Classification of pulmonary emphysema from chest CT scans using integral geometry descriptors

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van Rikxoort, E. M.; Goldin, J. G.; Galperin-Aizenberg, M.; Brown, M. S.

2011-03-01

To gain insight into the underlying pathways of emphysema and monitor the effect of treatment, methods to quantify and phenotype the different types of emphysema from chest CT scans are of crucial importance. Current standard measures rely on density thresholds for individual voxels, which is influenced by inspiration level and does not take into account the spatial relationship between voxels. Measures based on texture analysis do take the interrelation between voxels into account and therefore might be useful for distinguishing different types of emphysema. In this study, we propose to use Minkowski functionals combined with rotation invariant Gaussian features to distinguish between healthy and emphysematous tissue and classify three different types of emphysema. Minkowski functionals characterize binary images in terms of geometry and topology. In 3D, four Minkowski functionals are defined. By varying the threshold and size of neighborhood around a voxel, a set of Minkowski functionals can be defined for each voxel. Ten chest CT scans with 1810 annotated regions were used to train the method. A set of 108 features was calculated for each training sample from which 10 features were selected to be most informative. A linear discriminant classifier was trained to classify each voxel in the lungs into a subtype of emphysema or normal lung. The method was applied to an independent test set of 30 chest CT scans with varying amounts and types of emphysema with 4347 annotated regions of interest. The method is shown to perform well, with an overall accuracy of 95%.

Radiation exposure from Chest CT: Issues and Strategies

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Maher, Michael M.; Rizzo, Stefania; Kanarek, David; Shephard, Jo-Anne O.

2004-01-01

Concerns have been raised over alleged overuse of CT scanning and inappropriate selection of scanning methods, all of which expose patients to unnecessary radiation. Thus, it is important to identify clinical situations in which techniques with lower radiation dose such as plain radiography or no radiation such as MRI and occasionally ultrasonography can be chosen over CT scanning. This article proposes the arguments for radiation dose reduction in CT scanning of the chest and discusses recommended practices and studies that address means of reducing radiation exposure associated with CT scanning of the chest. PMID:15082885

The measurement of organic radiation dose of multi-slice CT scanning by using the Chinese anthropomorphic chest phantom

International Nuclear Information System (INIS)

Peng Gang; Zeng Yongming; Luo Tianyou; Zhao Feng; Zhang Zhiwei; Yu Renqiang; Peng Shengkun

2011-01-01

Objective: Using the Chinese anthropomorphic chest phantom to measure the absorbed dose of various tissues and organs under different noise index, and to assess the radiation dose of MSCT chest scanning with the effective dose (ED). Methods: The equivalence of the Chinese anthropomorphic chest phantom (CDP-1 C) and the adult chest on CT sectional anatomy and X-ray attenuation was demonstrated. The absorbed doses of various tissues and organs under different noise index were measured by laying thermoluminescent dosimeters (TLD) inside the phantom, and the corresponding dose-length products (DLP) were recorded. Both of them were later converted into ED and comparison was conducted to analyze the dose levels of chest CT scanning with automatic tube current modulation (ATCM) under different noise index. Student t-test was applied using SPSS 12.0 statistical software. Results: The Phantom was similar to the human body on CT sectional anatomy. The average CT value of phantom are - 788.04 HU in lung, 45.64 HU in heart, 65.84 HU in liver, 254.32 HU in spine and the deviations are 0.10%, 3.04%, 4.49% and 4.36% respectively compared to humans. The difference of average CT value of liver was statistically significant (t=-8.705, P 0.05). As the noise index increased from 8.5 to 22.5, the DLP decreased from 393.57 mGy · cm to 78.75 mGy · cm and the organs dose declined. For example, the average absorbed dose decreased from 22.38 mGy to 3.66 mGy in lung. Compared to ED calculating by absorbed dose, the ED calculating by DLP was lower. The ED values of the two methods were 6.69 mSv and 8.77 mSv when the noise index was set at 8.5. Conclusions: Application of the Chinese anthropomorphic chest phantom to carry out CT dose assessment is more accurate. The noise index should be set more than 8.5 during the chest CT scanning based on ATCM technique. (authors)

Evaluation of variation of voltage (kV) absorbed dose in chest CT scans

International Nuclear Information System (INIS)

Mendonca, Bruna G.A.; Mourao, Arnaldo P.

2013-01-01

Computed tomography (CT) is one of the most important diagnostic techniques images today. The increasing utilization of CT implies a significant increase of population exposure to ionizing radiation. Optimization of practice aims to reduce doses to patients because the image quality is directly related to the diagnosis. You can decrease the amount of dose to the patient, and maintain the quality of the image. There are several parameters that can be manipulated in a CT scan and these parameters can be used to reduce the energy deposited in the patient. Based on this, we analyzed the variation of dose deposited in the lungs, breasts and thyroid, by varying the supply voltage of the tube. Scans of the thorax were performed following the protocol of routine chest with constant and variable current for the same applied voltage. Moreover, a female phantom was used and thermoluminescent dosimeters (TLD-100), model bat, were used to record the specific organ doses. Scans were performed on a GE CT scanner, model 64 Discovery channels. Higher doses were recorded for the voltage of 120 kV with 200 mAs in the lungs (22.46 mGy) and thyroid (32.22 mGy). For scans with automatic mAs, variable between 100 and 440, this same tension contributed to the higher doses. The best examination in terms of the dose that was used with automatic 80 kV mAs, whose lungs and thyroid received lower dose. For the best breast exam was 100 kV. Since the increase in the 80 kV to 100 kV no impact so much the dose deposited in the lungs, it can be concluded that lowering the applied voltage to 100 kV resulted in a reduction in the dose absorbed by the patient. These results can contribute to optimizing scans of the chest computed tomography

Intra-abdominal fat area measurement using chest CT data

International Nuclear Information System (INIS)

Moriya, Hiroshi; Midorikawa, Shigeo; Hashimoto, Kouji; Ishii, Akira; Saitou, Kumi; Andou, Tomonori; Kitamura, Naoko; Sakuma, Koutarou

2007-01-01

Intra-abdominal fat obesity, which is linked with the metabolic syndrome, is usually characterized by measuring intra-abdominal fat area at the umbilical level of abdominal CT scan. In recent year, the chances of chest CT scanning are increased, as lung cancer screening survey or individual medical examination. Thus, we presented a method of measuring the areas of intra-abdominal fat and subcutaneous fat at the lower slice of chest CT scan. Fat areas found with this method were significantly correlated with those obtained at the umbilical level. (author)

Evaluation of the Significance of Incidental Breast Lesions Detected by Chest CT

International Nuclear Information System (INIS)

Kim, Jae Hyun; Chang, Yun Woo; Hwang, Jung Hwa; Kim, Hyung Hwan; Lee, Eun Hye; Yang, Seung Boo

2013-01-01

To evaluate the significance of incidentally detected breast lesions on a chest CT scan. Thirty-six incidental breast lesions in 26 patients were detected on a chest CT scan and were correlated with breast sonography, retrospectively. Among them, twenty-four breast lesions in 20 patients that were correlated with chest CT and sonography were available to pathology or follow up sonography. The CT findings were compared with sonographic findings according to the pathologic results. Incidentally detected breast lesions on a chest CT scan were correlated with sonography in 86% (31/36). Among 24 lesions that were available to pathology or follow up sonography, seven (29.2%) lesions were malignant and 17 (70.8%) lesions were benign. CT revealed a significant difference between benign and malignant lesions in terms of shape and margin (p = 0.007; p = 0.008, respectively). The CT findings were well correlated with sonographic findings in shape and margin (p = 0.001, respectively). Incidentally detected breast lesions on chest CT can be correlated with sonography. An irregular shape or a non-circumscribed margin of breast lesions on a CT scan can be considered as a suggestive sign of malignancy.

Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

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Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung [Samsung Medical Center, Seoul (Korea, Republic of); Chung, Seung Eun [Sangkye Paek Hospital, Seoul (Korea, Republic of)

1996-12-15

To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

International Nuclear Information System (INIS)

Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung; Chung, Seung Eun

1996-01-01

To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

Atelectasis on pediatric chest CT: comparison of sedation techniques

International Nuclear Information System (INIS)

Sargent, M.A.; McEachern, A.M.; Jamieson, D.H.

1999-01-01

Background. A change in practice at our institution resulted in increased use of anesthesia for CT scan of the chest in children who required sedation. Objective. To determine whether there is a difference in the frequency or severity of pulmonary atelectasis on CT scan in children sedated by anesthesiologists compared with children sedated by radiologists using intravenous pentobarbital. Materials and methods. Retrospective blinded review of 60 CT scans of the chest performed in 41 children. Forty-one studies in children sedated by radiologists (median age 29 months) were compared with 19 studies in children sedated by anesthesiologists (median age 25 months). Results. Atelectasis sufficient to obscure pulmonary metastases was shown in 5 of 41 (12 %) radiology sedations and 13 of 19 (68 %) anesthesiology sedations (P < 0.01). Higher grades of atelectasis were recorded in children under anesthesia (P < 0.01). Conclusion. Atelectasis is more frequent and more severe in children undergoing general anesthesia compared with intravenous pentobarbital sedation. Consideration should be given to the use of forced inspiration in children anesthetized for CT scan of the chest. (orig.)

Clinical value of CARE dose 4D technique in decreasing CT scanning dose of adult chest

International Nuclear Information System (INIS)

Wu Aiqin; Zheng Wenlong; Xu Chongyong; Fang Bidong; Ge Wen

2011-01-01

Objective: To investigate the value of CARE Dose 4D technique in decreasing radiation dose and improving image quality of multi-slice spiral CT in adult chest scanning. Methods: 100 patients of chest CT scanning were equally divided into study group and control group randomly. CARE Dose 4D Technique was used in study group. Effective mAs value, volume CT dose index (CTDI vol ) and dose length product (DLP) were displayed automatically in machine while chest scanning; those values and actual mAs value of every image were recorded respectively. The image quality at apex of lung, lower edge of aorta arch, middle area of left atrium and base of lung on every image of 400 images was judged and classified as three level (excellent, good, poor) by two deputy chief physicians with double blind method, the image noise at corresponding parts was measured. Results: While setting 80 mAs for quality reference mAs, the effective mAs value in study group most decreased 44 mAs than control group with an average decrease of 9.60 (12.0%), CTDI vol with 4.75 mGy with an average decrease of 0.95 mCy (11.0%), DLP 99.50% in study group, with 98.0% in control group. But it was higher at apex of lung and base of lung, lower at middle area of left atrium, and similar at lower edge of aorta arch in study group than contrast group. The image noise were lower at apex of lung and base of lung in study group than control group (t =6.299 and 2.332, all P<0.05), higher at middle area of left atrium in study group than control group (t=3.078, P<0.05) and similar at lower edge of aorta arch in study group than control group (t=1.191, P>0.05). Conclusions: CARE Dose 4D technique provides a function regulated mAs real-time on line, it not only raises utilization rate of radiation and decreases radiation dose, but also promises and increases image quality in chest CT scanning, and has some clinical significance. (authors)

CT of blunt chest trauma in children

International Nuclear Information System (INIS)

Manson, D.; Babyn, P.S.; Palder, S.; Bergmann, K.

1993-01-01

While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent therapy are also presented. We conclude that, in the event of clinically significant blunt chest trauma, the single supine chest examination in the trauma room is insufficient to adequately identify the extent of intrathoracic injury. With the exception of concern for aortic injury for which aortography is indicated, a dynamically enhanced CT scan of the thorax should be performed as clinically significant findings may result in altered therapy. (orig.)

Indications for chest CT. Retrospective study of cases with normal chest CT

International Nuclear Information System (INIS)

Obata, Shiro

1995-01-01

The usefulness of computed tomography (CT) in thoracic radiology is now well appreciated, and the number of chest CTs has greatly increased. There are, however, many chest CT cases that are completely or almost completely normal. Indications for chest CT should be re-evaluated considering the cost and radiation exposure associated with the examination. Reviewing the reports of 4930 chest CT examinations performed in three hospitals during the period of two years, the author found 620 (12.6%) negative CT examinations. In 312 of the 620, the CT was requested because of 'abnormal shadow' on chest radiograph. When the same chest radiographs were re-evaluated by two radiologists, no abnormality was noted in 257 cases (82.4%). CT examinations were considered justified in only 55 cases (17.6%). There was a significant difference in the frequency of normal chest CT examinations between the university hospital and two other hospitals. The causes of false positive interpretation of chest radiographs were analyzed, and it was felt that fundamental knowledge necessary to interpret chest radiographs was lacking. The importance of close cooperation between clinicians and radiologists should be emphasized. (author)

Ultrasound detection of pneumothorax compared with chest X-ray and computed tomography scan.

Science.gov (United States)

Nagarsheth, Khanjan; Kurek, Stanley

2011-04-01

Pneumothorax after trauma can be a life threatening injury and its care requires expeditious and accurate diagnosis and possible intervention. We performed a prospective, single blinded study with convenience sampling at a Level I trauma center comparing thoracic ultrasound with chest X-ray and CT scan in the detection of traumatic pneumothorax. Trauma patients that received a thoracic ultrasound, chest X-ray, and chest CT scan were included in the study. The chest X-rays were read by a radiologist who was blinded to the thoracic ultrasound results. Then both were compared with CT scan results. One hundred and twenty-five patients had a thoracic ultrasound performed in the 24-month period. Forty-six patients were excluded from the study due to lack of either a chest X-ray or chest CT scan. Of the remaining 79 patients there were 22 positive pneumothorax found by CT and of those 18 (82%) were found on ultrasound and 7 (32%) were found on chest X-ray. The sensitivity of thoracic ultrasound was found to be 81.8 per cent and the specificity was found to be 100 per cent. The sensitivity of chest X-ray was found to be 31.8 per cent and again the specificity was found to be 100 per cent. The negative predictive value of thoracic ultrasound for pneumothorax was 0.934 and the negative predictive value for chest X-ray for pneumothorax was found to be 0.792. We advocate the use of chest ultrasound for detection of pneumothorax in trauma patients.

CT findings of chest trauma

International Nuclear Information System (INIS)

Kim, Young Tong; Kim Young Il

1998-01-01

Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 persons under 40 years of age. Most pleural, pulmonary, mediastinal, and diaphragmatic injuries are not seen on conventional chest radiographs, or are underestimated. In patients with chest trauma, CT scanning is an effective and sensitive method of detecting thoracic injuries and provides accurate information regarding their pattern and extent. (author). 5 refs., 17 figs

Pulmonary disease in cystic fibrosis: assessment with chest CT at chest radiography dose levels.

Science.gov (United States)

Ernst, Caroline W; Basten, Ines A; Ilsen, Bart; Buls, Nico; Van Gompel, Gert; De Wachter, Elke; Nieboer, Koenraad H; Verhelle, Filip; Malfroot, Anne; Coomans, Danny; De Maeseneer, Michel; de Mey, Johan

2014-11-01

To investigate a computed tomographic (CT) protocol with iterative reconstruction at conventional radiography dose levels for the assessment of structural lung abnormalities in patients with cystic fibrosis ( CF cystic fibrosis ). In this institutional review board-approved study, 38 patients with CF cystic fibrosis (age range, 6-58 years; 21 patients 18 years) underwent investigative CT (at minimal exposure settings combined with iterative reconstruction) as a replacement of yearly follow-up posteroanterior chest radiography. Verbal informed consent was obtained from all patients or their parents. CT images were randomized and rated independently by two radiologists with use of the Bhalla scoring system. In addition, mosaic perfusion was evaluated. As reference, the previous available conventional chest CT scan was used. Differences in Bhalla scores were assessed with the χ(2) test and intraclass correlation coefficients ( ICC intraclass correlation coefficient s). Radiation doses for CT and radiography were assessed for adults (>18 years) and children (chest CT protocol can replace the two yearly follow-up chest radiographic examinations without major dose penalty and with similar diagnostic quality compared with conventional CT.

1024 matrix image reconstruction: usefulness in high resolution chest CT

International Nuclear Information System (INIS)

Jeong, Sun Young; Chung, Myung Jin; Chong, Se Min; Sung, Yon Mi; Lee, Kyung Soo

2006-01-01

We tried to evaluate whether high resolution chest CT with a 1,024 matrix has a significant advantage in image quality compared to a 512 matrix. Each set of 512 and 1024 matrix high resolution chest CT scans with both 0.625 mm and 1.25 mm slice thickness were obtained from 26 patients. Seventy locations that contained twenty-four low density lesions without sharp boundary such as emphysema, and forty-six sharp linear densities such as linear fibrosis were selected; these were randomly displayed on a five mega pixel LCD monitor. All the images were masked for information concerning the matrix size and slice thickness. Two chest radiologists scored the image quality of each ar rowed lesion as follows: (1) undistinguishable, (2) poorly distinguishable, (3) fairly distinguishable, (4) well visible and (5) excellently visible. The scores were compared from the aspects of matrix size, slice thickness and the different observers by using ANOVA tests. The average and standard deviation of image quality were 3.09 (± .92) for the 0.625 mm x 512 matrix, 3.16 (± .84) for the 0.625 mm x 1024 matrix, 2.49 (± 1.02) for the 1.25 mm x 512 matrix, and 2.35 (± 1.02) for the 1.25 mm x 1024 matrix, respectively. The image quality on both matrices of the high resolution chest CT scans with a 0.625 mm slice thickness was significantly better than that on the 1.25 mm slice thickness (ρ < 0.001). However, the image quality on the 1024 matrix high resolution chest CT scans was not significantly different from that on the 512 matrix high resolution chest CT scans (ρ = 0.678). The interobserver variation between the two observers was not significant (ρ = 0.691). We think that 1024 matrix image reconstruction for high resolution chest CT may not be clinical useful

Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

OpenAIRE

Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

2011-01-01

Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a tru...

Prevalence and Severity of Off-Centering During Diagnostic CT: Observations From 57,621 CT scans of the Chest, Abdomen, and/or Pelvis.

Science.gov (United States)

Akin-Akintayo, Oladunni O; Alexander, Lauren F; Neill, Rebecca; Krupinksi, Elizabeth A; Tang, Xiangyang; Mittal, Pardeep K; Small, William C; Moreno, Courtney C

2018-02-23

To determine distances between patient centroid and gantry isocenter during CT imaging of the chest, abdomen, and/or pelvis, and to evaluate differences based on patient gender, scan region, patient position, and gantry aperture. A water phantom and an anthropomorphic phantom were imaged in the centered position in the CT gantry and at several off-centered positions. Additionally, data from 57,621 adult chest, abdomen, and/or pelvic CT acquisitions were evaluated. Data were analyzed with an analysis of variance using the centroid-to-isocenter data as the dependent variable and the other parameters as independent variables. The majority of patient acquisitions (83.7% (48271/57621)) were performed with the patient's centroid positioned below isocenter (mean 1.7 cm below isocenter (SD 1.8 cm); range 12.1 cm below to 7.8 cm above isocenter). Off-centering in the x-axis was less severe (mean 0.01 cm left of isocenter (SD 1.6 cm)). Distance between centroid and isocenter in the y-axis did not differ as a function of sex but did differ based on scan region, patient position, and gantry aperture. Off-centering is common during CT imaging and has been previously demonstrated to impact dose and image quality. Copyright © 2018 Elsevier Inc. All rights reserved.

Scan Quality and Entrance Skin Dose in Thoracic CT: A Comparison between Bismuth Breast Shield and Posteriorly Centered Partial CT Scans

International Nuclear Information System (INIS)

Tappouni, Rafel; Mathers, Bradley

2012-01-01

Objectives. To compare the effectiveness of the bismuth breast shield and partial CT scan in reducing entrance skin dose and to evaluate the effect of the breast shield on image quality (IQ). Methods. Nanodots were placed on an adult anthropomorphic phantom. Standard chest CT, CT with shield, and partial CT were performed. Nanodot readings and effective doses were recorded. 50 patients with chest CTs obtained both with and without breast shields were reviewed. IQ was evaluated by two radiologists and by measuring Hounsfield units (HUs) and standard deviation (SD) of HU in anterior subcutaneous region. Results. Breast shield and the partial CT scans reduced radiation to the anterior chest by 38% and 16%, respectively. Partial CT increased dose to the posterior chest by 37% and effective dose by 8%. Change in IQ in shield CT was observed in the anterior chest wall. Significant change in IQ was observed in 5/50 cases. The shield caused an increase of 20 HU (P = 0.021) and a 1.86 reduction in SD of HU (P = 0.027) in the anterior compared to posterior subcutaneous regions. Summary. Bismuth breast shield is more effective than the partial CT in reducing entrance skin dose while maintaining image quality

Possibilities of CT examinations by chest trauma

International Nuclear Information System (INIS)

Ftacnikova, B.

1994-01-01

Chest trauma represents the most frequent associated injury in multiply injured patients. The success of treatment depends also on prompt and effective diagnosis and extent of the injuries, on quality interdisciplinary approach. Author presents contributions of computed tomography (CT) in the management of 77 critically injured patients. Attention is focused on the efficacy of CT examination routinely employed in the setting of thoracic trauma and its relationship to following rationalization of treatment. CT scans of thorax is modality of choice for evaluating patients with occult pneumothorax, chest wall deformity of rib fractures, early diagnosis of lung contusion and laceration. (author). 13 figs., 1 tab., 7 refs

Early Chest Computed Tomography Scan to Assist Diagnosis and Guide Treatment Decision for Suspected Community-acquired Pneumonia.

Science.gov (United States)

Claessens, Yann-Erick; Debray, Marie-Pierre; Tubach, Florence; Brun, Anne-Laure; Rammaert, Blandine; Hausfater, Pierre; Naccache, Jean-Marc; Ray, Patrick; Choquet, Christophe; Carette, Marie-France; Mayaud, Charles; Leport, Catherine; Duval, Xavier

2015-10-15

Clinical decision making relative to community-acquired pneumonia (CAP) diagnosis is difficult. Chest radiograph is key in establishing parenchymal lung involvement. However, radiologic performance may lead to misdiagnosis, rendering questionable the use of chest computed tomography (CT) scan in patients with clinically suspected CAP. To assess whether early multidetector chest CT scan affects diagnosis and management of patients visiting the emergency department with suspected CAP. A total of 319 prospectively enrolled patients with clinically suspected CAP underwent multidetector chest CT scan within 4 hours. CAP diagnosis probability (definite, probable, possible, or excluded) and therapeutic plans (antibiotic initiation/discontinuation, hospitalization/discharge) were established by emergency physicians before and after CT scan results. The adjudication committee established the final CAP classification on Day 28. Chest radiograph revealed a parenchymal infiltrate in 188 patients. CAP was initially classified as definite in 143 patients (44.8%), probable or possible in 172 (53.8%), and excluded in 4 (1.2%). CT scan revealed a parenchymal infiltrate in 40 (33%) of the patients without infiltrate on chest radiograph and excluded CAP in 56 (29.8%) of the 188 with parenchymal infiltrate on radiograph. CT scan modified classification in 187 (58.6%; 95% confidence interval, 53.2-64.0), leading to 50.8% definite CAP and 28.8% excluded CAP, and 80% of modifications were in accordance with adjudication committee classification. Because of CT scan, antibiotics were initiated in 51 (16%) and discontinued in 29 (9%), and hospitalization was decided in 22 and discharge in 23. In CAP-suspected patients visiting the emergency unit, early CT scan findings complementary to chest radiograph markedly affect both diagnosis and clinical management. Clinical trial registered with www.clinicaltrials.gov (NCT 01574066).

Chest wall tuberculosis; CT findings in 14 patients

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Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National Univ. School of Medicine, Chonju (Korea, Republic of); Kim, Dong Woo [Daejoen Eulji Hospital, Daejon (Korea, Republic of); Juhng, Seon Kwan [Wonkwang Univ. Medical School, Iksan (Korea, Republic of)

1996-01-01

To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis.

Chest wall tuberculosis; CT findings in 14 patients

International Nuclear Information System (INIS)

Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul; Kim, Dong Woo; Juhng, Seon Kwan

1996-01-01

To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis

Patient-specific radiation dose and cancer risk for pediatric chest CT.

Science.gov (United States)

Li, Xiang; Samei, Ehsan; Segars, W Paul; Sturgeon, Gregory M; Colsher, James G; Frush, Donald P

2011-06-01

To estimate patient-specific radiation dose and cancer risk for pediatric chest computed tomography (CT) and to evaluate factors affecting dose and risk, including patient size, patient age, and scanning parameters. The institutional review board approved this study and waived informed consent. This study was HIPAA compliant. The study included 30 patients (0-16 years old), for whom full-body computer models were recently created from clinical CT data. A validated Monte Carlo program was used to estimate organ dose from eight chest protocols, representing clinically relevant combinations of bow tie filter, collimation, pitch, and tube potential. Organ dose was used to calculate effective dose and risk index (an index of total cancer incidence risk). The dose and risk estimates before and after normalization by volume-weighted CT dose index (CTDI(vol)) or dose-length product (DLP) were correlated with patient size and age. The effect of each scanning parameter was studied. Organ dose normalized by tube current-time product or CTDI(vol) decreased exponentially with increasing average chest diameter. Effective dose normalized by tube current-time product or DLP decreased exponentially with increasing chest diameter. Chest diameter was a stronger predictor of dose than weight and total scan length. Risk index normalized by tube current-time product or DLP decreased exponentially with both chest diameter and age. When normalized by DLP, effective dose and risk index were independent of collimation, pitch, and tube potential (chest CT protocols. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101900/-/DC1. RSNA, 2011

An Evaluation of pectus excavatum by means of body surface measurements on chest CT scans

International Nuclear Information System (INIS)

Hirotani, Taichi; Ohama, Kazunori; Shimotake, Takashi; Ishikawa, Nobuki; Watanabe, Reiji

2009-01-01

The aim of this study is to determine whether the body surface index replaces the Haller index in order to evaluate the severity of pectus excavatum. Sixty-nine cases with a diagnosis of pectus excavatum between August 2001 and January 2008 were prospectively enrolled in the study. The anterior-posterior chest dimension, lateral chest dimension and depth of the most profound depressed area were measured. The body surface index was expressed as an equation A/(B-C), where A was the transverse diameter, B was the anterior-posterior diameter and C was the depth of the depressed area. This index was compared to the Haller index in each patient. In this study, each value was measured on a chest CT scan. The body surface index significantly correlated with the Haller index, in which the coefficient of correlation was 0.879 (p<0.01). The body surface index corresponding to Haller index 3.25 seems to be 1.67. We could find the body surface index corresponding to each Haller index. We propose that an evaluation of pectus excavatum by means of body surface measurements is clinically useful, and may replace the Haller index. The body surface index may allow us to assess the severity of pectus excavatum without a CT scan, resulting in a reduction of radiation exposure for children with pectus excavatum. It's possible to evaluate the body surface index by using a relational table between this index and the Hailer index. We'll evaluate the body surface index by using values measured on a real body. (author)

Cardiac CT for the assessment of chest pain: Imaging techniques and clinical results

International Nuclear Information System (INIS)

Becker, Hans-Christoph; Johnson, Thorsten

2012-01-01

Immediate and efficient risk stratification and management of patients with acute chest pain in the emergency department is challenging. Traditional management of these patients includes serial ECG, laboratory tests and further on radionuclide perfusion imaging or ECG treadmill testing. Due to the advances of multi-detector CT technology, dedicated coronary CT angiography provides the potential to rapidly and reliably diagnose or exclude acute coronary artery disease. Life-threatening causes of chest pain, such as aortic dissection and pulmonary embolism can simultaneously be assessed with a single scan, sometimes referred to as “triple rule out” scan. With appropriate patient selection, cardiac CT can accurately diagnose heart disease or other sources of chest pain, markedly decrease health care costs, and reliably predict clinical outcomes. This article reviews imaging techniques and clinical results for CT been used to evaluate patients with chest pain entering the emergency department.

Case report: Pulmonary syphilis mimicking pulmonary hematogenous metastases on chest CT and integrated PET/CT

International Nuclear Information System (INIS)

Kim, Hyung Jun; Seon, Hyun Ju; Shin, Hyo Hyun; Choi, Yoo-Duk

2011-01-01

We report a case of syphilis with pulmonary involvement. Chest CT scan and 18 F-fluorodeoxyglucose (FDG) PET/CT showed multiple pulmonary nodules mimicking pulmonary hematogenous metastases. This was confirmed on follow-up images that showed therapeutic response to penicillin

CT of chest trauma

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Goodman, P.C.

1986-01-01

There appears to be a limited role for computed tomography in the evaluation of chest trauma. The literature contains few papers specifically addressing the use of CT in the setting of chest trauma. Another series of articles relates anecdotal experiences in this regard. This paucity of reports attests to the remarkable amount of information present on conventional chest radiographs as well as the lack of clear indications for CT in the setting of chest trauma. In this chapter traumatic lesions of various areas of the thorax are discussed. The conventional radiographic findings are briefly described and the potential or proven application of CT is addressed

Case report: Pulmonary syphilis mimicking pulmonary hematogenous metastases on chest CT and integrated PET/CT

Directory of Open Access Journals (Sweden)

Hyung Jun Kim

2011-01-01

Full Text Available We report a case of syphilis with pulmonary involvement. Chest CT scan and 18 F-fluorodeoxyglucose (FDG PET/CT showed multiple pulmonary nodules mimicking pulmonary hematogenous metastases. This was confirmed on follow-up images that showed therapeutic response to penicillin.

Automated lung volumetry from routine thoracic CT scans: how reliable is the result?

Science.gov (United States)

Haas, Matthias; Hamm, Bernd; Niehues, Stefan M

2014-05-01

Today, lung volumes can be easily calculated from chest computed tomography (CT) scans. Modern postprocessing workstations allow automated volume measurement of data sets acquired. However, there are challenges in the use of lung volume as an indicator of pulmonary disease when it is obtained from routine CT. Intra-individual variation and methodologic aspects have to be considered. Our goal was to assess the reliability of volumetric measurements in routine CT lung scans. Forty adult cancer patients whose lungs were unaffected by the disease underwent routine chest CT scans in 3-month intervals, resulting in a total number of 302 chest CT scans. Lung volume was calculated by automatic volumetry software. On average of 7.2 CT scans were successfully evaluable per patient (range 2-15). Intra-individual changes were assessed. In the set of patients investigated, lung volume was approximately normally distributed, with a mean of 5283 cm(3) (standard deviation = 947 cm(3), skewness = -0.34, and curtosis = 0.16). Between different scans in one and the same patient the median intra-individual standard deviation in lung volume was 853 cm(3) (16% of the mean lung volume). Automatic lung segmentation of routine chest CT scans allows a technically stable estimation of lung volume. However, substantial intra-individual variations have to be considered. A median intra-individual deviation of 16% in lung volume between different routine scans was found. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Organ dose evaluation for CT scans based on in-phantom measurements

International Nuclear Information System (INIS)

Liu Haikuan; Zhuo Weihai; Chen Bo; Yi Yanling; Li Dehong

2009-01-01

Objective: To explore the organ doses and their distributions in different projections of CT scans. Methods: The CT values were measured and the linear absorption coefficients were derived for the main organs of the anthropomorphic phantom to compare with the normal values of human beings. The radiophotoluminescent glass dosimeters were set into various tissues or organs of the phantom for mimic measurements of the organ doses undergoing the head, chest, abdomen and pelvis CT scans, respectively. Results: The tissue equivalence of the phantom used in this study was good. The brain had the largest organ dose undergoing the head CT scan. The organ doses in thyroid, breast, lung and oesophagus were relatively large in performing the chest CT scan, while the liver, stomach, colon and lung had relatively hrge organ doses in abdomen CT practice. The doses in bone surface and colon exceeded by 50 mGy in a single pelvis CT scan. Conclusions: The organ doses and their distributions largely vary with different projections of CT scans. The organ doses of colon, bone marrow,gonads and bladder are fairly large in performing pelvis CT scan, which should be paid attention in the practice. (authors)

Estimated risk of radiation-induced cancer from paediatric chest CT: two-year cohort study

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Niemann, Tilo [Cantonal Hospital Baden, Department of Radiology, Baden (Switzerland); University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Colas, Lucie; Santangelo, Teresa; Faivre, Jean Baptiste; Remy, Jacques; Remy-Jardin, Martine [University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Roser, Hans W.; Bremerich, Jens [University of Basel Hospital, Clinic of Radiology and Nuclear Medicine, Medical Physics, Basel (Switzerland)

2015-03-01

The increasing absolute number of paediatric CT scans raises concern about the safety and efficacy and the effects of consecutive diagnostic ionising radiation. To demonstrate a method to evaluate the lifetime attributable risk of cancer incidence/mortality due to a single low-dose helical chest CT in a two-year patient cohort. A two-year cohort of 522 paediatric helical chest CT scans acquired using a dedicated low-dose protocol were analysed retrospectively. Patient-specific estimations of radiation doses were modelled using three different mathematical phantoms. Per-organ attributable cancer risk was then estimated using epidemiological models. Additional comparison was provided for naturally occurring risks. Total lifetime attributable risk of cancer incidence remains low for all age and sex categories, being highest in female neonates (0.34%). Summation of all cancer sites analysed raised the relative lifetime attributable risk of organ cancer incidence up to 3.6% in female neonates and 2.1% in male neonates. Using dedicated scan protocols, total lifetime attributable risk of cancer incidence and mortality for chest CT is estimated low for paediatric chest CT, being highest for female neonates. (orig.)

Evaluation of radiation doses delivered in different chest CT protocols

International Nuclear Information System (INIS)

Gorycki, Tomasz; Lasek, Iwona; Kamiński, Kamil; Studniarek, Michał

2014-01-01

There are differences in the reference diagnostic levels for the computed tomography (CT) of the chest as cited in different literature sources. The doses are expressed either in weighted CT dose index (CTDI VOL ) used to express the dose per slice, dose-length product (DLP), and effective dose (E). The purpose of this study was to assess the radiation dose used in Low Dose Computer Tomography (LDCT) of the chest in comparison with routine chest CT examinations as well as to compare doses delivered in low dose chest CT with chest X-ray doses. CTDI VOL and DLP doses were taken to analysis from routine CT chest examinations (64 MDCT TK LIGHT SPEED GE Medical System) performed in 202 adult patients with FBP reconstruction: 51 low dose, 106 helical, 20 angio CT, and 25 high resolution CT protocols, as well as 19 helical protocols with iterative ASIR reconstruction. The analysis of chest X-ray doses was made on the basis of reports from 44 examinations. Mean values of CTDI VOL and DLP were, respectively: 2.1 mGy and 85.1 mGy·cm, for low dose, 9.7 mGy and 392.3 mGy·cm for helical, 18.2 mGy and 813.9 mGy·cm for angio CT, 2.3 mGy and 64.4 mGy·cm for high resolution CT, 8.9 mGy. and 317.6 mGy·cm for helical ASIR protocols. Significantly lower CTDI VOL and DLP values were observed for low dose and high resolution CT versus the remaining CT protocols; doses delivered in CT ASIR protocols were also lower (80–81%). The ratio between medial doses in low dose CT and chest X-ray was 11.56. Radiation dose in extended chest LDCT with parameters allowing for identification of mediastinal structures and adrenal glands is still much lower than that in standard CT protocols. Effective doses predicted for LDCT may exceed those used in chest X-ray examinations by a factor of 4 to 12, depending on LDCT scan parameters. Our results, as well as results from other authors, suggest a possibility of reducing the dose by means of iterative reconstruction. Efforts towards further dose

Routine chest and abdominal high-pitch CT: An alternative low dose protocol with preserved image quality

International Nuclear Information System (INIS)

Amacker, Nadja A.; Mader, Caecilia; Alkadhi, Hatem; Leschka, Sebastian; Frauenfelder, Thomas

2012-01-01

Objective: To investigate the radiation dose and image quality of the high-pitch dual source computer tomography (DSCT) for routine chest and abdominal scans. Methods: 130 consecutive patients (62 female, 68 male, median age 55 years) were included. All patients underwent 128-slice high-pitch DSCT (chest n = 99; abdomen n = 84) at a pitch of 3.2. Two observers independently rated image quality using a 4-point score (1: excellent to 4: non-diagnostic). Image noise was measured and operational radiation dose quantities were recorded. An additional group of 132 patients (chest, n = 80; abdomen n = 52) scanned with standard-pitch CT matched for age, gender, and body mass index (BMI) served as control group. Results: Interobserver agreement for image quality rating was good (k = 0.74). Subjective image quality of high-pitch CT was diagnostic in all patients (median score chest; 2, median score abdomen: 2). Image noise of high-pitch CT was comparable to standard-pitch for the chest (p = 0.32) but increased in the abdomen (p < 0.0001). For high-pitch CT radiation dose was 4.4 ± 0.9 mSv (chest) and 6.5 ± 1.2 mSv (abdomen). These values were significantly lower compared to standard-pitch CT (chest: 5.5 ± 1.2 mSv; abdomen: 11.3 ± 3.8 mSv). Conclusion: Based on the technical background high-pitch dual source CT may serve as an alternative scan mode for low radiation dose routine chest and abdominal CT.

Doses in pediatric patients undergoing chest and abdomen CT examinations. Preliminary results

International Nuclear Information System (INIS)

Jornada, Tiago S.; Silva, Teogenes A. da

2011-01-01

Computed tomography (CT) is a non-invasive method of image production that imparts significant doses to a patient, it is expected that pediatric CT examinations will increase the risk of induced cancer in children. In this study the effective doses in a five year-old child submitted to chest or abdomen CT scans were assessed for comparison purposes. The CTEXPO computed program was used with data from routine protocols of a 0 to 13 year-old children in two public hospitals in Belo Horizonte. Hospital A used a Siemens Dual-Slice unit with 80 kV, 41 mA and pitch 2 for chest or abdomen; hospital B used a Multislice GE unit with 120 kV, 45 mA and pitch 1 for chest and 120 kV, 55 mA. and pitch 1 for abdomen. Results of effective doses in a five year-old child were 1.7 and 1.0 mSv in hospital A and 9.1 and 7.2 mSv in hospital B, for chest and abdomen, respectively. Results were compared to the reference effective doses of 7.2 and 5.0 mSv for chest and abdomen respectively that were derived from the air kerma length product values given in ICRP publication 87. Results of hospital A showed that low dose exposures also can be achieved in CT scans of children. Results showed that even a hospital with a modern facility (hospital B) can provided doses higher than reference values if protocols are not adjusted for children. Preliminary results suggested that there is a room for optimizing children exposure submitted to CT scans. (author)

Lateral topography for reducing effective dose in low-dose chest CT.

Science.gov (United States)

Bang, Dong-Ho; Lim, Daekeon; Hwang, Wi-Sub; Park, Seong-Hoon; Jeong, Ok-man; Kang, Kyung Wook; Kang, Hohyung

2013-06-01

The purposes of this study were to assess radiation exposure during low-dose chest CT by using lateral topography and to compare the lateral topographic findings with findings obtained with anteroposterior topography alone and anteroposterior and lateral topography combined. From November 2011 to February 2012, 210 male subjects were enrolled in the study. Age, weight, and height of the men were recorded. All subjects were placed into one of three subgroups based on the type of topographic image obtained: anteroposterior topography, lateral topography, and both anteroposterior and lateral topography. Imaging was performed with a 128-MDCT scanner. CT, except for topography, was the same for all subjects. A radiologist analyzed each image, recorded scan length, checked for any insufficiencies in the FOV, and calculated the effective radiation dose. One-way analysis of variance and multiple comparisons were used to compare the effective radiation exposure and scan length between groups. The mean scan length in the anteroposterior topography group was significantly greater than that of the lateral topography group and the combined anteroposterior and lateral topography group (p topography group (0.735 ± 0.033 mSv) was significantly lower than that for the anteroposterior topography group (0.763 ± 0.038 mSv) and the combined anteroposterior and lateral topography group (0.773 ± 0.038) (p < 0.001). Lateral topographic low-dose CT was associated with a lower effective radiation dose and scan length than either anteroposterior topographic low-dose chest CT or low-dose chest CT with both anteroposterior and lateral topograms.

