Radiology & Imaging Archives - Page 2 of 4 - PulmCCM

Radiology & Imaging Articles

Jan 292013
Forget "embolic burden" of pulmonary embolism: location is everything

In Most Patients with Pulmonary Embolism, Central Clot is Worse than Peripheral by Brett Ley, MD Pulmonary embolism (PE) presents with a wide range of clinical severity and course. Management decisions (level of care, length of observation, and aggressive therapies such as thrombolysis) are generally based on a patient’s risk of a poor outcome. Guidelines recommend risk [… read more]

Jan 022013
PET scans often inaccurate; may deny curative surgery for lung cancer

The use of positron emission tomography — better known as PET scans — has grown dramatically over the past 15 years, thanks to their seemingly magical ability to identify foci of undetected metastatic cancer. But PET scans’ perceived high accuracy in diagnosing metastatic non-small cell lung cancer (NSCLC) — a published 94% sensitivity and 83% [… read more]

Dec 282012
ACCP, ATS only weakly recommend lung cancer CT screening, warn of harms

The American College of Chest Physicians (ACCP) has issued its long-awaited recommendations on lung cancer screening with chest CT — and far from a ringing endorsement of screening, they are conservative and subdued, emphasizing the potential risks of an uncontrolled approach to lung cancer screening in the general population. The American Society of Clinical Oncology [… read more]

Dec 282012
American Lung Association recommends CT screening for lung cancer

The American Lung Association has become the largest advisory body to recommend lung cancer screening for high-risk people, advising nearly all people aged 55-74 with a 30+ pack-year smoking history (the entry criteria for the National Lung Screening Trial, or NLST) to undergo low-dose CT scanning to detect early lung cancer. The National Comprehensive Cancer Network, [… read more]

Nov 142012
New lung tissue growth can occur in adults, defying previous belief

New Lung Tissue Growth Discovered: Is Some Lung Regeneration Possible? Lung regeneration has never been thought possible in adults. But Steven Mentzer et al from Brigham and Women’s at Harvard reported a case of a 33 year old woman who had an apparent 64% increase in the number of functioning alveoli in her left lung, during [… read more]

Oct 192012
"Practice ischemia" on an arm reduces contrast nephropathy after procedures (RCT)

Contrast-induced nephropathy (kidney damage) is a serious problem that can occur after many medical tests and procedures, but coronary angiography (cardiac catheterization) is the main culprit. People with pre-existing renal disease are most susceptible to contrast-induced nephropathy (CIN) — about 1 in 8 of them develop a “bump” in creatinine of >0.5 mg/dL after cardiac [… read more]

Sep 302012
Treatment of Acute Deep Vein Thrombosis (DVT) of the Arm (Review/Guideline)

The content previously here was removed at the request of the American College of Chest Physicians. For the ACCP 9th edition clinical practice guidelines for prevention and treatment of venous thromboembolism (VTE), please visit the ACCP website. PulmCCM is not affiliated with ACCP or Chest.

Aug 172012
Advanced bronchoscopy yields are 70% in meta-analysis (Review)

(image: Wikipedia) As one after another specialty society endorses routine lung cancer screening with chest CT scans, we all know a Nodule Storm is coming to a pulmonology clinic near you. Thankfully, smart people are asking how we can systematically and successfully handle this soon-to-be-common outpatient clinical problem. Most of these many thousands of nodules [… read more]

Jul 102012
Sharpen your eye with these free online radiology tutorials

Pulmonologists become fairly good semi-professional chest radiologists simply by showing up, paying attention and working hard during their training, and making an effort to keep learning throughout their careers. We have the advantage over radiologists of actually being able to “clinically correlate” the findings with what’s really going on, and to integrate that into our understanding [… read more]

May 212012
Diagnosis of Lower-Extremity DVT (Guideline)

The content previously here was removed at the request of the American College of Chest Physicians. For the ACCP 9th edition clinical practice guidelines for prevention and treatment of venous thromboembolism (VTE), please visit the ACCP website. PulmCCM is not affiliated with ACCP or Chest.

Apr 282012
Inferior vena cava filters for acute PE and DVT (ACCP Guidelines)

The content here previously has been removed at the request of the American College of Chest Physicians. For the ACCP’s Guidelines for Diagnosis and Management of DVT/PE/VTE, 9th edition, please visit the ACCP’s web site. PulmCCM is not affiliated with the ACCP.

Apr 242012
How to make $25,000 on each EBUS (Chest)

(image: flickrCC) Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA), when performed by skilled physicians, reduces the need for mediastinoscopy and unnecessary thoracotomies with their associated morbidity, and is poised to permanently alter the landscape of lung cancer diagnosis and staging. Prior to 2008, Medicare seemed to recognize the potential value of EBUS by paying hospitals [… read more]

Apr 062012

The 5-year results of the Danish Lung Cancer Screening Trial (DLCST) were reported in the April 2012 Thorax, and they show no mortality benefit from annual screening for lung cancer with chest CT. Rather, it appeared that more harmless early stage cancers were identified through screening — “overdiagnosis” of cancers that would never have advanced [… read more]

Mar 222012

Mazen Albeldawi and Rohit Makkar of the Cleveland Clinic bring us a free image in the New England Journal of what the bronchial tree looks like when a barium swallow test goes horribly awry. This patient had a very poor outcome, particularly unfortunate since this was an elective test. The New England Journal also ran a previous [… read more]

Mar 072012

When someone with a pneumothorax lies supine — as in the 23-year old man described in this New England Journal mini-case from Saweera Sabbar and Eric James Nilles of Rashid Trauma Center in Dubai, UAE — air rises laterally and caudally, and creates displacement downward and medially of the hemidiaphragm, displaying as the “deep sulcus [… read more]

Feb 032012

Jean-Pierre Tourtier and Sophie Cottez of the Military Hospital Val-de-Grâce, Paris share the case of a 61-year-old man who underwent vertebroplasty after a therapeutic laminectomy for resection of a vertebral hemangioma. Cement made it into his paravertebral vascular system, and thence to his systemic circulation and pulmonary arteries, where it made for some interesting radiographic pictures. [… read more]

Jan 282012

Hayder Saeed and Suleiman Massarweh of the University of Kentucky share with us the story and images of a woman presenting with weight loss and cough, and discovered to have hypertrophic pulmonary osteoarthropathy, velvety palmar skin, clubbing … and an 11 cm adenocarcinoma in the right lung. Saeed H, Massarweh S. Hypertrophic Pulmonary Osteoarthropathy and [… read more]

Jan 202012

Richard Light and friends established that parapneumonic effusions (PPE) associated with community-acquired pneumonia very rarely progress if the effusion is freely layering and less than 1 cm in height on a lateral decubitus chest film. But who orders those anymore? Chest CT use has risen 20-fold since Light’s seminal 1980 paper. Often the CT has [… read more]