = 0.03) and SUVmean/SUVmax ratio (r2 = -0.34, P = 0.02). A higher fraction of short cfDNA fragments was found in patients with liver and pleural lesions. CONCLUSIONS This study supports the hypothesis that cfDNA concentration and short cfDNA fragment size fraction reflect the tumour burden as well as metabolic activity in advanced NSCLC patients. This suggests their suitability as complementary tests for a more accurate diagnosis of tumour metabolic behaviour and to allow personalised therapies.
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Affiliation(s)
| | | | | | - D Fuster
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - V Pastor
- Molecular Biology CORE, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - N Reguart
- Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain.,Medical Oncology Department, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - N Viñolas
- Medical Oncology Department, Hospital Clínic, Barcelona, Spain
| | - R Reyes
- Medical Oncology Department, Hospital Clínic, Barcelona, Spain
| | - I Vollmer
- Radiology Department, Hospital Clínic, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - P Paredes
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - J A Puig-Butillé
- Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain. .,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain. .,Molecular Biology CORE, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
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Porta Vilaró M, Capurro S, Martínez D, Vollmer I. Importancia del diagnóstico por imagen en el diagnóstico precoz de la mucormicosis pulmonar: a propósito de un caso. Open Respiratory Archives 2021. [PMID: 37497074 PMCID: PMC10369601 DOI: 10.1016/j.opresp.2021.100091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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29
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Vollmer I. Thoracic ultrasound in viral infections. Radiologia (Engl Ed) 2021; 63:252-257. [PMID: 33648749 DOI: 10.1016/j.rx.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/05/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
Ultrasonography has proven useful in the study of many pulmonary diseases that affect the subpleural regions. This article reviews the current evidence regarding the role of ultrasonography in the diagnosis and management of viral lung infections. It describes the examination technique and the main ultrasonographic findings for different viruses that can affect the lungs.
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Affiliation(s)
- I Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España.
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30
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Isus Olivé G, Páez Carpio A, Martínez D, Vollmer I. Role of Contrast-Enhanced Ultrasound in the Differentiation Between Pneumonia and Neoplasia Within a Lung Consolidation. Arch Bronconeumol 2021; 57:S0300-2896(21)00059-4. [PMID: 33726928 DOI: 10.1016/j.arbres.2021.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Gemma Isus Olivé
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España
| | | | - Daniel Martínez
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España.
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31
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Jiménez Serrano S, Radalov I, Vollmer I. Split Pleura Sign Diagnosis with Contrast-Enhanced Ultrasound. Arch Bronconeumol 2020. [PMID: 33008650 DOI: 10.1016/j.arbres.2020.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Igor Radalov
- Servicio de Radiodiagnóstico (CDIC). Hospital Clínic, Barcelona, España
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico (CDIC). Hospital Clínic, Barcelona, España.
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32
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Palomeque A, Vollmer I, Fontana A, Lucena CM, Agustí C. Focal Mediastinitis and Pulmonary Arterial Thrombosis after EBUS-TBNA. Arch Bronconeumol 2020; 57:73-74. [PMID: 32798007 DOI: 10.1016/j.arbres.2020.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/01/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Andrea Palomeque
- Servicio de Neumología y Alergia Respiratoria, Instituto Clínico Respiratorio, Hospital Clínic, Barcelona, España.