CT dose profiles and MSAD calculation in a chest phantom

International Nuclear Information System (INIS)

Oliveira, Bruno Beraldo; Silva, Teogenes Augusto da

2011-01-01

For optimizing patient doses in computed tomography (CT), the Brazilian legislation has only established diagnostic reference levels (DRLs) in terms of Multiple Scan Average Dose (MSAD) in a typical adult as a quality control parameter for CT scanners. Compliance with the DRLs can be verified by measuring the Computed Tomography Air Kerma Index with a calibrated pencil ionization chamber or by obtaining the dose distribution in CT scans. An analysis of the quality of five CT scanners in Belo Horizonte was done in terms of dose profile of chest scans and MSAD determinations. Measurements were done with rod shape lithium fluoride thermoluminescent dosimeters (TLD-100) distributed in cylinders positioned in peripheral and central regions of a polymethylmethacrylate chest phantom. The peripheral regions presented higher dose values. The longitudinal dose variation can be observed and the maximum dose was recorded at the edges of the phantom at the midpoint of the longitudinal axis. The MSAD results were in according to the DRL of 25 mGy established by Brazilian legislation. The results contribute to disseminate to hospitals and radiologists the proper procedure to use the thermoluminescent dosimeters for the calculation of the MSAD from the CT dose profiles and to notice the compliance with the DRLs. (author)

Bicuspid aortic valves: Diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT

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Murphy, David J., E-mail: david.murphy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); McEvoy, Sinead H., E-mail: s.mcevoy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); Iyengar, Sri, E-mail: sri.iyengar@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Feuchtner, Gudrun, E-mail: Gudrun.Feuchtner@i-med.ac.at [Department of Radiology, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck (Austria); Cury, Ricardo C., E-mail: r.cury@baptisthealth.net [Department of Radiology, Baptist Cardiac and Vascular Institute, 8900 North Kendall Drive, Miami, FL 33176 (United States); Roobottom, Carl, E-mail: carl.roobottom@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Plymouth University Peninsula Schools of Medicine and Dentistry (United Kingdom); Baumueller, Stephan, E-mail: Hatem.Alkadhi@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Alkadhi, Hatem, E-mail: stephan.baumueller@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Dodd, Jonathan D., E-mail: jonniedodd@gmail.com [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland)

2014-08-15

Objectives: To assess the diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves. Materials and methods: The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly analyzed for (i) the appearance of the valve cusps, (ii) the largest aortic sinus area, (iii) the longest aortic cusp length, (iv) the thickest aortic valve cusp and (v) valve calcification. A second blinded reader independently analyzed the appearance of the valve cusps. Forty-two age- and sex-matched patients with known tricuspid aortic valves were used as controls. Retrospectively ECG-gated cardiac CT multiphase reconstructions of the aortic valve were used as the gold-standard. Results: Fourteen (21%) scans were scored as unevaluable (7 bicuspid, 7 tricuspid). Of the remainder, there were 13 evaluable bicuspid valves, ten of which showed an aortic valve line sign, while the remaining three showed a normal Mercedes-Benz appearance owing to fused valve cusps. The 35 evaluable tricuspid aortic valves all showed a normal Mercedes-Benz appearance (P = 0.001). Kappa analysis = 0.62 indicating good interobserver agreement for the aortic valve cusp appearance. Aortic sinus areas, aortic cusp lengths and aortic cusp thicknesses of ≥3.8 cm{sup 2}, 3.2 cm and 1.6 mm respectively on standard axial chest CT best distinguished bicuspid from tricuspid aortic valves (P < 0.0001 for all). Of evaluable scans, the sensitivity, specificity, positive and negative predictive values of standard axial chest CT in diagnosing bicuspid aortic valves was 77% (CI 0.54–1.0), 100%, 100% and 70% respectively. Conclusion: The aortic valve is evaluable in approximately 80% of standard chest 64-slice CT scans. Bicuspid aortic valves may be diagnosed on evaluable scans with good diagnostic accuracy. An aortic valve line sign, enlarged aortic sinuses and elongated, thickened valve cusps are specific CT

Increased inspiratory pressure for reduction of atelectasis in children anesthetized for CT scan

International Nuclear Information System (INIS)

Sargent, Michael A.; Jamieson, Douglas H.; McEachern, Anita M.; Blackstock, Derek

2002-01-01

Background: Atelectasis is more frequent and more severe in children anesthetized for CT scan than it is in children sedated for CT scan.Objective: To determine the effect of increased inspiratory pressure on atelectasis during chest CT in anesthetized children. Materials and methods: Atelectasis on chest CT was assessed by two observers in three groups of patients. Group A comprised 13 children (26 lungs) anesthetized at inspiratory pressures up to and including 25 cm H 2 O. Group B included 11 children anesthetized at inspiratory pressures ≥30 cm H 2 O. Group C included 8 children under deep sedation. Results: Atelectasis was significantly more severe in group A than in groups B and C. There was no significant difference between groups B and C. Conclusion: An inspiratory pressure of 30 cm H 2 O is recommended for children anesthetized for CT scan of the chest. (orig.)

CT analysis of pulmonary injuries from blunt chest trauma

International Nuclear Information System (INIS)

Konno, Shoko

1996-01-01

The purpose of this paper is to analyze the CT findings of pulmonary parenchymal injuries due to blunt chest trauma and to categorize CT findings on the basis of their outcome. The materials of this study consist of 62 patients who had pulmonary injuries on CT obtained within 6 hours after blunt chest trauma. CT findings were analysed with regards to the shape, size, and distribution of the lesions. Follow-up CT scans were obtained in 35 patients at intervals from 1 day to 1 month after the initial CT study. CT showed ill-defined opacities in 59 patients (64 lesions in the peripheral area and 95 in the non-peripheral area) and pulmonary nodules with or without cavitary lesions in 30 patients (7 lesions in the peripheral area and 31 in the non-peripheral area). Follow-up CT allowed the classification of these pulmonary injuries into 3 types; the non-peripheral, ill-defined opacities showing immediate clearing, nodules with or without cavitary lesions over 1 cm in diameter showing prolongation, and the peripheral ill-defined opacities adjacent to the thoracic cage, and small nodules with or without cavitary lesions within 1 cm in diameter, showing various courses. CT has marked advantage over plain chest radiographs not only in the detection rate but in accurate estimation of the prognosis of the lesions. (author)

Diagnostic modalities x-ray and CT chest differ in the management of thoracic injury

Directory of Open Access Journals (Sweden)

D Chapagain

2015-06-01

Full Text Available Objective: To observe difference in the management of blunt trauma to the chest on the basis of conventional xray and computerised tomography of the chest. Methods: This prospective study was conducted between December 2011 to October 2012 in COMS in Bharatpur,a tertiary referral centre in central Nepal . Clinically stable thoracic injury patients were first evaluated with chest x-ray and the management on this basis was recorded. The findings of the CT chest were assessed and the type of management on the basis of CT was also recorded. Outcome was assessed in terms of mortality, morbidity, hospital and ICU stay with respect to the management on the basis of chest x-ray and CT scan. Results: Of the 129 patients, 74.4% were male and 25.6% were female with the patients ranging in age from 7 to 87 years (mean = 40.41 years. The most common mechanism of trauma to the chest was as a result of a motor vehicle accident (69.8%, followed by fall injury (20.2%. X-ray chest diagnosed rib fracture in 62%, haemothorax in 37%, pneumothorax in 27%, lung contusion in 10% and haemopneumothorax in 21% patients. Similarly CT chest diagnosed rib fracture in 86%, haemothorax in 54%, pneumothorax in 36%, lung contusion in 30% and haemopneumothorax in 30% patients. Mean hospital stay was 9.5 days in the group of patients having management on the basis of x-ray chest relative to mean stay of 10.2 days in the CT- chest group. In the management on the basis of xray group, there was a mean ICU stay of 2.8days compared to mean stays of 3.2 days in CT chest group. Conclusion: Though CT scan of the chest is more informative and differs the management of the blunt chest trauma, one should not forget to advise the cost effective, easily available and initial guiding agent, xray chest for early management of the chest injury patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i1.12764 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(1; 22-31

Laryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest

International Nuclear Information System (INIS)

Marchiori, Edson; Irion, Klaus Loureiro; Zanetti, Glaucia; Missrie, Israel; Sato, Juliana

2008-01-01

Objectives: To present the findings of computed tomography (CT) scans of the chest in patients with laryngotracheobronchial papillomatosis. Methods: We retrospectively analyzed CT scans of eight patients, five males and three females, ranging from 5 to 18 years of age with a mean age of 10.5 years. Images were independently reviewed by two radiologists. In discrepant cases, a consensus was reached. Results: The most common CT findings were intratracheal polypoid lesions and pulmonary nodules, many of which were cavitated. Conclusions: In patients with laryngotracheobronchial papillomatosis, the most common tomographic finding was the combination of intratracheal polypoid lesions and multiple pulmonary nodules, many of which were cavitated. (author)

Laryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest

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Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Dept. de Radiologia; Araujo Neto, Cesar de [Universidade Federal da Bahia (UFBA), Salvador, BA (Brazil). Dept. de Radiologia; Meirelles, Gustavo Souza Portes [Universidade Federal de Sao Paulo (UNIFESP-EPM), SP (Brazil); Irion, Klaus Loureiro [The Royal Liverpool University Hospital, Liverpool (United Kingdom); Zanetti, Glaucia [Faculdade de Medicina de Petropolis (FMP), RJ (Brazil); Missrie, Israel [Universidade Federal de Sao Paulo (UNIFESP-EPM), SP (Brazil). Dept. de Diagnostico por Imagem; Sato, Juliana [Universidade Federal de Sao Paulo (UNIFESP-EPM), SP (Brazil). Dept. de Otorrinolaringologia e Cirurgia de Cabeca e Pescoco

2008-12-15

Objectives: To present the findings of computed tomography (CT) scans of the chest in patients with laryngotracheobronchial papillomatosis. Methods: We retrospectively analyzed CT scans of eight patients, five males and three females, ranging from 5 to 18 years of age with a mean age of 10.5 years. Images were independently reviewed by two radiologists. In discrepant cases, a consensus was reached. Results: The most common CT findings were intratracheal polypoid lesions and pulmonary nodules, many of which were cavitated. Conclusions: In patients with laryngotracheobronchial papillomatosis, the most common tomographic finding was the combination of intratracheal polypoid lesions and multiple pulmonary nodules, many of which were cavitated. (author)

Comparison of radiation dose estimates, image noise, and scan duration in pediatric body imaging for volumetric and helical modes on 320-detector CT and helical mode on 64-detector CT

International Nuclear Information System (INIS)

Johnston, Jennifer H.; Podberesky, Daniel J.; Larson, David B.; Alsip, Christopher; Yoshizumi, Terry T.; Angel, Erin; Barelli, Alessandra; Toncheva, Greta; Egelhoff, John C.; Anderson-Evans, Colin; Nguyen, Giao B.; Frush, Donald P.; Salisbury, Shelia R.

2013-01-01

Advanced multidetector CT systems facilitate volumetric image acquisition, which offers theoretic dose savings over helical acquisition with shorter scan times. Compare effective dose (ED), scan duration and image noise using 320- and 64-detector CT scanners in various acquisition modes for clinical chest, abdomen and pelvis protocols. ED and scan durations were determined for 64-detector helical, 160-detector helical and volume modes under chest, abdomen and pelvis protocols on 320-detector CT with adaptive collimation and 64-detector helical mode on 64-detector CT without adaptive collimation in a phantom representing a 5-year-old child. Noise was measured as standard deviation of Hounsfield units. Compared to 64-detector helical CT, all acquisition modes on 320-detector CT resulted in lower ED and scan durations. Dose savings were greater for chest (27-46%) than abdomen/pelvis (18-28%) and chest/abdomen/pelvis imaging (8-14%). Noise was similar across scanning modes, although some protocols on 320-detector CT produced slightly higher noise. Dose savings can be achieved for chest, abdomen/pelvis and chest/abdomen/pelvis examinations on 320-detector CT compared to helical acquisition on 64-detector CT, with shorter scan durations. Although noise differences between some modes reached statistical significance, this is of doubtful diagnostic significance and will be studied further in a clinical setting. (orig.)

Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

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Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song [Dankook University College of Medicine, Dankook University Hospital, Cheonan (Korea, Republic of)

2010-12-15

The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

International Nuclear Information System (INIS)

Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song

2010-01-01

The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

Findings chest radiograph and CT in mediastinitis: effcacy of CT in patients with delayed diagnosis

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Son, Eun Ju; Hong, Yong Kook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

1999-01-01

To analyse the causes the radiologic findings in patients with mediastinitis and to evaluate the efficacy of chest CT scanning in patients with delayed diagnosis. Seventeen patients with histopathologically(n=15) or clinically diagnosed(n=2) mediastinitis were involved in this study. Eleven of the former group underwent surgery, and in four, tube drainage was performed. All underwent chest radiography and CT scanning, and in seven patients, the causes of delayed diagnosis were analysed. The most common cause of mediastinitis was esophageal rupture(n=11). Others were extension from neck abscess to the mediastinum(n=3), complications after a Benthall procedure(n=1), tuberculous lymphadenitis(n=1) and mycotic aneurysm(n=1). Patients with esophageal rupture suffered from underlying diseases such as esophageal cancer(n=2), iatrogenic esophageal rupture(n=2), Boerhaave's syndrome(n=2), and esophagitis(n=1). In patients with neck abscess (n=3), each was secondary to infected cystic hygroma, Ludwig angina, or deep neck infection, respectively. On chest CT, patients with esophageal rupture(n=11) had an abscess in the posterior mediastinum ; nine abscesses extended to the cervical area along the retropharyngeal space, and the patient with Ludwig angina had an abscess involving all compartments of the mediastinum. Among the total of 17 patients, diagnostic delays were found in seven, while five had spontaneous esophageal ruptures and two suffered complications after a Benthall procedure and Tbc lymphadenitis, respectively. The causes of diagnostic delay varied. Among seven patients, pnevmonia was initially diagnosed in two, who were treated ; one had multiorgan failure, and one was suffering from pericardial effusion and lung abscess. In three other patients, chest radiographs initially showed non-specific findings, leading to delayed CT examination. The most common cause of mediastinitis was esophageal rupture, and in these patients, chest radiographs and clinical

Findings chest radiograph and CT in mediastinitis: effcacy of CT in patients with delayed diagnosis

International Nuclear Information System (INIS)

Son, Eun Ju; Hong, Yong Kook; Choe, Kyu Ok

1999-01-01

To analyse the causes the radiologic findings in patients with mediastinitis and to evaluate the efficacy of chest CT scanning in patients with delayed diagnosis. Seventeen patients with histopathologically(n=15) or clinically diagnosed(n=2) mediastinitis were involved in this study. Eleven of the former group underwent surgery, and in four, tube drainage was performed. All underwent chest radiography and CT scanning, and in seven patients, the causes of delayed diagnosis were analysed. The most common cause of mediastinitis was esophageal rupture(n=11). Others were extension from neck abscess to the mediastinum(n=3), complications after a Benthall procedure(n=1), tuberculous lymphadenitis(n=1) and mycotic aneurysm(n=1). Patients with esophageal rupture suffered from underlying diseases such as esophageal cancer(n=2), iatrogenic esophageal rupture(n=2), Boerhaave's syndrome(n=2), and esophagitis(n=1). In patients with neck abscess (n=3), each was secondary to infected cystic hygroma, Ludwig angina, or deep neck infection, respectively. On chest CT, patients with esophageal rupture(n=11) had an abscess in the posterior mediastinum ; nine abscesses extended to the cervical area along the retropharyngeal space, and the patient with Ludwig angina had an abscess involving all compartments of the mediastinum. Among the total of 17 patients, diagnostic delays were found in seven, while five had spontaneous esophageal ruptures and two suffered complications after a Benthall procedure and Tbc lymphadenitis, respectively. The causes of diagnostic delay varied. Among seven patients, pnevmonia was initially diagnosed in two, who were treated ; one had multiorgan failure, and one was suffering from pericardial effusion and lung abscess. In three other patients, chest radiographs initially showed non-specific findings, leading to delayed CT examination. The most common cause of mediastinitis was esophageal rupture, and in these patients, chest radiographs and clinical symptoms

Application of low-dose radiation protocols in survey CT scans

International Nuclear Information System (INIS)

Fu Qiang; Liu Ting; Lu Tao; Xu Ke; Zhang Lin

2009-01-01

Objective: To characterize the protocols with low-dose radiation in survey CT scans for localization. Methods: Eighty standard adult patients, head and body phantoms were recruited. Default protocols provided by operator's manual setting were that all the tube voltage for head, chest, abdomen and lumbar was 120 kV; the tube currents were 20,10,20 and 40 mA, respectively. Values of kV and mA in the low-dose experiments were optimized according to the device options. For chest and abdomen, the tube position were compared between default (0 degree) and 180 degree. Phantoms were scanned with above protocols, and the radiation doses were measured respectively. Paired t-test were used for comparisons of standard deviation in CT value, noise and exposure surface dose (ESD) between group with default protocols and group with optimized protocols. Results: The optimized protocols in low-dose CT survey scans were 80 kV, 10 mA for head, 80 kV, 10 mA for chest, 80 kV, 10 mA for abdomen and 100 kV, 10 mA for lumbar. The values of ESD for phantom scan in default and optimized protocols were 0.38 mGy/0.16 mGy in head, 0.30 mGy/0.20 mGy in chest, 0.74 mGy/0.30 mGy in abdomen and 0.81 mGy/0.44 mGy in lumbar, respectively. Compared with default protocols, the optimized protocols reduced the radiation doses 59%, 33%, 59% and 46% in head, chest, abdomen and lumbar. When tube position changed from 0 degree to 180 degree, the ESD were 0.24 mGy/0.20 mGy for chest; 0.37 mGy/0.30 mGy for abdomen, and the radiation doses were reduced 20% and 17%. Conclusion: A certain amount of image noise is increased in low-dose protocols, but image quality is still acceptable without problem in CT localization. The reduction of radiation dose and the radiation harm to patients are the superiority. (authors)

Patient-specific dose estimation for pediatric chest CT

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Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P. [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Physics, Duke University, Durham, North Carolina 27710 (United States); and Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Global Applied Science Laboratory, GE Healthcare, Waukesha, Wisconsin 53188 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham North Carolina 27710 (United States)

2008-12-15

Current methods for organ and effective dose estimations in pediatric CT are largely patient generic. Physical phantoms and computer models have only been developed for standard/limited patient sizes at discrete ages (e.g., 0, 1, 5, 10, 15 years old) and do not reflect the variability of patient anatomy and body habitus within the same size/age group. In this investigation, full-body computer models of seven pediatric patients in the same size/protocol group (weight: 11.9-18.2 kg) were created based on the patients' actual multi-detector array CT (MDCT) data. Organs and structures in the scan coverage were individually segmented. Other organs and structures were created by morphing existing adult models (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. Organ and effective dose of these patients from a chest MDCT scan protocol (64 slice LightSpeed VCT scanner, 120 kVp, 70 or 75 mA, 0.4 s gantry rotation period, pitch of 1.375, 20 mm beam collimation, and small body scan field-of-view) was calculated using a Monte Carlo program previously developed and validated to simulate radiation transport in the same CT system. The seven patients had normalized effective dose of 3.7-5.3 mSv/100 mAs (coefficient of variation: 10.8%). Normalized lung dose and heart dose were 10.4-12.6 mGy/100 mAs and 11.2-13.3 mGy/100 mAs, respectively. Organ dose variations across the patients were generally small for large organs in the scan coverage (<7%), but large for small organs in the scan coverage (9%-18%) and for partially or indirectly exposed organs (11%-77%). Normalized effective dose correlated weakly with body weight (correlation coefficient: r=-0.80). Normalized lung dose and heart dose correlated strongly with mid-chest equivalent diameter (lung: r=-0.99, heart: r=-0.93); these strong correlation relationships can be used to estimate patient-specific organ

Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

Science.gov (United States)

Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

2015-01-01

Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in 20.6% (142 of 691 [95% CI: 17.6%, 23.8%]) of cases, and no corresponding abnormalities in 38

Increased opacity of left pericardiac area on chest radiograph : correlation with CT findings and its frequency

International Nuclear Information System (INIS)

Lee, Seung Ik; Kim, Jeung Sook; Kwak, Jin Young; Ryu, Chang Woo; Yoon, Sam Hyun

1998-01-01

The purpose of this study was to evaluate the incidence of extrapericardial fat in the left cardiac border, and with regard to left extrapericardial fat, to correlate chest radiographs with CT scans. This study involved 132 consecutive patients who underwent chest PA and lateral radiographs, and chest CT scans. According to the results of chest PA radiograph, patients were divided into three groups: those with a clear left cardiac border; those with an indistinct left cardiac border; and those with an indistinct left cardiac border with increased density; cardiophrenic angle, as seen on lateral radiograph, the presence of increased density in the anterior cardiophrenic angle, as seen on lateral radiographs was evaluated. On the basis of the results of CT scanning, patients were classified into four groups according to the amount of left extrapericardial fat : negative, minimum, moderate, and maximum. Left extrapericardial fat, as seen on CT, was correlated with the conspicuity of left cardiac border seen on PA radiograph and the presence of increased density in the anterior cardiophrenic angle, as seen on lateral radiograph. The conspicuousness of the left cardiac border, as seen on PA chest radiograph, correlated with the presence of left extrapericardial fat, as seen on CT, and was related to the amount of left extrapericardial fat. Increased density of the anterior cardiophrenic angle, as seen on lateral radiographs, correlated with the presence of left extrapericardial fat on CT, but the absence of increased density on lateral radiograph corresponds to the absence or a minimal amount of left extrapericardial fat, as seen on CT. (author). 8 refs., 4 tabs., 3 figs

Radiochromic film use to record dose profile variations in chest CT scan; Utilizacao do filme radiocromico para registro da variacao do perfil de dose em varredura de TC de torax

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Mourao, Arnaldo P.; Santana, Priscila C., E-mail: aprata@des.cefetmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Silva, Teogenes A. da; Alonso, Thessa C. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2015-12-15

The CT scans generate higher doses in patients than those caused by other types of diagnostic radiology using the attenuation of X-ray beams. Technological advances have increased the clinical applications of computed tomography (CT) and consequently the demand for these exams. Dose reduction strategies are difficult to implement because of a lack of proper guidance on the CT scanning. However, CT offers the possibility of adjusting the image acquisition parameters according to the patient physical profile and the diagnostic application for which it is intended to scan. Knowledge of the dose distribution is important when thinking about varying the acquisition parameters to reduce the dose. In this work was used a PMMA chest phantom to observe the dose deposition in 5 areas. Radiochromic film strips were placed inside the chest phantom, in peripheral and in the central region. The phantom was placed in the scanner isocenter and it was performed the irradiation of its central region using a chest acquisition protocol. After the phantom CT scan the radiochromic film strips were processed for obtaining digital images. Digital images were reworked to obtain the dose variation profiles for each position. The results showed a wide variation in absorbed dose by the phantom, either within a same position along the length of the film strip, as in the comparison among the five regions which the strips are placed. In this second case the dose variations were even greater. (author)

Low-dosage helical CT applications for chest medical checkup and lung cancer screening

International Nuclear Information System (INIS)

Wang Ping; Cui Fa; Liang Huanqing; Zheng Minfei

2005-01-01

Objective: A discussion on low-dosage helical CT applications on chest medical checkup and lung cancer screening. Methods: On the 100 chest medical check up with three different of protocols, including standard-dosage (the tube current was 230 mAs) were compared with low-dose (tube current was 50 mAs or 30 mAs). Results: Low-dosage helical CT scan provides excellent images. In 100 chest medical checkup, 39 nodules or masses were revealed, enlarged lymph node was noted in 1 case; emphysema or bullae was demonstrated in 3 segments; thickening of bronchial wall was shown in 2 cases; and localized pleural thickening was found in 1 case. Conclusion: In chest checkup or lung cancer screening low-dosage helical CT (tube current 30 mAs) will not only guarantee image quality but also reduce the radiation dose during the examination. (authors)

The use of CT scan in the pre-operative staging of bronchogenic carcinoma

International Nuclear Information System (INIS)

Pada, C.C.

1992-01-01

Surgery remains the treatment of choice in patients with localized bronchogenic carcinoma. Pre-operative identification of inoperability spares the patient from unnecessary surgery. This prospective study was carried out to determine the correctness of judgement regarding a patient's operability or inoperability based on the pre-operative staging of CT scan; to find out the sensitivity, specificity and overall accuracy of the CT scan in estimating tumor description, nodal status and metastatic spread to the chest. Staging was done by 3 senior radiologists aware of the diagnosis. Both the surgical and histopathologic findings and staging were gathered and used as measurement of truth in arriving at the CT scan's accuracy. Overall accuracy rate of CT scan in determining operability or inoperability is 80%; tumor description accuracy of assessment is 87% and nodal status estimation has an accuracy of 60%. Sensitivity of CT scan is assessment of metastatic spread to the chest is 93%. There is no statistically significant difference in the judgement of operability or interpretability by CT scan compared to surgical and histopathologic results. The CT scan is recommended as a valuable tool in the pre-operative staging of patients with bronchogenic carcinoma who are candidates for surgery. (auth.). 21 refs.; 8 tabs

Possibilities for exposure reduction in computed tomography examination of acute chest pain; Moeglichkeiten der Dosisreduktion bei CT-Untersuchungen des akuten Thoraxschmerzes

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Becker, H.C. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

2012-10-15

Electrocardiogram-gated (ECG) computed tomography (CT) investigations can be accompanied by high amounts of radiation exposure. This is particularly true for the investigation of patients with unclear and acute chest pain. The common approach in patients with acute chest pain is standard spiral CT of the chest. The chest pain or triple-rule-out CT protocol is a relatively new ECG-gated protocol of the entire chest. This article reviews and discusses different techniques for the CT investigation of patients with acute chest pain. By applying the appropriate scan technique, the radiation exposure for an ECG-gated protocol must not necessarily be higher than a standard chest CT scan Aortic pathologies are far better depicted by ECG-gated scan protocols and depending on the heart rate coronary artery disease can also be detected at the same time. The use of ECG-triggered scans will not support the diagnostics of the pulmonary arteries. However, in unspecific chest pain an ECG-triggered scan protocol can provide information on the differential diagnosis. (orig.) [German] EKG-getriggerte CT-Untersuchungen koennen mit einer relativ hohen Strahlenexposition einhergehen. Dies gilt im besonderen Masse fuer die Untersuchung des gesamten Thorax bei Patienten mit unklarem akutem Thoraxschmerz. Bisher wurden Untersuchungen bei Patienten mit akutem Thoraxschmerz in Spiraltechnik ohne EKG-Triggerung durchgefuehrt. Das ''Chest-pain-'' oder ''Triple-rule-out''-Protokoll ist ein neues EKG-getriggertes Untersuchungsprotokoll des gesamten Thorax. Im vorliegenden Artikel werden verschiedene Techniken zur CT-Untersuchung von Patienten mit akutem Thoraxschmerz vorgestellt und besprochen. Mit der richtigen Untersuchungstechnik muss die Strahlenexposition fuer ein EKG-getriggertes Untersuchungsprotokoll nicht hoeher sein als eine Standarduntersuchung ohne EKG. Mit einem EKG-getriggerten Untersuchungsprotokoll laesst sich die Aorta in Hinblick auf

Detection of pulmonary metastatic nodules: usefulness of low-dose multidetector CT in comparison with chest radiograph

International Nuclear Information System (INIS)

Kim, Ki Nam; Lee, Ki Nam; Yang, Doo Kyung; Lee, Soo Keol

2006-01-01

We wanted to evaluate the usefulness of low-dose multidetector CT for the detection and follow-up of pulmonary metastatic nodules in patients suffering with malignancy. We retrospectively reviewed the conventional chest radiographs and low-dose multidetector CT (low-dose CT) scans of 81 patients who had been under the diagnosis of malignancy. We reviewed the detection of pulmonary nodules and we counted the number of nodules detected by each method. The nodules were confirmed by surgical operation and by the radiologic criteria. The accuracy, sensitivity, specificity and positive and negative predictive values of each method for detecting metastatic nodules were compared with χ 2 tests. Low-dose CT depicted more nodules than did chest radiograph, and the indeterminate nodules seen on chest radiograph may be clearly benign on low-dose CT (eg. calcified granulomas or bony lesions). The accuracy of low-dose CT (75.3%) was significantly higher than that of chest radiograph (49.4%) for the detection for metastatic nodules (ρ < 0.05). Low-dose CT may provide better information than does chest radiograph for diagnosing pulmonary metastasis

A method for smoothing segmented lung boundary in chest CT images

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Yim, Yeny; Hong, Helen

2007-03-01

To segment low density lung regions in chest CT images, most of methods use the difference in gray-level value of pixels. However, radiodense pulmonary vessels and pleural nodules that contact with the surrounding anatomy are often excluded from the segmentation result. To smooth lung boundary segmented by gray-level processing in chest CT images, we propose a new method using scan line search. Our method consists of three main steps. First, lung boundary is extracted by our automatic segmentation method. Second, segmented lung contour is smoothed in each axial CT slice. We propose a scan line search to track the points on lung contour and find rapidly changing curvature efficiently. Finally, to provide consistent appearance between lung contours in adjacent axial slices, 2D closing in coronal plane is applied within pre-defined subvolume. Our method has been applied for performance evaluation with the aspects of visual inspection, accuracy and processing time. The results of our method show that the smoothness of lung contour was considerably increased by compensating for pulmonary vessels and pleural nodules.

Functional imaging in differentiating bronchial masses: an initial experience with a combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan.

Science.gov (United States)

Kumar, Arvind; Jindal, Tarun; Dutta, Roman; Kumar, Rakesh

2009-10-01

To evaluate the role of combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in differentiating bronchial tumors observed in contrast enhanced computed tomography scan of chest. Prospective observational study. Place of study: All India Institute of Medical Sciences, New Delhi, India. 7 patients with bronchial mass detected in computed tomography scan of the chest were included in this study. All patients underwent (18)F-FDG PET-CT scan, (68)Ga DOTA-TOC PET-CT scan and fiberoptic bronchoscope guided biopsy followed by definitive surgical excision. The results of functional imaging studies were analyzed and the results are correlated with the final histopathology of the tumor. Histopathological examination of 7 bronchial masses revealed carcinoid tumors (2 typical, 1 atypical), inflammatory myofibroblastic tumor (1), mucoepidermoid carcinoma (1), hamartoma (1), and synovial cell sarcoma (1). The typical carcinoids had mild (18)F-FDG uptake and high (68)Ga DOTA-TOC uptake. Atypical carcinoid had moderate uptake of (18)F-FDG and high (68)Ga DOTA-TOC uptake. Inflammatory myofibroblastic tumor showed high uptake of (18)F-FDG and no uptake of (68)Ga DOTA-TOC. Mucoepidermoid carcinoma showed mild (18)F-FDG uptake and no (68)Ga DOTA-TOC uptake. Hamartoma showed no uptake on either scans. Synovial cell sarcoma showed moderate (18)F-FDG uptake and mild focal (68)Ga DOTA-TOC uptake. This initial experience with the combined use of (18)F-FDG and (68)Ga DOTA-TOC PET-CT scan reveals different uptake patterns in various bronchial tumors. Bronchoscopic biopsy will continue to be the gold standard; however, the interesting observations made in this study merits further evaluation of the utility of the combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in larger number of patients with bronchial masses.

Breast dose reduction for chest CT by modifying the scanning parameters based on the pre-scan size-specific dose estimate (SSDE)

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Kidoh, Masafumi; Utsunomiya, Daisuke; Oda, Seitaro; Nakaura, Takeshi; Yuki, Hideaki; Hirata, Kenichiro; Namimoto, Tomohiro; Sakabe, Daisuke; Hatemura, Masahiro; Yamashita, Yasuyuki [Kumamoto University, Department of Diagnostic Radiology, Faculty of Life Sciences, Honjo, Kumamoto (Japan); Funama, Yoshinori [Kumamoto University, Department of Medical Physics, Faculty of Life Sciences, Honjo, Kumamoto (Japan)

2017-06-15

To investigate the usefulness of modifying scanning parameters based on the size-specific dose estimate (SSDE) for a breast-dose reduction for chest CT. We scanned 26 women with a fixed volume CT dose index (CTDI{sub vol}) (15 mGy) and another 26 with a fixed SSDE (15 mGy) protocol (protocol 1 and 2, respectively). In protocol 2, tube current was calculated based on the patient habitus obtained on scout images. We compared the mean breast dose and the inter-patient breast dose variability and performed linear regression analysis of the breast dose and the body mass index (BMI) of the two protocols. The mean breast dose was about 35 % lower under protocol 2 than protocol 1 (10.9 mGy vs. 16.8 mGy, p < 0.01). The inter-patient breast dose variability was significantly lower under protocol 2 than 1 (1.2 mGy vs. 2.5 mGy, p < 0.01). We observed a moderate negative correlation between the breast dose and the BMI under protocol 1 (r = 0.43, p < 0.01); there was no significant correlation (r = 0.06, p = 0.35) under protocol 2. The SSDE-based protocol achieved a reduction in breast dose and in inter-patient breast dose variability. (orig.)

The pictures of CT scan of gold pneumonitis

International Nuclear Information System (INIS)

Taguchi, Yoshio; Iwata, Takekuni; Kuroda, Yasumasa; Sadato, Norihiro; Tanemoto, Kiichiro; Adachi, Kazuhiko.

1987-01-01

We experienced two cases of gold pneumonitis and their interesting findings of CT scan. After the cessation of gold salt, both cases were treated with the corticosteroid, resulting in the disappearance of pulmonary manifestations and clearing of shadows on chest roentgenograms. The findings of CT scan on both cases were very interesting. They were the high density shadows along the bronchovascular bundles, the fluffy figures surroundings these shadows and band like shadows reached to the thoracic wall. We considered that each shadows were pathologically compatible with severe exudative changes of interstitial pneumonitis, shrinkage surroundings them and thickness of interlobular septum. (author)

Laryngotracheobronchial papillomatosis: chest CT findings

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Fortes, Helena Ribeiro; Zanetti, Glaucia; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Ranke, Felipe Mussi von [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil); Escuissato, Dante Luiz [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Dept. de Clinica Medica; Araujo Neto, Cesar Augusto [Universidade Federal da Bahia (UFBA), Salvador (Brazil). Dept. de Medicina e Apoio Diagnostico; Hochhegger, Bruno [Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA), RS (Brazil). Diagnostico por Imagem; Irion, Klaus Loureiro [Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool (United Kingdom); Souza, Carolina Althoff [Dept. of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario (Canada)

2017-07-15

To evaluate the findings on chest CTs in 16 patients (8 men and 8 women) with laryngotracheobronchial papillomatosis. Methods: This was a retrospective study involving patients ranging from 2 to 72 years of age. The evaluation of the CT scans was independently performed by two observers, and discordant results were resolved by consensus. The inclusion criteria were presence of abnormalities on the CT scans, and the diagnosis was confirmed by anatomopathological examination of the papillomatous lesions. Results: The most common symptoms were hoarseness, cough, dyspnea, and recurrent respiratory infections. The major CT findings were nodular formations in the trachea, solid or cavitated nodules in the lung parenchyma, air trapping, masses, and consolidation. Nodular formations in the trachea were observed in 14 patients (87.5%). Only 2 patients had lesions in lung parenchyma without tracheal involvement. Only 1 patient had no pulmonary dissemination of the disease, showing airway involvement only. Solid and cavitated lung nodules were observed in 14 patients (87.5%) and 13 (81.2%), respectively. Masses were observed in 6 patients (37.5%); air trapping, in 3 (18.7%); consolidation in 3 (18.7%); and pleural effusion, in 1 (6.3%). Pulmonary involvement was bilateral in all cases. Conclusions: The most common tomography findings were nodular formations in the trachea, as well as solid or cavitated nodules and masses in the lung parenchyma. Malignant transformation of the lesions was observed in 5 cases. (author)

Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

Science.gov (United States)

Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

2016-12-01

Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

Spiral CT for evaluation of chest trauma

International Nuclear Information System (INIS)

Roehnert, W.; Weise, R.

1997-01-01

After implementation of spiral CT in our department, we carried out an analysis for determining anew the value of CT as a modality of chest trauma diagnosis in the emergency department. The retrospective study covers a period of 10 months and all emergency patients with chest trauma exmined by spiral CT. The major lesions of varying seriousness covered by this study are: pneumothorax, hematothorax, pulmonary contusion or laceration, mediastinal hematoma, rupture of a vessel, injury of the heart and pericardium. The various fractures are not included in this study. In many cases, spiral CT within relatively short time yields significant diagnostic findings, frequently saving additional angiography. A rigid diagnostic procedure cannot be formulated. Plain-film chest radiography still remains a diagnostic modality of high value. (Orig.) [de

The role of CT in assessing chest pain

International Nuclear Information System (INIS)

Capsa, R.

2012-01-01

Full text: Objective: Thoracic pain represents the common feature of a wide range of diseases of different causes. Usually, chest pain requires a fast workup, in order to eliminate potentially hazardous underlying conditions. The objective of the paper consists of presenting the role of computerized tomography (CT) in assessing the different causes and conditions related to chest pain. Materials and methods: The educational presentation relies on current literature data and mostly on images obtained from patients admitted in the various clinics and departments of our hospital, suffering from chest pain as admittance condition or as a symptom appeared during the hospital stay. Results: There are various radiological and imaging options for assessing a patient with chest pain, with reference to the underlying condition, type of pain onset (acute or chronic), specific indications and contraindications. From all these, CT is considered one of the most useful imaging options, in terms of diagnosis accuracy, fast workup, cost and availability. This paper focuses on the role of CT, presenting the most important diseases and conditions related to potential occurrence of chest pain and the most specific CT signs and findings usually reported in this setting. Furthermore, the presentation separates acute and chronic conditions, presenting the actual imaging protocols employed in this circumstances. Finally, there are considerations regarding CT rule-out protocols used in patients with acute chest pain in emergency conditions. Conclusions: Fast and accurate diagnosis is crucial for patient outcome, often life-saving, but currently there is no single algorithm in the imaging assessment of chest pain, while choosing the best imaging option relies mainly on history, clinical and laboratory data. CT is one of the most important imaging options available in patients with both acute and chronic chest pain. CT rule-out techniques have still to establish their clear role in a

Air trapping on chest CT is associated with worse ventilation distribution in infants with cystic fibrosis diagnosed following newborn screening.

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Graham L Hall

Full Text Available BACKGROUND: In school-aged children with cystic fibrosis (CF structural lung damage assessed using chest CT is associated with abnormal ventilation distribution. The primary objective of this analysis was to determine the relationships between ventilation distribution outcomes and the presence and extent of structural damage as assessed by chest CT in infants and young children with CF. METHODS: Data of infants and young children with CF diagnosed following newborn screening consecutively reviewed between August 2005 and December 2009 were analysed. Ventilation distribution (lung clearance index and the first and second moment ratios [LCI, M(1/M(0 and M(2/M(0, respectively], chest CT and airway pathology from bronchoalveolar lavage were determined at diagnosis and then annually. The chest CT scans were evaluated for the presence or absence of bronchiectasis and air trapping. RESULTS: Matched lung function, chest CT and pathology outcomes were available in 49 infants (31 male with bronchiectasis and air trapping present in 13 (27% and 24 (49% infants, respectively. The presence of bronchiectasis or air trapping was associated with increased M(2/M(0 but not LCI or M(1/M(0. There was a weak, but statistically significant association between the extent of air trapping and all ventilation distribution outcomes. CONCLUSION: These findings suggest that in early CF lung disease there are weak associations between ventilation distribution and lung damage from chest CT. These finding are in contrast to those reported in older children. These findings suggest that assessments of LCI could not be used to replace a chest CT scan for the assessment of structural lung disease in the first two years of life. Further research in which both MBW and chest CT outcomes are obtained is required to assess the role of ventilation distribution in tracking the progression of lung damage in infants with CF.

Simple pulmonary eosinophilia (loeffler's syndrome): chest radiographic and CT findings

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Jung, Kyung Jae; Lee, Kyung Soo; Kim, Tae Sung; Chung, Man Pyo; Choi, Dong Chull; Kwon, O Jung [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2000-01-01

The purpose of our study is to describe the chest radiographic and CT findings of simple pulmonary eosinophilia. Twenty-six patients with simple pulmonary eosinophilia underwent chest radiography and CT scanning; the results were analyzed retrospectively by two chest radiologists, focusing on the patterns and distribution of the parenchymal abnormalities. The chest radiographs were normal in eight patients (31%), while among the remaining 18 patients, they showed subtle opacity (n=3D9), nodules (n=3D8), consolidation (n=3D2), and mass (n=3D1). Follow-up chest radiographs (m=3D18) demonstrated complete (n=3D16) or partial (n=3D1) resolution of parenchymal lesions or migratory lesions (n=3D1). On CT, nodule(s) (n=3D19) were most commonly seen, followed by ground-glass opacity (n=3D16), consolidation (n=3D3), and mass (n=3D1). A peripheral halo surrounding a nodule or an area of consolidation was seen in 18 patients. The nodules(s) (n=3D19) were subpleural (n=3D13) or random (=3D6). Areas of ground-glass opacity (n=3D16) were subpleural (n=3D13), random (n=3D2), or central (n=3D1). All lesions were patchy rather than diffuse. Follow-up CT in nine patients showed complete (n=3D7) or partial (n=3D2) resolution of parenchymal lesions. Chest radiographs of patients with simple pulmonary eosinophilia often reveal no abnormality. The most common finding is subtle opacity or nodule(s), while CT reveals transient nodule(s) with a surrounding halo or transient areas of ground glass opacity. (author)

Estimation of breast dose and cancer risk in chest and abdomen CT procedures

International Nuclear Information System (INIS)

Eltahir, Suha Abubaker Ali

2013-05-01

The use of CT in medical diagnosis delivers radiation doses to patents that are higher than those from other radiological procedures. Lack of optimized protocols be an additional source of increased dose in developing countries. The aims of this study are first, to measure patient doses during CT chest and abdomen procedures, second, to estimate the radiation dose to the breast, and third to quantify the radiation risks during the procedures. Patient doses from two common CT examinations were obtained from four hospitals in Khartoum.The patient doses were estimated using measurement of CT dose indexes (CTDI), exposure-related parameters, and the IMPACT spreadsheet based on NRPB conversion factors. A large variation of mean organ doses among hospitals was observed for similar CT examinations. These variations largely originated from different CT scanning protocols used in different hospitals and scanner type. The largest range was found for CT of the chest, for which the dose varied from 2.3 to 47 (average 24.7) mSv and for abdomen CT, it was 1.6 to 18.8 (average 10.2) mSv. Radiation dose to the breast ranged from 1.6 to 32.9 mSv for the chest and 1.1 to 13.2 mSv for the abdomen. The radiation risk per procedure was high. The obtained values were mostly higher than the values of organ doses reported from the other studies. It was concluded that current clinical chest and abdomen protocols result in variable radiation doses to the breast. The magnitude of exposure may have implications for imaging strategies.(Author)

Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma

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Chardoli Mojtaba

2013-12-01

Full Text Available 【Abstract】 Objective: Thoracic injuries are respon- sible for 25% of deaths of blunt traumas. Chest X-ray (CXR is the first diagnostic method in patients with blunt trauma. The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy (CT in hemodynami- cally stable patients with blunt chest trauma. Methods: Study was conducted at the emergency department of Sina Hospital from March 2011 to March 2012. Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included. All patients underwent the same diagnostic protocol which consisted of physical examination, CXR and CT scan respectively. Results: Two hundreds patients (84% male and 16% female were included with a mean age of (37.9±13.7 years. Chin J Traumatol 2013;16(6:351-354 Rib fracture was the most common finding of CXR (12.5% and CT scan (25.5%. The sensitivity of CXR for hemothorax, thoracolumbar vertebra fractures and rib fractures were 20%, 49% and 49%, respectively. Pneumothorax, foreign body, emphysema, pulmonary contusion, liver hematoma and ster- num fracture were not diagnosed with CXR alone. Conclusion: Applying CT scan as the first-line diag- nostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome. Key words: Radiography; Thoracic injuries; Tomography, X-ray computed

Tree-structured vector quantization of CT chest scans: Image quality and diagnostic accuracy

International Nuclear Information System (INIS)

Cosman, P.C.; Tseng, C.; Gray, R.M.; Olshen, R.A.; Moses, L.E.; Davidson, H.C.; Bergin, C.J.; Riskin, E.A.

