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]

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

 Clinic and Consults, Lung Cancer, Radiology & Imaging  Comments Off on PET scans often inaccurate; may deny curative surgery for lung cancer
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]

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

 Lung Cancer, Policy, Ethics, Education, Radiology & Imaging  Comments Off on ACCP, ATS only weakly recommend lung cancer CT screening, warn of harms
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.

Ultrasound Case 2: Discussion

 Radiology & Imaging  Comments Off on Ultrasound Case 2: Discussion
Sep 082012

Ultrasound Case 2: Discussion (Back to Case 2) (See All Ultrasound Cases) Case2: Left lower quadrant scan. Case2: Left subcostal coronal scan. Dilated, fluid filled stomach and fluid filled bowel loops. The ultrasound exam revealed a few B lines at the left lung base, and a diaphragm located quite high on the left, almost in [… read more]

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]

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

(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]

Dutch lung cancer prevention trial shows no benefit of CT screening

 Lung Cancer, Radiology & Imaging, Randomized Controlled Trials  Comments Off on Dutch lung cancer prevention trial shows no benefit of CT screening
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]

Westermark sign in pulmonary embolism (Image, NEJM)

 Pulmonary Embolism / DVT / VTE, Radiology & Imaging, Review Articles  Comments Off on Westermark sign in pulmonary embolism (Image, NEJM)
Mar 272012

Westermark sign: a focal area of decreased lucency on a plain chest film with an abrupt cut-off in the pulmonary artery, corresponding to a central occlusive pulmonary embolism. A.S. Krishnan and Tristan Barrett share a nice example of the Westermark sign in the March 15 New England Journal.

Barium swallow fail kills patient (Image, NEJM)

 Radiology & Imaging  Comments Off on Barium swallow fail kills patient (Image, NEJM)
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]

Deep sulcus sign in pneumothorax (Image, NEJM)

 Pleural Disease, Radiology & Imaging  Comments Off on Deep sulcus sign in pneumothorax (Image, NEJM)
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]

Pulmonary cement embolism caused by vertebroplasty (Image, NEJM)

 Radiology & Imaging  Comments Off on Pulmonary cement embolism caused by vertebroplasty (Image, NEJM)
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]

Hypertrophic pulmonary osteoarthropathy with tripe palms (Image, NEJM)

 Lung Cancer, Radiology & Imaging  Comments Off on Hypertrophic pulmonary osteoarthropathy with tripe palms (Image, NEJM)
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]