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen, Hospital Clínic, Barcelona, España
| | - Ainhoa Fontana
- Servicio de Neumología y Alergia Respiratoria, Instituto Clínico Respiratorio, Hospital Clínic, Barcelona, España
| | - Carmen M Lucena
- Servicio de Neumología y Alergia Respiratoria, Instituto Clínico Respiratorio, Hospital Clínic, Barcelona, España
| | - Carles Agustí
- Servicio de Neumología y Alergia Respiratoria, Instituto Clínico Respiratorio, Hospital Clínic, Barcelona, España
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33
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Páez-Carpio A, Vollmer I, Paredes P. Evaluación de la respuesta al tratamiento con radiofrecuencia de un nódulo pulmonar mediante ecografía con contraste (CEUS). Arch Bronconeumol 2020; 56:531-532. [DOI: 10.1016/j.arbres.2020.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/10/2020] [Accepted: 03/05/2020] [Indexed: 11/25/2022]
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34
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Marin E, Teixido C, Carmona-Rocha E, Reyes R, Arcocha A, Viñolas N, Rodríguez-Mues M, Cabrera C, Sánchez M, Vollmer I, Castillo S, Muñoz S, Sullivan IG, Rodriguez A, Garcia M, Alos S, Jares P, Martinez A, Prat A, Molina-Vila MÁ, Reguart N. Usefulness of Two Independent DNA and RNA Tissue-Based Multiplex Assays for the Routine Care of Advanced NSCLC Patients. Cancers (Basel) 2020; 12:E1124. [PMID: 32365867 PMCID: PMC7281583 DOI: 10.3390/cancers12051124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 02/07/2023] Open
Abstract
Personalized medicine is nowadays a paradigm in lung cancer management, offering important benefits to patients. This study aimed to test the feasibility and utility of embedding two multiplexed genomic platforms as the routine workup of advanced non-squamous non-small cell lung cancer (NSCLC) patients. Two parallel multiplexed approaches were performed based on DNA sequencing and direct digital detection of RNA with nCounter® technology to evaluate gene mutations and fusions. The results were used to guide genotype-directed therapies and patient outcomes were collected. A total of 224 advanced non-squamous NSCLC patients were prospectively included in the study. Overall, 85% of samples were successfully characterized at DNA and RNA levels and oncogenic drivers were found in 68% of patients, with KRAS, EGFR, METΔex14, BRAF, and ALK being the most frequent (31%, 19%, 5%, 4%, and 4%, respectively). Among all patients with complete genotyping results and follow-up data (n = 156), the median overall survival (OS) was 1.90 years (confidence interval (CI) 95% 1.69-2.10) for individuals harbouring an actionable driver treated with a matched therapy, compared with 0.59 years (CI 95% 0.39-0.79) in those not eligible for any targeted therapy and 0.61 years (CI 95% 0.12-1.10) in patients with no drivers identified (p < 0.001). Integrating DNA and RNA multiplexing technologies into the routine molecular testing of advanced NSCLC patients is feasible and useful and highlights the necessity of widespread integrating comprehensive molecular diagnosis into lung cancer care.
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Affiliation(s)
- Elba Marin
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
- Translational Genomics and Targeted Therapeutics in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain;
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
| | - Cristina Teixido
- Translational Genomics and Targeted Therapeutics in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain;
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
- Division of Pathology, Hospital Clínic, 08036 Barcelona, Spain; (M.G.); (S.A.); (P.J.); (A.M.)
| | - Elena Carmona-Rocha
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
| | - Roxana Reyes
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
| | - Ainara Arcocha
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
| | - Nuria Viñolas
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
| | - MªCarmen Rodríguez-Mues
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
| | - Carlos Cabrera
- Division of Medical Oncology, Instituto Oncologico Dr. Rosell, Teknon Hospital, 08028 Barcelona, Spain;
| | - Marcelo Sánchez
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
- Division of Thoracic Radiology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
| | - Ivan Vollmer
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
- Division of Thoracic Radiology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
| | - Sergi Castillo
- Division of Medical Oncology, Hospital General de Granollers, 08402 Barcelona, Spain; (S.C.); (S.M.)
| | - Silvia Muñoz
- Division of Medical Oncology, Hospital General de Granollers, 08402 Barcelona, Spain; (S.C.); (S.M.)
| | - Ivana G. Sullivan
- Division of Medical Oncology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
| | - Adela Rodriguez
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
| | - Mireia Garcia
- Division of Pathology, Hospital Clínic, 08036 Barcelona, Spain; (M.G.); (S.A.); (P.J.); (A.M.)
| | - Silvia Alos
- Division of Pathology, Hospital Clínic, 08036 Barcelona, Spain; (M.G.); (S.A.); (P.J.); (A.M.)
| | - Pedro Jares
- Division of Pathology, Hospital Clínic, 08036 Barcelona, Spain; (M.G.); (S.A.); (P.J.); (A.M.)
- Molecular Biology Core Facility, Hospital Clínic, 08036 Barcelona, Spain
| | - Antonio Martinez
- Division of Pathology, Hospital Clínic, 08036 Barcelona, Spain; (M.G.); (S.A.); (P.J.); (A.M.)
| | - Aleix Prat
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
- Translational Genomics and Targeted Therapeutics in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain;
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
| | - Miguel Ángel Molina-Vila
- Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, 08028 Barcelona, Spain;
| | - Noemi Reguart
- Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain; (E.M.); (E.C.-R.); (R.R.); (A.A.); (N.V.); (M.R.-M.); (A.R.); (A.P.)
- Translational Genomics and Targeted Therapeutics in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain;
- Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain; (M.S.); (I.V.)