1993-01-01

The quality of lossy compressed images is often characterized by signal-to-noise ratios, informal tests of subjective quality, or receiver operating characteristic (ROC) curves that include subjective appraisals of the value of an image for a particular application. The authors believe that for medical applications, lossy compressed images should be judged by a more natural and fundamental aspect of relative image quality: their use in making accurate diagnoses. They apply a lossy compression algorithm to medical images, and quantify the quality of the images by the diagnostic performance of radiologists, as well as by traditional signal-to-noise ratios and subjective ratings. The study is unlike previous studies of the effects of lossy compression in that they consider non-binary detection tasks, simulate actual diagnostic practice instead of using paired tests or confidence rankings, use statistical methods that are more appropriate for non-binary clinical data than are the popular ROC curves, and use low-complexity predictive tree-structured vector quantization for compression rather than DCT-based transform codes combined with entropy coding. Their diagnostic tasks are the identification of nodules (tumors) in the lungs and lymphadenopathy in the mediastinum from computerized tomography (CT) chest scans. For the image modality, compression algorithm, and diagnostic tasks they consider, the original 12 bit per pixel (bpp) CT image can be compressed to between 1 bpp and 2 bpp with no significant changes in diagnostic accuracy

Chest CT findings in pediatric Wegener's granulomatosis

International Nuclear Information System (INIS)

Levine, Daniel; Akikusa, Jonathan; Manson, David; Silverman, Earl; Schneider, Rayfel

2007-01-01

Although pulmonary involvement occurs in the majority of children and adolescents with Wegener's granulomatosis (WG), relatively little has been published regarding the CT imaging manifestations in this group of patients. To determine the frequency and types of chest CT abnormalities in active pediatric WG (pWG). The study was a retrospective examination of 29 chest CT examinations performed at diagnosis (n=14) and during disease flares (n=15) in 18 children. The most common abnormalities were nodules (seen in 90% of examinations), ground-glass opacification (52%), and air-space opacification (45%). Of examinations with nodules, 73% demonstrated nodules >5 mm in diameter and 69% demonstrated more than five nodules; 17% had cavitary lesions. The only abnormality with a significant difference in prevalence between diagnosis and disease flares was air-space opacification, present in 71% and 20%, respectively (P < 0.01). In accordance with the findings of published adult studies and at variance with those of prior pediatric studies, our findings indicate that chest CT abnormalities in active pWG are frequent, most commonly comprising nodules and ground-glass opacification, which may be difficult to detect on plain radiography. We therefore advocate the routine use of chest CT for all affected patients, both at the time of presentation and during disease flares. (orig.)

Derivation and validation of two decision instruments for selective chest CT in blunt trauma: a multicenter prospective observational study (NEXUS Chest CT).

Science.gov (United States)

Rodriguez, Robert M; Langdorf, Mark I; Nishijima, Daniel; Baumann, Brigitte M; Hendey, Gregory W; Medak, Anthony J; Raja, Ali S; Allen, Isabel E; Mower, William R

2015-10-01

Unnecessary diagnostic imaging leads to higher costs, longer emergency department stays, and increased patient exposure to ionizing radiation. We sought to prospectively derive and validate two decision instruments (DIs) for selective chest computed tomography (CT) in adult blunt trauma patients. From September 2011 to May 2014, we prospectively enrolled blunt trauma patients over 14 y of age presenting to eight US, urban level 1 trauma centers in this observational study. During the derivation phase, physicians recorded the presence or absence of 14 clinical criteria before viewing chest imaging results. We determined injury outcomes by CT radiology readings and categorized injuries as major or minor according to an expert-panel-derived clinical classification scheme. We then employed recursive partitioning to derive two DIs: Chest CT-All maximized sensitivity for all injuries, and Chest CT-Major maximized sensitivity for only major thoracic injuries (while increasing specificity). In the validation phase, we employed similar methodology to prospectively test the performance of both DIs. We enrolled 11,477 patients-6,002 patients in the derivation phase and 5,475 patients in the validation phase. The derived Chest CT-All DI consisted of (1) abnormal chest X-ray, (2) rapid deceleration mechanism, (3) distracting injury, (4) chest wall tenderness, (5) sternal tenderness, (6) thoracic spine tenderness, and (7) scapular tenderness. The Chest CT-Major DI had the same criteria without rapid deceleration mechanism. In the validation phase, Chest CT-All had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of 20.8% (95% CI 19.2%-22.4%), and a negative predictive value (NPV) of 99.8% (95% CI 98.9%-100%) for major injury, and a sensitivity of 95.4% (95% CI 93.6%-96.9%), a specificity of 25.5% (95% CI 23.5%-27.5%), and a NPV of 93.9% (95% CI 91.5%-95.8%) for either major or minor injury. Chest CT-Major had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of

Clinical utility of coronary CT angiography with low-dose chest CT in the evaluation of patients with atypical chest pain: a preliminary report

International Nuclear Information System (INIS)

Lim, Soo Jin; Choo, Ki Seok; Kim, Chang Won

2008-01-01

To determine the clinical utility of coronary CT angiography (CCTA) with low-dose chest CT in the evaluation of patients with atypical chest pain. Ninety-six patients (mean age 60.2 years; age range, 41-68 years; 70 males) were referred for CCTA with low-dose chest CT (16-slice MDCT, Siemens) for an evaluation of atypical chest pain. When significant stenoses (lumen diameter reduction > 50%) were detected on CCTA, invasive coronary angiography (CA) was performed as the standard of reference. In all patients, medical chart review or telephone contact with patients was used to evaluate the contribution of CCTA with low-dose chest CT to the final clinical diagnosis, at least 6 months after performing CCTA. Among 96 patients, seven patients (7%) had significant stenoses as detected on CCTA, whereas two patients (2%) had significant stenoses and five patients had insignificant stenoses or no stenosis, as detected on conventional catheter angiography. In 18 (19%) of the 89 patients without significant stenosis detected on CCTA, this protocol provided additional information that suggested or confirmed an alternate clinical diagnosis. In patients with atypical chest pain, CCTA with low-dose chest CT could help to exclude ischemic heart disease and could provide important ancillary information for the final diagnosis

Posterior diaphragmatic defect detected on chest CT: the incidence according to age and the lateral chest radiographic appearances

International Nuclear Information System (INIS)

Lee, Son Youl; Choi, Yo Won; Jeon, Seok Chol; Heo, Jeong Nam; Park, Choong Ki

2007-01-01

We wanted to investigate the incidence of posterior diaphragmatic defect on chest CT in various age groups and its lateral chest radiographic appearances. The chest CT scans of 78 patients of various ages with posterior diaphragmatic defect were selected among 1,991 patients, and they were analyzed for the incidence of defect in various age groups, the defect location and the herniated contents. Their lateral chest radiographs were analyzed for the shape of the posterior diaphragm and the posterior costophrenic sulcus. The patients' ages ranged from 34 to 87 with the tendency of a higher incidence in the older patients. The defect most frequently involved the medial two thirds (n = 49, 50.4%) and middle one third (n = 36, 37%) of the posterior diaphragm. The retroperitoneal fat was herniated into the thorax through the defect in all patients, and sometimes with the kidney (n = 8). Lateral chest radiography showed a normal diaphragmatic contour (n = 51, 49.5%), blunting of the posterior costophrenic sulcus (n = 41, 39.8%), focal humping of the posterior diaphragm (n = 7, 6.8%), or upward convexity (n = 4, 3.9%) of the posterior costophrenic sulcus on the affected side. The posterior diaphragmatic defect discovered in asymptomatic patients who are without a history of peridiaphragmatic disease is most likely acquired, and this malady increases in incidence according to age. An abnormal contour of the posterior diaphragm or the costophrenic sulcus on a lateral chest radiograph may be a finding of posterior diaphragmatic defect

Dual energy CT of the chest: how about the dose?

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Schenzle, Jan C; Sommer, Wieland H; Neumaier, Klement; Michalski, Gisela; Lechel, Ursula; Nikolaou, Konstantin; Becker, Christoph R; Reiser, Maximilian F; Johnson, Thorsten R C

2010-06-01

New generation Dual Source computed tomography (CT) scanners offer different x-ray spectra for Dual Energy imaging. Yet, an objective, manufacturer independent verification of the dose required for the different spectral combinations is lacking. The aim of this study was to assess dose and image noise of 2 different Dual Energy CT settings with reference to a standard chest scan and to compare image noise and contrast to noise ratios (CNR). Also, exact effective dose length products (E/DLP) conversion factors were to be established based on the objectively measured dose. An anthropomorphic Alderson phantom was assembled with thermoluminescent detectors (TLD) and its chest was scanned on a Dual Source CT (Siemens Somatom Definition) in dual energy mode at 140 and 80 kVp with 14 x 1.2 mm collimation. The same was performed on another Dual Source CT (Siemens Somatom Definition Flash) at 140 kVp with 0.8 mm tin filter (Sn) and 100 kVp at 128 x 0.6 mm collimation. Reference scans were obtained at 120 kVp with 64 x 0.6 mm collimation at equivalent CT dose index of 5.4 mGy*cm. Syringes filled with water and 17.5 mg iodine/mL were scanned with the same settings. Dose was calculated from the TLD measurements and the dose length products of the scanner. Image noise was measured in the phantom scans and CNR and spectral contrast were determined in the iodine and water samples. E/DLP conversion factors were calculated as ratio between the measured dose form the TLDs and the dose length product given in the patient protocol. The effective dose measured with TLDs was 2.61, 2.69, and 2.70 mSv, respectively, for the 140/80 kVp, the 140 Sn/100 kVp, and the standard 120 kVp scans. Image noise measured in the average images of the phantom scans was 11.0, 10.7, and 9.9 HU (P > 0.05). The CNR of iodine with optimized image blending was 33.4 at 140/80 kVp, 30.7 at 140Sn/100 kVp and 14.6 at 120 kVp. E/DLP conversion factors were 0.0161 mSv/mGy*cm for the 140/80 kVp protocol, 0.0181 m

Pediatric chest CT after trauma: impact on surgical and clinical management

International Nuclear Information System (INIS)

Patel, Rina P.; Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H.; Yu, Chang; Ray, Jackie

2010-01-01

Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. To assess the impact of chest CT compared with chest radiography on pediatric trauma management. Two hundred thirty-five consecutive pediatric trauma patients who had both chest CT and radiography were identified. Images were reviewed and findings were categorized and correlated with subsequent chest interventions, blinded to final outcome and management. Of the 235 children, 38.3% (90/235) had an abnormal chest radiograph and 63.8% (150/235) had an abnormal chest CT (P < 0.0001). Chest interventions followed in 4.7% (11/235); of these, the findings could be made 1 cm above the dome of the liver in 91% (10/11). Findings requiring chest intervention included pneumothorax (PTX) and vertebral fractures. PTX was found on 2.1% (5/235) of chest radiographs and 20.0% (47/235) of chest CTs (P < 0.0001); 1.7% (4/235) of the children received a chest tube for PTX, 0.85% (2/235) seen on chest CT only. Vertebral fractures were present in 3.8% of the children (9/235) and 66.7% (6/9) of those cases were treated with spinal fusion or brace. There were no instances of mediastinal vascular injury. Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients. (orig.)

Pediatric chest CT after trauma: impact on surgical and clinical management

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Patel, Rina P. [Vanderbilt University School of Medicine, Nashville, TN (United States); Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H. [Vanderbilt University, Department of Radiology and Radiological Sciences, Vanderbilt Children' s Hospital, Nashville, TN (United States); Yu, Chang [Vanderbilt University, Department of Biostatistics, Nashville, TN (United States); Ray, Jackie [Vanderbilt University, Department of Pediatric Surgery, Vanderbilt Children' s Hospital, Nashville, TN (United States)

2010-07-15

Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. To assess the impact of chest CT compared with chest radiography on pediatric trauma management. Two hundred thirty-five consecutive pediatric trauma patients who had both chest CT and radiography were identified. Images were reviewed and findings were categorized and correlated with subsequent chest interventions, blinded to final outcome and management. Of the 235 children, 38.3% (90/235) had an abnormal chest radiograph and 63.8% (150/235) had an abnormal chest CT (P < 0.0001). Chest interventions followed in 4.7% (11/235); of these, the findings could be made 1 cm above the dome of the liver in 91% (10/11). Findings requiring chest intervention included pneumothorax (PTX) and vertebral fractures. PTX was found on 2.1% (5/235) of chest radiographs and 20.0% (47/235) of chest CTs (P < 0.0001); 1.7% (4/235) of the children received a chest tube for PTX, 0.85% (2/235) seen on chest CT only. Vertebral fractures were present in 3.8% of the children (9/235) and 66.7% (6/9) of those cases were treated with spinal fusion or brace. There were no instances of mediastinal vascular injury. Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients. (orig.)

Effect of Localizer Radiography Projection on Organ Dose at Chest CT with Automatic Tube Current Modulation.

Science.gov (United States)

Saltybaeva, Natalia; Krauss, Andreas; Alkadhi, Hatem

2017-03-01

Purpose To calculate the effect of localizer radiography projections to the total radiation dose, including both the dose from localizer radiography and that from subsequent chest computed tomography (CT) with tube current modulation (TCM). Materials and Methods An anthropomorphic phantom was scanned with 192-section CT without and with differently sized breast attachments. Chest CT with TCM was performed after one localizer radiographic examination with anteroposterior (AP) or posteroanterior (PA) projections. Dose distributions were obtained by means of Monte Carlo simulations based on acquired CT data. For Monte Carlo simulations of localizer radiography, the tube position was fixed at 0° and 180°; for chest CT, a spiral trajectory with TCM was used. The effect of tube start angles on dose distribution was investigated with Monte Carlo simulations by using TCM curves with fixed start angles (0°, 90°, and 180°). Total doses for lungs, heart, and breast were calculated as the sum of the dose from localizer radiography and CT. Image noise was defined as the standard deviation of attenuation measured in 14 circular regions of interest. The Wilcoxon signed rank test, paired t test, and Friedman analysis of variance were conducted to evaluate differences in noise, TCM curves, and organ doses, respectively. Results Organ doses from localizer radiography were lower when using a PA instead of an AP projection (P = .005). The use of a PA projection resulted in higher TCM values for chest CT (P chest CT. © RSNA, 2016 Online supplemental material is available for this article.

TU-F-CAMPUS-I-01: Investigation of the Effective Dose From Bolus Tracking Acquisitions at Different Anatomical Locations in the Chest for CT

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Nowik, P; Bujila, R; Merzan, D [Dept. of Medical Physics, Karolinska University Hospital, Stockholm (Sweden)

2015-06-15

Purpose: Stationary table acquisitions (Bolus tracking) in X-ray Computed Tomography (CT) can Result in dose length products (DLP) comparable to spiral scans. It is today unclear whether or not the effective dose (E) for Bolus Tracking can be approximated using target region specific conversion factors (E/DLP). The purpose of this study was to investigate how E depends on the anatomical location of the Bolus Tracking in relation to Chest CT scans with the same DLP. Methods: Effective doses were approximated for the ICRP 110 adult Reference Male (AM) and adult Reference Female (FM) computational voxel phantoms using software for CT dose approximations (pre-simulated MC data). The effective dose was first approximated for a Chest CT scan using spiral technique and a CTDIvol (32 cm) of 6 mGy. The effective dose from the spiral scan was then compared to E approximated for contiguous Bolus Tracking acquisitions (1 cm separation), with a total collimation of 1 cm, over different locations of the chest of the voxel phantoms. The number of rotations used for the Bolus Tracking acquisitions was adjusted to yield the same DLP (32 cm) as the spiral scan. Results: Depending on the anatomical location of the Bolus Tracking, E ranged by factors of 1.3 to 6.8 for the AM phantom and 1.4 to 3.3 for the AF phantom, compared to the effective dose of the spiral scans. The greatest E for the Bolus Tracking acquisitions was observed for anatomical locations coinciding with breast tissue. This can be expected as breast tissue has a high tissue weighting factor in the calculation of E. Conclusion: For Chest CT scans, the effective dose from Bolus Tracking is highly dependent on the anatomical location where the scan is administered and will not always accurately be represented using target region specific conversion factors.

Using 99mTc-DTPA radioaerosol inhalation lung scan as compared with computed tomography to detect lung injury in blunt chest trauma

International Nuclear Information System (INIS)

Esme, H.; Kaya, E.; Solak, O.; Yavuz, Y.; Yurumez, Y.; Sezer, M.

2007-01-01

Detection of pulmonary contusion in patients with blunt chest trauma is very important so as to commence therapy immediately to avoid irreversible damage. The purpose of our study was to evaluate the efficacy of technetium-99m diethylene triamine penta-acetic acid ( 99m Tc-DTPA) aerosol inhalation lung scintigraphy in comparison with chest computed tomography (CT) in the diagnosis of pulmonary contusion at acute blunt chest trauma. Twenty-nine patients with isolated blunt chest trauma were referred to the emergency department of our hospital, and nine healthy people participated in this study. Sixteen patients who had pulmonary contusion on CT scans were referred to as group 1, and 13 patients who had normal CT scans as group 2. Nine healthy people comprised a control group. 99m Tc-DTPA aerosol inhalation lung scintigraphy was performed on the first day in all patients. The mean half time (T 1/2 ) and penetration index values of 99m Tc-DTPA clearance were significantly lower in groups 1 and 2 compared with the control group. Among the three groups, there were no significant differences in arterial blood gas analysis except for PO 2 . The mean T 1/2 value of 99m Tc-DTPA clearance did correlate with PO 2 values but not with pH, PCO 2 , or HCO 3 values. 99m Tc-DTPA radioaerosol inhalation lung imaging may serve as a useful adjunct and supportive method to chest CT scanning for detecting mild pulmonary contusion. (author)

Birt-Hogg-Dube syndrome prospectively detected by review of chest computed tomography scans.

Directory of Open Access Journals (Sweden)

Hye Jung Park

Full Text Available Birt-Hogg-Dube syndrome (BHD is a rare disorder caused by mutations in the gene that encodes folliculin (FLCN and is inherited in an autosomal dominant manner. BHD is commonly accompanied by fibrofolliculomas, renal tumors, multiple pulmonary cysts, and spontaneous pneumothorax. The aim of this study was to detect BHD prospectively in patients undergoing chest computed tomography (CT scans and to evaluate further the characteristics of BHD in Korea.We prospectively checked and reviewed the chest CT scans obtained for 10,883 patients at Gangnam Severance Hospital, Seoul, Korea, from June 1, 2015 to May 31, 2016. Seventeen patients met the study inclusion criteria and underwent screening for FLCN mutation to confirm BHD. We analyzed the characteristics of the patients confirmed to have BHD and those for a further 6 patients who had previously been described in Korea.Six (0.06% of the 10,883 patients reviewed were diagnosed with BHD. There was no difference in demographic or clinical features between the patients with BHD (n = 6 and those without BHD (n = 11. Pneumothorax was present in 50% of the patients with BHD but typical skin and renal lesions were absent. The maximum size of the cysts in the BHD group (median 39.4 mm; interquartile range [IQR] 11.4 mm was significantly larger than that in the non-BHD group (median 15.8 mm; IQR 7.8 mm; P = 0.001. Variable morphology was seen in 100.0% of the cysts in the BHD group but in only 18.2% of the cysts in the non-BHD group (P = 0.002. Nine (95% of the total of 12 Korean patients with BHD had experienced pneumothorax. Typical skin and renal lesions were present in 20.0% of patients with BHD.Our findings suggest that BHD can be detected if chest CT scans are read in detail.

Spiral CT for evaluation of chest trauma; Spiral-CT beim Thoraxtrauma

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Roehnert, W. [Universitaetsklinikum Dresden (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Weise, R. [Universitaetsklinikum Dresden (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik

1997-07-01

After implementation of spiral CT in our department, we carried out an analysis for determining anew the value of CT as a modality of chest trauma diagnosis in the emergency department. The retrospective study covers a period of 10 months and all emergency patients with chest trauma exmined by spiral CT. The major lesions of varying seriousness covered by this study are: pneumothorax, hematothorax, pulmonary contusion or laceration, mediastinal hematoma, rupture of a vessel, injury of the heart and pericardium. The various fractures are not included in this study. In many cases, spiral CT within relatively short time yields significant diagnostic findings, frequently saving additional angiography. A rigid diagnostic procedure cannot be formulated. Plain-film chest radiography still remains a diagnostic modality of high value. (Orig.) [Deutsch] Nach Einfuehrung der Spiral-CT in unserer Einrichtung versuchten wir, den Stellenwert der Computertomographie in der Notfalldiagnostik des Thoraxtraumas neu zu bestimmen. Dazu wurden retrospektiv ueber einen Zeitraum von 10 Monaten alle mittels Spiral-CT untersuchten Notfallpatienten mit Thoraxverletzungen ausgewertet. Im Vordergrund standen folgende Befunde unterschiedlichen Schweregrades: Pneumothorax, Haematothorax, Lungenkontusion/-lazeration, Mediastinalhaematom, Gefaessruptur, Herz- und Herzbeutelverletzung. Auf die unterschiedlichen Frakturen wird bewusst nicht naeher eingegangen. In vielen Faellen liefert die Spiral-CT mit relativ geringem Zeitaufwand wesentliche diagnostische Aussagen. Haeufig kann auf eine Angiographie verzichtet werden. Ein starres diagnostisches Stufenschema laesst sich nicht definieren. Die Thoraxuebersichtsaufnahme besitzt einen unveraendert hohen Stellenwert. (orig.)

Noncontrast chest computed tomography immediately after transarterial chemoembolization in patients with hepatocellular carcinoma: Clinical benefits and effect of radiation reduction on image quality in low-dose scanning

International Nuclear Information System (INIS)

Choi, Joon-Il; Kim, Hyun Beom; Kim, Min Ju; Lee, Jong Seok; Koh, Young Whan; An, Sang Bu; Ko, Heung-kyu; Park, Joong-Won

2011-01-01

Purpose: To evaluate the clinical benefits of noncontrast chest computed tomography (CT) immediately after transarterial chemoembolization in patients with hepatocellular carcinoma and to assess the effect of radiation reduction on image quality in low-dose scanning. Materials and methods: From June to October 2010, we performed standard-dose, noncontrast chest CTs immediately after transarterial chemoembolization in 160 patients and low-dose CTs in 88 patients. We reviewed the entire noncontrast chest CTs and follow-up CTs to reveal the clinical benefits of CT evaluation immediately after transarterial chemoembolization. Using two independent readers, we also retrospectively evaluated the radiation dose and image quality in terms of the image noise, contrast between the liver parenchyma and iodized oil and diagnostic acceptability for the evaluation of treatment response after transarterial chemoembolization. Results: In 5.2% of the patients, additional treatment was performed immediately after the interpretation of the noncontrast chest CT, and additional pulmonary lesions were found in 8.5% of the patients. The measured mean dose-length product for the low-dose scanning was 18.4% of that of the standard-dose scanning. The image noise was significantly higher with the low-dose scanning (p < 0.001). However, all of the low-dose CT scans were diagnostically acceptable, and the mean scores for the subjective assessments of the contrast and diagnostic acceptability showed no significant differences for either reader. Conclusion: A noncontrast chest CT immediately after transarterial chemoembolization has some clinical benefits for immediate decision making and detecting pulmonary lesions. Low-dose, noncontrast chest CTs immediately after transarterial chemoembolization consistently provide diagnostically acceptable images and information on treatment response in patients who have undergone transarterial chemoembolization.

The relationship between image quality and CT dose index of multi-slice low-dose chest CT

International Nuclear Information System (INIS)

Zhu Xiaohua; Shao Jiang; Shi Jingyun; You Zhengqian; Li Shijun; Xue Yongming

2003-01-01

Objective: To explore the rationality and possibility of multi-slice low-dose CT scan in the examination of the chest. Methods: (1) X-ray dose index measurement: 120 kV tube voltage, 0.75 s rotation, 8 mm and 3 mm slice thickness, and the tube current setting of 115.0, 40.0, 25.0, and 7.5 mAs were employed in every section. The X-ray radiation dose was measured and compared statistically. (2) phantom measurement of homogeneity and noise: The technical parameters were 120 kV, 0.75 s, 8 mm and 3 mm sections, and every slice was scanned using tube current of 115.0, 40.0, 25.0, and 7.5 mAs. Five same regions of interest were measured on every image. The homogeneity and noise level of CT were appraised. (3) The multi-slice low-dose CT in patients: 30 patients with mass and 30 with patch shadow in the lung were selected randomly. The technical parameters were 120 kV, 0.75 s, 8 mm and 3 mm slice thickness. 115.0, 40.0, 25.0, 15.0, and 7.5 mAs tube current were employed in each same slice. Otherwise, 15 cases with helical scan were examined using 190, 150, 40, 25, and 15 mAs tube current. The reconstruction images of MIP, MPR, CVR, HRCT, 3D, CT virtual endoscopy, and variety of interval reconstruction were compared. (4) Evaluation of image quality: CT images were evaluated by four doctors using single-blind method, and 3 degrees including normal image, image with few artifact, and image with excessive artifact, were employed and analyzed statistically. Results: (1) The CT dose index with 115.0 mAs tube current exceeded those of 40.0, 25.0, and 7.5 mAs by about 60%, 70%, and 85%, respectively. (2) The phantom measurement showed that the lower of CT dose the lower of homogeneity, the lower of CT dose the higher of noise level. (3) Result of image quality evaluation: The percentage of the normal image had no significant difference between 8 and 3 mm in 115, 40, and 25 mAs (P>0.05). Conclusion: Multi-slice low-dose chest CT technology may protect the patients and guarantee the

The oblique interface in the right cardiophrenic angle: chest radiographic-CT correlation

International Nuclear Information System (INIS)

Kim, Jeung Sook; Lee, Kyung Soo; Choo, Sung Wook; Choo, In Wook

1996-01-01

An oblique interface in the right cardiophrenic angle, extending superomedially from right retrocardiac or supradiaphragmatic region inferolaterally to peridiaphragmatic region, is occasionally observed on posteroanterior chest radiograph. The aim of this study was to evaluate the frequency of visualization of the interface on chest radiographs and to elucidate its nature on radiographic-CT correlation. Posteroanterior chest radiographs from 300 consecutive subjects were analyzed to evaluate the frequency and demographic data about an oblique interface in the right cardiophrenic angle. Thin-section CT scans(1-mm collimation and 5-mm intervals) were obtained from the subjects with positive interface on chest radiograph for assessment of the nature of the interface. The demographic data in the subjects with and without the interface were tested statistically to note any difference between two groups. Oblique interface in the right cardiophrenic angle was present in 29 subjects(9.7%) on chest radiograph. The age of the subjects with positive interface(13 men and 16 women) ranged from 19 to 70 years(mean±SD, 47±12.7 years) whereas the age of the subjects without the interface from 16 to 82 years (mean±SD, 50±9.1 years)(p>0.1). The body weight of the subjects with the interface ranged from 41 to 72 Kg(mean±SD, 60±8.0Kg) whereas the body weight of the subjects without the interface from 41 to 85Kg(mean±SD, 63±10.1Kg)(p>0.1). On CT scan, it was formed due to contact between the epipericardial fat and the right middle lobe of the lung in 27 subjects(93%) and between the inferior vena cava and the medial basal segment of the right lower lobe of the lung in two(7%). Oblique interface in the right cardiophrenic angle is occasionally visualized on chest radiograph. It is formed due to contact between the right middle lobe of the lung and pericardial fat in most cases. The frequency of visualization of the interface has no relationship to age and body weight of the

Occult pneumomediastinum in blunt chest trauma: clinical significance.

Science.gov (United States)

Rezende-Neto, J B; Hoffmann, J; Al Mahroos, M; Tien, H; Hsee, L C; Spencer Netto, F; Speers, V; Rizoli, S B

2010-01-01

Thoracic injuries are potentially responsible for 25% of all trauma deaths. Chest X-ray is commonly used to screen patients with chest injury. However, the use of computed tomography (CT) scan for primary screening is increasing, particularly for blunt trauma. CT scans are more sensitive than chest X-ray in detecting intra-thoracic abnormalities such as pneumothoraces and pneumomediastinums. Pneumomediastinum detected by chest X-ray or "overt pneumomediastinum", raises the concern of possible aerodigestive tract injuries. In contrast, there is scarce information on the clinical significance of pneumomediastinum diagnosed by CT scan only or "occult pneumomediastinum". Therefore we investigated the clinical consequences of occult pneumomediastinum in our blunt trauma population. A 2-year retrospective chart review of all blunt chest trauma patients with initial chest CT scan admitted to a level I trauma centre. Data extracted from the medical records include; demographics, occult, overt, or no pneumomediastinum, the presence of intra-thoracic aerodigestive tract injuries (trachea, bronchus, and/or esophagus), mechanism and severity of injury, endotracheal intubation, chest thoracostomy, operations and radiological reports by an attending radiologist. All patients with intra-thoracic aerodigestive tract injuries from 1994 to 2004 were also investigated. Of 897 patients who met the inclusion criteria 839 (93.5%) had no pneumomediastinum. Five patients (0.6%) had overt pneumomediastinum and 53 patients (5.9%) had occult pneumomediastinum. Patients with occult pneumomediastinum had significantly higher ISS and AIS chest (pchest thoracostomy tube was more common (ppneumothorax. None of the patients with occult pneumomediastinum had aerodigestive tract injuries (95%CI 0-0.06). Follow up CT scan of patients with occult pneumomediastinum showed complete resolution in all cases, in average 3 h after the initial exam. Occult pneumomediastinum occurred in approximately 6% of

Dual-source CT in chest pain diagnosis

International Nuclear Information System (INIS)

Johnson, Thorsten R.C.; Nikolaou, K.; Fink, C.; Rist, C.; Reiser, M.F.; Becker, C.R.; Becker, A.; Knez, A.

2007-01-01

With the depiction of pulmonary arteries, coronary arteries, and the aorta, CT angiography of the chest offers a comprehensive diagnostic work-up of unclear chest pain. The aim of this study was to assess the diagnostic accuracy of dual-source CT in this patient group. A total of 47 patients suffering from unclear chest pain were examined with a Siemens Somatom Definition. Volume and flow of contrast media (Ultravist, Schering) were adapted to the body weight. The examinations were evaluated with regard to image quality and contrast opacification and to the diagnostic accuracy with reference to the final clinical diagnosis. Adequate contrast opacification was achieved in all examinations. The depiction of the coronary arteries was diagnostic in all cases. The cause of chest pain could be identified in 41 cases. Among the diagnoses were coronary and myocardial pathologies, valvular disease, aortic aneurysms and dissections, pulmonary embolism, and pneumonic consolidation. DSCT angiography of the chest offers a very good image quality even at high heart rates so that a high diagnostic accuracy is achieved in patients with acute chest pain. (orig.) [de

Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures

OpenAIRE

Chapman, Brandon C.; Overbey, Douglas M.; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T.; French, Andrew; Johnson, Jeffrey L.; Burlew, Clay C.; Barnett, Carlton; Moore, Ernest E.; Pieracci, Fredric M.

2016-01-01

Background Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. Objectives The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Methods Retrospective coho...

Diagnosis of Grave's disease with pulmonary hypertension on chest CT.

Science.gov (United States)

Lee, Hwa Yeon; Yoo, Seung Min; Kim, Hye Rin; Chun, Eun Ju; White, Charles S

To evaluate the diagnostic accuracy of chest CT findings to diagnose Grave's disease in pulmonary hypertension. We retrospectively evaluated chest CT and the medical records of 13 patients with Grave's disease with (n=6) or without pulmonary hypertension (n=7) and in 17 control patients. Presence of iso-attenuation of diffusely enlarged thyroid glands compared with adjacent neck muscle on non-enhanced CT as a diagnostic clue of Grave's disease, and assessment of pulmonary hypertension on CT has high diagnostic accuracy. Chest CT has the potential to diagnose Grave's disease with pulmonary hypertension in the absence of other information. Copyright © 2017 Elsevier Inc. All rights reserved.

Emphysema quantification and lung volumetry in chest X-ray equivalent ultralow dose CT - Intra-individual comparison with standard dose CT.

Science.gov (United States)

Messerli, Michael; Ottilinger, Thorsten; Warschkow, René; Leschka, Sebastian; Alkadhi, Hatem; Wildermuth, Simon; Bauer, Ralf W

2017-06-01

To determine whether ultralow dose chest CT with tin filtration can be used for emphysema quantification and lung volumetry and to assess differences in emphysema measurements and lung volume between standard dose and ultralow dose CT scans using advanced modeled iterative reconstruction (ADMIRE). 84 consecutive patients from a prospective, IRB-approved single-center study were included and underwent clinically indicated standard dose chest CT (1.7±0.6mSv) and additional single-energy ultralow dose CT (0.14±0.01mSv) at 100kV and fixed tube current at 70mAs with tin filtration in the same session. Forty of the 84 patients (48%) had no emphysema, 44 (52%) had emphysema. One radiologist performed fully automated software-based pulmonary emphysema quantification and lung volumetry of standard and ultralow dose CT with different levels of ADMIRE. Friedman test and Wilcoxon rank sum test were used for multiple comparison of emphysema and lung volume. Lung volumes were compared using the concordance correlation coefficient. The median low-attenuation areas (LAA) using filtered back projection (FBP) in standard dose was 4.4% and decreased to 2.6%, 2.1% and 1.8% using ADMIRE 3, 4, and 5, respectively. The median values of LAA in ultralow dose CT were 5.7%, 4.1% and 2.4% for ADMIRE 3, 4, and 5, respectively. There was no statistically significant difference between LAA in standard dose CT using FBP and ultralow dose using ADMIRE 4 (p=0.358) as well as in standard dose CT using ADMIRE 3 and ultralow dose using ADMIRE 5 (p=0.966). In comparison with standard dose FBP the concordance correlation coefficients of lung volumetry were 1.000, 0.999, and 0.999 for ADMIRE 3, 4, and 5 in standard dose, and 0.972 for ADMIRE 3, 4 and 5 in ultralow dose CT. Ultralow dose CT at chest X-ray equivalent dose levels allows for lung volumetry as well as detection and quantification of emphysema. However, longitudinal emphysema analyses should be performed with the same scan protocol and

Computer-assisted solid lung nodule 3D volumetry on CT : influence of scan mode and iterative reconstruction: a CT phantom study

NARCIS (Netherlands)

Coenen, Adriaan; Honda, Osamu; van der Jagt, Eric J.; Tomiyama, Noriyuki

2013-01-01

To evaluate the effect of high-resolution scan mode and iterative reconstruction on lung nodule 3D volumetry. Solid nodules with various sizes (5, 8, 10 and 12 mm) were placed inside a chest phantom. CT images were obtained with various tube currents, scan modes (conventional mode, high-resolution

Radiation dose and image quality in pediatric chest CT: effects of iterative reconstruction in normal weight and overweight children

International Nuclear Information System (INIS)

Yoon, Haesung; Kim, Myung-Joon; Shin, Hyun Joo; Kim, Hyun Gi; Lee, Mi-Jung; Yoon, Choon-Sik; Choi, Jiin

2015-01-01

New CT reconstruction techniques may help reduce the burden of ionizing radiation. To quantify radiation dose reduction when performing pediatric chest CT using a low-dose protocol and 50% adaptive statistical iterative reconstruction (ASIR) compared with age/gender-matched chest CT using a conventional dose protocol and reconstructed with filtered back projection (control group) and to determine its effect on image quality in normal weight and overweight children. We retrospectively reviewed 40 pediatric chest CT (M:F = 21:19; range: 0.1-17 years) in both groups. Radiation dose was compared between the two groups using paired Student's t-test. Image quality including noise, sharpness, artifacts and diagnostic acceptability was subjectively assessed by three pediatric radiologists using a four-point scale (superior, average, suboptimal, unacceptable). Eight children in the ASIR group and seven in the control group were overweight. All radiation dose parameters were significantly lower in the ASIR group (P < 0.01) with a greater than 57% dose reduction in overweight children. Image noise was higher in the ASIR group in both normal weight and overweight children. Only one scan in the ASIR group (1/40, 2.5%) was rated as diagnostically suboptimal and there was no unacceptable study. In both normal weight and overweight children, the ASIR technique is associated with a greater than 57% mean dose reduction, without significantly impacting diagnostic image quality in pediatric chest CT examinations. However, CT scans in overweight children may have a greater noise level, even when using the ASIR technique. (orig.)

Radiation dose and image quality in pediatric chest CT: effects of iterative reconstruction in normal weight and overweight children

Energy Technology Data Exchange (ETDEWEB)

Yoon, Haesung; Kim, Myung-Joon; Shin, Hyun Joo; Kim, Hyun Gi; Lee, Mi-Jung [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Seoul (Korea, Republic of); Yoon, Choon-Sik [Yonsei University College of Medicine, Department of Radiology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Choi, Jiin [Yonsei University College of Medicine, Biostatistics Collaboration Unit, Seoul (Korea, Republic of)

2015-03-01

New CT reconstruction techniques may help reduce the burden of ionizing radiation. To quantify radiation dose reduction when performing pediatric chest CT using a low-dose protocol and 50% adaptive statistical iterative reconstruction (ASIR) compared with age/gender-matched chest CT using a conventional dose protocol and reconstructed with filtered back projection (control group) and to determine its effect on image quality in normal weight and overweight children. We retrospectively reviewed 40 pediatric chest CT (M:F = 21:19; range: 0.1-17 years) in both groups. Radiation dose was compared between the two groups using paired Student's t-test. Image quality including noise, sharpness, artifacts and diagnostic acceptability was subjectively assessed by three pediatric radiologists using a four-point scale (superior, average, suboptimal, unacceptable). Eight children in the ASIR group and seven in the control group were overweight. All radiation dose parameters were significantly lower in the ASIR group (P < 0.01) with a greater than 57% dose reduction in overweight children. Image noise was higher in the ASIR group in both normal weight and overweight children. Only one scan in the ASIR group (1/40, 2.5%) was rated as diagnostically suboptimal and there was no unacceptable study. In both normal weight and overweight children, the ASIR technique is associated with a greater than 57% mean dose reduction, without significantly impacting diagnostic image quality in pediatric chest CT examinations. However, CT scans in overweight children may have a greater noise level, even when using the ASIR technique. (orig.)

Chest Computed Tomography (CT) Immediately after CT-Guided Transthoracic Needle Aspiration Biopsy as a Predictor of Overt Pneumothorax

Science.gov (United States)

Noh, Tae June; Lee, Chang Hoon; Kang, Young Ae; Kwon, Sung-Youn; Yoon, Ho-Il; Kim, Tae Jung; Lee, Kyung Won; Lee, Jae Ho

2009-01-01

Background/Aims This study examined the correlation between pneumothorax detected by immediate post-transthoracic needle aspiration-biopsy (TTNB) chest computed tomography (CT) and overt pneumothorax detected by chest PA, and investigated factors that might influence the correlation. Methods Adult patients who had undergone CT-guided TTNB for lung lesions from May 2003 to June 2007 at Seoul National University Bundang Hospital were included. Immediate post-TTNB CT and chest PA follow-up at 4 and 16 hours after CT-guided TTNB were performed in 934 patients. Results Pneumothorax detected by immediate chest CT (CT-pneumothorax) was found in 237 (25%) and overt pneumothorax was detected by chest PA follow-up in 92 (38.8%) of the 237 patients. However, overt pneumothorax was found in 18 (2.6%) of the 697 patients without CT-pneumothorax. The width and depth of CT-pneumothorax were predictive risk factors for overt pneumothorax. Conclusions CT-pneumothorax is very sensitive for predicting overt pneumothorax, and the width and depth on CT-pneumothorax are reliable risk factors for predicting overt pneumothorax. PMID:19949733

Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

Energy Technology Data Exchange (ETDEWEB)

Park, Hyun Jeong; Hwang, Jung Hwa [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

2011-09-15

We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV{sub 1}/FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV{sub 1}/FVC and the dyspnea score.

Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

International Nuclear Information System (INIS)

Park, Hyun Jeong; Hwang, Jung Hwa

2011-01-01

We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV 1 /FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV 1 /FVC and the dyspnea score.

Radiation exposure distribution in patients undergoing CT brain scans

International Nuclear Information System (INIS)

Yang Zhanshan; Feng Dinghua; Chang Zichi; Li Shijun

1989-12-01

The distribution of surface exposures in patients undergoing single and multiple computerized tomographic brain scans with Hitachi CT-W500 was measured by LiF(Mg, Ti) thermoluminescent dosimetry. It was found that there was no significant difference in the sufrace exposures from different scanning slices. However, the exposure doses at different scanning angles around the head were different significantly. The reference point of the maximum surface exposure was at the temporal part of the head. the maximum surface exposure was at 1.65 x 10 -3 C·kg -1 while the average exposure was 1.55 x 10 -3 C·kg -1 . The ratio of the average dose resulting from nine scans to that from a single scan was 1.3, and the surface exposure contribution of scattered radiation was computed. At the same time the radiation doses to eyes, thyroid, chest and gonads of patiens at corresponding position were also measured and were compared with those from CT cranial scans in children and skull radiographic procedures respectively

Nodule detection methods using autocorrelation features on 3D chest CT scans

International Nuclear Information System (INIS)

Hara, T.; Zhou, X.; Okura, S.; Fujita, H.; Kiryu, T.; Hoshi, H.

2007-01-01

Lung cancer screening using low dose X-ray CT scan has been an acceptable examination to detect cancers at early stage. We have been developing an automated detection scheme for lung nodules on CT scan by using second-order autocorrelation features and the initial performance for small nodules (< 10 mm) shows a high true-positive rate with less than four false-positive marks per case. In this study, an open database of lung images, LIDC (Lung Image Database Consortium), was employed to evaluate our detection scheme as an consistency test. The detection performance for solid and solitary nodules in LIDC, included in the first data set opened by the consortium, was 83% (10/12) true-positive rate with 3.3 false-positive marks per case. (orig.)

Evaluation of a Chest Circumference-Adapted Protocol for Low-Dose 128-Slice Coronary CT Angiography with Prospective Electrocardiogram Triggering

Energy Technology Data Exchange (ETDEWEB)

Lu, Chenying; Wang, Zufei; Ji, Jiansong; Wang, Hailin; Hu, Xianghua; Chen, Chunmiao [Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang 323000 (China)

2015-11-01

To assess the effect of chest circumference-adapted scanning protocol on radiation exposure and image quality in patients undergoing prospective electrocardiogram (ECG)-triggered coronary CT angiography (CCTA). One hundred-eighty-five consecutive patients, who had undergone prospective ECG triggering CCTA with a 128-slice CT, were included in the present study. Nipple-level chest circumference, body weight and height were measured before CT examinations. Patients were divided into four groups based on kV/ref·mAs = 100/200, 100/250, 120/200, and 120/250, when patient's chest circumference was ≤ 85.0 (n = 56), 85.0-90.0 (n = 53), 90.0-95.0 (n = 44), and > 95.0 (n = 32), respectively. Image quality per-segment was independently assessed by two experienced observers. Image noise and attenuation were also measured. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The effective radiation dose was calculated using CT dose volume index and the dose-length product. A significant correlation was observed between patients' chest circumference and body mass index (r = 0.762, p < 0.001). Chest circumference ranged from 74 to 105 cm, and the mean effective radiation dose was 1.9-3.8 mSv. Diagnostic image quality was obtained in 98.5% (2440/2478) of all evaluated coronary segments without any significant differences among the four groups (p = 0.650). No significant difference in image noise was observed among the four groups (p = 0.439), thus supporting the validity of the chest circumference-adapted scanning protocol. However, vessel attenuation, SNR and CNR were significantly higher in the 100 kV groups than in the 120 kV groups (p < 0.05). A measure of chest circumference can be used to adapt tube voltage and current for individualized radiation dose control, with resultant similar image noise and sustained diagnostic image quality.

CT of the chest in suspected child abuse using submillisievert radiation dose

International Nuclear Information System (INIS)

Sanchez, Thomas R.; Seibert, J.A.; Stein-Wexler, Rebecca; Lee, Justin S.; Coulter, Kevin P.

2015-01-01

The cornerstone of child abuse imaging is the skeletal survey, but initial imaging with radiographs may not demonstrate acute and non-displaced fractures, especially those involving the ribs. Given the high mortality of undiagnosed non-accidental trauma, timely diagnosis is crucial. CT is more sensitive in assessing rib fractures; however the effective radiation dose of a standard chest CT is high. We retrospectively identified four children (three boys, one girl; age range 1-4 months) admitted between January 2013 and February 2014 with high suspicion for non-accidental trauma from unexplained fractures of the long bones; these children all had CT of the chest when no rib fractures were evident on the skeletal survey. The absorbed radiation dose estimates for organs and tissue from the four-view chest radiographs and subsequent CT were determined using Monte Carlo photon transport software, and the effective dose was calculated using published tissue-weighting factors. In two children, CT showed multiple fractures of the ribs, scapula and vertebral body that were not evident on the initial skeletal survey. The average effective dose for a four-view chest radiograph across the four children was 0.29 mSv and the average effective dose for the chest CT was 0.56 mSv. Therefore the effective dose of a chest CT is on average less than twice that of a four-view chest radiograph. Our protocol thus shows that a reduced-dose chest CT may be useful in the evaluation of high specificity fractures of non-accidental trauma when the four-view chest radiographs are negative. (orig.)

CT of the chest in suspected child abuse using submillisievert radiation dose

Energy Technology Data Exchange (ETDEWEB)

Sanchez, Thomas R.; Seibert, J.A.; Stein-Wexler, Rebecca [Medical Center Children' s Hospital, Division of Pediatric Radiology, University of California-Davis, Sacramento, CA (United States); Lee, Justin S. [University of California-Davis, Department of Radiology, Sacramento, CA (United States); Coulter, Kevin P. [Medical Center Children' s Hospital, Department of Pediatrics, University of California-Davis, Sacramento, CA (United States)

2015-07-15

The cornerstone of child abuse imaging is the skeletal survey, but initial imaging with radiographs may not demonstrate acute and non-displaced fractures, especially those involving the ribs. Given the high mortality of undiagnosed non-accidental trauma, timely diagnosis is crucial. CT is more sensitive in assessing rib fractures; however the effective radiation dose of a standard chest CT is high. We retrospectively identified four children (three boys, one girl; age range 1-4 months) admitted between January 2013 and February 2014 with high suspicion for non-accidental trauma from unexplained fractures of the long bones; these children all had CT of the chest when no rib fractures were evident on the skeletal survey. The absorbed radiation dose estimates for organs and tissue from the four-view chest radiographs and subsequent CT were determined using Monte Carlo photon transport software, and the effective dose was calculated using published tissue-weighting factors. In two children, CT showed multiple fractures of the ribs, scapula and vertebral body that were not evident on the initial skeletal survey. The average effective dose for a four-view chest radiograph across the four children was 0.29 mSv and the average effective dose for the chest CT was 0.56 mSv. Therefore the effective dose of a chest CT is on average less than twice that of a four-view chest radiograph. Our protocol thus shows that a reduced-dose chest CT may be useful in the evaluation of high specificity fractures of non-accidental trauma when the four-view chest radiographs are negative. (orig.)

Proton MRI in the evaluation of pulmonary sarcoidosis: Comparison to chest CT

International Nuclear Information System (INIS)

Chung, Jonathan H.; Little, Brent P.; Forssen, Anna V.; Yong, Jin; Nambu, Atsushi; Kazlouski, Demitry; Puderbach, Michael; Biederer, Juergen; Lynch, David A.

2013-01-01

Purpose: The purpose of this study was to determine the feasibility of proton MRI of the lung in sarcoidosis patients and the agreement between the imaging appearance of pulmonary sarcoidosis on MRI and CT. Materials and methods: Chest CT scans and dedicated pulmonary MRI scans (including HASTE, VIBE, and TrueFISP sequences) were performed within 90 days of each other in 29 patients. The scans were scored for gross parenchymal opacification, reticulation, nodules, and masses using a 3-point lobar scale. Total and subset scores for corresponding MRI and CT scans were compared using the Spearman correlation test, Bland–Altman plots, and Cohen's quadratic-weighted kappa analysis. MRI scores were compared to CT by lobe and disease category, using percentage agreement, Spearman rank correlation, and Cohen's quadratic-weighted kappa. Results: The mean (±s.d.) time between MRI and CT scans was 33 ± 32 days. There was substantial correlation and agreement between total disease scoring on MRI and CT with a Spearman correlation coefficient of 0.774 (p < 0.0001) and a Cohen's weighted kappa score of 0.646. Correlation and agreement were highest for gross parenchymal opacification (0.695, 0.528) and reticulation (0.609, 0.445), and lowest in the setting of nodules (0.501, 0.305). Agreement testing was not performed for mass scores due to low prevalence. Upper lobe scoring on MRI and CT demonstrated greater agreement compared to the lower lobes (average difference in Cohen's weighted kappa score of 0.112). Conclusion: There is substantial correlation and agreement between MRI and CT in the scoring of pulmonary sarcoidosis, though MRI evaluation in the upper lobes may be more accurate than in the lower lobes

Cardiac pathologies incidentally detected with non-gated chest CT; Inzidentelle Pathologien des Herzens im Thorax-CT

Energy Technology Data Exchange (ETDEWEB)

Scherer, Axel; Kroepil, P.; Lanzman, R.S.; Moedder, U. [Inst. fuer Radiologie, Universitaetsklinikum Duesseldorf, Heinrich-Heine-Univ. (Germany); Choy, G.; Abbara, S. [Cardiovascular Imaging Section, Massachusetts General Hospital, Harvard Medical School (United States)

2009-12-15

Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits noninvasive diagnosis of congenital and acquired cardiac pathologies and has thus become increasingly important in the last years. Several studies investigated the incidence and relevance of incidental extracardiac structures within the lungs, mediastinum, chest wall, and abdomen with gated coronary CT. This resulted in the general acceptance of the review of extracardiac structures as a routine component of coronary CT interpretation. On the other hand radiologists tend to neglect pericardial and cardiac pathologies in non-gated chest CT, which is primarily performed for the evaluation of the respiratory system or for tumor staging. Since the introduction of multi-detector spiral CT technology, the incidental detection of cardiac and pericardial findings has become possible using non-gated chest CT. This article reviews the imaging appearances and differential diagnostic considerations of incidental cardiac entities that may be encountered in non-gated chest CT. (orig.)

Lung nodule detection on chest CT: evaluation of a computer-aided detection (CAD) system

International Nuclear Information System (INIS)

Lee, In Jae; Gamsu, Gordon; Czum, Julianna; Johnson, Rebecca; Chakrapani, Sanjay; Wu, Ning

2005-01-01

To evaluate the capacity of a computer-aided detection (CAD) system to detect lung nodules in clinical chest CT. A total of 210 consecutive clinical chest CT scans and their reports were reviewed by two chest radiologists and 70 were selected (33 without nodules and 37 with 1-6 nodules, 4-15.4 mm in diameter). The CAD system (ImageChecker CT LN-1000) developed by R2 Technology, Inc. (Sunnyvale, CA) was used. Its algorithm was designed to detect nodules with a diameter of 4-20 mm. The two chest radiologists working with the CAD system detected a total of 78 nodules. These 78 nodules form the database for this study. Four independent observers interpreted the studies with and without the CAD system. The detection rates of the four independent observers without CAD were 81% (63/78), 85% (66/78), 83% (65/78), and 83% (65/78), respectively. With CAD their rates were 87% (68/78), 85% (66/78), 86% (67/78), and 85% (66/78), respectively. The differences between these two sets of detection rates did not reach statistical significance. In addition, CAD detected eight nodules that were not mentioned in the original clinical radiology reports. The CAD system produced 1.56 false-positive nodules per CT study. The four test observers had 0, 0.1, 0.17, and 0.26 false-positive results per study without CAD and 0.07, 0.2, 0.23, and 0.39 with CAD, respectively. The CAD system can assist radiologists in detecting pulmonary nodules in chest CT, but with a potential increase in their false positive rates. Technological improvements to the system could increase the sensitivity and specificity for the detection of pulmonary nodules and reduce these false-positive results

Coronary artery visibility in free-breathing young children on non-gated chest CT: impact of temporal resolution

Energy Technology Data Exchange (ETDEWEB)

Bridoux, Alexandre; Hutt, Antoine; Faivre, Jean-Baptiste; Pagniez, Julien; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), 59037 Lille Cedex (France); Flohr, Thomas [Siemens Healthcare, Department of Research and Development in CT, Forchheim (Germany); Duhamel, Alain [Universite de Lille, Department of Biostatistics, Lille (France)

2015-11-15

Dual-source CT allows scanning of the chest with high pitch and high temporal resolution, which can improve the detection of proximal coronary arteries in infants and young children when scanned without general anesthesia, sedation or beta-blockade. To compare coronary artery visibility between higher and standard temporal resolution. We analyzed CT images in 93 children who underwent a standard chest CT angiographic examination with reconstruction of images with a temporal resolution of 75 ms (group 1) and 140 ms (group 2). The percentage of detected coronary segments was higher in group 1 than in group 2 when considering all segments (group 1: 27%; group 2: 24%; P = 0.0004) and proximal segments (group 1: 37%; group 2: 32%; P = 0.0006). In both groups, the highest rates of detection were observed for the left main coronary artery (S1) (group 1: 65%; group 2: 58%) and proximal left anterior descending coronary artery (S2) (group 1: 43%; group 2: 42%). Higher rates of detection were seen in group 1 for the left main coronary artery (P = 0.03), proximal right coronary artery (P = 0.01), proximal segments of the left coronary artery (P = 0.02) and proximal segments of the left and right coronary arteries (P = 0.0006). Higher temporal resolution improved the visibility of proximal coronary arteries in pediatric chest CT. (orig.)

Volume-monitored chest CT: a simplified method for obtaining motion-free images near full inspiratory and end expiratory lung volumes

Energy Technology Data Exchange (ETDEWEB)

Mueller, Kathryn S. [The Ohio State University College of Medicine, Columbus, OH (United States); Long, Frederick R. [Nationwide Children' s Hospital, The Children' s Radiological Institute, Columbus, OH (United States); Flucke, Robert L. [Nationwide Children' s Hospital, Department of Pulmonary Medicine, Columbus, OH (United States); Castile, Robert G. [The Research Institute at Nationwide Children' s Hospital, Center for Perinatal Research, Columbus, OH (United States)

2010-10-15

Lung inflation and respiratory motion during chest CT affect diagnostic accuracy and reproducibility. To describe a simple volume-monitored (VM) method for performing reproducible, motion-free full inspiratory and end expiratory chest CT examinations in children. Fifty-two children with cystic fibrosis (mean age 8.8 {+-} 2.2 years) underwent pulmonary function tests and inspiratory and expiratory VM-CT scans (1.25-mm slices, 80-120 kVp, 16-40 mAs) according to an IRB-approved protocol. The VM-CT technique utilizes instruction from a respiratory therapist, a portable spirometer and real-time documentation of lung volume on a computer. CT image quality was evaluated for achievement of targeted lung-volume levels and for respiratory motion. Children achieved 95% of vital capacity during full inspiratory imaging. For end expiratory scans, 92% were at or below the child's end expiratory level. Two expiratory exams were judged to be at suboptimal volumes. Two inspiratory (4%) and three expiratory (6%) exams showed respiratory motion. Overall, 94% of scans were performed at optimal volumes without respiratory motion. The VM-CT technique is a simple, feasible method in children as young as 4 years to achieve reproducible high-quality full inspiratory and end expiratory lung CT images. (orig.)

Correlation between image quality of CT scan and amount of intravenous contrast media

International Nuclear Information System (INIS)

Yoon, Dae Young; Choi, Dae Seob; Kim, Seung Hyup; Han, Joon Koo; Choi, Byung Ihn; Im, Jung Gi; Han, Moon Hee; Chang, Kee Hyun; Kim, Jong Hyo; Han, Man Chung

1993-01-01

A blind, comparative clinical study was performed prospectively to examine the correlation between image quality of CT scan in terms of contrast enhancement effect and amount of intravenous contrast media. A total of 357 patients were randomized into two groups. Ionic high-osmolality contrast media (68% meglumine ioglicate) was administered intravenously as 100 ml bolus in one group and as 50 ml bolus in the other group. Statistically significant differences of image quality were found in CT scans of the brain, head and neck, chest and abdomen (p 0.05). We suggest that amount of contrast media may be reduced in pelvis CT without significant degradation of image quality

Chest CT findings of toxocariasis: Correlation with laboratory results

International Nuclear Information System (INIS)

Hur, J.H.; Lee, I.J.; Kim, J.-H.; Kim, D.-G.; Hwang, H.J.; Koh, S.H.; Lee, K.

2014-01-01

Aim: To assess the relationship between chest computed tomography (CT) findings of patients with toxocariasis and levels of serological markers. Materials and methods: A total of 38 cases of patients diagnosed with toxocariasis by enzyme-linked immunosorbent assay (ELISA), CT, and serological markers were retrospectively reviewed. The presence of nodule with or without ground-glass opacity (GGO) halo, consolidation, focal GGO, pleural effusion, and lymphadenopathy at chest CT were evaluated. Statistical analysis was performed with the Fisher's exact test. Results: The most common chest CT findings were nodule (n = 12, 31.6%) and focal GGO (n = 12, 31.6%). In patients with normal eosinophil levels, focal GGO (n = 9, 37.5%) was the most common finding. In contrast, nodule with a GGO halo (n = 7, 50%) was the most common finding in the eosinophilia group. Nodule with a GGO halo was more common in the eosinophilia group, with a statistically significant difference (p = 0.017). Nodule was more common in the eosinophilia group, and focal GGO was more common in the normal eosinophil group. Conclusion: The most common chest CT findings in toxocariasis were nodule with or without GGO halo, and focal GGO. In the eosinophilia group, nodule with a GGO halo was significantly more frequent. Other CT findings did not show a statistically significant relationship with serological markers

Role of contrast-enhanced helical CT in the evaluation of acute thoracic aortic injuries after blunt chest trauma

International Nuclear Information System (INIS)

Scaglione, M.; Pinto, A.; Pinto, F.; Romano, L.; Ragozzino, A.; Grassi, R.

2001-01-01

The purpose of this retrospective study was to determine the value of contrast-enhanced helical CT for detecting and managing acute thoracic aortic injury (ATAI). Between June 1995 and February 2000, 1419 consecutive chest CT examinations were performed in the setting of major blunt trauma. The following CT findings were considered indicative of ATAI: intimal flap; pseudoaneurysm; contour irregularity; lumen abnormality; and extravasation of contrast material. On the basis of these direct findings no further diagnostic investigations were performed. Isolated mediastinal hematoma on CT scans was considered an indirect sign of ATAI: In these cases, thoracic aortography was performed even if CT indicated normal aorta. Seventy-seven patients had abnormal CT scans: Among the 23 patients with direct CT signs, acute thoracic aortic injuries was confirmed at thoracotomy in 21. Two false-positive cases were observed. The 54 remaining patients had isolated mediastinal hematoma without aortic injuries at CT and corresponding negative angiograms. The 1342 patients with negative CT scans were included in the 8-month follow-up program and did not show any adverse sequela based on clinical and radiographic criteria. Contrast-enhanced helical CT has a critical role in the exclusion of thoracic aortic injuries in patient with major blunt chest trauma and prevents unnecessary thoracic aortography. Direct CT signs of ATAI do not require further diagnostic investigations to confirm the diagnosis: Isolated aortic bands or contour vessel abnormalities should be first considered as possible artifacts or related to non-traumatic etiologies especially when mediastinal hematoma is absent. In cases of isolated mediastinal hematoma other possible sources of bleeding should be considered before directing patients to thoracic aortography. (orig.)

Chest CT findings in pediatric Wegener's granulomatosis

Energy Technology Data Exchange (ETDEWEB)

Levine, Daniel [British Columbia Children' s Hospital, Department of Radiology and Nuclear Medicine, Vancouver, British Columbia (Canada); Akikusa, Jonathan [Royal Children' s Hospital Melbourne, Department of Rheumatology, Melbourne (Australia); Manson, David [Hospital for Sick Children, Department of Radiology, Toronto (Canada); Silverman, Earl; Schneider, Rayfel [Hospital for Sick Children, Department of Rheumatology, Toronto (Canada)

2007-01-15

Although pulmonary involvement occurs in the majority of children and adolescents with Wegener's granulomatosis (WG), relatively little has been published regarding the CT imaging manifestations in this group of patients. To determine the frequency and types of chest CT abnormalities in active pediatric WG (pWG). The study was a retrospective examination of 29 chest CT examinations performed at diagnosis (n=14) and during disease flares (n=15) in 18 children. The most common abnormalities were nodules (seen in 90% of examinations), ground-glass opacification (52%), and air-space opacification (45%). Of examinations with nodules, 73% demonstrated nodules >5 mm in diameter and 69% demonstrated more than five nodules; 17% had cavitary lesions. The only abnormality with a significant difference in prevalence between diagnosis and disease flares was air-space opacification, present in 71% and 20%, respectively (P < 0.01). In accordance with the findings of published adult studies and at variance with those of prior pediatric studies, our findings indicate that chest CT abnormalities in active pWG are frequent, most commonly comprising nodules and ground-glass opacification, which may be difficult to detect on plain radiography. We therefore advocate the routine use of chest CT for all affected patients, both at the time of presentation and during disease flares. (orig.)

Ultralow dose CT for pulmonary nodule detection with chest X-ray equivalent dose - a prospective intra-individual comparative study

Energy Technology Data Exchange (ETDEWEB)

Messerli, Michael [University Zurich, Department of Nuclear Medicine, University Hospital Zurich, Zurich (Switzerland); Cantonal Hospital St. Gallen, Division of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Kluckert, Thomas; Knitel, Meinhard; Desbiolles, Lotus; Bauer, Ralf W.; Wildermuth, Simon [Cantonal Hospital St. Gallen, Division of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Waelti, Stephan [Cantonal Hospital St. Gallen, Division of Radiology and Nuclear Medicine, St. Gallen (Switzerland); University of Montreal, Department of Radiology, CHU Sainte-Justine, Montreal, Quebec (Canada); Rengier, Fabian [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Warschkow, Rene [Cantonal Hospital St. Gallen, Department of Surgery, St. Gallen (Switzerland); Alkadhi, Hatem [University Zurich, Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich (Switzerland); Leschka, Sebastian [Cantonal Hospital St. Gallen, Division of Radiology and Nuclear Medicine, St. Gallen (Switzerland); University Zurich, Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich (Switzerland)

2017-08-15

To prospectively evaluate the accuracy of ultralow radiation dose CT of the chest with tin filtration at 100 kV for pulmonary nodule detection. 202 consecutive patients undergoing clinically indicated chest CT (standard dose, 1.8 ± 0.7 mSv) were prospectively included and additionally scanned with an ultralow dose protocol (0.13 ± 0.01 mSv). Standard dose CT was read in consensus by two board-certified radiologists to determine the presence of lung nodules and served as standard of reference (SOR). Two radiologists assessed the presence of lung nodules and their locations on ultralow dose CT. Sensitivity and specificity of the ultralow dose protocol was compared against the SOR, including subgroup analyses of different nodule sizes and types. A mixed effects logistic regression was used to test for independent predictors for sensitivity of pulmonary nodule detection. 425 nodules (mean diameter 3.7 ± 2.9 mm) were found on SOR. Overall sensitivity for nodule detection by ultralow dose CT was 91%. In multivariate analysis, nodule type, size and patients BMI were independent predictors for sensitivity (p < 0.001). Ultralow dose chest CT at 100 kV with spectral shaping enables a high sensitivity for the detection of pulmonary nodules at exposure levels comparable to plain film chest X-ray. (orig.)

Pulmonary Metastasis from Rectal Cancer on Chest CT Is Correlated with 3T MRI Primary Tumor Location

International Nuclear Information System (INIS)

Han, Na Yeon; Kim, Min Ju; Park, Beon Jin; Sung, Deuk Jae; Chung, Kyoo Byung; Oh, Yu Whan

2011-01-01

To evaluate the association between the incidence of pulmonary metastasis on chest CT and the location of the primary tumor on rectal MRI. One hundred and nine consecutive patients with rectal adenocarcinoma underwent chest CT and 3T rectal MRI. Two radiologists classified the tumor on MRI as an upper (> 10 cm from the anal verge), mid (5-10 cm), or lower rectal tumor (< 5 cm) by consensus. All chest CT scans were retrospectively reviewed for the presence of metastasis. We used Fisher's exact test to evaluate the correlation between the incidence of pulmonary metastasis with the location of the rectal cancer and the Mantel-Haenszel test to control for local tumor stage. We only included the 60 patients with upper (n = 26) or lower (n = 34) rectal cancer, because of the complicated venous drainage system of the mid rectum. Among these, 9 (15%) showed evidence of pulmonary metastasis on chest CT and almost all (89%, 8/9) patients had lower rectal cancer. The incidence of pulmonary metastasis between the two groups was statistically different (p < 0.05) when local tumor stage was controlled. The incidence of pulmonary metastasis was significantly higher for lower than upper rectal cancers when the T-stage of the tumor was accounted for.

Pulmonary effects of synthetic marijuana: chest radiography and CT findings.

Science.gov (United States)

Berkowitz, Eugene A; Henry, Travis S; Veeraraghavan, Srihari; Staton, Gerald W; Gal, Anthony A

2015-04-01

The purpose of this article is to present the first chest radiographic and CT descriptions of organizing pneumonia in response to smoking synthetic marijuana. Chest radiographs showed a diffuse miliary-micronodular pattern. Chest CT images showed diffuse centrilobular nodules and tree-in-bud pattern and a histopathologic pattern of organizing pneumonia with or without patchy acute alveolar damage. This distinct imaging pattern should alert radiologists to include synthetic marijuana abuse in the differential diagnosis.

A coarse-to-fine approach for pericardial effusion localization and segmentation in chest CT scans

Science.gov (United States)

Liu, Jiamin; Chellamuthu, Karthik; Lu, Le; Bagheri, Mohammadhadi; Summers, Ronald M.

2018-02-01

Pericardial effusion on CT scans demonstrates very high shape and volume variability and very low contrast to adjacent structures. This inhibits traditional automated segmentation methods from achieving high accuracies. Deep neural networks have been widely used for image segmentation in CT scans. In this work, we present a two-stage method for pericardial effusion localization and segmentation. For the first step, we localize the pericardial area from the entire CT volume, providing a reliable bounding box for the more refined segmentation step. A coarse-scaled holistically-nested convolutional networks (HNN) model is trained on entire CT volume. The resulting HNN per-pixel probability maps are then threshold to produce a bounding box covering the pericardial area. For the second step, a fine-scaled HNN model is trained only on the bounding box region for effusion segmentation to reduce the background distraction. Quantitative evaluation is performed on a dataset of 25 CT scans of patient (1206 images) with pericardial effusion. The segmentation accuracy of our two-stage method, measured by Dice Similarity Coefficient (DSC), is 75.59+/-12.04%, which is significantly better than the segmentation accuracy (62.74+/-15.20%) of only using the coarse-scaled HNN model.

Assessment of noise reduction potential and image quality improvement of a new generation adaptive statistical iterative reconstruction (ASIR-V) in chest CT.

Science.gov (United States)

Tang, Hui; Yu, Nan; Jia, Yongjun; Yu, Yong; Duan, Haifeng; Han, Dong; Ma, Guangming; Ren, Chenglong; He, Taiping

2018-01-01

To evaluate the image quality improvement and noise reduction in routine dose, non-enhanced chest CT imaging by using a new generation adaptive statistical iterative reconstruction (ASIR-V) in comparison with ASIR algorithm. 30 patients who underwent routine dose, non-enhanced chest CT using GE Discovery CT750HU (GE Healthcare, Waukesha, WI) were included. The scan parameters included tube voltage of 120 kVp, automatic tube current modulation to obtain a noise index of 14HU, rotation speed of 0.6 s, pitch of 1.375:1 and slice thickness of 5 mm. After scanning, all scans were reconstructed with the recommended level of 40%ASIR for comparison purpose and different percentages of ASIR-V from 10% to 100% in a 10% increment. The CT attenuation values and SD of the subcutaneous fat, back muscle and descending aorta were measured at the level of tracheal carina of all reconstructed images. The signal-to-noise ratio (SNR) was calculated with SD representing image noise. The subjective image quality was independently evaluated by two experienced radiologists. For all ASIR-V images, the objective image noise (SD) of fat, muscle and aorta decreased and SNR increased along with increasing ASIR-V percentage. The SD of 30% ASIR-V to 100% ASIR-V was significantly lower than that of 40% ASIR (p ASIR-V reconstructions had good diagnostic acceptability. However, the 50% ASIR-V to 70% ASIR-V series showed significantly superior visibility of small structures when compared with the 40% ASIR and ASIR-V of other percentages (p ASIR-V was the best series of all ASIR-V images, with a highest subjective image quality. The image sharpness was significantly decreased in images reconstructed by 80% ASIR-V and higher. In routine dose, non-enhanced chest CT, ASIR-V shows greater potential in reducing image noise and artefacts and maintaining image sharpness when compared to the recommended level of 40%ASIR algorithm. Combining both the objective and subjective evaluation of images, non

Automated Agatston score computation in non-ECG gated CT scans using deep learning

Science.gov (United States)

Cano-Espinosa, Carlos; González, Germán.; Washko, George R.; Cazorla, Miguel; San José Estépar, Raúl

2018-03-01

Introduction: The Agatston score is a well-established metric of cardiovascular disease related to clinical outcomes. It is computed from CT scans by a) measuring the volume and intensity of the atherosclerotic plaques and b) aggregating such information in an index. Objective: To generate a convolutional neural network that inputs a non-contrast chest CT scan and outputs the Agatston score associated with it directly, without a prior segmentation of Coronary Artery Calcifications (CAC). Materials and methods: We use a database of 5973 non-contrast non-ECG gated chest CT scans where the Agatston score has been manually computed. The heart of each scan is cropped automatically using an object detector. The database is split in 4973 cases for training and 1000 for testing. We train a 3D deep convolutional neural network to regress the Agatston score directly from the extracted hearts. Results: The proposed method yields a Pearson correlation coefficient of r = 0.93; p <= 0.0001 against manual reference standard in the 1000 test cases. It further stratifies correctly 72.6% of the cases with respect to standard risk groups. This compares to more complex state-of-the-art methods based on prior segmentations of the CACs, which achieve r = 0.94 in ECG-gated pulmonary CT. Conclusions: A convolutional neural network can regress the Agatston score from the image of the heart directly, without a prior segmentation of the CACs. This is a new and simpler paradigm in the Agatston score computation that yields similar results to the state-of-the-art literature.

Chest pain: Coronary CT in the ER

NARCIS (Netherlands)

E. Maffei (Erica); S. Seitun (Sara); A.I. Guaricci (Andrea); F. Cademartiri (Filippo)

2016-01-01

textabstractCardiac CT has developed into a robust clinical tool during the past 15 years. Of the fields in which the potential of cardiac CT has raised more interest is chest pain in acute settings. In fact, the possibility to exclude with high reliability obstructive coronary artery disease (CAD)

Dosimetric study in chest computed tomography scans of adult and pediatric phantoms

International Nuclear Information System (INIS)

Namen A, W.; Prata M, A.; Guedes, G.

2016-10-01

The computed tomography scan is a radiological technique that permits an evaluation of the patient internal structures. In the last ten years, this technique has had a high growth due to clinical cases of medical emergencies, cancer and pediatric trauma. Widespread of this technique has a significant increase in the patient dose. The risk associated with the radiological examination can be considered very low compared to the natural risk. However, any additional risk, no matter how small, is unacceptable if it does not benefit the patient. To be aware of the dose distribution is important when the objective is to vary the acquisition parameters aiming a dose reduction. The aim os this study is develop a pediatric chest phantom to evaluate the dose variation in CT scans. In this work, a cylindrical adult chest phantom made in polymethyl methacrylate was used and a second chest phantom was developed, based on dimensions of in eight year old patient in oblong shape. The two simulators have 5 openings, one is central and four are peripheral lagged by 90 degrees Celsius, which allow positioning a pencil chamber aiming and observation of the dose in 5 regions. In a GE CT scanner, Discovery model and 64 channels, the central slice of both simulators were irradiated successively to obtain dose measurements using a pencil chamber. The irradiation of the central slice was conducted using the service protocol. The registered dose values showed that the pediatric phantom had higher doses especially in the anterior, posterior and central regions. The results also enabled a comparison among the index dose values obtained from the measurements with the pencil chamber. (Author)

Dosimetric study in chest computed tomography scans of adult and pediatric phantoms

Energy Technology Data Exchange (ETDEWEB)

Namen A, W.; Prata M, A. [Universidade Federal de Minas Gerais, Departamento de Engenharia Nuclear, Av. Pte. Antonio Carlos 6627, 31270-901 Pampulha, Belo Horizonte, Minas Gerais (Brazil); Guedes, G., E-mail: wadia.namen@gmail.com [Centro Federal de Educacao Tecnologica de Minas Gerais, Centro de Engenharia Biomedica, Av. Amazonas 5253, 30421-169 Nova Suica, Belo Horizonte, Minas Gerais (Brazil)

2016-10-15

The computed tomography scan is a radiological technique that permits an evaluation of the patient internal structures. In the last ten years, this technique has had a high growth due to clinical cases of medical emergencies, cancer and pediatric trauma. Widespread of this technique has a significant increase in the patient dose. The risk associated with the radiological examination can be considered very low compared to the natural risk. However, any additional risk, no matter how small, is unacceptable if it does not benefit the patient. To be aware of the dose distribution is important when the objective is to vary the acquisition parameters aiming a dose reduction. The aim os this study is develop a pediatric chest phantom to evaluate the dose variation in CT scans. In this work, a cylindrical adult chest phantom made in polymethyl methacrylate was used and a second chest phantom was developed, based on dimensions of in eight year old patient in oblong shape. The two simulators have 5 openings, one is central and four are peripheral lagged by 90 degrees Celsius, which allow positioning a pencil chamber aiming and observation of the dose in 5 regions. In a GE CT scanner, Discovery model and 64 channels, the central slice of both simulators were irradiated successively to obtain dose measurements using a pencil chamber. The irradiation of the central slice was conducted using the service protocol. The registered dose values showed that the pediatric phantom had higher doses especially in the anterior, posterior and central regions. The results also enabled a comparison among the index dose values obtained from the measurements with the pencil chamber. (Author)

Radiation Dose Reduction of Chest CT with Iterative Reconstruction in Image Space - Part I: Studies on Image Quality Using Dual Source CT

International Nuclear Information System (INIS)

Hwang, Hye Jeon; Seo, Joon Beom; Lee, Jin Seong; Song, Jae Woo; Lee, Hyun Joo; Lim, Chae Hun; Kim, Song Soo

2012-01-01

To determine whether the image quality (IQ) is improved with iterative reconstruction in image space (IRIS), and whether IRIS can be used for radiation reduction in chest CT. Standard dose chest CT (SDCT) in 50 patients and low dose chest CT (LDCT) in another 50 patients were performed, using a dual-source CT, with 120 kVp and same reference mAs (50 mAs for SDCT and 25 mAs for LDCT) employed to both tubes by modifying a dual-energy scan mode. Full-dose data were obtained by combining the data from both tubes and half-dose data were separated from a single tube. These were reconstructed by using a filtered back projection (FBP) and IRIS: full-dose FBP (F-FBP); full-dose IRIS (F-IRIS); half-dose FBP (H-FBP) and half-dose IRIS (H-IRIS). Objective noise was measured. The subjective IQ was evaluated by radiologists for the followings: noise, contrast and sharpness of mediastinum and lung. Objective noise was significantly lower in H-IRIS than in F-FBP (p < 0.01). In both SDCT and LDCT, the IQ scores were highest in F-IRIS, followed by F-FBP, H-IRIS and H-FBP, except those for sharpness of mediastinum, which tended to be higher in FBP. When comparing CT images between the same dose and different reconstruction (F-IRIS/F-FBP and H-IRIS/H-FBP) algorithms, scores tended to be higher in IRIS than in FBP, being more distinct in half-dose images. However, despite the use of IRIS, the scores were lower in H-IRIS than in F-FBP. IRIS generally helps improve the IQ, being more distinct at the reduced radiation. However, reduced radiation by half results in IQ decrease even when using IRIS in chest CT.

Detection of breast abnormalities on enhanced chest CT: Correlation with breast composition on mammography

Energy Technology Data Exchange (ETDEWEB)

Cho, Eun Mi; Kang, Hee; Shin, Young Gyung; Yun, Jong Hyouk; Oh, Kyung Seung [Dept. of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of)

2017-02-15

To investigate the capability of enhanced chest computed tomography (CT) for detecting breast abnormalities and to assess the influence of breast composition on this detectability. From 2000 to 2013, 75 patients who underwent mammography, breast sonography, and enhanced chest CT within one month and had abnormalities on sonography were included. Detection rate of breast abnormality on enhanced chest CT was compared among 4 types of breast composition by the Breast Imaging Reporting and Data System. Contribution of breast composition, size and enhancement of target lesions to detectability of enhanced chest CT was assessed using logistic regression and chi-square test. Of the 75 target lesions, 34 (45.3%) were detected on enhanced chest CT, corresponding with those on breast sonography; there were no significantly different detection rates among the 4 types of breast composition (p = 0.078). Breast composition [odds ratio (OR) = 1.07, p = 0.206] and enhancement (OR = 21.49, p = 0.998) had no significant effect, but size (OR = 1.23, p = 0.004) was a significant contributing factor influencing the detectability of enhanced chest CT for breast lesions. About half of the cases (45.3%) demonstrated breast lesions on chest CT corresponding with target lesions on sonography. Breast composition defined on mammography did not affect the detectability of enhanced chest CT for breast lesions.

Chest CT findings in breast cancer patients treated with postoperative irradiation

Energy Technology Data Exchange (ETDEWEB)

Jeong, Yeon Joo; Kim, Kun Il; Lee, Suk Hong; Kim, Dong Won; Bae, Yeong Tae [College of Medicine, Pusan National Univ., Pusan (Korea, Republic of)

2002-07-01

The determine the chest CT findings in breast cancer patients who have undergone postoperative irradiation. The chest CT findings in 36 female patients who underwent breast surgery and radiotherapy between May 1996 and March 2000 were rerospectively analysed. Prior to radiotheraphy, baseline chest CT depicted normal parenchyma in all cases. In 11 patients, the ipsilateral breast and chest wall were irradiated using opposed tangential fields, while 25 were treated by the four fields method (opposed tangential fields plus anterior and posterior supraclavicular/high axillary fields), with a total dose of 5040-5400 cGy for 5-9 weeks. CT after radiotherapy demonstrated reticular opacity (n=24), perpendicular linear opacity (n=15), traction bronchiectasis (n=7), consolidation (n=6), ground glass attenuation (n=3), pathologic rib fractures (n=3) pleural effusion (n=2), and pleural thickening (n=1), while in five patients no abnormality was observed. in addition, in the anterolateral lung area of 23 (64%) of 36 patients who underwent tangential beam irradiation, CT demonstrated peripheral opacities. When supraclavicular and axillary portals were used, radiation-induced lung changes mostly occurred at the apex of the lung (n=24). Chest radiographs were abnormal in 26 patients and normal in ten; in five of these ten, CT demonstrated reticular opacity. Depending on the irradiation CT findings of radiation-induced lung injury in breast cancer include areas of increased opacity with or without fibrosis, in apical and/or anterior subpleural regions. CT may help differentiate radiation-induced parenchymal change from superimposed or combined lung disease.

