- An assessment of18F-FDG PET/CT for thoracic screening and risk stratification of Pulmonary Nodules in Multiple Endocrine Neoplasia Type 1. [Journal Article]
- CEClin Endocrinol (Oxf) 2018 Feb 15
- CONCLUSIONS: Thoracic imaging with18F-FDG PET/CT effectively identifies pulmonary nodules and ThC. FDG-avid pulmonary lesions are significantly more likely to progress than non-avid lesions. This article is protected by copyright. All rights reserved.
- Localized thin-section CT with radiomics feature extraction and machine learning to classify early-detected pulmonary nodules from lung cancer screening. [Journal Article]
- PMPhys Med Biol 2018 Feb 15
- Lung cancer screening aims to detect small pulmonary nodules and decrease the mortality rate. However, studies from large-scale clinical trials of lung cancer screening showed false-positive rate is ...
Lung cancer screening aims to detect small pulmonary nodules and decrease the mortality rate. However, studies from large-scale clinical trials of lung cancer screening showed false-positive rate is high and positive predictive value is low. To address these problems, it is highly needed to have a technical approach for accurate malignancy differentiation among these early-detected nodules. We studied the clinical feasibility of an additional protocol of localized thin-section CT for further assessment on these recalled patients from lung cancer screening tests. Our approach of localized thin-section CT was integrated with radiomics features extraction and machine learning classification which was supervised by the pathological diagnosis. Localized thin-section CT images of 122 nodules were retrospectively reviewed and 374 radiomics features were extracted. In this study, 48 nodules were benign and 74 malignant. There were 9 patients with multiple nodules and 4 with synchronous multiple malignant nodules. Different machine learning classifiers with stratified 10-fold cross-validation were used and repeated 100 times to evaluate classification accuracy. 238 (64%) of image features extracted from thin-section CT images were useful to differentiate between benign and malignant nodules. These useful features include CT density (p=0.002518), sigma (p=0.002781), uniformity (p=0.03241), and entropy (p=0.006685). The highest classification accuracy was 79% by the logistic classifier. The performance metrics of this logistic classification model was 0.80 for positive predictive value, 0.36 for false-positive rate, and 0.80 for the area under the receiver operating characteristic curve. Our approach of direct risk classification supervised by the pathological diagnosis with localized thin-section CT and radiomics feature extraction may support clinical physicians to determine true malignant nodules and therefore reduce the problems in the lung cancer screening.
- Fatal air embolism following local anaesthetisation: does needle size matter? [Journal Article]
- BCBMJ Case Rep 2018 Feb 05; 2018
- A 76--year--old male cigarette smoker presented with a 2-week history of cough and haemoptysis. Chest CT on admission revealed multiple new lung nodules concerning for malignancy. CT--guided biopsy o...
A 76--year--old male cigarette smoker presented with a 2-week history of cough and haemoptysis. Chest CT on admission revealed multiple new lung nodules concerning for malignancy. CT--guided biopsy of the nodule in left lower lobe was attempted in prone oblique position for tissue diagnosis. Local anaesthetic (lidocaine) was administered using a 25--gauge (1.5-inch) needle to anaesthetise the skin and subcutaneous tissue. This was followed by insertion of a 25-gauge (3.5-inch) Whitacre needle to anaesthetise deeper tissues and parietal pleura. Due to patient's coughing and proximity of the nodule to the diaphragm, the circumstances were judged to be too risky for a needle biopsy. Therefore, it was decided to biopsy another nodule in the left lung that was visible on the same CT section. During this portion of the procedure, the patient became hypoxic and developed pulseless electrical activity arrest. Cardiopulmonary resuscitation was unsuccessful and the efforts ceased after 45 min. Subsequent review of CT scan revealed air in the left ventricle.
- New horizons in surgical treatment of ground-glass nodules of the lung: experience and controversies. [Review]
- TCTher Clin Risk Manag 2018; 14:203-211
- Ground-glass nodule (GGN) is defined as a nodular shadow with ground-glass opacity that is generally associated with the early-stage lung adenocarcinoma. Nowadays, GGNs of the lung are increasingly d...
Ground-glass nodule (GGN) is defined as a nodular shadow with ground-glass opacity that is generally associated with the early-stage lung adenocarcinoma. Nowadays, GGNs of the lung are increasingly detected with thin-section computed tomography scan. GGNs are categorized as pure GGNs and mixed GGNs according to the images from a high-resolution computed tomography. Meanwhile, it is routine to divide GGNs into different categories according to the number, solitary, or multiple, the management of which there is very different. A great number of studies have been conducted to analyze the different characteristics of GGNs in various aspects ranging from radiology, pathology, and surgery to molecular biology. However, plenty of problems still remain unsolved, ranging from the preoperative localization to intraoperative surgical resection procedure, the lymphadenectomy, and sampling of lymph nodes, as well as the accuracy of frozen sections. There has been a large volume of updated published information summarizing recently emerging and rapidly progressing aspects of surgical treatment of solitary and multiple GGNs with the unsolved problems mentioned above. However, there have been few specific reviews of surgical treatment of GGNs so far. This review presents a timely outline of advances in relevant experience and controversies of GGNs for a better understanding of this kind of lesion.