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Cabedo-Esteve L, Pérez-Serrano C, Vollmer I. Migrating Pleuropericardial Cyst: A Case Report. Arch Bronconeumol 2020; 57:S0300-2896(20)30051-X. [PMID: 32143911 DOI: 10.1016/j.arbres.2020.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 11/25/2022]
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36
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Casas F, Sánchez D, Boada M, Munoz D, Cabrera C, Martin R, Martinez D, Paredes P, Vollmer I, Cortes K, Barreto T, Oses G, Parera M, Castillo S. P2.18-19 Radiological and Pathological Response to the Induction of Surgery in the NSCLC Stage III. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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Cornellas L, Soler-Perromat JC, Vollmer I. Pleurolito: una rara causa de lesión torácica migratoria. Arch Bronconeumol 2019; 55:534. [DOI: 10.1016/j.arbres.2019.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 01/24/2019] [Accepted: 01/24/2019] [Indexed: 11/29/2022]
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Hermida-Lama E, Marco-Hernández J, Medaglia AA, Pagès M, Vollmer I, Ramírez J, Martínez D, Mallolas J, García F. Cholangitis and pulmonary nodules in a clinical presentation of syphilis in an HIV-infected patient. Int J STD AIDS 2019; 30:820-824. [PMID: 31046616 DOI: 10.1177/0956462418823386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Several clinical manifestations attributed to syphilitic infection have been described in the literature. This is important because of the increased incidence of this infection mainly among men who have sex with men. We report the case of an HIV-infected patient who was hospitalized due to severe cholestasis, initially interpreted as drug-induced liver disease. It evolved slowly, with increasing intrahepatic cholangitis confirmed by magnetic resonance cholangiography and the appearance of several pulmonary nodules. In lung and liver biopsies, the presence of Treponema pallidum was detected by molecular and immunohistochemistry techniques, and a diagnosis of cholangitis and pulmonary syphilis was made.
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Affiliation(s)
- Evelyn Hermida-Lama
- 1 Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Alice Annalisa Medaglia
- 1 Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain.,2 Infectious Diseases Department, Policlinico P. Giaccone, Palermo, Italy
| | - Mario Pagès
- 3 Radiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- 3 Radiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josep Ramírez
- 4 Pathology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Daniel Martínez
- 4 Pathology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josep Mallolas
- 1 Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain.,5 AIDS Research Group, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Felipe García
- 1 Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain.,5 AIDS Research Group, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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39
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Reyes R, Mayo-de-las-Casas C, Teixidó C, Cabrera C, Marín E, Vollmer I, Jares P, Garzón M, Molina-Vila MÁ, Reguart N. Clinical Benefit From BRAF/MEK Inhibition in a Double Non-V600E BRAF Mutant Lung Adenocarcinoma: A Case Report. Clin Lung Cancer 2019; 20:e219-e223. [DOI: 10.1016/j.cllc.2019.02.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/11/2019] [Accepted: 02/21/2019] [Indexed: 02/09/2023]
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40
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Soler-Perromat A, Vollmer I, Ramírez J, Sánchez M. Invasive Mucinous Adenocarcinoma in Congenital Pulmonary Airway Malformation: A Case Report. Arch Bronconeumol 2019; 55:384-385. [PMID: 30595422 DOI: 10.1016/j.arbres.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 12/02/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Affiliation(s)
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España.
| | - José Ramírez
- Servicio de Anatomía Patológica (CDB), Hospital Clínic, Barcelona, España
| | - Marcelo Sánchez
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España
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41
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Affiliation(s)
- Ivan Vollmer
- Centre of Imaging Diagnosis, Radiology Dept, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Centre of Imaging Diagnosis, Radiology Dept, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ramón Rami-Porta
- Dept of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Barcelona, Spain.,Network of Centres for Biomedical Research in Respiratory Diseases (CIBERES) Lung Cancer Group, Barcelona, Spain
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Abstract
Due to the increase of incidentally detected pulmonary nodules and the information obtained from several screening programs, updated guidelines with new recommendations for the management of small pulmonary nodules have been proposed. These international guidelines coincide in proposing periodic follow-up for small nodules, less than 8 mm of diameter. Fleischner and British Thoracic Society guidelines are the most recent and popular guidelines for incidental pulmonary nodules management. They have specific recommendations according to nodule characteristics (density and size) and cancer risk of the patient. Both guidelines separate recommendations for solid and subsolid nodules. Predictive risk models have been developed to improve the nodule management. In certain cases follow up may not be the best option. We discuss the scenarios and options to achieve a histologic diagnosis of these tiny pulmonary nodules.