Computer-aided detection (CAD) of solid pulmonary nodules in chest x-ray equivalent ultralow dose chest CT - first in-vivo results at dose levels of 0.13 mSv

Energy Technology Data Exchange (ETDEWEB)

Messerli, Michael, E-mail: Michael.Messerli@usz.ch [Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen (Switzerland); Kluckert, Thomas; Knitel, Meinhard [Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen (Switzerland); Rengier, Fabian [Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg (Germany); Warschkow, René [Department of Surgery, Cantonal Hospital St. Gallen (Switzerland); Alkadhi, Hatem [Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich (Switzerland); Leschka, Sebastian [Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich (Switzerland); Wildermuth, Simon; Bauer, Ralf W. [Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen (Switzerland)

2016-12-15

Highlights: • Computer-aided detection (CAD) of solid pulmonary nodules was compared in 202 patients in standard dose and ultralow dose CT. • The per–nodule sensitivity of CAD was 70% in standard dose CT and 68% in ultralow dose CT. • The per–nodule sensitivity of CAD in standard dose CT was similar to ultralow dose CT in all size subgroups (all p > 0.05). • Adding CAD markings in ultralow dose CT significantly improved the sensitivity of two radiologists from 77% to 88% and from 66% to 79%, respectively. • CAD can serve as an excellent second reader for nodule detection in CT even at dose levels similar to chest X-ray. - Abstract: Objectives: To determine the value of computer-aided detection (CAD) for solid pulmonary nodules in ultralow radiation dose single-energy computed tomography (CT) of the chest using third-generation dual-source CT at 100 kV and fixed tube current at 70 mAs with tin filtration. Methods: 202 consecutive patients undergoing clinically indicated standard dose chest CT (1.8 ± 0.7 mSv) were prospectively included and scanned with an additional ultralow dose CT (0.13 ± 0.01 mSv) in the same session. Standard of reference (SOR) was established by consensus reading of standard dose CT by two radiologists. CAD was performed in standard dose and ultralow dose CT with two different reconstruction kernels. CAD detection rate of nodules was evaluated including subgroups of different nodule sizes (<5, 5–7, >7 mm). Sensitivity was further analysed in multivariable mixed effects logistic regression. Results: The SOR included 279 solid nodules (mean diameter 4.3 ± 3.4 mm, range 1–24 mm). There was no significant difference in per–nodule sensitivity of CAD in standard dose with 70% compared to 68% in ultralow dose CT both overall and in different size subgroups (all p > 0.05). CAD led to a significant increase of sensitivity for both radiologists reading the ultralow dose CT scans (all p < 0.001). In multivariable analysis, the use

Computer-aided detection (CAD) of solid pulmonary nodules in chest x-ray equivalent ultralow dose chest CT - first in-vivo results at dose levels of 0.13 mSv

International Nuclear Information System (INIS)

Messerli, Michael; Kluckert, Thomas; Knitel, Meinhard; Rengier, Fabian; Warschkow, René; Alkadhi, Hatem; Leschka, Sebastian; Wildermuth, Simon; Bauer, Ralf W.

2016-01-01

Highlights: • Computer-aided detection (CAD) of solid pulmonary nodules was compared in 202 patients in standard dose and ultralow dose CT. • The per–nodule sensitivity of CAD was 70% in standard dose CT and 68% in ultralow dose CT. • The per–nodule sensitivity of CAD in standard dose CT was similar to ultralow dose CT in all size subgroups (all p > 0.05). • Adding CAD markings in ultralow dose CT significantly improved the sensitivity of two radiologists from 77% to 88% and from 66% to 79%, respectively. • CAD can serve as an excellent second reader for nodule detection in CT even at dose levels similar to chest X-ray. - Abstract: Objectives: To determine the value of computer-aided detection (CAD) for solid pulmonary nodules in ultralow radiation dose single-energy computed tomography (CT) of the chest using third-generation dual-source CT at 100 kV and fixed tube current at 70 mAs with tin filtration. Methods: 202 consecutive patients undergoing clinically indicated standard dose chest CT (1.8 ± 0.7 mSv) were prospectively included and scanned with an additional ultralow dose CT (0.13 ± 0.01 mSv) in the same session. Standard of reference (SOR) was established by consensus reading of standard dose CT by two radiologists. CAD was performed in standard dose and ultralow dose CT with two different reconstruction kernels. CAD detection rate of nodules was evaluated including subgroups of different nodule sizes (<5, 5–7, >7 mm). Sensitivity was further analysed in multivariable mixed effects logistic regression. Results: The SOR included 279 solid nodules (mean diameter 4.3 ± 3.4 mm, range 1–24 mm). There was no significant difference in per–nodule sensitivity of CAD in standard dose with 70% compared to 68% in ultralow dose CT both overall and in different size subgroups (all p > 0.05). CAD led to a significant increase of sensitivity for both radiologists reading the ultralow dose CT scans (all p < 0.001). In multivariable analysis, the use

An assessment of pulmonary emphysema in smokers using CT scan

International Nuclear Information System (INIS)

Satoh, Katashi; Kobayashi, Takuya; Misao, Takahiko

1999-01-01

We assessed the relationship between PE and smoking in 639 cases (411 males and 228 females with age ranged 21-86 years) who underwent CT scans during the period, from December 1997 to December 1998, under suspicion of respiratory disease on chest radiograph or some respiratory complaints. PE was diagnosed by the existence of low attenuation areas in CT scan and not by pulmonary function tests. CT was performed with 10 mm collimation in a standard algorithm. PE, regardless of the grade, was seen: in 189 out of 348 (54.3%) cases in male smokers and in only 2 out of 63 (3.2%) cases in male non-smokers; and in 5 out of 25 (20.0%) female smokers and in 4 out of 203 (2.0%) female non-smokers. PE was observed in more than half of male smokers. High incidence of PE was also observed in even younger generation, and its severity progresses with advancing age and increasing smoking index. (author)

CT of the chest in the evaluation of idiopathic pulmonary arterial hypertension in children

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Chaudry, Gulraiz [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto (Canada); Children' s Hospital Boston, Department of Radiology, Boston, MA (United States); MacDonald, Cathy; Gundogan, Munire; Manson, David [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto (Canada); Adatia, Ian [UCSF Children' s Hospital, Department of Pediatric Cardiology, San Francisco, CA (United States)

2007-04-15

Idiopathic pulmonary arterial hypertension (IPAH) is a rare disease in children. By definition it is a diagnosis of exclusion, and CT of the chest is primarily performed to exclude other causes. Previous studies have defined CT features suggestive of the diagnosis of IPAH, but these have all been limited to the adult population. Contrast-enhanced chest CT and high-resolution CT findings in IPAH were evaluated in an attempt to define features consistently seen in children with this condition. The chest CT scans performed at initial presentation were reviewed in 17 children with echocardiographic or angiographic evidence of IPAH. There were nine boys and eight girls, ranging in age from 1 month to 17 years. The extrapulmonary findings included cardiomegaly with right-sided cardiac enlargement, which was seen in 13 children. The central pulmonary arteries were enlarged in 15 children, with peripheral enlargement in two. In six children this resulted in bronchial compression. In addition, mediastinal and hilar lymphadenopathy was noted in three children. Prominent intrapulmonary features included a peripheral vasculopathy, with enlarged tortuous vessels, seen in eight children. Ill-defined ground-glass centrilobular opacities were also noted in eight children, representing the most common parenchymal abnormality. Other findings included septal lines in five, diffuse ground-glass opacification in four and focal hyperlucent zones in three. Mosaic attenuation was seen in one child. A variety of imaging findings are identified in IPAH. Features particularly consistent with the diagnosis include peripheral vasculopathy and centrilobular opacities in the setting of cardiomegaly and central pulmonary arterial enlargement. (orig.)

CT of the chest in the evaluation of idiopathic pulmonary arterial hypertension in children

International Nuclear Information System (INIS)

Chaudry, Gulraiz; MacDonald, Cathy; Gundogan, Munire; Manson, David; Adatia, Ian

2007-01-01

Idiopathic pulmonary arterial hypertension (IPAH) is a rare disease in children. By definition it is a diagnosis of exclusion, and CT of the chest is primarily performed to exclude other causes. Previous studies have defined CT features suggestive of the diagnosis of IPAH, but these have all been limited to the adult population. Contrast-enhanced chest CT and high-resolution CT findings in IPAH were evaluated in an attempt to define features consistently seen in children with this condition. The chest CT scans performed at initial presentation were reviewed in 17 children with echocardiographic or angiographic evidence of IPAH. There were nine boys and eight girls, ranging in age from 1 month to 17 years. The extrapulmonary findings included cardiomegaly with right-sided cardiac enlargement, which was seen in 13 children. The central pulmonary arteries were enlarged in 15 children, with peripheral enlargement in two. In six children this resulted in bronchial compression. In addition, mediastinal and hilar lymphadenopathy was noted in three children. Prominent intrapulmonary features included a peripheral vasculopathy, with enlarged tortuous vessels, seen in eight children. Ill-defined ground-glass centrilobular opacities were also noted in eight children, representing the most common parenchymal abnormality. Other findings included septal lines in five, diffuse ground-glass opacification in four and focal hyperlucent zones in three. Mosaic attenuation was seen in one child. A variety of imaging findings are identified in IPAH. Features particularly consistent with the diagnosis include peripheral vasculopathy and centrilobular opacities in the setting of cardiomegaly and central pulmonary arterial enlargement. (orig.)

Computed tomography of chest trauma

International Nuclear Information System (INIS)

Dinkel, E.; Uhl, H.; Reinbold, W.D.; Wimmer, B.; Wenz, W.

1987-01-01

Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal, if aortic laceration is clinically suspected. Despite all technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for selected problems in the traumatized patient. (orig.) [de

Computed tomography of chest trauma

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Dinkel, E.; Uhl, H.; Reinbold, W.D.; Wimmer, B.; Wenz, W.

1987-09-01

Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal, if aortic laceration is clinically suspected. Despite all technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for selected problems in the traumatized patient.

Deep convolutional neural networks for automatic coronary calcium scoring in a screening study with low-dose chest CT

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Lessmann, Nikolas; Išgum, Ivana; Setio, Arnaud A. A.; de Vos, Bob D.; Ciompi, Francesco; de Jong, Pim A.; Oudkerk, Matthjis; Mali, Willem P. Th. M.; Viergever, Max A.; van Ginneken, Bram

2016-03-01

The amount of calcifications in the coronary arteries is a powerful and independent predictor of cardiovascular events and is used to identify subjects at high risk who might benefit from preventive treatment. Routine quantification of coronary calcium scores can complement screening programs using low-dose chest CT, such as lung cancer screening. We present a system for automatic coronary calcium scoring based on deep convolutional neural networks (CNNs). The system uses three independently trained CNNs to estimate a bounding box around the heart. In this region of interest, connected components above 130 HU are considered candidates for coronary artery calcifications. To separate them from other high intensity lesions, classification of all extracted voxels is performed by feeding two-dimensional 50 mm × 50 mm patches from three orthogonal planes into three concurrent CNNs. The networks consist of three convolutional layers and one fully-connected layer with 256 neurons. In the experiments, 1028 non-contrast-enhanced and non-ECG-triggered low-dose chest CT scans were used. The network was trained on 797 scans. In the remaining 231 test scans, the method detected on average 194.3 mm3 of 199.8 mm3 coronary calcifications per scan (sensitivity 97.2 %) with an average false-positive volume of 10.3 mm3 . Subjects were assigned to one of five standard cardiovascular risk categories based on the Agatston score. Accuracy of risk category assignment was 84.4 % with a linearly weighted κ of 0.89. The proposed system can perform automatic coronary artery calcium scoring to identify subjects undergoing low-dose chest CT screening who are at risk of cardiovascular events with high accuracy.

Evaluation of automatic image quality assessment in chest CT - A human cadaver study.

Science.gov (United States)

Franck, Caro; De Crop, An; De Roo, Bieke; Smeets, Peter; Vergauwen, Merel; Dewaele, Tom; Van Borsel, Mathias; Achten, Eric; Van Hoof, Tom; Bacher, Klaus

2017-04-01

The evaluation of clinical image quality (IQ) is important to optimize CT protocols and to keep patient doses as low as reasonably achievable. Considering the significant amount of effort needed for human observer studies, automatic IQ tools are a promising alternative. The purpose of this study was to evaluate automatic IQ assessment in chest CT using Thiel embalmed cadavers. Chest CT's of Thiel embalmed cadavers were acquired at different exposures. Clinical IQ was determined by performing a visual grading analysis. Physical-technical IQ (noise, contrast-to-noise and contrast-detail) was assessed in a Catphan phantom. Soft and sharp reconstructions were made with filtered back projection and two strengths of iterative reconstruction. In addition to the classical IQ metrics, an automatic algorithm was used to calculate image quality scores (IQs). To be able to compare datasets reconstructed with different kernels, the IQs values were normalized. Good correlations were found between IQs and the measured physical-technical image quality: noise (ρ=-1.00), contrast-to-noise (ρ=1.00) and contrast-detail (ρ=0.96). The correlation coefficients between IQs and the observed clinical image quality of soft and sharp reconstructions were 0.88 and 0.93, respectively. The automatic scoring algorithm is a promising tool for the evaluation of thoracic CT scans in daily clinical practice. It allows monitoring of the image quality of a chest protocol over time, without human intervention. Different reconstruction kernels can be compared after normalization of the IQs. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Chest computed tomography in children undergoing extra-corporeal membrane oxygenation: a 9-year single-centre experience

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Goodwin, Susie J.; Calder, Alistair D. [Great Ormond Street Hospital for Children NHS Foundation Trust, Radiology Department, London (United Kingdom); Randle, Elise; Iguchi, Akane; Brown, Katherine; Hoskote, Aparna [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiac Intensive Care and ECMO, London (United Kingdom)

2014-06-15

We retrospectively reviewed the imaging findings, indications, technique and clinical impact in children who had undergone chest CT while undergoing extra-corporeal membrane oxygenation (ECMO). Radiology and ECMO databases were searched to identify all 19 children who had undergone chest CT (20 scans in total) while on ECMO at our institution between May 2003 and May 2012. We reviewed all CT scans for imaging findings. Chest CT is performed in a minority of children on ECMO (4.5% in our series). Timing of chest CT following commencement of ECMO varied among patient groups but generally it was performed earlier in the neonatal group. Clinically significant imaging findings were found in the majority of chest CT scans. Many scans contained several findings, with most cases demonstrating parenchymal or pleural abnormalities. Case examples illustrate the spectrum of imaging findings, including underlying pathology such as necrotising pneumonia and severe barotrauma, and ECMO-related complications such as tension haemothoraces and cannula migration. The results of chest CT led to a change in patient management in 16 of 19 children (84%). There were no adverse events related to patient transfer. An understanding of scan technique and awareness of potential findings is important for the radiologist to provide prompt and optimal image acquisition and interpretation in appropriate patients. (orig.)

Prevalence and Diagnostic Performance of Isolated and Combined NEXUS Chest CT Decision Criteria.

Science.gov (United States)

Raja, Ali S; Mower, William R; Nishijima, Daniel K; Hendey, Gregory W; Baumann, Brigitte M; Medak, Anthony J; Rodriguez, Robert M

2016-08-01

The use of chest computed tomography (CT) to evaluate emergency department patients with adult blunt trauma is rising. The NEXUS Chest CT decision instruments are highly sensitive identifiers of adult blunt trauma patients with thoracic injuries. However, many patients without injury exhibit one of more of the criteria so cannot be classified "low risk." We sought to determine screening performance of both individual and combined NEXUS Chest CT criteria as predictors of thoracic injury to inform chest CT imaging decisions in "non-low-risk" patients. This was a secondary analysis of data on patients in the derivation and validation cohorts of the prospective, observational NEXUS Chest CT study, performed September 2011 to May 2014 in 11 Level I trauma centers. Institutional review board approval was obtained at all study sites. Adult blunt trauma patients receiving chest CT were included. The primary outcome was injury and major clinical injury prevalence and screening performance in patients with combinations of one, two, or three of seven individual NEXUS Chest CT criteria. Across the 11 study sites, rates of chest CT performance ranged from 15.5% to 77.2% (median = 43.6%). We found injuries in 1,493/5,169 patients (28.9%) who had chest CT; 269 patients (5.2%) had major clinical injury (e.g., pneumothorax requiring chest tube). With sensitivity of 73.7 (95% confidence interval [CI] = 68.1 to 78.6) and specificity of 83.9 (95% CI = 83.6 to 84.2) for major clinical injury, abnormal chest-x-ray (CXR) was the single most important screening criterion. When patients had only abnormal CXR, injury and major clinical injury prevalences were 60.7% (95% CI = 52.2% to 68.6%) and 12.9% (95% CI = 8.3% to 19.4%), respectively. Injury and major clinical injury prevalences when any other single criterion alone (other than abnormal CXR) was present were 16.8% (95% CI = 15.2% to 18.6%) and 1.1% (95% CI = 0.1% to 1.8%), respectively. Injury and major clinical injury prevalences

Children's (Pediatric) CT (Computed Tomography)

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Full Text Available ... for the chest x-ray, CT is the most commonly used imaging procedure for evaluating the chest. ... scanning, especially if the chest is being scanned. Most children older than six years are able to ...

CT scanning in pediatric head trauma: correlation of clinical features with CT scan diagnosis

International Nuclear Information System (INIS)

Arkoncel, Mary Ann P.; Posadas, Ma. Belen A.

1997-01-01

A retrospective review was conducted on 205 cases of pediatric head trauma for which cranial computed tomography scans were done at the Makati Medical Center, to determine which clinical features might positively predict an abnormality on CT scan. The clinical findings of loss of consciousness, GCS < 12, vomiting headache, seizures, and focal abnormalities on Neurologic Examination were significantly associated with abnormal findings on CT scan. However, a significant discrepancy does exist as to how accurately clinical findings do in fact predict normal and abnormal CT scan findings. Such a discrepancy allows us to conclude that a more liberal use of CT Scanning in cases of pediatric head trauma must be stressed to insure proper diagnosis. This study shows that when a patient presents with the aforementioned positive signs and symptoms, or with a focal neurologic deficit, or in combination, a 60-100 % positive prediction of abnormal CT Scan can be made. However, prediction of normal CT Scan is only 0-40%. (Author)

Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

Science.gov (United States)

Prakash, Priyanka; Gilman, Matthew D.; Shepard, Jo-Anne O.; Digumarthy, Subba R.

2010-01-01

Objective To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. Materials and Methods With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Results Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 ± 3.1) and weight-adjusted (16.1 ± 5.6) AEC techniques (p > 0.05). Conclusion The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT. PMID:20046494

Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

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Prakash, Priyanka; Kalra, Mannudeep K.; Gilman, Matthew D.; Shepard, Jo Anne O.; Digumarthy, Subba R. [Massachusetts General Hospital and Harvard Medical School, Boston (United States)

2010-02-15

To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and nonweight- adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 {+-} 3.1) and weight-adjusted (16.1 {+-} 5.6) AEC techniques (p > 0.05). The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT.

3D automatic exposure control for 64-detector row CT: Radiation dose reduction in chest phantom study

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Matsumoto, Keiko, E-mail: palm_kei@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Department of Radiology, Yamanashi University, Shimokato, Yamanashi (Japan); Ohno, Yoshiharu; Koyama, Hisanobu; Kono, Atsushi [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Inokawa, Hiroyasu [Toshiba Medical Systems, Ohtawara, Tochigi (Japan); Onishi, Yumiko [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Image-Based Medicine, Institute of Biomedical Research and Innovation, Kobe, Hyogo (Japan); Takenaka, Daisuke [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Araki, Tsutomu [Department of Radiology, Yamanashi University, Shimokato, Yamanashi (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan)

2011-03-15

Purpose: The purpose of this study was to determine the utility of three-dimensional (3D) automatic exposure control (AEC) for low-dose CT examination in a chest phantom study. Materials and methods: A chest CT phantom including simulated focal ground-glass opacities (GGOs) and nodules was scanned with a 64-detector row CT with and without AEC. Performance of 3D AEC included changing targeted standard deviations (SDs) of image noise from scout view. To determine the appropriate targeted SD number for identification, the capability of overall identification with the CT protocol adapted to each of the targeted SDs was compared with that obtained with CT without AEC by means of receiver operating characteristic analysis. Results: When targeted SD values equal to or higher than 250 were used, areas under the curve (Azs) of nodule identification with CT protocol using AEC were significantly smaller than that for CT protocol without AEC (p < 0.05). When targeted SD numbers at equal to or more than 180 were adapted, Azs of CT protocol with AEC had significantly smaller than that without AEC (p < 0.05). Conclusion: This phantom study shows 3D AEC is useful for low-dose lung CT examination, and can reduce the radiation dose while maintaining good identification capability and good image quality.

The influence of upper limb position on the effect of a contrast agent in chest CT enhancement

International Nuclear Information System (INIS)

Feng, Shi-Ting; Wang, Meng; Gao, Zhenhua; Tan, Guosheng; Cai, Huasong; Hu, Xiaoshu; Yang, Jianyong; Li, Zi-Ping

2013-01-01

Purpose: To compare the influence of two different upper limb positions on contrast agent effects in chest CT enhancement. Materials and methods: In 142 patients undergoing contrast-enhanced CT chest scanning, an indwelling venous catheter was placed in the right hand and iodinated contrast agent was injected through a high-pressure single syringe pump. The patients were divided into three age groups (<40 years; 40–60 years; and >60 years) and randomly assigned to one of two upper limb position groups: (1) supine position, both upper limbs extended and raised above head in the same horizontal plane as the body; and (2) supine position, both upper limbs raised and crossed on the forehead, with the right arm on top. Differences in mean CT values on the two sides of the thoracic inlet along the right subclavian vein were used to evaluate the effects of the contrast agent. Results: Although contrast agent effects were not significantly different among the three age groups with either limb position, there was a significant difference between patients adopting the second limb positions (Chi-square value was 5.936, P < 0.05). An excellent or good contrast agent effect was observed in 63.08% of patients assuming the first limb position, as compared with 81.69% assuming the second position. Conclusion: For contrast-enhanced CT chest scans, use of the second limb position can reduce retention of the contrast agent in the right axillary vein and the right subclavian vein outside the thorax, increase contrast agent utilization, and decrease artifacts caused by high-density, local retention of the contrast agent

The forgotten view: Chest X-ray - Lateral view

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Abraham M. Ittyachen

2017-01-01

Full Text Available With CT (computed tomography chest gaining more importance as a diagnostic tool, chest X-ray especially the lateral view is taken less commonly nowadays. Besides CT chest is also proven to be superior to chest X-ray in patients with major blunt trauma. We are presenting a 68-year old male who was partially treated from outside for a left sided pneumonia. He came to our hospital because of persisting chest pain. Chest X-ray, frontal view (postero-anterior was almost normal except for a mild opacity in the left lower zone. CT scan of the chest revealed a fluid collection posteriorly enclosed within enhancing pleura. Chest X-ray, left lateral view showed a corresponding posterior pleural based opacity. We are presenting this case to highlight the importance of the lateral view of the chest X-ray. In selected cases there is still a role for the lateral view. With the three dimensional visualization provided by the CT, the lateral view of the chest may be easier to understand. Consequent to the initial diagnosis by CT further follow up can be done with the chest X-ray. In a limited way this mitigates unnecessary expenditure and more importantly prevents the patient from exposure to harmful radiation in the form of repeated CT.

What is the clinical significance of chest CT when the chest x-ray result is normal in patients with blunt trauma?

Science.gov (United States)

Kea, Bory; Gamarallage, Ruwan; Vairamuthu, Hemamalini; Fortman, Jonathan; Lunney, Kevin; Hendey, Gregory W; Rodriguez, Robert M

2013-08-01

Computed tomography (CT) has been shown to detect more injuries than plain radiography in patients with blunt trauma, but it is unclear whether these injuries are clinically significant. This study aimed to determine the proportion of patients with normal chest x-ray (CXR) result and injury seen on CT and abnormal initial CXR result and no injury on CT and to characterize the clinical significance of injuries seen on CT as determined by a trauma expert panel. Patients with blunt trauma older than 14 years who received emergency department chest imaging as part of their evaluation at 2 urban level I trauma centers were enrolled. An expert trauma panel a priori classified thoracic injuries and subsequent interventions as major, minor, or no clinical significance. Of 3639 participants, 2848 (78.3%) had CXR alone and 791 (21.7%) had CXR and chest CT. Of 589 patients who had chest CT after a normal CXR result, 483 (82.0% [95% confidence interval [CI], 78.7-84.9%]) had normal CT results, and 106 (18.0% [95% CI, 15.1%-21.3%]) had CTs diagnosing injuries-primarily rib fractures, pulmonary contusion, and incidental pneumothorax. Twelve patients had injuries classified as clinically major (2.0% [95% CI, 1.2%-3.5%]), 78 were clinically minor (13.2% [95% CI, 10.7%-16.2%]), and 16 were clinically insignificant (2.7% (95% CI, 1.7%-4.4%]). Of 202 patients with CXRs suggesting injury, 177 (87.6% [95% CI, 82.4%-91.5%]) had chest CTs confirming injury and 25 (12.4% [95% CI, 8.5%-17.6%]) had no injury on CT. Chest CT after a normal CXR result in patients with blunt trauma detects injuries, but most do not lead to changes in patient management. Copyright © 2013 Elsevier Inc. All rights reserved.

Lung nodule detection by microdose CT versus chest radiography (standard and dual-energy subtracted).

Science.gov (United States)

Ebner, Lukas; Bütikofer, Yanik; Ott, Daniel; Huber, Adrian; Landau, Julia; Roos, Justus E; Heverhagen, Johannes T; Christe, Andreas

2015-04-01

The purpose of this study was to investigate the feasibility of microdose CT using a comparable dose as for conventional chest radiographs in two planes including dual-energy subtraction for lung nodule assessment. We investigated 65 chest phantoms with 141 lung nodules, using an anthropomorphic chest phantom with artificial lung nodules. Microdose CT parameters were 80 kV and 6 mAs, with pitch of 2.2. Iterative reconstruction algorithms and an integrated circuit detector system (Stellar, Siemens Healthcare) were applied for maximum dose reduction. Maximum intensity projections (MIPs) were reconstructed. Chest radiographs were acquired in two projections with bone suppression. Four blinded radiologists interpreted the images in random order. A soft-tissue CT kernel (I30f) delivered better sensitivities in a pilot study than a hard kernel (I70f), with respective mean (SD) sensitivities of 91.1%±2.2% versus 85.6%±5.6% (p=0.041). Nodule size was measured accurately for all kernels. Mean clustered nodule sensitivity with chest radiography was 45.7%±8.1% (with bone suppression, 46.1%±8%; p=0.94); for microdose CT, nodule sensitivity was 83.6%±9% without MIP (with additional MIP, 92.5%±6%; pmicrodose CT for readers 1, 2, 3, and 4 were 84.3%, 90.7%, 68.6%, and 45.0%, respectively. Sensitivities with chest radiography for readers 1, 2, 3, and 4 were 42.9%, 58.6%, 36.4%, and 90.7%, respectively. In the per-phantom analysis, respective sensitivities of microdose CT versus chest radiography were 96.2% and 75% (pmicrodose CT, the applied dose was 0.1323 mSv. Microdose CT is better than the combination of chest radiography and dual-energy subtraction for the detection of solid nodules between 5 and 12 mm at a lower dose level of 0.13 mSv. Soft-tissue kernels allow better sensitivities. These preliminary results indicate that microdose CT has the potential to replace conventional chest radiography for lung nodule detection.

CT Scan

Science.gov (United States)

... disease, lung nodules and liver masses Monitor the effectiveness of certain treatments, such as cancer treatment Detect ... scan done in a hospital or an outpatient facility. CT scans are painless and, with newer machines, ...

Role of computed tomography (CT scan in staging of cervical carcinoma

Directory of Open Access Journals (Sweden)

T V Prasad

2014-01-01

Full Text Available Background & objectives: Staging of cervical carcinoma is done clinically using International Federation of Obstetrics and Gynecology (FIGO guidelines. It is based on physical examination findings and also includes results of biopsy, endoscopy and conventional radiological tests like chest radiograph, intravenous urography and barium enema. These conventional radiological investigations have largely been replaced by computed tomography (CT and magnetic resonance imaging (MRI at present. FIGO staging system does not consider CT and MRI mandatory; however, use of these modalities are encouraged. This prospective study was conducted to determine the role of CT in staging work up in women diagnosed with cervical carcinoma. Methods: Fifty three women diagnosed with cervical carcinoma were evaluated with contrast enhanced CT scan of abdomen and pelvis. CT scan images were especially evaluated to determine tumour size, invasion of parmetrium, pelvic walls, rectum, urinary bladder and ureters, pelvic or retroperitoneal lymphadenopathy and distant metastases. CT findings were associated with clinical findings and staging, including findings from cystoscopy and sigmoidoscopy. Results: There was a poor agreement between clinical and CT staging of cervical carcinoma. Primary tumour was demonstrated on CT in 36 (70% of 53 patients. CT underestimated the parametrial, vaginal and pelvic wall invasion when compared with physical examination. CT overestimated the urinary bladder and rectal invasion when compared with cysto-sigmoidoscopy, however, CT had 100 per cent negative predictive value (NPV to exclude bladder and rectal involvement. CT detection of lymph node enlargement and lung metastases influenced the management. Interpretation & conclusions: Our findings show that CT scan does not reliably correlate with clinical FIGO staging of cervical cancer. However, it can detect urinary obstruction as well as nodal or distant metastases and thus improves the

CT angiography - chest

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... your provider if you take the diabetes medication metformin (Glucophage). You may need to take extra precautions. ... Damage to kidneys from contrast dye CT scans use more radiation than regular x-rays. Having many ...

Chest radiology

International Nuclear Information System (INIS)

Reed, J.C.

1990-01-01

This book is a reference in plain chest film diagnosis provides a thorough background in the differential diagnosis of 22 of the most common radiologic patterns of chest disease. Each chapter is introduced with problem cases and a set of questions, followed by a tabular listing of the appropriate differential considerations. The book emphasizes plain films, CT and some MR scans are integrated to demonstrate how these modalities enhance the work of a case

Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?

International Nuclear Information System (INIS)

Jairam, Pushpa M.; Jong, Pim A. de; Mali, Willem P.T.M.; Isgum, Ivana; Graaf, Yolanda van der

2015-01-01

Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings. A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification. During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71-0.74) to 0.74 (95 % CI 0.72-0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)). Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans. (orig.)

Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?

Energy Technology Data Exchange (ETDEWEB)

Jairam, Pushpa M. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Jong, Pim A. de; Mali, Willem P.T.M. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Isgum, Ivana [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: PROVIDI study-group

2015-06-01

Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings. A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification. During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71-0.74) to 0.74 (95 % CI 0.72-0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)). Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans. (orig.)

Head CT scan

Science.gov (United States)

... scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... head size in children Changes in thinking or behavior Fainting Headache, when you have certain other signs ...

Predictors of abnormal chest CT after blunt trauma: a critical appraisal of the literature

International Nuclear Information System (INIS)

Brink, M.; Kool, D.R.; Dekker, H.M.; Deunk, J.; Jager, G.J.; Kuijk, C. van; Edwards, M.J.R.; Blickman, J.G.

2009-01-01

Aim: To identify and to evaluate predictors that determine whether chest computed tomography (CT) is likely to reveal relevant injuries in adult blunt trauma patients. Methods: After a comprehensive literature search for original studies on blunt chest injury diagnosis, two independent observers included studies on the accuracy of parameters derived from history, physical examination, or diagnostic imaging that might predict injuries at (multidetector row) CT in adults and that allowed construction of 2 x 2 contingency tables. For each article, methodological quality was scored and relevant predictors for injuries at CT were extracted. For each predictor, sensitivity, specificity, positive and negative likelihood ratio and diagnostic odds ratio (DOR) including 95% confidence intervals were calculated. Results: Of 147 articles initially identified, the observers included 10 original studies in consensus. Abnormalities at physical examination (abnormal respiratory effort, need for assisted ventilation, reduced airentry, coma, chest wall tenderness) and pelvic fractures were significant predictors (DOR: 2.1-6.7). The presence of any injuries at conventional radiography of the chest (eight articles) was a more powerful significant predictor (DOR: 2.2-37). Abnormal chest ultrasonography (four articles) was the most accurate predictor for chest injury at CT (DOR: 491-infinite). Conclusion: The current literature indicates that in blunt trauma patients with abnormal physical examination, abnormal conventional radiography, or abnormal ultrasonography of the chest, CT was likely to reveal relevant chest injuries. However, there was no strong evidence to suggest that CT could be omitted in patients without these criteria, or whether these findings are beneficial for patients

Lung involvement quantification in chest radiographs

International Nuclear Information System (INIS)

Giacomini, Guilherme; Alvarez, Matheus; Oliveira, Marcela de; Miranda, Jose Ricardo A.; Pina, Diana R.; Pereira, Paulo C.M.; Ribeiro, Sergio M.

2014-01-01

Tuberculosis (TB) caused by Mycobacterium tuberculosis, is an infectious disease which remains a global health problem. The chest radiography is the commonly method employed to assess the TB's evolution. The methods for quantification of abnormalities of chest are usually performed on CT scans (CT). This quantification is important to assess the TB evolution and treatment and comparing different treatments. However, precise quantification is not feasible for the amount of CT scans required. The purpose of this work is to develop a methodology for quantification of lung damage caused by TB through chest radiographs. It was developed an algorithm for computational processing of exams in Matlab, which creates a lungs' 3D representation, with compromised dilated regions inside. The quantification of lung lesions was also made for the same patients through CT scans. The measurements from the two methods were compared and resulting in strong correlation. Applying statistical Bland and Altman, all samples were within the limits of agreement, with a confidence interval of 95%. The results showed an average variation of around 13% between the two quantification methods. The results suggest the effectiveness and applicability of the method developed, providing better risk-benefit to the patient and cost-benefit ratio for the institution. (author)

Reduced-dose chest CT with 3D automatic exposure control vs. standard chest CT: Quantitative assessment of emphysematous changes in smokers’ lung parenchyma

International Nuclear Information System (INIS)

Koyama, Hisanobu; Ohno, Yoshiharu; Yamazaki, Youichi; Matsumoto, Keiko; Onishi, Yumiko; Takenaka, Daisuke; Yoshikawa, Takeshi; Nishio, Mizuho; Matsumoto, Sumiaki; Murase, Kenya; Nishimura, Yoshihiro

2012-01-01

Objectives: To determine the capability of reduced-dose chest CT with three-dimensional (3D) automatic exposure control (AEC) on quantitative assessment of emphysematous change in smoker’ lung parenchyma, compared to standard chest CT. Methods: Twenty consecutive smoker patients (mean age 62.8 years) underwent CT examinations using a standard protocol (150 mAs) and a protocol with 3D-AEC. In this study, the targeted standard deviations number was set to 160. For quantitative assessment of emphysematous change in lung parenchyma in each subject using the standard protocol, a percentage of voxels less than −950 HU in the lung (%LAA −950 ) was calculated. The 3D-AEC protocol's %LAA was computed from of voxel percentages under selected threshold CT value. The differences of radiation doses between these two protocols were evaluated, and %LAAs −950 was compared with the 3D-AEC protocol %LAAs. Results: Mean dose length products were 780.2 ± 145.5 mGy cm (standard protocol), and 192.0 ± 95.9 (3D-AEC protocol). There was significant difference between them (paired Student's t test, p −950 and 3D-AEC protocol %LAAs. In adopting the feasible threshold CT values of the 3D-AEC protocol, the 3D-AEC protocol %LAAs were significantly correlated with %LAAs −950 (r = 0.98, p < 0.001) and limits of agreement from Bland–Altman analysis was 0.52 ± 4.3%. Conclusions: Changing threshold CT values demonstrated that reduced-dose chest CT with 3D-AEC can substitute for the standard protocol in assessments of emphysematous change in smoker’ lung parenchyma.

Dose profile in computed tomography chest scan; Perfil de dose em varredura de torax em tomografia computadorizada

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Oliveira, Bruno B., E-mail: bbo@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Pos-graduacao em Ciencias e Tecnologia das Radiacoes, Minerais e Materiais; Mourao, Arnaldo P. [Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET/MG), Belo Horizonte, MG (Brazil); Alonso, Thessa C.; Silva, Teogenes A. da [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2010-07-01

For the optimization of the patient dose in computed tomography (CT), the Brazilian legislation only established the diagnostic reference levels (DRL's) in terms of Multiple Scan Average Dose (MSAD) in a typical adult as a parameter of quality control of CT scanners. Conformity to the DRL's can be verified by measuring the dose distribution in CT scans and MSAD determination. An analysis of the quality of CT scans of the metropolitan region of Belo Horizonte is necessary by conducting pertinent tests to the study that are presented in the ANVISA (National Agency of Sanitary Vigilance) Guide. The purpose of this study is to investigate, in a chest scan, the variation of dose in CT. To measure the dose profile are used lithium fluoride thermoluminescent dosimeters (TLD-100 Rod) distributed in cylinders positioned in peripheral and central regions of a phantom of polymethylmethacrylate (PMMA). The data obtained allow us to observe the variation of the dose profile inside the phantom. The peripheral region shows higher dose values than the central region. The longitudinal variation can be observed and the maximum dose was recorded at the edges of the phantom (41,58{+-}5,10) mGy at the midpoint of the longitudinal axis. The results will contribute to disseminate the proper procedure and optimize the dosimetry and the tests of quality control in CT, as well as make a critical analysis of the DRL's. (author)

Doses from pediatric CT examinations in Norway: are pediatric scan protocols developed and in daily use?

International Nuclear Information System (INIS)

Friberg, Eva G.

2008-01-01

Doses to pediatric patients from CT examinations are known to be unnecessarily high if scan protocols developed for adult patients are adopted. This overexposure is most often not recognized by the operating radiographer, due to the digital behavior of the imaging system. Use of optimized size-specific pediatric scan protocols is therefore essential to keep the doses at an appropriate level. The aim of this study was to investigate the doses to pediatric patients from CT examinations and to evaluate the level of optimization of the scan protocols. Patient data, applied scan parameters together with the dose parameters volume computed tomography dose index (CTD vol ) and dose length product (DLP) for examinations of the head, chest and abdomen were collected by means of a questionnaire from five university hospitals. The effective dose was estimated from the total DLP by use of region-specific conversion coefficients (E DLP ). Totally 136, 108 and 82 questionnaires were received for examinations of the head, chest and abdomen, respectively. Large variations in patient doses between the hospitals were observed, addressing the need for optimization of the scan protocols in general. Most of the hospitals applied successive lower mAs with decreasing patient age for all scan areas, while the use of lower tube voltage for small patients and a higher tube voltage for large patients were more rarely. This indicates the presence, to a certain level, of size specific scan protocols at some Norwegian hospitals. Focus on developing size-specific scan protocols for pediatric patients are important to reduce the doses and risks associated with pediatric CT examinations. (author)

CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

International Nuclear Information System (INIS)

Mahmoud, Mohamed; Towe, Christopher; Fleck, Robert J.

2015-01-01

Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

Energy Technology Data Exchange (ETDEWEB)

Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

2015-07-15

Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

Comparison of radiation doses between newborns and 6-y-old children undergoing head, chest and abdominal CT examinations-A phantom study

International Nuclear Information System (INIS)

Sugimoto, N.; Aoyama, T.; Koyama, S.; Yamauchi-Kawaura, C.; Fujii, K.

2013-01-01

Radiation doses in paediatric computed tomography (CT) were investigated for various types of recent CT scanners with newborn and 6-y-old phantoms in which silicon-photodiode dosemeters were implanted at various organ positions. In the head, chest and abdominal CT for the newborn phantom, doses for organs within the scan region were 21-40, 3-8 and 3-12 mGy, respectively. The corresponding doses for the child phantom were 20-37, 2-11 and 4-17 mGy, respectively. In the head, chest and abdominal CT, the effective doses were respectively 2.1-3.3, 2.0-6.0 and 2.2-10.0 mSv for the newborn, and 1.0-2.0, 1.2-6.6 and 2.9-11.8 mSv for the child. Radiation doses for the newborn were at the same levels as those for the child, excepting effective doses in head CT for the newborn, which were 1.8 times higher than those for the child. (authors)

Adult head CT scans: the uncertainties of effective dose estimates

International Nuclear Information System (INIS)

Gregory, Kent J.; Bibbo, Giovanni; Pattison, John E.

2008-01-01

sizes and positions within patients, and advances in CT scanner design that have not been taken into account by the effective dose estimation methods. The analysis excludes uncertainties due to variation in patient head size and the size of the model heads. For each of the four dose estimation methods analysed, the smallest and largest uncertainties (stated at the 95% confidence interval) were; 20-31% (Nagel), 14-28% (ImpaCT), 20-36% (Wellhoefer) and 21-32% (DLP). In each case, the smallest dose estimate uncertainties apply when the CT Dose Index for the scanner has been measured. In general, each of the four methods provide reasonable estimates of effective dose from head CT scans, with the ImpaCT method having the marginally smaller uncertainties. This uncertainty analysis method may be applied to other types of CT scans, such as chest, abdomen and pelvis studies, and may reveal where improvements can be made to reduce the uncertainty of those effective dose estimates. As identified in the BEIR VII report (2006), improvement in the uncertainty of effective dose estimates for individuals is expected to lead to a greater understanding of the hazards posed by diagnostic radiation exposures. (author)

Role of computed tomography in blunt chest trauma

International Nuclear Information System (INIS)

Cho, Jae Hyun; Kim, Sang Jin; Lee, Chan Wha; Kim, Hae Kyoon

1994-01-01

In patient with blunt trauma of chest, supine AP x-ray cannot differentiate the lung contusion, laceration, atelectasis, and hemothorax definitely. Therefore, computed tomographic evaluation is needed for accurate evaluation of the injuries. In our knowledge, there are few reports about CT findings of blunt chest trauma, in our country, therefore we tried to fluid the characteristic CT findings in patients with blunt trauma. We analyzed the plain x-ray and CT image of 4 patients with blunt chest trauma. Location and morphology of lung parenchymal contusion and laceration, hemopneumothorax, chest wall injuries and location of chest tube. Lung parenchymal contusion was noted in 53 segments., of 16 patients infiltration(n=27 segment), and multiple nodular pattern was noted in 15 segment, pattern of consolidation along the lung periphery was seen in 11 segment. Laceration was noted in 18 lesion and most commonly located in paravertebral area(b=8). CT scan of chest in patient with blunt chest trauma, provides accurate information of the pattern of injuries, and localization, therefore, should be performed as possible

Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT

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Hutt, Antoine; Faivre, Jean-Baptiste; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); Duhamel, Alain; Deken, Valerie [CHRU et Universite de Lille, Department of Biostatistics (EA 2694), Lille (France); Molinari, Francesco [Centre Hospitalier General de Tourcoing, Department of Radiology, Tourcoing (France)

2016-06-15

To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening. One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT). Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93-0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = -0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136). Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations. (orig.)