- Cryptogenic organizing pneumonia masquerading as lung carcinoma: A case report and review of the literature. [Journal Article]
- ETExp Ther Med 2018; 15(1):39-46
- Cryptogenic organizing pneumonia (COP) is a rare pulmonary disorder of unknown etiology. COP with hemoptysis as the primary presenting symptom has rarely been reported. The present study reported a c...
Cryptogenic organizing pneumonia (COP) is a rare pulmonary disorder of unknown etiology. COP with hemoptysis as the primary presenting symptom has rarely been reported. The present study reported a case of COP that resembled lung carcinoma with hemoptysis as the only clinical symptom. The patient recovered well following thoracoscope surgery. A literature review of 119 COP cases between 1995 and 2015 was presented. Cough, fever and dyspnea were the most common clinical manifestations. The most common imaging manifestations were multiple or single consolidation, lung nodules, migratory sign, reversed halo sign, and multiple ground-glass opacity. A total of 3 cases exhibited COP accompanied by lung cancer. Glucocorticoids were effective for the majority of cases and invasive surgeries were implemented in most cases. The majority of cases recovered or relieved, and the prognosis of COP was relatively good. COP was easily confused with lung tumor and it is necessary to make differential diagnosis between COP and lung cancer. Invasive surgery should be avoided when possible to avoid or reduce patient trauma.
- [Interstitial lung disease and pancreatic cancer: Series of two cases]. [Journal Article]
- RMRev Mal Respir 2018 Feb 01
- CONCLUSIONS: Where atypical interstitial lung disease occurs, biopsy should be considered in order not to delay a diagnosis of cancer, especially pancreatic cancer.
- [A Case of Successful Collective Treatment of Colon Cancer with Multiple Metachronous Pulmonary Metastases]. [Journal Article]
- GTGan To Kagaku Ryoho 2017; 44(12):1232-1234
- A case is a 46-year-old woman visited us with a chief complaint of bloody stools. A diagnosis of rectal cancer(Rs)was made, and laparoscopic resectomy plus D3 was performed. After progressing to pT4a...
A case is a 46-year-old woman visited us with a chief complaint of bloody stools. A diagnosis of rectal cancer(Rs)was made, and laparoscopic resectomy plus D3 was performed. After progressing to pT4a(SE)N2, M0, pStage III b, postoperative adjuvant chemotherapy(6 courses of XELOX)was administered. Two months after initiating chemotherapy, since the CEA value increased, chest abdominal CT was performed. Five nodules were found in the bilateral lungs and diagnosed as lung metastases(PUL2). Systemic chemotherapy(IRIS plus BV)is administered to PUL2(Grade C)of rectal cancer metachronous metastases. After 3 courses, the effect judgment was SD. Based on the recurrence period from postoperative adjuvant chemotherapy and the findings during this time, it was judged that weight loss surgery was appropriate for the rectal cancer lung metastatic lesions in which chemotherapy was ineffective, and partial resection of both lungs under thoracoscopic assistance was performed. Systemic chemotherapy(TAS-102 plus BV)was initiated to prevent postoperative recurrence. The patient is currently alive without relapse after 12 months. We reported a case of metachronous metastasis of colon cancer in which multidisciplinary treatment was successful.
- An Unusual Presentation of Sarcoidosis. [Journal Article]
- IMIr Med J 2017 10 10; 110(9):668
- Bilateral pleural effusions are a rare manifestation of sarcoidosis. We describe here the case of a 30 year old Vietnamese man living in Ireland who presented with a 4 month history of cough, dyspnoe...
Bilateral pleural effusions are a rare manifestation of sarcoidosis. We describe here the case of a 30 year old Vietnamese man living in Ireland who presented with a 4 month history of cough, dyspnoea on exertion and fatigue. On chest CT, he was found to have bilateral pleural effusions, bihilar lymphadenopathy and multiple pulmonary nodules. Pleural biopsy confirmed the presence of non caseating granulomas. He was commenced on steroids with excellent clinical response.
- Reevaluation of the efficacy of preoperative computed tomography-guided hook wire localization: A retrospective analysis. [Journal Article]
- IJInt J Surg 2018 Feb 01; 51:24-30
- CONCLUSIONS: CT-guided hook wire localization is a safe, reliable and convenient technique and can be applied widely to facilitate the resection of SPNs. Simultaneous localization for multiple nodules in ipsilateral lung may be associated with a higher risk of localization-related pneumothorax.
New Search Next
- Automatic detection of multisize pulmonary nodules in CT images: Large-scale validation of the false-positive reduction step. [Journal Article]
- MPMed Phys 2018 Jan 23
- CONCLUSIONS: The authors conclude that the proposed CAD system can identify dissimilar nodule candidates in the multiple heterogeneous datasets. It could be considered as a useful tool to support radiologists during screening trials.