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Affiliation(s)
- Marcelo Sánchez
- Radiology Department, Diagnostic Imaging Center, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Mariana Benegas
- Radiology Department, Diagnostic Imaging Center, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Radiology Department, Diagnostic Imaging Center, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
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43
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Rami-Porta R, Call S, Dooms C, Obiols C, Sánchez M, Travis WD, Vollmer I. Lung cancer staging: a concise update. Eur Respir J 2018; 51:13993003.00190-2018. [PMID: 29700105 DOI: 10.1183/13993003.00190-2018] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/04/2018] [Indexed: 12/13/2022]
Abstract
Diagnosis and clinical staging of lung cancer are fundamental to planning therapy. The techniques for clinical staging, i.e anatomic and metabolic imaging, endoscopies and minimally invasive surgical procedures, should be performed sequentially and with an increasing degree of invasiveness. Intraoperative staging, assessing the magnitude of the primary tumour, the involved structures, and the loco-regional lymphatic spread by means of systematic nodal dissection, is essential in order to achieve a complete resection. In resected tumours, pathological staging, with the systematic study of the resected specimens, is the strongest prognostic indicator and is essential to make further decisions on therapy. In the present decade, the guidelines on lung cancer staging of the American College of Chest Physicians and the European Society of Thoracic Surgeons are based on the best available evidence and are widely followed. Recent advances in the classification of the adenocarcinoma of the lung, with the definition of adenocarcinoma in situ, minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma, and the publication of the eighth edition of the tumour, node and metastasis classification of lung cancer, have to be integrated into the staging process. The present review complements the latest guidelines on lung cancer staging by providing an update of all these issues.
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Affiliation(s)
- Ramón Rami-Porta
- Dept of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Barcelona, Spain.,Network of Centres for Biomedical Research in Respiratory Diseases (CIBERES) Lung Cancer Group, Barcelona, Spain
| | - Sergi Call
- Dept of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Barcelona, Spain.,Dept of Morphological Sciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Christophe Dooms
- Dept of Respiratory Diseases, University Hospitals, KU Leuven, Leuven, Belgium
| | - Carme Obiols
- Dept of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Centre of Imaging Diagnosis, Radiology Dept, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - William D Travis
- Dept of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ivan Vollmer
- Centre of Imaging Diagnosis, Radiology Dept, Hospital Clínic, University of Barcelona, Barcelona, Spain
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44
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García-Alfonso L, Vollmer I, Benegas M, Sánchez M. Ecografía con contraste en el diagnóstico de la atelectasia redonda: a propósito de un caso. Arch Bronconeumol 2018; 54:113-114. [DOI: 10.1016/j.arbres.2017.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/09/2017] [Indexed: 11/27/2022]
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45
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Corominas D, Vollmer I, Paredes P. Pulmonary Tumor Embolism due to Cardiac Metastasis of Lung Cancer. Arch Bronconeumol 2017; 53:396. [PMID: 28279519 DOI: 10.1016/j.arbres.2017.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/27/2016] [Accepted: 01/03/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Daniel Corominas
- Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen Clínic, Hospital Clínic, Barcelona, España
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen Clínic, Hospital Clínic, Barcelona, España.
| | - Pilar Paredes
- Servicio de Medicina Nuclear, Centro de Diagnóstico por la Imagen Clínic, Hospital Clínic, Barcelona, España
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46
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Barnes D, Gutiérrez Chacoff J, Benegas M, Perea RJ, de Caralt TM, Ramirez J, Vollmer I, Sanchez M. Central airway pathology: clinic features, CT findings with pathologic and virtual endoscopy correlation. Insights Imaging 2017; 8:255-270. [PMID: 28197883 PMCID: PMC5359148 DOI: 10.1007/s13244-017-0545-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/16/2017] [Accepted: 01/18/2017] [Indexed: 12/15/2022] Open
Abstract
Objectives To describe the imaging features of the central airway pathology, correlating the findings with those in pathology and virtual endoscopy. To propose a schematic and practical approach to reach diagnoses, placing strong emphasis on multidetector computed tomography (MDCT) findings. Methods We reviewed our thoracic pathology database and the central airway pathology-related literature. Best cases were selected to illustrate the main features of each disease. MDCT was performed in all cases. Multiplanar and volume-rendering reconstructions were obtained when necessary. Virtual endoscopy was obtained from the CT with dedicated software. Results Pathological conditions affecting the central airways are a heterogeneous group of diseases. Focal alterations include benign neoplasms, malignant neoplasms, and non-neoplastic conditions. Diffuse abnormalities are divided into those that produce dilation and those that produce stenosis and tracheobronchomalacia. Direct bronchoscopy (DB) visualises the mucosal layer and is an important diagnostic and therapeutic weapon. However, assessing the deep layers or the adjacent tissue is not possible. MDCT and post-processing techniques such as virtual bronchoscopy (VB) provide an excellent evaluation of the airway wall. Conclusion This review presents the complete spectrum of the central airway pathology with its clinical, pathological and radiological features. Teaching points • Dividing diseases into diffuse and focal lesions helps narrow the differential diagnosis. • Focal lesions with nodularity are more likely to correspond to tumours. • Focal lesions with stenosis are more likely to correspond to inflammatory disease. • Posterior wall involvement is the main feature in diffuse lesions with stenosis.