Mass preserving image registration for lung CT

DEFF Research Database (Denmark)

Gorbunova, Vladlena; Sporring, Jon; Lo, Pechin Chien Pau

2012-01-01

This paper presents a mass preserving image registration algorithm for lung CT images. To account for the local change in lung tissue intensity during the breathing cycle, a tissue appearance model based on the principle of preservation of total lung mass is proposed. This model is incorporated...... on four groups of data: 44 pairs of longitudinal inspiratory chest CT scans with small difference in lung volume; 44 pairs of longitudinal inspiratory chest CT scans with large difference in lung volume; 16 pairs of expiratory and inspiratory CT scans; and 5 pairs of images extracted at end exhale and end...

Reporting of coronary artery calcification on chest CT studies in breast cancer patients at high risk of cancer therapy related cardiac events

Directory of Open Access Journals (Sweden)

William J. Phillips

2018-03-01

Full Text Available Background: The identification of coronary artery calcification (CAC detected coincidentally on chest CT exams could assist in cardiovascular risk assessment but may not be reported consistently on clinical studies. Cardiovascular risk factor stratification is important to predict short term cardiac events during cancer therapy and long term cardiac event free survival in cancer patients. We sought to determine the prevalence of CAC and clinical reporting rates in a cohort of cancer patients at high risk of cancer therapy related cardiac events. Methods: 408 Breast cancer patients who were referred to a cardiac oncology clinic were screened. Inclusion criteria included having had a CT chest and the absence of known coronary disease. Among those screened 263 patients were included in the study. Results: CAC was identified in 70 patients (26%. CAC was reported in 18% of studies. The reporting rates of CAC increased with the extent of coronary calcification (p < 0.01 and increased during the period of the study (p < 0.05. Conclusions: CAC was commonly detected on chest CT studies in this observational study of breast cancer patients at high risk of cardiac oncology events. The presence of CAC was often not reported clinically but reporting rates have increased over time. Recent SCCT/STR guidelines recommend reporting the presence of CAC on routine chest CT scans in recognition of the importance of CAC as a predictor of cardiovascular events. Reporting of CAC on chest CTs may help to further risk stratify breast cancer patients and improve cardiovascular outcomes in this vulnerable population. Keywords: Cardiac oncology, Coronary calcification and chest CT

The significance of collateral vessels, as seen on chest CT, in predicting SVC obstruction

International Nuclear Information System (INIS)

Yeouk, Young Soo; Kim, Sung Jin; Bae, Il Hun; Kim, Jae Youn; Hwang, Seung Min; Han, Gi Seok; Park, Kil Sun; Kim, Dae Young

1998-01-01

To evaluate the significance of collateral veins, as seen on chest CT, in the diagnosis of superior vena cava obstruction. We retrospectively the records of 81 patients in whom collateral veins were seen on chest CT. On spiral CT(n=49), contrast material was infused via power injector, and on conventional CT(n=32), 50 ml bolus infusion was followed by 50 ml drip infusion. Obstruction of the SVC was evaluated on chest CT; if, however, evaluation of the SVC of its major tributaries was difficult, as in five cases, the patient underwent SVC phlebography. Collateral vessels were assigned to one of ten categories. On conventional CT, the jugular venous arch in the only collateral vessel to predict SVC obstruction; on spiral CT, however, collateral vessels are not helpful in the diagnosis of SVC obstruction, but are a nonspecific finding. (author). 12 refs., 2 tab., 2 figs

Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

International Nuclear Information System (INIS)

Kim, Tae Jung; Lee, Kyoung Ho; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon; Hahn, Seokyung; Lee, Kyung Won

2009-01-01

Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

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Kim, Tae Jung [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)], E-mail: kholee@snubhrad.snu.ac.kr; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Hahn, Seokyung [Medical Research Collaborating Center, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Seoul National University College of Medicine (Korea, Republic of); Lee, Kyung Won [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)

2009-03-15

Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

The sensitivity of computed tomography (CT) scans in detecting trauma: are CT scans reliable enough for courtroom testimony?

Science.gov (United States)

Molina, D Kimberley; Nichols, Joanna J; Dimaio, Vincent J M

2007-09-01

Rapid and accurate recognition of traumatic injuries is extremely important in emergency room and surgical settings. Emergency departments depend on computed tomography (CT) scans to provide rapid, accurate injury assessment. We conducted an analysis of all traumatic deaths autopsied at the Bexar County Medical Examiner's Office in which perimortem medical imaging (CT scan) was performed to assess the reliability of the CT scan in detecting trauma with sufficient accuracy for courtroom testimony. Cases were included in the study if an autopsy was conducted, a CT scan was performed within 24 hours before death, and there was no surgical intervention. Analysis was performed to assess the correlation between the autopsy and CT scan results. Sensitivity, specificity, positive predictive value, and negative predictive value were defined for the CT scan based on the autopsy results. The sensitivity of the CT scan ranged from 0% for cerebral lacerations, cervical vertebral body fractures, cardiac injury, and hollow viscus injury to 75% for liver injury. This study reveals that CT scans are an inadequate detection tool for forensic pathologists, where a definitive diagnosis is required, because they have a low level of accuracy in detecting traumatic injuries. CT scans may be adequate for clinicians in the emergency room setting, but are inadequate for courtroom testimony. If the evidence of trauma is based solely on CT scan reports, there is a high possibility of erroneous accusations, indictments, and convictions.

Limiting chest computed tomography in the evaluation of pediatric thoracic trauma.

Science.gov (United States)

Golden, Jamie; Isani, Mubina; Bowling, Jordan; Zagory, Jessica; Goodhue, Catherine J; Burke, Rita V; Upperman, Jeffrey S; Gayer, Christopher P

2016-08-01

Computed tomography (CT) of the chest (chest CT) is overused in blunt pediatric thoracic trauma. Chest CT adds to the diagnosis of thoracic injury but rarely changes patient management. We sought to identify a subset of blunt pediatric trauma patients who would benefit from a screening chest CT based on their admission chest x-ray (CXR) findings. We hypothesize that limiting chest CT to patients with an abnormal mediastinal silhouette identifies intrathoracic vascular injuries not otherwise seen on CXR. All blunt trauma activations that underwent an admission CXR at our Level 1 pediatric trauma center from 2005 to 2013 were retrospectively reviewed. Patients who had a chest CT were evaluated for added diagnoses and change in management after CT. An admission CXR was performed in 1,035 patients. One hundred thirty-nine patients had a CT, and the diagnosis of intra-thoracic injury was added in 42% of patients. Chest CT significantly increased the diagnosis of contusion or atelectasis (30.3% vs 60.4%; p pneumothorax (7.2% vs 18.7%; p chest CT. Chest CT changed the management of only 4 patients (2.9%). Two patients underwent further radiologic evaluation that was negative for injury, one had a chest tube placed for an occult pneumothorax before exploratory laparotomy, and one patient had a thoracotomy for repair of aortic injury. Chest CT for select patients with an abnormal mediastinal silhouette on CXR would have decreased CT scans by 80% yet still identified patients with an intrathoracic vascular injury. The use of chest CT should be limited to the identification of intrathoracic vascular injuries in the setting of an abnormal mediastinal silhouette on CXR. Therapeutic study, level IV; diagnostic study, level III.

SU-E-I-48: The Behavior of AEC in Scan Regions Outside the Localizer Radiograph FOV: An In Phantom Study of CT Systems From Four Vendors

Energy Technology Data Exchange (ETDEWEB)

Supanich, M [Rush University Medical Center, Chicago, IL (United States); Bevins, N [Henry Ford Health System, Detroit, MI (United States)

2014-06-01

Purpose: This review of scanners from 4 major manufacturers examines the clinical impact of performing CT scans that extend into areas of the body that were not acquired in the CT localizer radiograph. Methods: Anthropomorphic chest and abdomen phantoms were positioned together on the tables of CT scanners from 4 different vendors. All of the scanners offered an Automatic Exposure Control (AEC) option with both lateral and axial tube current modulation. A localizer radiograph was taken covering the entire extent of both phantoms and then the scanner's Chest-Abdomen-Pelvis (CAP) study was performed with the clinical AEC settings employed and the scan and reconstruction range extending from the superior portion of the chest phantom through the inferior portion of the abdomen phantom. A new study was then initiated with a localizer radiograph extending the length of the chest phantom (not covering the abdomen phantom). The same CAP protocol and AEC settings were then used to scan and reconstruct the entire length of both phantoms. Scan parameters at specific locations in the abdomen phantom from both studies were investigated using the information contained in the DICOM metadata of the reconstructed images. Results: The AEC systems on all scanners utilized different tube current settings in the abdomen phantom for the scan completed without the full localizer radiograph. The AEC system behavior was also scanner dependent with the default manual tube current, the maximum tube current and the tube current at the last known position observed as outcomes. Conclusion: The behavior of the AEC systems of CT scanners in regions not covered by the localizer radiograph is vendor dependent. To ensure optimal image quality and radiation exposure it is important to include the entire planned scan region in the localizer radiograph.

SU-E-I-48: The Behavior of AEC in Scan Regions Outside the Localizer Radiograph FOV: An In Phantom Study of CT Systems From Four Vendors

International Nuclear Information System (INIS)

Supanich, M; Bevins, N

2014-01-01

Purpose: This review of scanners from 4 major manufacturers examines the clinical impact of performing CT scans that extend into areas of the body that were not acquired in the CT localizer radiograph. Methods: Anthropomorphic chest and abdomen phantoms were positioned together on the tables of CT scanners from 4 different vendors. All of the scanners offered an Automatic Exposure Control (AEC) option with both lateral and axial tube current modulation. A localizer radiograph was taken covering the entire extent of both phantoms and then the scanner's Chest-Abdomen-Pelvis (CAP) study was performed with the clinical AEC settings employed and the scan and reconstruction range extending from the superior portion of the chest phantom through the inferior portion of the abdomen phantom. A new study was then initiated with a localizer radiograph extending the length of the chest phantom (not covering the abdomen phantom). The same CAP protocol and AEC settings were then used to scan and reconstruct the entire length of both phantoms. Scan parameters at specific locations in the abdomen phantom from both studies were investigated using the information contained in the DICOM metadata of the reconstructed images. Results: The AEC systems on all scanners utilized different tube current settings in the abdomen phantom for the scan completed without the full localizer radiograph. The AEC system behavior was also scanner dependent with the default manual tube current, the maximum tube current and the tube current at the last known position observed as outcomes. Conclusion: The behavior of the AEC systems of CT scanners in regions not covered by the localizer radiograph is vendor dependent. To ensure optimal image quality and radiation exposure it is important to include the entire planned scan region in the localizer radiograph

Abnormal chest shadow on CT in immunosuppressed patients

International Nuclear Information System (INIS)

Tanaka, Nobuyuki; Matsumoto, Tsuneo; Nakamura, Hiroshi

1992-01-01

An abnormal chest shadow was observed on CT scans in 25 cases of 23 immunosuppressed patients. Pulmonary disease was pathologically confirmed to be pneumocystis carinii pneumonia (PC pneumonia) in four patients, cytomegalovirus pneumonia (CMV pneumonia) in one, bacterial pneumonia in seven, fungal infection in three, miliary tuberculosis in one, leukemic infiltration in two, lymphangitis carcinomatosa in three, drug-induced pneumonitis in three, and ARDS in one. In almost all patients, especially those with infectious diseases such as PC pneumonia, CMV pneumonia, and bacterial pneumonia, the abnormal shadow was wide and visible in the bilateral lung fields. We presumed that such findings as lobular shadow, centrilobular shadow, and mosaic pattern reflected the extension of disease via the respiratory tract, and that those findings are typical of infectious diseases. Because such findings as abnormal linear shadow and swelling of a broncho-vascular bundle were very frequently recognized in patients with lymphangitis carcinomatosa and frequently recognized in those with drug-induced pneumonitis, these diseases may be distinguished from other diseases. An area of slightly increased density was frequently recognized in patients with PC pneumonia, bacterial pneumonia, and drug-induced pneumonitis. Such lesions were pathologically confirmed to be located in the interstitium and/or alveolus. CT was extremely useful in comprehending the character and extension of particular diseases among various diseases. As the number of patients studied was small, the utility of CT in immunosuppressed patients requires further investigation in a larger number of patients. (author)

Chest CT findings in patients with non-cardiovascular causes of chest pain: Focusing on pulmonary tuberculosis in a tuberculosis endemic country

International Nuclear Information System (INIS)

Lee, So Won; Shim, Sung Shine; Kim, Yoo Kyung; Ryu, Yon Ju

2015-01-01

To review the common causes of non-cardiovascular chest pain (NCCP) according to the location and lesion type as seen on chest CT, and to evaluate CT findings in tuberculosis (TB) as a cause of NCCP. In the period 2009 to 2012, patients having NCCP without definitive evidence of acute myocardial infarction, pulmonary thromboembolism, and aortic dissection, were included. In total, 162 patients (60.5% male; 39.5% female), with a mean age of 51 years, were enrolled. CT images were evaluated by location and lesion type, for causes of NCCP. Chest CT revealed that the most common location for the cause of NCCP was the pleura (45.1%), followed by the subpleural lung parenchyma (30.2%). The most common lesion causing NCCP was TB (33.3%), followed by pneumonia (19.1%). Of the 54 TB cases, 40 (74.1%) were stable TB and 14 (25.9%) were active TB; among these 54 patients, NCCP was most commonly the result of fibrotic pleural thickening (55.6%), followed by subpleural stable pulmonary TB (14.8%). Results of chest CT revealed that TB was a major cause of NCCP in a TB endemic area. Among the TB patients, fibrotic pleural thickening in patients with stable TB was the most common cause of NCCP

Chest CT findings in patients with non-cardiovascular causes of chest pain: Focusing on pulmonary tuberculosis in a tuberculosis endemic country

Energy Technology Data Exchange (ETDEWEB)

Lee, So Won; Shim, Sung Shine; Kim, Yoo Kyung; Ryu, Yon Ju [Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

2015-10-15

To review the common causes of non-cardiovascular chest pain (NCCP) according to the location and lesion type as seen on chest CT, and to evaluate CT findings in tuberculosis (TB) as a cause of NCCP. In the period 2009 to 2012, patients having NCCP without definitive evidence of acute myocardial infarction, pulmonary thromboembolism, and aortic dissection, were included. In total, 162 patients (60.5% male; 39.5% female), with a mean age of 51 years, were enrolled. CT images were evaluated by location and lesion type, for causes of NCCP. Chest CT revealed that the most common location for the cause of NCCP was the pleura (45.1%), followed by the subpleural lung parenchyma (30.2%). The most common lesion causing NCCP was TB (33.3%), followed by pneumonia (19.1%). Of the 54 TB cases, 40 (74.1%) were stable TB and 14 (25.9%) were active TB; among these 54 patients, NCCP was most commonly the result of fibrotic pleural thickening (55.6%), followed by subpleural stable pulmonary TB (14.8%). Results of chest CT revealed that TB was a major cause of NCCP in a TB endemic area. Among the TB patients, fibrotic pleural thickening in patients with stable TB was the most common cause of NCCP.

Multi-Detector CT Findings of Palpable Chest Wall Masses in Children: A Pictorial Essay

Energy Technology Data Exchange (ETDEWEB)

Park, Chan Ho; Kim, Young Tong [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of); Hong, Hyun Sook [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

2013-03-15

A wide variety of diseases manifest as palpable chest wall masses in children. These include normal variation, congenital anomalies, trauma, infection, axillary lymphadenopathies, soft tissue tumors and bone tumors. Given that most of these diseases are associated with chest wall deformity, diagnosis is difficult by physical examination or ultrasonography alone. However, multi-detector CT with three dimensional reconstruction is useful in the characterization and differential diagnosis of palpable chest wall lesions. In this article, we review the spectrum of palpable chest wall diseases and illustrate their multi-detector CT presentation.

Patient doses in chest CT examinations: Comparison of various CT scanners

Directory of Open Access Journals (Sweden)

Božović Predrag

2013-01-01

Full Text Available This paper presents results from study on patient exposure level in chest CT examinations. CT scanners used in this study were various Siemens and General Electric (GE models. Data on patient doses were collected for adult and pediatric patients. Doses measured for adult patients were lower then those determined as Diagnostic Reference Levels (DRL for Europe, while doses for pediatric patients were similar to those found in published data. As for the manufactures, slightly higher doses were measured on GE devices, both for adult and pediatric patients.

Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

Energy Technology Data Exchange (ETDEWEB)

Lanzman, Rotem S.; Blondin, Dirk; Furst, Gunter; Scherer, Axel; R Miese, Falk; Kroepil, Patric [University of Duesseldorf, Medical Faculty, 40225 Duesseldorf (Germany); Winter, Joachim [University Hospital Duesseldorf, 40225 Duesseldorf (Germany); Abbara, Suhny [Massachusetts General Hospital, Boston, MA (US)

2011-10-15

Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein.

Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

International Nuclear Information System (INIS)

Lanzman, Rotem S.; Blondin, Dirk; Furst, Gunter; Scherer, Axel; R Miese, Falk; Kroepil, Patric; Winter, Joachim; Abbara, Suhny

2011-01-01

Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein.

Technique and clinical applications of full-inflation and end-exhalation controlled-ventilation chest CT in infants and young children

International Nuclear Information System (INIS)

Long, F.R.; Castile, R.G.

2001-01-01

Background. The inability of young children to cooperate with breath holding limits the usefulness of chest CT. Objective. To describe the technique and utility of a non-invasive method called controlled-ventilation CT (CVCT) for obtaining motion-free full-inflation and end-exhalation images of the lung in infants and young children. Materials and methods. Eighty-seven children (ages 1 week to 5 years, mean 2 years) underwent CVCT of the chest during suspended respiration at full-lung inflation and end-exhalation for a variety of clinical indications. Respiratory pauses were produced using conscious sedation and positive-pressure face-mask ventilation. Forty-one of 87 children had recordings of respiratory motion during CVCT. Results. Respiratory pause lengths increased with age (P < 0.003), were highly reproducible (r = 0.85), and lasted sufficiently long to be practical for full-inflation (24 ± 9 s) and end-exhalation (12 ± 5 s) CT scanning. Full-inflation CVCT was useful in evaluating tracheal and bronchial stenosis, bronchial wall thickening, early bronchiectasis, bronchial fistula, extent of interstitial fibrosis, and lung nodules. End-exhalation CVCT was useful in evaluating tracheomalacia and air trapping. Conclusion. Controlled-ventilation chest CT is a practical and reliable technique that promises to be clinically useful for a number of clinical indications in infants and young children. (orig.)

Developing optimized CT scan protocols: Phantom measurements of image quality

International Nuclear Information System (INIS)

Zarb, Francis; Rainford, Louise; McEntee, Mark F.

2011-01-01

Purpose: The increasing frequency of computerized tomography (CT) examinations is well documented, leading to concern about potential radiation risks for patients. However, the consequences of not performing the CT examination and missing injuries and disease are potentially serious, impacting upon correct patient management. The ALARA principle of dose optimization must be employed for all justified CT examinations. Dose indicators displayed on the CT console as either CT dose index (CTDI) and/or dose length product (DLP), are used to indicate dose and can quantify improvements achieved through optimization. Key scan parameters contributing to dose have been identified in previous literature and in previous work by our group. The aim of this study was to optimize the scan parameters of mA; kV and pitch, whilst maintaining image quality and reducing dose. This research was conducted using psychophysical image quality measurements on a CT quality assurance (QA) phantom establishing the impact of dose optimization on image quality parameters. Method: Current CT scan parameters for head (posterior fossa and cerebrum), abdomen and chest examinations were collected from 57% of CT suites available nationally in Malta (n = 4). Current scan protocols were used to image a Catphan 600 CT QA phantom whereby image quality was assessed. Each scan parameter: mA; kV and pitch were systematically reduced until the contrast resolution (CR), spatial resolution (SR) and noise were significantly lowered. The Catphan 600 images, produced by the range of protocols, were evaluated by 2 expert observers assessing CR, SR and noise. The protocol considered as the optimization threshold was just above the setting that resulted in a significant reduction in CR and noise but not affecting SR at the 95% confidence interval. Results: The limit of optimization threshold was determined for each CT suite. Employing optimized parameters, CTDI and DLP were both significantly reduced (p ≤ 0.001) by

CT diagnosis of mediastinal tuberculous lymphadenopathy in adults

International Nuclear Information System (INIS)

Liu Fugeng; Pan Jishu; Wu Guogeng; Chen Qihang; Yu Jingying; Zhou Cheng

2001-01-01

Objective: To evaluate the features of mediastinal tuberculous lymphadenopathy in adults on CT, especially on enhanced CT scan. Methods: Seventeen patients with adult mediastinal tuberculous lymphadenopathy proved by operation, biopsy, and (or) anti-tuberculous therapy were evaluated on chest film and CT scan, and 6 patients were performed with enhanced CT scan. Results: The chest film finding was intrathoracic mass and (or) hilar mass only in 6 patients, but CT detected 37 enlarged nodes in all patients. Most of the enlarged nodes were located in 2R and (or) 4R (59.4%). 30 nodes (81.1%) presented as low-density in the center of nodes, and there were marked enhancement at the periphery areas of the nodes after enhancement in all 6 patients (100.0%). Conclusion: CT scan, especially the enhanced CT scan, is the first method of choice to diagnose the mediastinal tuberculous lymphadenopathy in adults

Combining automatic tube current modulation with adaptive statistical iterative reconstruction for low-dose chest CT screening.

Science.gov (United States)

Chen, Jiang-Hong; Jin, Er-Hu; He, Wen; Zhao, Li-Qin

2014-01-01

To reduce radiation dose while maintaining image quality in low-dose chest computed tomography (CT) by combining adaptive statistical iterative reconstruction (ASIR) and automatic tube current modulation (ATCM). Patients undergoing cancer screening (n = 200) were subjected to 64-slice multidetector chest CT scanning with ASIR and ATCM. Patients were divided into groups 1, 2, 3, and 4 (n = 50 each), with a noise index (NI) of 15, 20, 30, and 40, respectively. Each image set was reconstructed with 4 ASIR levels (0% ASIR, 30% ASIR, 50% ASIR, and 80% ASIR) in each group. Two radiologists assessed subjective image noise, image artifacts, and visibility of the anatomical structures. Objective image noise and signal-to-noise ratio (SNR) were measured, and effective dose (ED) was recorded. Increased NI was associated with increased subjective and objective image noise results (PASIR levels (PASIR had average subjective image noise scores and nearly average anatomical structure visibility scores, with a mean objective image noise of 23.42 HU. The EDs for groups 1, 2, 3 and 4 were 2.79 ± 1.17, 1.69 ± 0.59, 0.74 ± 0.29, and 0.37 ± 0.22 mSv, respectively. Compared to group 1 (NI = 15), the ED reductions were 39.43%, 73.48%, and 86.74% for groups 2, 3, and 4, respectively. Using NI = 30 with 50% ASIR in the chest CT protocol, we obtained average or above-average image quality but a reduced ED.

Cystic Fibrosis: Are Volumetric Ultra-Low-Dose Expiratory CT Scans Sufficient for Monitoring Related Lung Disease?

DEFF Research Database (Denmark)

Loeve, Martine; Lequin, Maarten H; Bruijne, Marleen de

2009-01-01

Purpose: To assess whether chest computed tomography (CT) scores from ultra-low-dose end-expiratory scans alone could suffice for assessment of all cystic fibrosis (CF)-related structural lung abnormalities. Materials and Methods: In this institutional review board–approved study, 20 patients...... with CF aged 6–20 years (eight males, 12 females) underwent low-dose end-inspiratory CT and ultra-low-dose end-expiratory CT. Informed consent was obtained. Scans were randomized and scored by using the Brody-II CT scoring system to assess bronchiectasis, airway wall thickening, mucus plugging......-Altman plots. Results: Median age was 12.6 years (range, 6.3–20.3 years), median forced expiratory volume in 1 second was 100% (range, 46%–127%) of the predicted value, and median forced vital capacity was 99% (range, 61%–123%) of the predicted value. Very good agreement was observed between end...

AP diameter shows the strongest correlation with CTDI and DLP in abdominal and chest CT.

LENUS (Irish Health Repository)

Zarb, Francis

2010-01-01

The purpose of this study is to investigate the relationships among cross-sectional diameters, weight and computed tomography (CT) dose descriptors (CTDI and DLP) to identify which is best used as a measure for the establishment of DRLs in CT. Data (gender, weight, cross-sectional diameters, dose descriptors) from 56 adult patients attending for either a CT examination of the abdomen or chest was obtained from two spiral CT units using automatic milliampere modulation. The AP diameter was demonstrated as the main contributing factor influencing the dose in CT (CTDI: r(2) = 0.269, p-value < or =0.001; DLP: r(2) = 0.260, p-value < or =0.001) since it has a greater correlation with radiation dose than body weight and can thus be its substitute in dose-reduction strategies and establishment of DRLs. The advantages of using the AP diameter are that it can easily be measured prior to scanning or retrospectively from previous CT images. However, further studies on the practicality of this approach are recommended.

Frequency and significance of thoracic injuries detected on abdominal trauma CT scans

International Nuclear Information System (INIS)

Hareli, G.S.; Rhea, J.T.; Novelline, R.A.; Lawrason, N.; Sacknoff, R.; Oser, A.

1987-01-01

The authors have noted that in multiple trauma patients chest injuries inapparent on initial chest radiographs may be detected at abdominal CT. In an ongoing series of 112 patients to date, 50 chest injuries were detected in 33 patients (29%). The injuries included 15 bilateral hemothoraces, seven unilateral hemothoraces, seven posttraumatic atrelectasis, seven lung contusions, five pneumothoraces, four rib factures, two thoracic spine fractures, two chest wall emphysema, and one mediastinal emphysema. In 24 of the 33 patients (72%) the injury was not seen on the initial chest radiographs; in seven patients treatment of the chest injury was required. The authors have included screening cuts of the middle and upper chest as part of their abdominal CT protocol

Large pneumothorax in blunt chest trauma: Is a chest drain always necessary in stable patients? A case report.

Science.gov (United States)

Idris, Baig M; Hefny, Ashraf F

2016-01-01

Pneumothorax is the most common potentially life-threatening blunt chest injury. The management of pneumothorax depends upon the etiology, its size and hemodynamic stability of the patient. Most clinicians agree that chest drainage is essential for the management of traumatic large pneumothorax. Herein, we present a case of large pneumothorax in blunt chest trauma patient that resolved spontaneously without a chest drain. A 63- year- old man presented to the Emergency Department complaining of left lateral chest pain due to a fall on his chest at home. On examination, he was hemodynamically stable. An urgent chest X-ray showed evidence of left sided pneumothorax. CT scan of the chest showed pneumothorax of more than 30% of the left hemithorax (around 600ml of air) with multiple left ribs fracture. Patient refused tube thoracostomy and was admitted to surgical department for close observation. The patient was managed conservatively without chest tube insertion. A repeat CT scan of the chest has shown complete resolution of the pneumothorax. The clinical spectrum of pneumothorax varies from asymptomatic to life threatening tension pneumothorax. In stable patients, conservative management can be safe and effective for small pneumothorax. To the best of our knowledge, this is the second reported case in the English literature with large pneumothorax which resolved spontaneously without chest drain. Blunt traumatic large pneumothorax in a clinically stable patient can be managed conservatively. Current recommendations for tube placement may need to be reevaluated. This may reduce morbidity associated with chest tube thoracostomy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Computer-aided segmentation system for 3D chest CT

International Nuclear Information System (INIS)

Iwasawa, Tae; Komagata, Takanobu; Ogura, Takashi; Iwao, Yuma; Goto, Toshiyuki; Asakura, Akira; Inoue, Tomio

2012-01-01

We will introduce the quantitative analysis of the chest CT images using computer-assisted segmentation system (Gaussian Histogram Normalized Correlation; GHNC). This system can divide the lung into several patterns, for example, normal, emphysema and fibrous lesion, and measure each lesion volume quantitatively. We analyzed 3D-CT images of 20 patients with lung cancer. GHNC could measure the volumes of emphysema and fibrosis lesions, respectively. GHNC analysis will be feasible for preoperative CT evaluation, especially in the patients with combined pulmonary fibrosis and emphysema. (author)

CT guided percutaneous needle biopsy of the chest: initial experience

African Journals Online (AJOL)

The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

Cross-sectional imaging with CT and/or MRI of pediatric chest tumors

International Nuclear Information System (INIS)

Wyttenbach, R.; Vock, P.; Tschaeppeler, H.

1998-01-01

The purpose of this study was to provide an overview of the spectrum of pediatric chest masses, to present the results of cross-sectional imaging with CT and/or MRI, and to define diagnostic criteria to limit differential diagnosis. Seventy-eight children with thoracic mass lesions were retrospectively evaluated using CT (72 patients) and/or MR imaging (12 patients). All masses were evaluated for tissue characteristics (attenuation values or signal intensity, enhancement, and calcification) and were differentiated according to age, gender, location, and etiology. Twenty-eight of 38 (74 %) mediastinal masses were malignant (neuroblastoma, malignant lymphoma). Thirty of 38 (79 %) pulmonary masses were metastatic in origin, all with an already known primary tumor (osteosarcoma, Wilms tumor). With one exception, all remaining pulmonary lesions were benign. Seventeen of 21 (81 %) chest wall lesions were malignant (Ewing sarcoma, primitive neuroectodermal tumor). The majority of mediastinal and chest wall tumors in children is malignant. Lung lesions are usually benign, unless a known extrapulmonary tumor suggests pulmonary metastases. Cross-sectional imaging with CT and/or MRI allows narrowing of the differential diagnosis of pediatric chest masses substantially by defining the origin and tissue characteristics. Magnetic resonance imaging is preferred for posterior mediastinal lesions, whereas CT should be used for pulmonary lesions. For the residual locations both modalities are complementary. (orig.)

Application of triple rule-out with 64-slice spiral CT in the diagnosis of acute chest pain

International Nuclear Information System (INIS)

Li Pengyu; Li Kuncheng; Du Xiangyin; Cao Lizhen; Liu Jiabin; Yang Yanhuui; Liang Zhigang; Zhu Xiaolian; Liu Jian

2007-01-01

Objective: To investigate the performance of triple rule-out with 64-slice spiral CT in the combined examination of pulmonary artery, thoracic aorta and coronary artery for patients with acute chest pain. Methods: Seventy patients who presented with acute chest pain were included in the study. All of the patients underwent retrospective ECG-gated 64-slice computed tomography triple rule-out examination to evaluate the pulmonary arteries, thoracic aorta and coronary arteries. Multi-planar reconstruction (MPR), maximum intensity projection (MIP), curved-planar reconstruction (CPR) and volume rendering (VR) were used to display pulmonary arteries, thoracic aorta and coronary arteries. We evaluated the image quality of coronary artery and the enhancement of the pulmonary artery and thoracic aorta to estimate if the examination can fulfill the clinical demand for the differential diagnosis of acute chest pain. Results: The mean scan time was (8.5±1.0) s, and the dose of contrast medium injected was 100 ml. There were 95.7% (67/70) of patients whose CT values detected in the pulmonary artery and thoracic aorta after enhancement Were ≥200 HU. The image quality of 85.8% (720/839) coronary segments was classified as excellent, 8.6% (72/839) as good, and 5.6% (47/839) as poor. There were 20 eases with coronary stenoses ≥50%, 2 cases with pulmonary embolism, and 2 cases with aortic dissection. Conclusion: The triple rule-out examination with 64-slice spiral CT could depict pulmonary artery, thoracic aorta, and coronary artery in 8 s with good image quality. It has great potential in the etiological diagnosis for the patients with acute chest pain. (authors)

Imaging of chest disease due to intravenous heroin abuse

International Nuclear Information System (INIS)

Lian Xuhui; Chen Zhong; Ye Wenqin

2002-01-01

Objective: To study the imaging findings of the chest disease due to intravenous heroin abuse. Methods: Twenty-five cases of clinically confirmed chest disease due to intravenous heroin abuse were retrospectively analyzed. 25 cases had conventional X-ray film, 6 cases had CT scanning, and 6 cases had echocardiography scanning. Results: On X-ray and CT, the following signs were found: lung making manifold (n = 5), small patchy shadow (n = 15), pneumatocele (n = 16), small cavity (n = 16), small node (n = 7), pleural effusion (n = 8 ), pneumothorax (n = 2), hydropneumothorax (n = 6), pulmonary edema (n = 2), megacardia (n = 11), multiple-shaped lesion (n = 20). On echocardiography, tricuspid vegetation (n = 4) and tricuspid insufficiency (n = 4) were found. Conclusion: The X-ray and CT manifestations of chest inflammation due to intravenous heroin abuse are multiple. The multiple small cavities and pneumatoceles sign are of some value in the diagnosis of lung inflammation due to intravenous heroin abuse among young patients

Intrapulmonary pseudo-malposition of chest tubes on computed tomography (CT)

International Nuclear Information System (INIS)

Flueckiger, F.; Kullnig, P.; Juettner-Smolle, F.; Melzer, G.; Graz Univ.

1991-01-01

The diagnosis of an intrapulmonary malposition of chest tubes on CT may be problematic. We report about 13 chest tubes which were suspected on CT to be in an intrapulmonary malposition. In all cases as well as clinical and radiological follow up ruled out such a malposition. The use of a stiff tube and the presence of a soft lung parenchyma obviously led to a sinking of the tube into a 'channel'. Whereas after removal of the tube in case of such a pseudo-malposition solely a transitory local fluid collection and later a tender scar is seen, real intrapumonary malposition leads to parenchymal injury and concomitant complications. The diagnosis of intrapulmonary malposition should be doubted, if the drain is positioned within the pleural space after having crossed the lung parenchyma in a supposed intrapulmonary rout. The CT criterias of this pseudo-malposition are presented and discussed. (orig.) [de

Optimization of protocol in computerized tomography scans of children's chest

International Nuclear Information System (INIS)

Lima, L.T.A.; Roberto, W. dos S.; Mourão Filho, A.P.

2017-01-01

The diffusion of the Computed Tomography (CT) has promoted a significant increase of the dose absorbed by patients. This technique showed a high growth as a result of clinical cases of medical emergencies, neoplasia and pediatric traumas. The risks of stochastic effects are greater for children due to tissue radiosensitivity coupled with longer life expectancy. In the present work, a cylindrical simulator was used, representing an adult thorax made of polymethylmethacrylate (PMMA), and a second simulator object of the same material was developed in oblong format including the axillary regions, based on the dimensions of the patient's thorax one-year-old pediatric population. The scanning on the adult simulator object was performed with the chest radiograph diagnostic service with a 120 kV supply voltage and in the pediatric simulator object were performed optimized scans with 120, 100 and 80 kV. This work compared the dose variation absorbed by the pediatric simulator object mentioned by the change in the tube supply voltage

Necrotizing pneumonia: CT findings and its clinical significance

International Nuclear Information System (INIS)

Park, Hong Suk; Im, Jung Gi; Ryoo, Jae Wook; Yeon, Kyung Mo; Han, Man Chung

1995-01-01

To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy (n = 7) and culture (n = 15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47 years). The pathogens of necrotizing pneumonia were Klebsiella spp (n = 7), Enterobacter spp (n = 5), Actinomyces spp (n = 4), Pseudomonas spp (n = 4), Nocardia spp (n = 4), and others (n = 5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients (16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia

What did we learn from two decades of chest computed tomography in cystic fibrosis?

International Nuclear Information System (INIS)

Tiddens, Harm A.W.M.; Rosenow, Tim

2014-01-01

Despite our current treatment, many cystic fibrosis (CF) patients still show progressive bronchiectasis and small airways disease. Adequate detection and monitoring of progression of these structural abnormalities is needed to personalize treatment to the severity of CF lung disease of the patient. Chest computed tomography (CT) is the gold standard to diagnose and monitor bronchiectasis. Many studies have been done to validate the role of chest CT in CF and to improve the protocols. From these studies it became clear that for correct interpretation of the severity of bronchiectasis and small airways disease standardization of lung volume for the inspiratory and expiratory CT scan acquisition is needed. The risk related to the radiation exposure of a chest CT scan every second year is considered low. Automated and quantitative image analysis systems are developed to improve the reliability and sensitivity of assessments of structural lung changes in CF, particularly in early life. In this paper an overview is given of the lessons learned from two decades of monitoring CF lung disease using chest CT. (orig.)

What did we learn from two decades of chest computed tomography in cystic fibrosis?

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Tiddens, Harm A.W.M. [Erasmus MC-Sophia Children' s Hospital, Department of Pediatric Pulmonology, Rotterdam (Netherlands); Erasmus MC, Department of Radiology, Rotterdam (Netherlands); Rosenow, Tim [Erasmus MC-Sophia Children' s Hospital, Department of Pediatric Pulmonology, Rotterdam (Netherlands); The University of Western Australia, Telethon Institute for Child Health Research, Perth (Australia); The University of Western Australia, School of Paediatrics and Child Health Research, Perth (Australia)

2014-12-15

Despite our current treatment, many cystic fibrosis (CF) patients still show progressive bronchiectasis and small airways disease. Adequate detection and monitoring of progression of these structural abnormalities is needed to personalize treatment to the severity of CF lung disease of the patient. Chest computed tomography (CT) is the gold standard to diagnose and monitor bronchiectasis. Many studies have been done to validate the role of chest CT in CF and to improve the protocols. From these studies it became clear that for correct interpretation of the severity of bronchiectasis and small airways disease standardization of lung volume for the inspiratory and expiratory CT scan acquisition is needed. The risk related to the radiation exposure of a chest CT scan every second year is considered low. Automated and quantitative image analysis systems are developed to improve the reliability and sensitivity of assessments of structural lung changes in CF, particularly in early life. In this paper an overview is given of the lessons learned from two decades of monitoring CF lung disease using chest CT. (orig.)

Prospective evaluation of fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) for axillary staging in breast cancer

International Nuclear Information System (INIS)

Yamaguchi, Masahide; Noguchi, Akinori; Tani, Naoki

2008-01-01

Seventy-two patients from 2005 October to 2007 February with operative breast cancer underwent fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) of chest and body, ultrasound scan (US) and enhanced computed tomography scan (CT) followed by sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND). The results of PET/CT were compared with histopathological diagnosis of SLNB and ALND. Sensitivity, specificity and accuracy of PET/CT for detection of axillary lymph node metastases were 61%, 96% and 88%, respectively. Seven false-negative and two false-positive of PET/CT results were found. In patients with false-negative of PET/CT results there are two skin-invasive breast cancer patients and axillary lymph node metastases were detected in three patients with US, in one with CT and in four with SLNB. In clinical method for diagnosis of axillary lymph node metastases SLNB should be recommended because sensitivity of PET/CT for early breast cancer patients were low and positive diagnosis of axillary lymph node metastases with PET needs more than 1 cm size of lesion. PET/CT is useful for not-early breast cancer patients. To decide the operation of axillary lymph node disection needs total diagnosis of US, CT, SLNB and clinical findings. (author)

Spinal CT scan, 1

International Nuclear Information System (INIS)

Nakagawa, Hiroshi

1982-01-01

Methods of CT of the cervical and thoracic spines were explained, and normal CT pictures of them were described. Spinal CT was evaluated in comparison with other methods in various spinal diseases. Plain CT revealed stenosis due to spondylosis or ossification of posterior longitudinal ligament and hernia of intervertebral disc. CT took an important role in the diagnosis of spinal cord tumors with calcification and destruction of the bone. CT scan in combination with other methods was also useful for the diagnosis of spinal injuries, congenital anomalies and infections. (Ueda, J.)

Dose reduction with adaptive statistical iterative reconstruction for paediatric CT: phantom study and clinical experience on chest and abdomen CT.

Science.gov (United States)

Gay, F; Pavia, Y; Pierrat, N; Lasalle, S; Neuenschwander, S; Brisse, H J

2014-01-01

To assess the benefit and limits of iterative reconstruction of paediatric chest and abdominal computed tomography (CT). The study compared adaptive statistical iterative reconstruction (ASIR) with filtered back projection (FBP) on 64-channel MDCT. A phantom study was first performed using variable tube potential, tube current and ASIR settings. The assessed image quality indices were the signal-to-noise ratio (SNR), the noise power spectrum, low contrast detectability (LCD) and spatial resolution. A clinical retrospective study of 26 children (M:F = 14/12, mean age: 4 years, range: 1-9 years) was secondarily performed allowing comparison of 18 chest and 14 abdominal CT pairs, one with a routine CT dose and FBP reconstruction, and the other with 30 % lower dose and 40 % ASIR reconstruction. Two radiologists independently compared the images for overall image quality, noise, sharpness and artefacts, and measured image noise. The phantom study demonstrated a significant increase in SNR without impairment of the LCD or spatial resolution, except for tube current values below 30-50 mA. On clinical images, no significant difference was observed between FBP and reduced dose ASIR images. Iterative reconstruction allows at least 30 % dose reduction in paediatric chest and abdominal CT, without impairment of image quality. • Iterative reconstruction helps lower radiation exposure levels in children undergoing CT. • Adaptive statistical iterative reconstruction (ASIR) significantly increases SNR without impairing spatial resolution. • For abdomen and chest CT, ASIR allows at least a 30 % dose reduction.

Chest CT using spectral filtration: radiation dose, image quality, and spectrum of clinical utility

Energy Technology Data Exchange (ETDEWEB)

Braun, Franziska M.; Johnson, Thorsten R.C.; Sommer, Wieland H.; Thierfelder, Kolja M.; Meinel, Felix G. [University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

2015-06-01

To determine the radiation dose, image quality, and clinical utility of non-enhanced chest CT with spectral filtration. We retrospectively analysed 25 non-contrast chest CT examinations acquired with spectral filtration (tin-filtered Sn100 kVp spectrum) compared to 25 examinations acquired without spectral filtration (120 kV). Radiation metrics were compared. Image noise was measured. Contrast-to-noise-ratio (CNR) and figure-of-merit (FOM) were calculated. Diagnostic confidence for the assessment of various thoracic pathologies was rated by two independent readers. Effective chest diameters were comparable between groups (P = 0.613). In spectral filtration CT, median CTDI{sub vol}, DLP, and size-specific dose estimate (SSDE) were reduced (0.46 vs. 4.3 mGy, 16 vs. 141 mGy*cm, and 0.65 vs. 5.9 mGy, all P < 0.001). Spectral filtration CT had higher image noise (21.3 vs. 13.2 HU, P < 0.001) and lower CNR (47.2 vs. 75.3, P < 0.001), but was more dose-efficient (FOM 10,659 vs. 2,231/mSv, P < 0.001). Diagnostic confidence for parenchymal lung disease and osseous pathologies was lower with spectral filtration CT, but no significant difference was found for pleural pathologies, pulmonary nodules, or pneumonia. Non-contrast chest CT using spectral filtration appears to be sufficient for the assessment of a considerable spectrum of thoracic pathologies, while providing superior dose efficiency, allowing for substantial radiation dose reduction. (orig.)

Evaluation in the use of bismuth shielding on cervical spine CT scan using a male phantom

International Nuclear Information System (INIS)

Aleme, C.; Mourao, A. P.; Lyra, M. A.

2014-08-01

The cervical spine is the region of the column that articulates the head and chest. The tests of computed tomography (CT) performed in this region have as main objectives to diagnose fractures, dislocations and tumors. In CT scans the cervical spine volume is limited by the foramen Magnum and the first thoracic vertebra. In this region is the thyroid that is directly irradiated by X-ray beam during cervical scan. Based on this information, it was studied the dose variation deposited in thyroid and in nearby organs, such as: lenses, spinal cord in the foramen Magnum region and breasts, with and without the use of bismuth protector. In this study was used a male anthropomorphic phantom and thermoluminescent s dosimeters (TLD-100) were required to register the individual doses in the organs of interest. CT scans were performed on a GE Bright Speed scanner of 32 channels. With the data obtained, it was found the organ dose variation. The largest recorded dose was in the thyroid. Comparing two scans it was possible to note that the use of the bismuth protector promoted a 26% reduction in the thyroid dose and an increase in the lens dose. (Author)

Evaluation in the use of bismuth shielding on cervical spine CT scan using a male phantom

Energy Technology Data Exchange (ETDEWEB)

Aleme, C.; Mourao, A. P. [Centro Federal de Educacion Tecnologica de Minas Gerais, Biomedical Engineering Center, Belo Horizonte - MG (Brazil); Lyra, M. A., E-mail: carolinaaleme@gmail.com [Universidad Federal de Minas Gerais, Department of Nuclear Engineering, Av. Pdte. Antonio Carlos 6627, Pampulha, 31270-91 Belo Horizonte - MG (Brazil)

2014-08-15

The cervical spine is the region of the column that articulates the head and chest. The tests of computed tomography (CT) performed in this region have as main objectives to diagnose fractures, dislocations and tumors. In CT scans the cervical spine volume is limited by the foramen Magnum and the first thoracic vertebra. In this region is the thyroid that is directly irradiated by X-ray beam during cervical scan. Based on this information, it was studied the dose variation deposited in thyroid and in nearby organs, such as: lenses, spinal cord in the foramen Magnum region and breasts, with and without the use of bismuth protector. In this study was used a male anthropomorphic phantom and thermoluminescent s dosimeters (TLD-100) were required to register the individual doses in the organs of interest. CT scans were performed on a GE Bright Speed scanner of 32 channels. With the data obtained, it was found the organ dose variation. The largest recorded dose was in the thyroid. Comparing two scans it was possible to note that the use of the bismuth protector promoted a 26% reduction in the thyroid dose and an increase in the lens dose. (Author)

Awareness of radiation exposure of thoracic CT scans and conventional radiographs: what do non-radiologists know?

International Nuclear Information System (INIS)

Heyer, C.M.; Peters, S.; Lemburg, S.; Nicolas, V.

2007-01-01

Purpose: Assessment of the knowledge of non-radiological physicians concerning radiation exposure during radiological procedures on the thorax. Material and Methods: 124 non-radiological physicians from the departments of surgery, internal medicine, anesthesiology, and neurology at a university hospital were questioned during a four-week period using a standardized questionnaire as to the effective dose (ED) of different radiological procedures on the thorax. The interviewees were asked to estimate the ED of chest X-rays and CT examinations and to compare these with the ED of other radiological methods. Length of professional experience, field of clinical training, and hierarchical position were also documented. The T-test and chi-square test were used for statistical analysis. Results: 119/124 (96.0 %) physicians with an average work experience of 8.2 years (0.3 - 32 years) were willing to participate. 47/119 (39.5 %) correctly estimated the ED of conventional chest X-ray (0.01 - 0.1 mSv), and 40/119 (33.6 %) correctly gauged the ED of adult chest CT (1 - 10 mSv). The ED of cardiac CT and pediatric chest CT without dose reduction (10 - 100 mSv) were correctly judged by 31/119 (26.1 %) and 32/119 (26.9 %), respectively. The correct ratio of the ED of chest X-ray to that of chest CT (factor 100 - 1000) was given by 28/119 (23.5 %), while 86/119 (72.3 %) underestimated the ratio. 50/119 (42.0 %) and 35/119 (29.4 %) correctly stated that the ED of pediatric chest CT without dose reduction and that of cardiac CT are greater than that of adult chest CT. 24/119 (20.2 %) and 10/119 (8.4 %) thought that the ED of low-dose chest CT is smaller than that of chest X-ray or chest MRI, respectively. The length of professional experience, field of clinical training, and hierarchical position of the participants did not have a significant influence on the test results. (orig.)

Usefulness of preoperative chest multidetector CT for evaluation of breast cancer: comparison with breast MRI

International Nuclear Information System (INIS)

Chang, Yun Woo; Kim, Dong Hun; Lee, Min Hyuk

2005-01-01

To evaluate the efficacy of chest multidetector-row helical computed tomography (MDCT) in detecting breast cancer in preoperative metastasis work-ups and to assess the accuracy of MDCT compared with magnetic resonance imaging (MRI). MDCT were performed on 69 consecutive patients with 94 lesions of histologically proven breast cancer. Retrospectively, two radiologists performed a blind review of the MDCT images for margin, shape, mass enhancement pattern and the enhancing distribution of non-mass lesions with consensus. CT attenuation values were measured in the average HU on pre-enhancing and enhanced CT in gland, fat, muscle, and in masses with the largest region of interest (ROI). MDCT finding were analyzed and compared with breast MRI. Of the 91 breast lesions detected on MDCT, 64 were mass lesions and 24 were non-mass lesions on enhancement, 86 lesions were malignant and 5 were benign. Three pathologically proven malignant masses were not detected on MDCT. Positive predictive value, false positive rate and false negative rate were 94.5%, 5.3%, 3.2% respectively. The highly predictive features for malignancy were a spiculated or irregular margin, an irregular of round shape, and a heterogeneously or rim enhanced mass. Another highly predictive feature for malignancy was linear or segmentally distributed enhancing non-mass lesions. The CT values of masses in pre-enhanced scans were 38.6 ± 7.9 HU; these values increased to 110.9 ± 26.6 HU after contrast injection (90 sec). The attenuation values from enhancing CT of malignant lesions were significantly higher than those of non-enhancing lesions. The depiction of enhancing masses on MDCT compared with MR imaging were 88.6%. The extension of malignancy were equally well correlated MDCT with MR imaging. The diagnostic value of chest MDCT for preoperative staging is comparable with MR imaging for the detection and extension of lesions. Therefore, chest MDCT of breast cancer can add to the information obtained from

Traumatic rupture of the diaphragm: CT findings

International Nuclear Information System (INIS)

Cho, Sung Tae; Kim, Sung Jin; Cha, Sang Hoon; Park, Kil Sun; Kim, Jin Hee; Yim, Se Hwan

1995-01-01

The aim of this study was to assess the clinical utility of the known CT signs of the traumatic rupture of the diaphragm. CT scans and chest radiographs were retrospectively reviewed in 13 patients who had diaphragmatic rupture confirmed by surgery. On chest radiographs the elevation of the diaphragm was evaluated. On CT, 1) discontinuity of the diaphragm, 2) lack of depiction of the diaphragm surrounding the herniated intraabdominal organs (absent diaphragm sign), and 3) fat seen lateral to the diaphragm (fat sign) were evaluated. Chest radiographs showed the elevation of the diaphragm in 11 patients (85%). CT scan showed absent diaphragm sign in 11 patients (85%), discontinuity of the diaphragm in 8 (62%), and fat sign in 7 (54%). All of 12 patients who had the left diaphragmatic rupture had one or more of the above findings. Discontinuity of the diaphragm, absent diaphragm sign, and fat sign may be helpful CT findings in the diagnosis of the traumatic rupture of the left diaphragm

Chest pain

International Nuclear Information System (INIS)

Martinez A, Juan Carlos; Saenz M, Oscar; Martinez M, Camilo; Gonzales A Francisco; Nicolas R, Jose; Vergara V, Erika P; Pereira G, Alberto M

2010-01-01

In emergency departments, chest pain is one of the leading motives of consultation. We thus consider it important to review aspects such as its classification, causes, and clinical profiles. Initial assessment should include a full clinical history comprising thorough anamnesis and physical examination. Adequate interpretation of auxiliary tests, ordered in accordance with suspected clinical conditions, should lead to accurate diagnosis. We highlight certain symptoms and clinical signs, ECG and X-ray findings, cardiac bio markers, arterial blood gases, and CT-scanning. Scores of severity and prognosis such as TIMI are assessed. Optimal treatment of the clinical conditions leading to chest pain depends on adequate initial approach and assessment.

Radiology illustrated. Chest radiology

International Nuclear Information System (INIS)

Lee, Kyung Soo; Han, Joungho; Chung, Man Pyo; Jeong, Yeon Joo

2014-01-01

Pattern approach to the diagnosis of lung diseases based on CT scan appearances. Guide to quick and reliable differential diagnosis. CT-pathology correlation. Emphasis on state-of-the-art MDCT. The purpose of this atlas is to illustrate how to achieve reliable diagnoses when confronted by the different abnormalities, or ''disease patterns'', that may be visualized on CT scans of the chest. The task of pattern recognition has been greatly facilitated by the advent of multidetector CT (MDCT), and the focus of the book is very much on the role of state-of-the-art MDCT. A wide range of disease patterns and distributions are covered, with emphasis on the typical imaging characteristics of the various focal and diffuse lung diseases. In addition, clinical information relevant to differential diagnosis is provided and the underlying gross and microscopic pathology is depicted, permitting CT-pathology correlation. The entire information relevant to each disease pattern is also tabulated for ease of reference. This book will be an invaluable handy tool that will enable the reader to quickly and easily reach a diagnosis appropriate to the pattern of lung abnormality identified on CT scans.

Ultra-high pitch chest computed tomography at 70 kVp tube voltage in an anthropomorphic pediatric phantom and non-sedated pediatric patients: Initial experience with 3rd generation dual-source CT.

Science.gov (United States)

Hagelstein, Claudia; Henzler, Thomas; Haubenreisser, Holger; Meyer, Mathias; Sudarski, Sonja; Schoenberg, Stefan O; Neff, K Wolfgang; Weis, Meike

2016-12-01

Minimizing radiation dose while at the same time preserving image quality is of particular importance in pediatric chest CT. Very recently, CT imaging with a tube voltage of 70 kVp has become clinically available. However, image noise is inversely proportional to the tube voltage. We aimed to investigate radiation dose and image quality of pediatric chest CT performed at 70 kVp in an anthropomorphic pediatric phantom as well as in clinical patients. An anthropomorphic pediatric phantom, which resembles a one-year-old child in physiognomy, was scanned on the 3 rd generation dual-source CT (DSCT) system at 70 kVp and 80 kVp and a fixed ultra low tube-current of 8 mAs to solely evaluate the impact of lowering tube voltage. After the phantom measurements, 18 pediatric patients (mean 29.5 months; range 1-91 months; 21 examinations) underwent 3.2 high-pitch chest CT on the same DSCT system at 70 kVp tube voltage without any sedation. Radiation dose and presence of motion artifacts was compared to a retrospectively identified patient cohort examined at 80 kVp on a 16-slice single-source-CT (SSCT; n=15; 14/15 with sedation; mean 30.7 months; range 0-96 months; pitch=1.5) or on a 2 nd generation DSCT without any sedation (n=6; mean 32.8 months; range 4-61 months; pitch=3.2). Radiation dose in the phantom scans was reduced by approximately 40% when using a tube voltage of 70 kVp instead of 80 kVp. In the pediatric patient group examined at 70 kVp age-specific effective dose (ED; mean 0.5±0.2 mSv) was significantly lower when compared to the retrospective cohort scanned at 80 kVp on the 16-slice-SSCT (mean ED: 1.0±0.3 mSv; pCT examinations showed any motion artifacts whereas 13/15 examinations of the retrospective patient cohort scanned at 80 kVp with a pitch of 1.5 showed motion artifacts. 3.2 high-pitch chest CT performed with 70 kVp significantly reduces radiation dose when compared to 80 kVp while at the same time provides good image quality without any motion artifacts

Chest computed tomography-based scoring of thoracic sarcoidosis: Inter-rater reliability of CT abnormalities

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Heuvel, D.A.V. den; Es, H.W. van; Heesewijk, J.P. van; Spee, M. [St. Antonius Hospital Nieuwegein, Department of Radiology, Nieuwegein (Netherlands); Jong, P.A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Zanen, P.; Grutters, J.C. [University Medical Center Utrecht, Division Heart and Lungs, Utrecht (Netherlands); St. Antonius Hospital Nieuwegein, Center of Interstitial Lung Diseases, Department of Pulmonology, Nieuwegein (Netherlands)

2015-09-15

To determine inter-rater reliability of sarcoidosis-related computed tomography (CT) findings that can be used for scoring of thoracic sarcoidosis. CT images of 51 patients with sarcoidosis were scored by five chest radiologists for various abnormal CT findings (22 in total) encountered in thoracic sarcoidosis. Using intra-class correlation coefficient (ICC) analysis, inter-rater reliability was analysed and reported according to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) criteria. A pre-specified sub-analysis was performed to investigate the effect of training. Scoring was trained in a distinct set of 15 scans in which all abnormal CT findings were represented. Median age of the 51 patients (36 men, 70 %) was 43 years (range 26 - 64 years). All radiographic stages were present in this group. ICC ranged from 0.91 for honeycombing to 0.11 for nodular margin (sharp versus ill-defined). The ICC was above 0.60 in 13 of the 22 abnormal findings. Sub-analysis for the best-trained observers demonstrated an ICC improvement for all abnormal findings and values above 0.60 for 16 of the 22 abnormalities. In our cohort, reliability between raters was acceptable for 16 thoracic sarcoidosis-related abnormal CT findings. (orig.)

Chest computed tomography-based scoring of thoracic sarcoidosis: Inter-rater reliability of CT abnormalities

International Nuclear Information System (INIS)

Heuvel, D.A.V. den; Es, H.W. van; Heesewijk, J.P. van; Spee, M.; Jong, P.A. de; Zanen, P.; Grutters, J.C.

2015-01-01

To determine inter-rater reliability of sarcoidosis-related computed tomography (CT) findings that can be used for scoring of thoracic sarcoidosis. CT images of 51 patients with sarcoidosis were scored by five chest radiologists for various abnormal CT findings (22 in total) encountered in thoracic sarcoidosis. Using intra-class correlation coefficient (ICC) analysis, inter-rater reliability was analysed and reported according to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) criteria. A pre-specified sub-analysis was performed to investigate the effect of training. Scoring was trained in a distinct set of 15 scans in which all abnormal CT findings were represented. Median age of the 51 patients (36 men, 70 %) was 43 years (range 26 - 64 years). All radiographic stages were present in this group. ICC ranged from 0.91 for honeycombing to 0.11 for nodular margin (sharp versus ill-defined). The ICC was above 0.60 in 13 of the 22 abnormal findings. Sub-analysis for the best-trained observers demonstrated an ICC improvement for all abnormal findings and values above 0.60 for 16 of the 22 abnormalities. In our cohort, reliability between raters was acceptable for 16 thoracic sarcoidosis-related abnormal CT findings. (orig.)

Application of Super-Resolution Convolutional Neural Network for Enhancing Image Resolution in Chest CT.

Science.gov (United States)

Umehara, Kensuke; Ota, Junko; Ishida, Takayuki

2017-10-18

In this study, the super-resolution convolutional neural network (SRCNN) scheme, which is the emerging deep-learning-based super-resolution method for enhancing image resolution in chest CT images, was applied and evaluated using the post-processing approach. For evaluation, 89 chest CT cases were sampled from The Cancer Imaging Archive. The 89 CT cases were divided randomly into 45 training cases and 44 external test cases. The SRCNN was trained using the training dataset. With the trained SRCNN, a high-resolution image was reconstructed from a low-resolution image, which was down-sampled from an original test image. For quantitative evaluation, two image quality metrics were measured and compared to those of the conventional linear interpolation methods. The image restoration quality of the SRCNN scheme was significantly higher than that of the linear interpolation methods (p < 0.001 or p < 0.05). The high-resolution image reconstructed by the SRCNN scheme was highly restored and comparable to the original reference image, in particular, for a ×2 magnification. These results indicate that the SRCNN scheme significantly outperforms the linear interpolation methods for enhancing image resolution in chest CT images. The results also suggest that SRCNN may become a potential solution for generating high-resolution CT images from standard CT images.

Quantification of pneumothorax volume on chest radiographs: comparison between the collins' and the axel's methods with three-dimensional CT as the standard of reference

International Nuclear Information System (INIS)

Lee, Chang Keun; Kim, Hyung Jin; Lee, Kyung Hee; Kim, Joung Taek; Kim, Kwang Ho; Suh, Chang Hae; Han, Heon

1999-01-01

The purpose of this study was twofold. In a preliminary study, we evaluated the accuracy of 3-D (three-dimensional) CT for the estimation of pneumothorax volume and for providing the optimal postprocessing method for clinical study. In the clinical study, we determined which of the two methods, Collins' and Axel's, was more accurate for the estimation of pneumothorax volume, as seen on chest radiographs, using 3-D CT as the standard of reference. In the preliminary study, 3-D CT was applied to phantoms and to four patients with pneumothorax using two different postprocessing methods, manual contour delineation and thresholding. In the clinical study, 3-D CT was performed in 13 patients with pneumothorax. For the purpose of evaluating conventional radiographs, a localizer scan was used for comparing the accuracy of Collins' method with that of Axel's method, with 3-D CT as the standard of reference. The preliminary study revealed that 3-D CT estimated pneumothorax volume with great accuracy and that manual contour delineation and thresholding measured volume equally well. Because of the shorter postprocessing time required with thresholding than with manual contour delineation (5 min versus 30 min), the former was used during clinical study. The results of this indicated close correlation between the measurements obtained using Collins' method on chest radiographs and those obtained by 3-D CT(r=0.95, p 0.05). 3-D CT can estimate pneumothorax volume with great accuracy. Collins' method is superior to Axel's method for the quantification of pneumothorax volume as seen on chest radiographs

Case of multiple hepatic abscesses detected by CT scan in the patient with acute lymphoblastic leukemia

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Saburi, Yoshio; Shuto, Ryusuke; Mizutani, Ryoko; Hosokawa, Takafumi; Itoga, Takashi (Medical Coll. of Oita (Japan))

1983-12-01

A 34 year old man admitted to a hospital on 21 Feb. 1983 was diagnosed acute lymphoblastic leukemia. A hematological complete remission was achieved by combination therapy of vincristine, prednisolone and L-asparaginase. However, he had been complaining of high fever and right hypochondralgia since early in Apr. 1983, and it was revealed that elevation of right diaphragm on chest X-ray. Therefore, he was also given several antibiotics (CPZ, TOB, LMOX, PIPC, LCM, AMK, MINO and GM) for complication of probable liver abscess. Remittent fever persisted in spite of as mentioned above various antibiotics. The multiple hepatic abscesses were found by CT scan of the mid-abdomen as the low density lesions, but bacterial cultures detected no pathogens. His complaining of remittent fever and right hypochondralgia were improved by treatment with Miconazole during about one month, and decreasing in size and number of multiple hepatic abscesses were found by CT scan. Though we could not determine clearly, but suspected that multiple hepatic abscesses were due to fungus infection, by reason of therapeutic result. Regarding the complication of hepatic abscesses with leukemia, 5 cases have been reported in Japan, and one case out of 5 cases were detected by CT scan. We thought that CT scans were useful procedures for early diagnosis of hepatic abscesses. Recently, the patient has continued complete remission hematologically.

Changes in Cross-Sectional Area and Transverse Diameter of the Heart on Inspiratory and Expiratory Chest CT: Correlation with Changes in Lung Size and Influence on Cardiothoracic Ratio Measurement.

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Hayato Tomita

Full Text Available The aim of this study was to investigate physiological changes in cardiac area and diameters between inspiratory and expiratory chest computed tomography (CT, and to assess their correlation with lung size change and influence on cardiothoracic ratio (CTR measurements.The institutional review board of our institution approved this study, and informed consent was waived. Forty-three subjects underwent inspiratory and expiratory chest CT as part of routine clinical care. On both inspiratory and expiratory scans, lung volumes and maximum lung diameters (transverse and vertical directions were measured. The maximum cardiac cross-sectional area (CSA and the maximum transverse cardiac diameter were measured on both scans, and the CT-based CTR was calculated. Changes in the lung and cardiac measurements were expressed as the expiratory/inspiratory (E/I ratios. Comparisons between inspiratory and expiratory measurements were made by the Wilcoxon signed-rank test. Correlations between the E/I ratios of lung and heart measurements were evaluated by Spearman's rank correlation analysis.Cardiac CSA and transverse cardiac diameter was significantly larger on expiratory than on inspiratory CT (p < 0.0001. Significant negative correlations were found between the E/I ratios of these cardiac measurements and the E/I ratios of lung volume and vertical lung diameter (p < 0.01. CT-based CTR was significantly larger on expiration than on inspiration (p < 0.0001.Heart size on chest CT depends on the phase of ventilation, and is correlated with changes in lung volume and craniocaudal lung diameter. The CTR is also significantly influenced by ventilation.

Radiation dose levels in pediatric chest CT: experience in 499 children evaluated with dual-source single-energy CT

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Martine, Remy-Jardin; Colas, Lucie; Jean-Baptiste, Faivre; Remy, Jacques [CHU Lille (EA 2694) University of Lille, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Santangelo, Teresa [CHU Lille (EA 2694) University of Lille, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Bambino Gesu Children' s Hospital, Department of Imaging, Rome (Italy); Duhamel, Alain [University of Lille (EA 2694), Department of Biostatistics, CHU Lille, Lille (France); Deschildre, Antoine [CHU Lille - University of Lille, Department of Pediatric Pulmonology, Lille (France)

2017-02-15

The availability of dual-source technology has introduced the possibility of scanning children at lower kVp with a high-pitch mode, combining high-speed data acquisition and high temporal resolution. To establish the radiation dose levels of dual-source, single-energy chest CT examinations in children. We retrospectively recorded the dose-length product (DLP) of 499 consecutive examinations obtained in children <50 kg, divided into five weight groups: group 1 (<10 kg, n = 129); group 2 (10-20 kg, n = 176); group 3 (20-30 kg, n = 99), group 4 (30-40 kg, n = 58) and group 5 (40-49 kg, n = 37). All CT examinations were performed with high temporal resolution (75 ms), a high-pitch mode and a weight-adapted selection of the milliamperage. CT examinations were obtained at 80 kVp with a milliamperage ranging between 40 mAs and 90 mAs, and a pitch of 2.0 (n = 162; 32.5%) or 3.0 (n = 337; 67.5%). The mean duration of data acquisition was 522.8 ± 192.0 ms (interquartile range 390 to 610; median 490). In the study population, the mean CT dose index volume (CTDIvol{sub 32}) was 0.83 mGy (standard deviation [SD] 0.20 mGy; interquartile range 0.72 to 0.94; median 0.78); the mean DLP{sub 32} was 21.4 mGy.cm (SD 9.1 mGy.cm; interquartile range 15 to 25; median 19.0); and the mean size-specific dose estimate (SSDE) was 1.7 mGy (SD 0.4 mGy; interquartile range 1.5 to 1.9; median 1.7). The DLP{sub 32}, CTDI{sub vol32} and SSDE were found to be statistically significant in the five weight categories (P < 0.0001). This study establishes the radiation dose levels for dual-source, single-kVp chest CT from a single center. In the five weight categories, the median values varied 15-37 mGy.cm for the DLP{sub 32}, 0.78-1.25 mGy for the CTDI{sub vol32} and 1.6-2.1 mGy for the SSDE. (orig.)

Radiation dose levels in pediatric chest CT: experience in 499 children evaluated with dual-source single-energy CT

International Nuclear Information System (INIS)

Martine, Remy-Jardin; Colas, Lucie; Jean-Baptiste, Faivre; Remy, Jacques; Santangelo, Teresa; Duhamel, Alain; Deschildre, Antoine

2017-01-01

The availability of dual-source technology has introduced the possibility of scanning children at lower kVp with a high-pitch mode, combining high-speed data acquisition and high temporal resolution. To establish the radiation dose levels of dual-source, single-energy chest CT examinations in children. We retrospectively recorded the dose-length product (DLP) of 499 consecutive examinations obtained in children <50 kg, divided into five weight groups: group 1 (<10 kg, n = 129); group 2 (10-20 kg, n = 176); group 3 (20-30 kg, n = 99), group 4 (30-40 kg, n = 58) and group 5 (40-49 kg, n = 37). All CT examinations were performed with high temporal resolution (75 ms), a high-pitch mode and a weight-adapted selection of the milliamperage. CT examinations were obtained at 80 kVp with a milliamperage ranging between 40 mAs and 90 mAs, and a pitch of 2.0 (n = 162; 32.5%) or 3.0 (n = 337; 67.5%). The mean duration of data acquisition was 522.8 ± 192.0 ms (interquartile range 390 to 610; median 490). In the study population, the mean CT dose index volume (CTDIvol 32 ) was 0.83 mGy (standard deviation [SD] 0.20 mGy; interquartile range 0.72 to 0.94; median 0.78); the mean DLP 32 was 21.4 mGy.cm (SD 9.1 mGy.cm; interquartile range 15 to 25; median 19.0); and the mean size-specific dose estimate (SSDE) was 1.7 mGy (SD 0.4 mGy; interquartile range 1.5 to 1.9; median 1.7). The DLP 32 , CTDI vol32 and SSDE were found to be statistically significant in the five weight categories (P < 0.0001). This study establishes the radiation dose levels for dual-source, single-kVp chest CT from a single center. In the five weight categories, the median values varied 15-37 mGy.cm for the DLP 32 , 0.78-1.25 mGy for the CTDI vol32 and 1.6-2.1 mGy for the SSDE. (orig.)

Lung cancer detection with digital chest tomosynthesis: first round results from the SOS observational study.

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Bertolaccini, Luca; Viti, Andrea; Tavella, Chiara; Priotto, Roberto; Ghirardo, Donatella; Grosso, Maurizio; Terzi, Alberto

2015-04-01

Baseline results of the Studio OSservazionale (SOS), observational study, a single-arm observational study of digital chest tomosynthesis for lung cancer detection in an at-risk population demonstrated a detection rate of lung cancer comparable to that of studies that used low dose CT scan (LDCT). We present the results of the first round. Totally 1,703 out of 1,843 (92%) subjects who had a baseline digital chest tomosynthesis underwent a first round reevaluation after 1 year. At first round chest digital tomosynthesis, 13 (0.7%) subjects had an indeterminate nodule larger than 5 mm and underwent low-dose CT scan for nodule confirmation. PET/CT study was obtained in 10 (0.5%) subjects and 2 subjects had a low-dose CT follow up. Surgery, either video-assisted thoracoscopic or open surgery for indeterminate pulmonary nodules was performed in 10 (0.2%) subjects. A lung cancer was diagnosed and resected in five patients. The lung cancer detection rate at first round was 0.3% (5/1,703). The detection rate of lung cancer at first round for tomosynthesis is comparable to rates reported for CT. In addition, results of first round digital chest tomosynthesis confirm chest tomosynthesis as a possible first-line lung cancer-screening tool.

Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia.

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Esayag, Yaacov; Nikitin, Irina; Bar-Ziv, Jacob; Cytter, Ruth; Hadas-Halpern, Irith; Zalut, Todd; Yinnon, Amos M

2010-01-01

To assess the diagnostic value of the chest radiograph for the diagnosis of pneumonia in bedridden patients, using non-contrast-enhanced high-resolution chest computed tomography (CT) as the gold standard. We prospectively evaluated bedridden patients hospitalized with moderate to high clinical probability of pneumonia. Chest radiographs were interpreted in a blinded fashion by 3 observers and classified as definite, normal, or uncertain for pneumonia. Chest CT was obtained within 12 hours of chest radiograph. We applied Bayesian analysis to assess the accuracy of chest radiograph in the diagnosis of pneumonia. In a 5-month period, 58 patients were evaluated, 31 (53%) were female. Their chest radiographs were interpreted as negative, uncertain, or positive for pneumonia in 31 (53%), 15 (26%), and 12 (21%) patients, respectively, while CT confirmed pneumonia in 11 (35%), 10 (67%), and in 10 (83%). The sensitivity of the chest radiograph to diagnose pneumonia was 65%, the specificity was 93%, the positive and negative predictive values were, respectively, 83% and 65%, while the overall accuracy was 69% (95% confidence interval, 50%-79%). In bedridden patients with suspected pneumonia, a normal chest radiograph does not rule out the diagnosis, hence, a chest CT scan might provide valuable diagnostic information. Copyright 2010 Elsevier Inc. All rights reserved.

Influence of MR imaging in radiation therapy of chest lymphoma

International Nuclear Information System (INIS)

Carlsen, S.E.; Hoppe, R.; Bergin, C.J.

1991-01-01

This paper evaluates the influence of MR detection of additional sites of chest lymphoma on radiation therapy. Chest MR images and CT scans of 56 patients with new or recurrent mediastinal lymphoma obtained within 1 month of each other were retrospectively reviewed. MR images included T1- and T2-weighted SE and STIR sequences. Images were assessed for pleural and extrapleural disease. Radiation portals of patients with pleural or chest wall disease were reevaluated and compared with portals originally designed with CT. MR imaging demonstrated chest wall disease in 15 patients (21 sites). Ten patients also had pleural disease (13 sites). CT identified chest wall disease in four of these patients (five sites) and pleural disease in three patients (five sites). Seven of the 15 patients with chest wall disease were treated with radiation therapy alone. Two of the seven patients had significant modification of radiation portals based on MR findings. Retrospectively, therapy would have been altered in an additional two patients in whom pleural disease was identified at MR. The increased sensitivity of MR in detecting chest wall or pleural disease has important implications for treatment planning in chest wall lymphoma

Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients

International Nuclear Information System (INIS)

D'Agostino, A.G.; Remy-Jardin, M.; Khalil, C.; Remy, J.; Delannoy-Deken, V.; Duhamel, A.; Flohr, T.

2006-01-01

The purpose of this study was to evaluate image quality of low-dose electrocardiogram (ECG)-gated multislice helical computed tomography (CT) angiograms of the chest. One hundred and five consecutive patients with a regular sinus rhythm (72 men; 33 women) underwent ECG-gated CT angiographic examination of the chest without administration of beta blockers using the following parameters: (a) collimation 32 x 0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.6-mm slices, rotation time 0.33 s, pitch 0.3; (b) 120 kV, 200 mAs; (c) use of two dose modulation systems, including adjustment of the mAs setting to the patient's size and anatomical shape and an ECG-controlled tube current. Subjective and objective image quality was evaluated by two radiologists in consensus on 3-mm-thick scans reconstructed at 55% of the response rate (RR) interval. The population and protocol characteristics included: (a) a mean [±standard deviation (SD)] body mass index (BMI) of 24.47 (±4.64); (b) a mean (±SD) heart rate of 72.04 (±15.76) bpm; (c) a mean (±SD) scanning time of 18.3 (±2.73) s; (d) a mean (±SD) dose-length product (DLP) value of 260.57 (±83.67) mGy/cm; (e) an estimated average effective dose of 4.95 (±1.59) mSv. Subjective noise was depicted in a total of nine examinations (8.5%), always rated as mild. Objective noise was assessed by measuring the standard deviation of pixel values in a homogeneous region of interest within the trachea and descending aorta; SD was 15.91 HU in the trachea and 22.16 HU in the descending aorta, with no significant difference in the mean value of the standard deviations between the four categories of BMI except for obese patients, who had a higher mean SD within the aorta. Interpolation artefacts were depicted in 22 patients, with a mean heart rate significantly lower than that of patients without interpolation artifacts, rated as mild in 11 patients and severe in 11 patients. The severity of interpolation artefacts

Pediatric CT Scans

Science.gov (United States)

The Radiation Epidemiology Branch and collaborators have initiated a retrospective cohort study to evaluate the relationship between radiation exposure from CT scans conducted during childhood and adolescence and the subsequent development of cancer.

Pulmonary manifestations in HIV patients: The role of chest films, CT and HRCT

International Nuclear Information System (INIS)

Kauczor, H.U.; Schnuetgen, M.; Fischer, B.; Schwickert, H.C.; Haertel, S.; Schadmand-Fischer, S.; Gerken, G.; Schweden, F.

1995-01-01

64 HIV patients were examined prospectively. 15 had no respiratory symptoms (group I), 30 had non-specific respiratory symptoms (group II), 19 complained of dyspnoea (group III). Chest radiographs and CT were performed within a week. In patients with positive findings, bronchoscopy was carried out with bacteriological and histological examinations. In group I, 13% of chest radiographs and 40% of CT's showed infiltrative changes. In group II, the figures were 27% and 57% respectively. In group III, abnormalities were found in all cases by both examinations. (orig./MG) [de

Thallium myocardial scanning in the emergency department evaluation of chest pain

International Nuclear Information System (INIS)

Mace, S.E.

1989-01-01

Chest pain is a common complaint of patients seen in the emergency department. The causes are legion, and range from the non-life threatening to the potentially catastrophic. Thallium heart scanning was done prospectively in 20 patients with a ''classic'' history for myocardial infarction (eight patients) or atypical chest pain and/or associated symptoms plus an abnormal ECG (12 patients) to discern a subset of patients from whom thallium scintography may be indicated in the emergency department. Although further investigation is needed, our preliminary study suggests that myocardial scanning with thallium can be a safe, fairly rapid, and useful objective parameter in the emergency department detection of suspected myocardial infarction, and in differential diagnosis of chest pain when other data such as the history, physical examination, ECG, or enzymes are inconclusive

Heart CT scan

Science.gov (United States)

... make to decrease the risk of heart disease. Risks Risks of CT scans include: Being exposed to ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

Fluid Collection in the Right Lateral Portion of the Superior Aortic Recess Mimicking a Right Mediastinal Mass: Assessment with Chest Posterior Anterior and MDCT

International Nuclear Information System (INIS)

Shn, Dong Rock; Ryu, Dae Shick; Park, Man Soo; Jung, Seung Mun; Ahn, Jae Hong; Lee, Jong Hyeog; Choi, Soo Jung

2012-01-01

We observed patients in whom the fluid collection in the right lateral portion of the superior aortic recess on computed tomography (CT) scans mimicked a right anterior mediastinal mass on chest PA radiographs. The purpose of this study was to assess chest PA and CT features of these patients. All chest PA radiographs and CT scans in 9 patients were reviewed by two radiologists on a consensus basis; for the presence of pleural effusion, pulmonary edema and heart size on chest PA radiographs. For the portion of the fluid collection in the superior aortic recess (SAR), a connection between the right lateral portion of the SAR (rSAR) and posterior portion of the SAR (pSAR) on CT scans, and the distance between the right lateral margin of the rSAR and the right lateral margin of the superior vena cava. Fluid collection in the rSAR on CT scans caused a right anterior mediastinal mass or a bulging contour on chest PA radiographs in all women patients. All patients showed cardiomegaly, five patients had pleural effusion, and two patients had mild pulmonary edema. Further, eight patients showed a connection between the rSAR and the pSAR. The characteristic features of these patients are the right anterior mediastinal mass-like opacity due to fluid collection in the rSAR, are bulging contour with a smooth margin and cardiomegaly regardless of pulmonary edema on the chest PA radiographs, and fluid connection between the rSAR and the pSAR on CT scans

Fluid Collection in the Right Lateral Portion of the Superior Aortic Recess Mimicking a Right Mediastinal Mass: Assessment with Chest Posterior Anterior and MDCT

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Shn, Dong Rock; Ryu, Dae Shick; Park, Man Soo; Jung, Seung Mun; Ahn, Jae Hong; Lee, Jong Hyeog; Choi, Soo Jung [Dept. of Radiology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung (Korea, Republic of)

2012-09-15

We observed patients in whom the fluid collection in the right lateral portion of the superior aortic recess on computed tomography (CT) scans mimicked a right anterior mediastinal mass on chest PA radiographs. The purpose of this study was to assess chest PA and CT features of these patients. All chest PA radiographs and CT scans in 9 patients were reviewed by two radiologists on a consensus basis; for the presence of pleural effusion, pulmonary edema and heart size on chest PA radiographs. For the portion of the fluid collection in the superior aortic recess (SAR), a connection between the right lateral portion of the SAR (rSAR) and posterior portion of the SAR (pSAR) on CT scans, and the distance between the right lateral margin of the rSAR and the right lateral margin of the superior vena cava. Fluid collection in the rSAR on CT scans caused a right anterior mediastinal mass or a bulging contour on chest PA radiographs in all women patients. All patients showed cardiomegaly, five patients had pleural effusion, and two patients had mild pulmonary edema. Further, eight patients showed a connection between the rSAR and the pSAR. The characteristic features of these patients are the right anterior mediastinal mass-like opacity due to fluid collection in the rSAR, are bulging contour with a smooth margin and cardiomegaly regardless of pulmonary edema on the chest PA radiographs, and fluid connection between the rSAR and the pSAR on CT scans.

Children's (Pediatric) CT (Computed Tomography)

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Full Text Available ... vessels. CT scans may be performed on newborns, infants and older children. top of page What are ... heart and blood vessels in children, even newborn infants. Except for the chest x-ray, CT is ...

Evaluation of image quality and radiation dose by adaptive statistical iterative reconstruction technique level for chest CT examination.

Science.gov (United States)

Hong, Sun Suk; Lee, Jong-Woong; Seo, Jeong Beom; Jung, Jae-Eun; Choi, Jiwon; Kweon, Dae Cheol

2013-12-01

The purpose of this research is to determine the adaptive statistical iterative reconstruction (ASIR) level that enables optimal image quality and dose reduction in the chest computed tomography (CT) protocol with ASIR. A chest phantom with 0-50 % ASIR levels was scanned and then noise power spectrum (NPS), signal and noise and the degree of distortion of peak signal-to-noise ratio (PSNR) and the root-mean-square error (RMSE) were measured. In addition, the objectivity of the experiment was measured using the American College of Radiology (ACR) phantom. Moreover, on a qualitative basis, five lesions' resolution, latitude and distortion degree of chest phantom and their compiled statistics were evaluated. The NPS value decreased as the frequency increased. The lowest noise and deviation were at the 20 % ASIR level, mean 126.15 ± 22.21. As a result of the degree of distortion, signal-to-noise ratio and PSNR at 20 % ASIR level were at the highest value as 31.0 and 41.52. However, maximum absolute error and RMSE showed the lowest deviation value as 11.2 and 16. In the ACR phantom study, all ASIR levels were within acceptable allowance of guidelines. The 20 % ASIR level performed best in qualitative evaluation at five lesions of chest phantom as resolution score 4.3, latitude 3.47 and the degree of distortion 4.25. The 20 % ASIR level was proved to be the best in all experiments, noise, distortion evaluation using ImageJ and qualitative evaluation of five lesions of a chest phantom. Therefore, optimal images as well as reduce radiation dose would be acquired when 20 % ASIR level in thoracic CT is applied.