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Affiliation(s)
- Daniel Barnes
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | | | - Mariana Benegas
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Rosario J Perea
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Teresa M de Caralt
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - José Ramirez
- Pathology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Marcelo Sanchez
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
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47
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Vaz N, Vollmer I, Perea RJ. Pulmonary venous varix: A rare entity imitating arteriovenous malformation. Arch Bronconeumol 2016; 52:562-563. [PMID: 26518655 DOI: 10.1016/j.arbres.2015.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 08/13/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Nuno Vaz
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España
| | - Ivan Vollmer
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España.
| | - Rosario J Perea
- Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, España
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48
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Lafuente S, Fuster D, Arguis P, Granados U, Perlaza P, Paredes P, Vollmer I, Sánchez M, Lomeña F. Dual time-point 18 F-FDG PET/CT to assess response to radiofrequency ablation of lung metastases. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2015.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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49
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Vollmer I, Benegas M, Sánchez M. Is bilateral thoracocentesis necessary in bilateral pleural effusion? Arch Bronconeumol 2016; 52:345-6. [PMID: 26896304 DOI: 10.1016/j.arbres.2015.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 12/22/2015] [Accepted: 12/27/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Ivan Vollmer
- Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen Clínic, Hospital Clínic, Barcelona, España.
| | - Mariana Benegas
- Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen Clínic, Hospital Clínic, Barcelona, España
| | - Marcelo Sánchez
- Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen Clínic, Hospital Clínic, Barcelona, España
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50
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Lafuente S, Fuster D, Arguis P, Granados U, Perlaza P, Paredes P, Vollmer I, Sánchez M, Lomeña F. Dual time-point (18)F-FDG PET/CT to assess response to radiofrequency ablation of lung metastases. Rev Esp Med Nucl Imagen Mol 2016; 35:226-31. [PMID: 26848142 DOI: 10.1016/j.remn.2015.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/10/2015] [Accepted: 12/14/2015] [Indexed: 11/16/2022]
Abstract
AIM To establish the usefulness of dual time-point PET/CT imaging in determining the response to radiofrequency ablation (RFA) of solitary lung metastases from gastrointestinal cancer. MATERIALS AND METHODS This prospective study included 18 cases (3 female, 15 male, mean age 71±15 yrs) with solitary lung metastases from malignant digestive tract tumors candidates for RFA. PET/CT images 1h after injection of 4.07MBq/kg of (18)F-FDG (standard images) were performed at baseline, 1 month, and 3 months after RFA. PET/CT images 2h after injection centered in the thorax at 1 month after RFA were also performed (delayed images). A retention index (RI) of dual time-point images was calculated as follows: RI=(SUVmax delayed image-SUVmax standard image/SUVmax standard image)*100. Pathological confirmation of residual tumor by histology of the treated lesion was considered as local recurrence. A negative imaging follow-up was considered as complete response. RESULTS Local recurrence was found in 6/18 lesions, and complete response in the remaining 12. The mean percentage change in SUVmax at 1 month and at 3 months showed a sensitivity and specificity for PET/CT of 50% and 33%, and 67% and 92%, respectively. The RI at 1 month after RFA showed a sensitivity and specificity of 83% and 92%, respectively. CONCLUSIONS Dual time point PET/CT can predict the outcome at one month after RFA in lung metastases from digestive tract cancers. The RI can be used to indicate the need for further procedures to rule out persistent tumor due to incomplete RFA.
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Affiliation(s)
- S Lafuente
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain
| | - D Fuster
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain.
| | - P Arguis
- Radiology Department, Hospital Clínic, Barcelona, Spain
| | - U Granados
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain
| | - P Perlaza
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain
| | - P Paredes
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain
| | - I Vollmer
- Radiology Department, Hospital Clínic, Barcelona, Spain
| | - M Sánchez
- Radiology Department, Hospital Clínic, Barcelona, Spain
| | - F Lomeña
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain
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