Analyize manifestations of DR and CT of 20 cases of bronchioloalveolar carcinoma

International Nuclear Information System (INIS)

Yang Zhongcheng

2006-01-01

Objective: Exploring the characters and changing rules between DR chest fluoroscopy and CT of bronchioloalveolar carcinoma. Methods: Collecting 20 cases DR chest fluoroscopies and CT scanning results of bron-chioloalveolar carcinoma, proved by biopsy, to reviewing analysis. Results: Bronchioloalveolar carcinoma divided into 3 types, nodular type, diffused type, infiltrated type. Nodular type focuses congregate and fused into node, density of the nodular shadow bad-distributed, vesical low-density shadow showed; Diffused type focus, multiple diffused nodish shadow gradually fused into patech consolidated shadow;Infiltrated focus distributed to pulmonary segment or lobes,like common pneumonia feature, existed airobronchogram, CT contrast scan shows typical 'CT angiogram'. Conclusion: No matter which type: nodular, diffused or infiltrated type, whose DR chest fluoroscopy and CT exists some features: Nodular type, DR chest fluoroscopy shows focuses mostly in periphery of pulmonary, margin with burr and plueral sunken sign, and whose HRCT manifestationshows typical small vesical sign in mediastinal window; Diffused type, DR chest fluoroscopy shows multiple diffused granular nodish shadow, however, CT manifestation can find more multiple focus than DR chest fluoroscopy, typical manifestation of HRCT is extensive small nodular shadow, with the thicken lobular interal; Infiltrated focus: DR chest fluoroscopy shows pulmonary consolidation and airobronchogram, And CT manifestations are CT angiogram and low-density consolidation shadow, wth specific property. Master all types of manifestation of DR and CT of bronchioloalveolar carcinoma, can help you improve the diagnosis of bronchioloalveolar carcinoma. (authors)

CT staging of lung cancer: the role of artificial pneumothorax

International Nuclear Information System (INIS)

Lee, Jin Seong; Im, Jung Gi; Han, Man Chung

1991-01-01

To determine the role of artificially induced pneumothorax in the evaluation of the chest wall and mediastinal invasion in patients with peripheral bronchogenic carcinoma. CT scans of 22 patients obtained after induced pneumothorax were evaluated. All patients had peripheral lung mass abutting the pleura on a routine CT scan. Room air of 200-400ml was introduced through intrathoracic negative pressure initially, followed by pressure injection through the 18 gauge long bevelled needle under fluoroscopic control. Conclusively, CT with artificial pneumothorax added more information than conventional CT in the evaluation of the chest wall or mediastinal invasion by lung cancer without notable risk

Ultra-high pitch chest computed tomography at 70 kVp tube voltage in an anthropomorphic pediatric phantom and non-sedated pediatric patients. Initial experience with 3{sup rd} generation dual-source CT

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Hagelstein, Claudia; Henzler, Thomas; Haubenreisser, Holger; Meyer, Mathias; Sudarski, Sonja; Schoenberg, Stefan O.; Neff, K. Wolfgang; Weis, Meike [Univ. Medical Center Mannheim (Germany). Inst. of Clinical Radiology and Nuclear Medicine

2016-07-01

Minimizing radiation dose while at the same time preserving image quality is of particular importance in pediatric chest CT. Very recently, CT imaging with a tube voltage of 70 kVp has become clinically available. However, image noise is inversely proportional to the tube voltage. We aimed to investigate radiation dose and image quality of pediatric chest CT performed at 70 kVp in an anthropomorphic pediatric phantom as well as in clinical patients. An anthropomorphic pediatric phantom, which resembles a one-year-old child in physiognomy, was scanned on the 3{sup rd} generation dual-source CT (DSCT) system at 70 kVp and 80 kVp and a fixed ultra low tube-current of 8 mAs to solely evaluate the impact of lowering tube voltage. After the phantom measurements, 18 pediatric patients (mean 29.5 months; range 1-91 months; 21 examinations) underwent 3.2 high-pitch chest CT on the same DSCT system at 70 kVp tube voltage without any sedation. Radiation dose and presence of motion artifacts was compared to a retrospectively identified patient cohort examined at 80 kVp on a 16-slice single-source-CT (SSCT; n = 15; 14/15 with sedation; mean 30.7 months; range 0-96 months; pitch = 1.5) or on a 2{sup nd} generation DSCT without any sedation (n = 6; mean 32.8 months; range 4-61 months; pitch = 3.2). Radiation dose in the phantom scans was reduced by approximately 40% when using a tube voltage of 70 kVp instead of 80 kVp. In the pediatric patient group examined at 70 kVp age-specific effective dose (ED; mean 0.5 ± 0.2 mSv) was significantly lower when compared to the retrospective cohort scanned at 80 kVp on the 16-slice-SSCT (mean ED: 1.0 ± 0.3 mSv; p < 0.0001) and also considerably lower when compared to the cohort scanned at 80 kVp on the 2{sup nd} generation DSCT (mean ED: 0.9 ± 0.5 mSv). None of the prospective, sedation-free CT examinations showed any motion artifacts whereas 13/15 examinations of the retrospective patient cohort scanned at 80 kVp with a pitch of 1

Incremental Role of Mammography in the Evaluation of Gynecomastia in Men Who Have Undergone Chest CT.

Science.gov (United States)

Sonnenblick, Emily B; Salvatore, Mary; Szabo, Janet; Lee, Karen A; Margolies, Laurie R

2016-08-01

The purpose of this study was to determine whether additional breast imaging is clinically valuable in the evaluation of patients with gynecomastia incidentally observed on CT of the chest. In a retrospective analysis, 62 men were identified who had a mammographic diagnosis of gynecomastia and had also undergone CT within 8 months (median, 2 months). We compared the imaging findings of both modalities and correlated them with the clinical outcome. Gynecomastia was statistically significantly larger on mammograms than on CT images; however, there was a high level of concordance in morphologic features and distribution of gynecomastia between mammography and CT. In only one case was gynecomastia evident on mammographic but not CT images, owing to cachexia. Two of the 62 men had ductal carcinoma, which was obscured by gynecomastia. Both of these patients had symptoms suggesting malignancy. The appearance of gynecomastia on CT scans and mammograms was highly correlated. Mammography performed within 8 months of CT is unlikely to reveal cancer unless there is a suspicious clinical finding or a breast mass eccentric to the nipple. Men with clinical symptoms of gynecomastia do not need additional imaging with mammography to confirm the diagnosis if they have undergone recent cross-sectional imaging.

Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan

International Nuclear Information System (INIS)

Marini, Davide; Agnoletti, Gabriella; Brunelle, Francis; Sidi, Daniel; Bonnet, Damien; Ou, Phalla

2009-01-01

Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery. Population and methods: Fifteen consecutive children (8 male and 7 female; age 9.2 ± 6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8 ± 3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard. Results: CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography. Conclusion: In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surgery.

CT-morphological characterization of respiratory syncytial virus (RSV) pneumonia in immune-compromised adults; Morphologische Charakterisierung und Verlaufsbeurteilung von Respiratory Syncytial Virus (RSV) Pneumonien bei immunkompromittierten Erwachsenen in der Thorax-CT

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Mayer, J.L.; Kauczor, H.U. [Univ. Hospital Heidelberg (Germany). Diagnostic and Interventional Radiology; Lehners, N.; Egerer, G. [Univ. Hospital Heidelberg (Germany). Internal Medicine V of Hematology, Oncoloy and Rheumatology; Heussel, C.P. [Thoracic Hospital at Univ. Hospital Heidelberg (Germany). Diagnostic and Interventional Radiology with Nuclear Medicine

2014-07-15

Characterization and follow-up evaluation of chest CT of RSV pneumonia in immune-compromised adults during a seasonal epidemic. Retrospective analysis of 132 chest CT examinations of 51 adult immune-compromised patients (29 m/22f, diameter 58 years) with clinical signs of pneumonia and positive RSV test in winter 2011/2012. Two experienced chest radiologists evaluated the morphology (bronchial wall thickening, tree-in-bud, nodules, halo, ground-glass opacities, consolidations, pleural fluid) of the CT scans by consensus. Pathological findings were in 86 % of the chest CT scans: Areas of ground-glass attenuation in 64 %, consolidations in 56 %, nodules in 55 % (diameter 8 mm in maximal diameter, with halo in 71 %), pleural fluid in 44 % (diameter 2 cm), tree-in-bud in 36 %, bronchial wall thickening in 27 % and more than one morphological finding in 72 %. There were no pathological CT findings in 14 % of patients with clinical symptoms of pneumonia because these patients did not undergo follow-up. Radiological progression was found in 45 % of patients and regression in 33 % in follow-up examinations. In 37 % an additional examination of the paranasal sinuses was performed and showed sinusitis in 63 % of cases. 90 % of the patients had sinusitis as well as pneumonia. In addition to RSV, a further pathogenic agent was found in bronchoalveolar lavage of five patients (Aspergillus spec., herpes simplex virus, Pseudomonas aeruginosa). The most characteristic signs in chest CT scans were at the beginning of pneumonia with nodules and tree-in-bud often combined with bronchial wall thickening. The following CT scans showed characteristic but not pathognomonic chest CT findings of RSV pneumonia. These morphological findings should be recognized seasonally (winter) especially at the beginning of the case of pneumonia. RSV-associated additional sinusitis is probably common and should be noticed.

Combining automatic tube current modulation with adaptive statistical iterative reconstruction for low-dose chest CT screening.

Directory of Open Access Journals (Sweden)

Jiang-Hong Chen

Full Text Available To reduce radiation dose while maintaining image quality in low-dose chest computed tomography (CT by combining adaptive statistical iterative reconstruction (ASIR and automatic tube current modulation (ATCM.Patients undergoing cancer screening (n = 200 were subjected to 64-slice multidetector chest CT scanning with ASIR and ATCM. Patients were divided into groups 1, 2, 3, and 4 (n = 50 each, with a noise index (NI of 15, 20, 30, and 40, respectively. Each image set was reconstructed with 4 ASIR levels (0% ASIR, 30% ASIR, 50% ASIR, and 80% ASIR in each group. Two radiologists assessed subjective image noise, image artifacts, and visibility of the anatomical structures. Objective image noise and signal-to-noise ratio (SNR were measured, and effective dose (ED was recorded.Increased NI was associated with increased subjective and objective image noise results (P<0.001, and SNR decreased with increasing NI (P<0.001. These values improved with increased ASIR levels (P<0.001. Images from all 4 groups were clinically diagnosable. Images with NI = 30 and 50% ASIR had average subjective image noise scores and nearly average anatomical structure visibility scores, with a mean objective image noise of 23.42 HU. The EDs for groups 1, 2, 3 and 4 were 2.79 ± 1.17, 1.69 ± 0.59, 0.74 ± 0.29, and 0.37 ± 0.22 mSv, respectively. Compared to group 1 (NI = 15, the ED reductions were 39.43%, 73.48%, and 86.74% for groups 2, 3, and 4, respectively.Using NI = 30 with 50% ASIR in the chest CT protocol, we obtained average or above-average image quality but a reduced ED.

[The best noise index combined with ASIR weighting selection in low-dose chest scanning].

Science.gov (United States)

Xiao, Huijuan; Hou, Ping; Liu, Jie; Gao, Jianbo; Tan, Hongna; Liang, Pan; Pu, Shi

2015-10-06

To discuss the best noise index combined with ASIR weighting selection in low-dose chest scanning based on BMI. 200 patients collected from May to December 2014 underwent non-contrast chest CT examinations, they were randomly assigned into standard dose group (Group A, NI15 combined with 30% ASIR) and low-dose groups (Group B, NI25 combined with 40% ASIR, Group C, NI30 combined with 50% ASIR, Group D, NI35 combined with 60% ASIR), 50 cases in each group; the patients were assigned into three groups based on BMI (kg/m2): BMI25. Signal-to-nosie ratio (SNR), contrast-to noise ratio (CNR), CT dose index volume (CTDIvol), dose-length product (DLP), effective dose (ED) and subjective scoring between the standard and low-dose groups were compared and analyzed statistically. Differences of SNR, CNR, CTDIvol, DLP and ED among groups were determined with ANOVA analysis and the consistency of diagnosis with Kappa test. SNR, CTDIvol, DLP and ED reduced with the increase of nosie index, the differences among the groups were statistically significant (P25 kg/m2 group. NI35 combined with 60% ASIR in BMIASIR in 18.5 kg/m2≤BMI≤25 kg/m2 group; NI25 combined with 40% ASIR in 18.5 kg/m2≤BMI≤25 kg/m2 group were the best parameters combination which both can significantly reduce the radiation dose and ensure the image quality.

A case of multiple hepatic abscesses detected by CT scan in the patient with acute lymphoblastic leukemia

International Nuclear Information System (INIS)

Saburi, Yoshio; Shuto, Ryusuke; Mizutani, Ryoko; Hosokawa, Takafumi; Itoga, Takashi

1983-01-01

A 34 years old man admitted to a hospital on 21 Feb. 1983 and was diagnosed acute lymphoblastic leukemia. A hematological complete remission was achieved by combination therapy of vincristine, prednisolone and L-asparaginase. However, he had complaining of high fever and right hypochondralgia since early in Apr. 1983, and it was revealed that elevation of right diaphragm on chest X-ray. Therefore, he was also given several antibiotics (CPZ, TOB, LMOX, PIPC, LCM, AMK, MINO and GM) for complication of probable liver abscess. Remittent fever was persisted in spite of as mentioned above various antibiotics. The multiple hepatic abscesses were found by CT scan of the mid-abdomen as the low density lesions, but bacterial cultures detected no any pathogens. His complaining of remittent fever and right hypochondralgia were improved by treated with Miconazole during about one month, and decreasing in size and number of multiple hepatic abscesses were found by CT scan. Though we could not determined clearly, but suspected that, multiple hepatic abscesses were due to fungus infection, by reason of therapeutic result. Regarding the complication of hepatic abscesses with leukemia, 5 cases have been reported in Japan, and one case out of 5 cases were detected by CT scan. We thought that CT scan were useful procedure for a early diagnosis of hepatic abscesses. In recently, the patient has continued of complete remission hematologically. (author)

CT-morphological characterization of respiratory syncytial virus (RSV) pneumonia in immune-compromised adults

International Nuclear Information System (INIS)

Mayer, J.L.; Kauczor, H.U.; Lehners, N.; Egerer, G.; Heussel, C.P.

2014-01-01

Characterization and follow-up evaluation of chest CT of RSV pneumonia in immune-compromised adults during a seasonal epidemic. Retrospective analysis of 132 chest CT examinations of 51 adult immune-compromised patients (29 m/22f, diameter 58 years) with clinical signs of pneumonia and positive RSV test in winter 2011/2012. Two experienced chest radiologists evaluated the morphology (bronchial wall thickening, tree-in-bud, nodules, halo, ground-glass opacities, consolidations, pleural fluid) of the CT scans by consensus. Pathological findings were in 86 % of the chest CT scans: Areas of ground-glass attenuation in 64 %, consolidations in 56 %, nodules in 55 % (diameter 8 mm in maximal diameter, with halo in 71 %), pleural fluid in 44 % (diameter 2 cm), tree-in-bud in 36 %, bronchial wall thickening in 27 % and more than one morphological finding in 72 %. There were no pathological CT findings in 14 % of patients with clinical symptoms of pneumonia because these patients did not undergo follow-up. Radiological progression was found in 45 % of patients and regression in 33 % in follow-up examinations. In 37 % an additional examination of the paranasal sinuses was performed and showed sinusitis in 63 % of cases. 90 % of the patients had sinusitis as well as pneumonia. In addition to RSV, a further pathogenic agent was found in bronchoalveolar lavage of five patients (Aspergillus spec., herpes simplex virus, Pseudomonas aeruginosa). The most characteristic signs in chest CT scans were at the beginning of pneumonia with nodules and tree-in-bud often combined with bronchial wall thickening. The following CT scans showed characteristic but not pathognomonic chest CT findings of RSV pneumonia. These morphological findings should be recognized seasonally (winter) especially at the beginning of the case of pneumonia. RSV-associated additional sinusitis is probably common and should be noticed.

Predictors of abnormal chest CT after blunt trauma: a critical appraisal of the literature.

NARCIS (Netherlands)

Brink, M.; Kool, D.R.; Dekker, H.M.; Deunk, J.; Jager, G.J.; Kuijk, C. van; Edwards, M.J.R.; Blickman, J.G.

2009-01-01

AIM: To identify and to evaluate predictors that determine whether chest computed tomography (CT) is likely to reveal relevant injuries in adult blunt trauma patients. METHODS: After a comprehensive literature search for original studies on blunt chest injury diagnosis, two independent observers

Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates.

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Yubing Tong

Full Text Available Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh versus a volumetric CT, which have not been addressed in the literature.Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2, 16 with chronic obstructive pulmonary disease (COPD, 16 with idiopathic pulmonary fibrosis (IPF, and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT and visceral adipose tissue (VAT in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU distributions were determined from each chest slice and from the

Chest computed tomography

DEFF Research Database (Denmark)

Loeve, Martine; Krestin, Gabriel P.; Rosenfeld, Margaret

2013-01-01

are not suitable to study CF lung disease in young children. Chest computed tomography (CT) holds great promise for use as a sensitive surrogate endpoint in CF. A large body of evidence has been produced to validate the use of chest CT as primary endpoint to study CF lung disease. However, before chest CT can...

A 51-Year-Old Woman With an Increasing Chest Wall Mass Years After Resection of an Early Stage Lung Cancer.

Science.gov (United States)

Dhakal, Ajay; Chen, Hongbin; Dexter, Elisabeth U

2017-12-01

A 51-year-old woman was found to have a new 14 × 6 mm soft tissue mass under the right serratus muscle on a CT scan of the chest performed for routine surveillance due to her history of stage I lung cancer. A follow-up CT scan performed 4 months later showed that the mass had increased in size to 22 × 8 mm. The patient presents to the oncology clinic to discuss the results of the CT scan. She has no pain or swelling on the right lateral chest and no cough, fever, or shortness of breath. She is at her baseline health with good appetite and functional status. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Hematogenous candida pneumonia in major burn patients: plain chest radiograph and thin-section CT findings

International Nuclear Information System (INIS)

Kim, Hyo Heon; Lee, Eil Seong; Shim, Ya Seong; Kim, Ji Hun; Suh, Hong Kil; Cho, Sin Young; Kim, Dae Sun; Lee, Kil Woo; Kang, Ik Won

1995-01-01

To describe plain radiographic and thin-section CT findings of hematogenous candida pneumonia in major burn patients. We reviewed nine cases of hematogenous candida pneumonia in major burn patients who had positive blood culture for candida and findings of pneumonia on plain chest radiograph. On five of nine cases, thin-section CT was done. We evaluated retrospectively nine cases for onset, the pattern, distribution, and size of lesions on plain chest radiograph and thin-section CT. On plain chest radiograph, randomly distributed 2-10 mm nodules were seen in six cases(66%) and randomly distributed 10-15 mm consolidations in remaining three cases(33%). Lesion occurred in 11th to 75th post-burn day(average, 34th post-burn day). Other findings were cardiomegaly in three cases, atelectasis in three cases, and pulmonary edema in one case. Thin-section CT showed variable shaped subpleural nodules in all five cases. The size of nodules were 1-5 mm in two cases(40%) and 5-10 mm(60%) in three cases. Feeding vessel signs were seen in two cases. Other findings were atelectasis in three cases, cardiomegaly in three cases, ground-glass opacity and interlobular septal thickenings by pulmonary edema in two cases. Plain chest radiographic findings of hematogenous candida pneumonia in major burn patients are randomly distributed nodules or consolidations of variable size. Thin-section CT findings are variable shaped subpleural nodules less than 1 cm

Can anterior junction line be used to distinguish right middle from right upper lobe on CT scan?

International Nuclear Information System (INIS)

Cha, Jae Heon; Suh, Ja Young; Jo, Jin Man; Jeong, Hyeon Jo; Cheon, Mal Soon; Lee, Chul Woo; Yoon, Soon Min

1997-01-01

To evalvate the usefulness on a CT chest scan, of the anterior junction line as an anatomical landmark to distinguish the right middle and the right upper lobe We found that the anterior junction line has a constant anatomical relationship with the right upper and middle lobe, and with this in mind, analysed connvcntional CT films of 86 patients with normal lung(group A) and 30 with architectural distortion(group B). On a series of slices, we compared the location of slice 1 with that of slice 2(slice 1:the slice which includes the lowest portion of the anterior junction line, slice 2:the initial slice, in which the right middle lobe occupies the whole of the lung anterior to the right major fissure). In group A(n=86), the right upper lobe, as seen in the anteromedial zone of slice 1, was present in 83 cases(96.5%). The right upper lobe on slice 1 was absent in two cases(2.3%) in which a minor fissure was almost completely abent. In group B(n=30), the right upper lobe on slice 1 was absent in 19 cases(63.3%). We suggest that on a CT chest scan, the anterior junction line can be used as an anatomical landmark in the differentiation of the right middle from the right upper lobe, and as an indicator of the presence of architectural distortion

Dose reduction with adaptive statistical iterative reconstruction for paediatric CT: phantom study and clinical experience on chest and abdomen CT

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Gay, F.; Lasalle, S.; Neuenschwander, S.; Brisse, H.J. [Institut Curie, Imaging Department, Paris (France); Pavia, Y.; Pierrat, N. [Institut Curie, Medical Physics Department, Paris (France)

2014-01-15

To assess the benefit and limits of iterative reconstruction of paediatric chest and abdominal computed tomography (CT). The study compared adaptive statistical iterative reconstruction (ASIR) with filtered back projection (FBP) on 64-channel MDCT. A phantom study was first performed using variable tube potential, tube current and ASIR settings. The assessed image quality indices were the signal-to-noise ratio (SNR), the noise power spectrum, low contrast detectability (LCD) and spatial resolution. A clinical retrospective study of 26 children (M:F = 14/12, mean age: 4 years, range: 1-9 years) was secondarily performed allowing comparison of 18 chest and 14 abdominal CT pairs, one with a routine CT dose and FBP reconstruction, and the other with 30 % lower dose and 40 % ASIR reconstruction. Two radiologists independently compared the images for overall image quality, noise, sharpness and artefacts, and measured image noise. The phantom study demonstrated a significant increase in SNR without impairment of the LCD or spatial resolution, except for tube current values below 30-50 mA. On clinical images, no significant difference was observed between FBP and reduced dose ASIR images. Iterative reconstruction allows at least 30 % dose reduction in paediatric chest and abdominal CT, without impairment of image quality. (orig.)

Dose reduction with adaptive statistical iterative reconstruction for paediatric CT: phantom study and clinical experience on chest and abdomen CT

International Nuclear Information System (INIS)

Gay, F.; Lasalle, S.; Neuenschwander, S.; Brisse, H.J.; Pavia, Y.; Pierrat, N.

2014-01-01

To assess the benefit and limits of iterative reconstruction of paediatric chest and abdominal computed tomography (CT). The study compared adaptive statistical iterative reconstruction (ASIR) with filtered back projection (FBP) on 64-channel MDCT. A phantom study was first performed using variable tube potential, tube current and ASIR settings. The assessed image quality indices were the signal-to-noise ratio (SNR), the noise power spectrum, low contrast detectability (LCD) and spatial resolution. A clinical retrospective study of 26 children (M:F = 14/12, mean age: 4 years, range: 1-9 years) was secondarily performed allowing comparison of 18 chest and 14 abdominal CT pairs, one with a routine CT dose and FBP reconstruction, and the other with 30 % lower dose and 40 % ASIR reconstruction. Two radiologists independently compared the images for overall image quality, noise, sharpness and artefacts, and measured image noise. The phantom study demonstrated a significant increase in SNR without impairment of the LCD or spatial resolution, except for tube current values below 30-50 mA. On clinical images, no significant difference was observed between FBP and reduced dose ASIR images. Iterative reconstruction allows at least 30 % dose reduction in paediatric chest and abdominal CT, without impairment of image quality. (orig.)

Image quality in children with low-radiation chest CT using adaptive statistical iterative reconstruction and model-based iterative reconstruction.

Directory of Open Access Journals (Sweden)

Jihang Sun

Full Text Available OBJECTIVE: To evaluate noise reduction and image quality improvement in low-radiation dose chest CT images in children using adaptive statistical iterative reconstruction (ASIR and a full model-based iterative reconstruction (MBIR algorithm. METHODS: Forty-five children (age ranging from 28 days to 6 years, median of 1.8 years who received low-dose chest CT scans were included. Age-dependent noise index (NI was used for acquisition. Images were retrospectively reconstructed using three methods: MBIR, 60% of ASIR and 40% of conventional filtered back-projection (FBP, and FBP. The subjective quality of the images was independently evaluated by two radiologists. Objective noises in the left ventricle (LV, muscle, fat, descending aorta and lung field at the layer with the largest cross-section area of LV were measured, with the region of interest about one fourth to half of the area of descending aorta. Optimized signal-to-noise ratio (SNR was calculated. RESULT: In terms of subjective quality, MBIR images were significantly better than ASIR and FBP in image noise and visibility of tiny structures, but blurred edges were observed. In terms of objective noise, MBIR and ASIR reconstruction decreased the image noise by 55.2% and 31.8%, respectively, for LV compared with FBP. Similarly, MBIR and ASIR reconstruction increased the SNR by 124.0% and 46.2%, respectively, compared with FBP. CONCLUSION: Compared with FBP and ASIR, overall image quality and noise reduction were significantly improved by MBIR. MBIR image could reconstruct eligible chest CT images in children with lower radiation dose.

Diagnosis of gynecologic pelvic masses by CT scans

International Nuclear Information System (INIS)

Ito, Hisao; Kubo, Atsushi; Takagi, Yaeko; Kinoshita, Fumio; Maekawa, Akira.

1981-01-01

Two hundred eighty four patients with gynecologic pelvic masses were evaluated with CT scans. Of the patients, 196 had subsequent surgical determination of abnormalities and pathological proof of diagnosis was obtained. Only these 196 patients were included in this study. The CT scans could provide correct diagnosis in 113 of 114 (99%) patients with benign uterine tumor and in all (100%) patients with either serous cystadenoma or dermoid cyst. However, evaluation of mucinous cystadenoma (44%) and endometriosis cyst (37%) by CT scan has some limitations. It was difficult to differentiate mucinous cystadenoma from ovarian carcinoma, because both lesions had partial multiloculation and solid-like areas in the cyst. The CT findings of endometriosis cyst had similarity with serous cystadenoma, and 5 of 8 patients with this disease were diagnosed as serous cystadenoma. Ovarian fibroma and endometrial cancer were also not determined by CT scans. CT identified 87% of patients with ovarian cancer, while false positive rate of this disease was 38% (8/21). In 6 of 13 patients with both of leiomyoma and ovarian cyst, CT was able to demonstrate ovarian lesions that were overlooked by bimanual examinations. The role of CT scanning in our clinical practice is discussed. (author)

Deep learning for biomarker regression: application to osteoporosis and emphysema on chest CT scans

Science.gov (United States)

González, Germán.; Washko, George R.; San José Estépar, Raúl

2018-03-01

Introduction: Biomarker computation using deep-learning often relies on a two-step process, where the deep learning algorithm segments the region of interest and then the biomarker is measured. We propose an alternative paradigm, where the biomarker is estimated directly using a regression network. We showcase this image-tobiomarker paradigm using two biomarkers: the estimation of bone mineral density (BMD) and the estimation of lung percentage of emphysema from CT scans. Materials and methods: We use a large database of 9,925 CT scans to train, validate and test the network for which reference standard BMD and percentage emphysema have been already computed. First, the 3D dataset is reduced to a set of canonical 2D slices where the organ of interest is visible (either spine for BMD or lungs for emphysema). This data reduction is performed using an automatic object detector. Second, The regression neural network is composed of three convolutional layers, followed by a fully connected and an output layer. The network is optimized using a momentum optimizer with an exponential decay rate, using the root mean squared error as cost function. Results: The Pearson correlation coefficients obtained against the reference standards are r = 0.940 (p < 0.00001) and r = 0.976 (p < 0.00001) for BMD and percentage emphysema respectively. Conclusions: The deep-learning regression architecture can learn biomarkers from images directly, without indicating the structures of interest. This approach simplifies the development of biomarker extraction algorithms. The proposed data reduction based on object detectors conveys enough information to compute the biomarkers of interest.

Interstitial shadow on chest CT is associated with the onset of interstitial lung disease caused by chemotherapeutic drugs

International Nuclear Information System (INIS)

Niho, Seiji; Goto, Koichi; Yoh, Kiyotaka; Kim, Y.H.; Ohmatsu, Hironobu; Kubota, Kaoru; Saijo, Nagahiro; Nishiwaki, Yutaka

2006-01-01

Pretreatment computerized tomography (CT) films of the chest was studied to clarify the influence of interstitial shadow on developing interstitial lung disease (ILD). Eligible patients were those lung cancer patients who started to receive first-line chemotherapy between October 2001 and March 2004. Patients who received thoracic radiotherapy to the primary lesion, mediastinum, spinal or rib metastases were excluded. We reviewed pretreatment conventional CT and plain X-ray films of the chest. Ground-glass opacity, consolidation or reticular shadow without segmental distribution was defined as interstitial shadow, with this event being graded as mild, moderate or severe. If interstitial shadow was detected on CT films of the chest, but not via plain chest X-ray, it was graded as mild. Patients developing ILD were identified from medial records. A total of 502 patients were eligible. Mild, moderate and severe interstitial shadow was identified in 7, 8 and 5% of patients, respectively. A total of 188 patients (37%) received tyrosine kinase inhibitor (TKI) treatment, namely gefitinib or erlotinib. Twenty-six patients (5.2%) developed ILD either during or after chemotherapy. Multivariate analyses revealed that interstitial shadow on CT films of the chest and treatment history with TKI were associated with the onset of ILD. It is recommended that patients with interstitial shadow on chest CT are excluded from future clinical trials until this issue is further clarified, as it is anticipated that use of chemotherapeutic agents frequently mediate onset of ILD in this context. (author)

CT Chest and pulmonary functional changes in patients with HTLV-associated myelopathy in the Eastern Brazilian Amazon.

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Luiz Fábio Magno Falcão

Full Text Available The aim of this study was to compare computed tomography (CT scans of chest and lung function among patients with Human T-Lymphotropic Virus Type 1 (HTLV with and without HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP. In this cross-sectional study performed between January 2013 and June 2016, we included 48 patients with HAM/TSP (19 women and 11 men and without HAM/TSP (12 women and 6 men. We compared CT findings and lung functions of these groups. Patients who had HAM/TSP had abnormal CT findings (P = 0.000, including more frequent bronchiectasis (P = 0.049, parenchymal bands (P = 0.007, interlobular septal thickening (P = 0.035, and pleural thickening (P = 0.009. In addition, neither patients with HAM/TSP (9/30; 30% nor the controls (0/18; 0% had obstructive or restrictive lung disease (P = 0.009. HTLV diagnosis should be considered in all patients with abnormal CT findings in whom no other cause is apparent. It is important to remember that lung disease increases the rates of morbidity and mortality in developing countries.

Assessment of chest pain in the emergency room: What is the role of multidetector CT?

International Nuclear Information System (INIS)

White, Charles; Read, Katrina; Kuo, Dick

2006-01-01

Chest pain is one of the most frequent complaints for patients seen in the emergency department. The current article describes the clinical stratification of patients who present to the emergency department with chest pain and discusses imaging options and analysis for these patients. It reviews conventional imaging approaches to assessing chest pain including chest radiography and stress testing. The main discussion focuses on the potential utility use of cross-sectional imaging, particularly multidetector CT, in the evaluation of chest pain in the emergency department

CT findings of slilcosis

International Nuclear Information System (INIS)

Jung, Dong Hee; Kim, Kun Il; Son, Hyun Ju; Ro, Young Jin; Jung, Doo Young; Park, Jae Yeong; Lee, Jun Woo; Kim, Byung Soo

1996-01-01

To describe chest radiographic and CT findings of silicosis, and to compare their findings. Ten coal miners and six stonemasons were included in this study. All were male and their mean age was 53.1. The mean duration of dust exposure was 15.2 years(range, 5-30 years) in coal miners and 25.3 years(range, 15-35 years) in stonemasons. Chest radiographs(n=16), conventional CT scans(n=4), and high resolution CT(HRCT) scans(n=13) were evaluated. Parenchymal abnormalities were interpreted on the basis of ILO standard films(1980) in chest radiographs and on the basis of CAP(College of American Pathologists, 1979) in CT(HRCT) films. Chest radiographs revealed large opacities(n=8), small opacities(n=6), and normal findings(n=2). Type r(n=4) and category 1/1(n=2) were most common for small opacities, while for large opacities, category B(n=4) and category c(n=4) were most common. These small and large opacities were located predominantly in the area of the upper and middle lung. Associated findings were emphysema(n=7), eggshell nodal calcifications(n=3), pneumothorax(n=3), C-P angle blunting(n=4), and pleural thickening(n=1). CT scans revealed micronodules(n=16), nodules(n=3), and progressive massive fibrosis(PMF, n=8). All these lesions were located in the upper and middle lungs, especially in the central portion of the posterior lung. PMF showed diffuse and homogenous(n=3) and puntate(n=2) calcifications, cavitations(n=5), air bronchograms(n=3), and necrosis(n=1). Peripheral paracicatrical emphysema was associated with PMF(n=8). Other findings were pneumothorax(n=4), emphysema(n=10), hilar and mediastinal nodal enlargement(n=11) bronchial wall thick- enings(n=6), bronchiectasis(n=1), pleural thickening(n=7), parenchymal fibrosis(n=1), and pulmonary tuberculosis(n=2). Small and large opacities in chest radiographs and micronodules, nodules, and PMFs in CT (HRCT) films were located predominately in the upper and middle lungs, especially in the central portion of the

Mosaic Pattern of Lung Attenuation on Chest CT in Patients with Pulmonary Hypertension

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Kamonpun Ussavarungsi

2015-09-01

Full Text Available A mosaic pattern of lung attenuation on chest computed tomography (CT may be due to various etiologies. There is limited published data on CT results when used to evaluate pulmonary hypertension (PH. We retrospectively studied the frequency of mosaic pattern in patients with PH and the cause of the PH by diagnostic group, as well as the correlation between the mosaic pattern and the following: demographics, severity of the PH, main pulmonary artery (PA size, PA/aorta (PA/Ao ratio, pulmonary function tests (PFT, and ventilation perfusion scan results. Overall, 18% of the cohort had CT mosaic pattern (34/189. Mosaic pattern was present in 17/113 (15% in Group 1 pulmonary arterial hypertension, 5/13 (28% in Group 2 pulmonary venous hypertension and 8/50 (16% in Group 3 PH. Conversely, Group 4 chronic thromboembolic PH was more prevalent in 4/8 (50%. Main PA size, PA/Ao ratio, and segmental perfusion defect were positively associated with mosaic pattern. In contrast, factors such as age, gender, body mass index, functional class, hemodynamic data, and PFT values were not associated with mosaic pattern. Mosaic pattern is not specific as an isolated finding for distinguishing the subtype of PH.

CT scan of Parkinson's disease

Energy Technology Data Exchange (ETDEWEB)

Konishi, T; Noguchi, S; Nishitani, H [National Sanatorium of Utano, Kyoto (Japan); Kitano, H; Ikegami, Y

1981-04-01

In forty-eight patients with Parkinson's disease, we examined the ventricular size and the degree of cortical atrophy which were measured by the photos of CT scan and compared them with their clinical symptoms and side effects of anti-parkinsonian drugs. The ventricular size was expressed as the ventricular ratio which is the percentage of superimposed lateral ventricular area to the white and gray matter area at the slice number 2B of CT scan photos. The degree of the cortical atrophy was expressed as the sulcal numbers which were clearly visualized at the slice number 3B or 4A of CT scan photos. We used the CT scan photos of age-matched other patients which did not show definit central nervous system abnormalities. Our findings were as follows: (1) The ventricular enlargement was observed in the parkinsonian patients who showed dementia and/or Yahr's classification grades IV or V. (2) There was no correlation between the duration of this disease and the L--dopa treatments with the ventricular size and sulcal numbers. (3) The side effects of drugs such as visual hallucination were tended to be observed in the patients who showed the ventricular enlargement. (4) There was no definite correlation between the degree of cortical atrophy with clinical symptoms and side effects of various drugs. These findings suggested that the ventricular enlargement in Parkinson's disease was an important sign of dementia and the tendency of appearance of side effects of various drugs.

CT scan of Parkinson's disease

International Nuclear Information System (INIS)

Konishi, Tetsuro; Noguchi, Sadako; Nishitani, Hiroshi; Kitano, Haruo; Ikegami, Yoshinori.

1981-01-01

In forty-eight patients with Parkinson's disease, we examined the ventricular size and the degree of cortical atrophy which were measured by the photos of CT scan and compared them with their clinical symptoms and side effects of anti-parkinsonian drugs. The ventricular size was expressed as the ventricular ratio which is the percentage of superimposed lateral ventricular area to the white and gray matter area at the slice number 2B of CT scan photos. The degree of the cortical atrophy was expressed as the sulcal numbers which were clearly visualized at the slice number 3B or 4A of CT scan photos. We used the CT scan photos of age-matched other patients which did not show definit central nervous system abnormalities. Our findings were as follows: (1) The ventricular enlargement was observed in the parkinsonian patients who showed dementia and/or Yahr's classification grades IV or V. (2) There was no correlation between the duration of this disease and the L--dopa treatments with the ventricular size and sulcal numbers. (3) The side effects of drugs such as visual hallucination were tended to be observed in the patients who showed the ventricular enlargement. (4) There was no definite correlation between the degree of cortical atrophy with clinical symptoms and side effects of various drugs. These findings suggested that the ventricular enlargement in Parkinson's disease was an important sign of dementia and the tendency of appearance of side effects of various drugs. (author)

Metal artifact reduction of CT scans to improve PET/CT

NARCIS (Netherlands)

Van Der Vos, Charlotte S.; Arens, Anne I.J.; Hamill, James J.; Hofmann, Christian; Panin, Vladimir Y.; Meeuwis, Antoi P.W.; Visser, Eric P.; De Geus-Oei, Lioe Fee

2017-01-01

In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans

Metal Artifact Reduction of CT Scans to Improve PET/CT

NARCIS (Netherlands)

Vos, C.S. van der; Arens, A.I.J.; Hamill, J.J.; Hofmann, C.; Panin, V.Y.; Meeuwis, A.P.W.; Visser, E.P.; Geus-Oei, L.F. de

2017-01-01

In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans

The chest radiological manifestation in psittacosis

International Nuclear Information System (INIS)

Zhang Jun; Fu Jiazhen; Wang Shulan; Zhang Shuxin; Sun Guochang; Tang Guangjian

2005-01-01

Objective: To summarize the clinical characteristics and imaging features of psittacosis. Methods: The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed. Results: The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dissociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of neutrophils might be increased. The chest X-ray and CT scan showed air-space consolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were also present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittaci. Erythromycin was effective in all 3 patients. Conclusion: Although the appearance of psittacosis on clinical findings and chest X-ray and CT scan is not characteristic, psittacosis can be diagnosed with the combination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging features of psittacosis is helpful in differential diagnosis. (authors)

Identification of Pulmonary Hypertension Caused by Left-Sided Heart Disease (World Health Organization Group 2) Based on Cardiac Chamber Volumes Derived From Chest CT Imaging.

Science.gov (United States)

Aviram, Galit; Rozenbaum, Zach; Ziv-Baran, Tomer; Berliner, Shlomo; Topilsky, Yan; Fleischmann, Dominik; Sung, Yon K; Zamanian, Roham T; Guo, Haiwei Henry

2017-10-01

Evaluations of patients with pulmonary hypertension (PH) commonly include chest CT imaging. We hypothesized that cardiac chamber volumes calculated from the same CT scans can yield additional information to distinguish PH related to left-sided heart disease (World Health Organization group 2) from other PH subtypes. Patients who had PH confirmed by right heart catheterization and contrast-enhanced chest CT studies were enrolled in this retrospective multicenter study. Cardiac chamber volumes were calculated using automated segmentation software and compared between group 2 and non-group 2 patients with PH. This study included 114 patients with PH, 27 (24%) of whom were classified as group 2 based on their pulmonary capillary wedge pressure. Patients with group 2 PH exhibited significantly larger median left atrial (LA) volumes (118 mL vs 63 mL; P volumes (90 mL vs 76 mL; P = .02), and smaller median right ventricular (RV) volumes (173 mL vs 210 mL; P = .005) than did non-group 2 patients. On multivariate analysis adjusted for age, sex, and mean pulmonary arterial pressure, group 2 PH was significantly associated with larger median LA and LV volumes (P volume ratios of RA/LA, RV/LV, and RV/LA (P = .001, P = .004, and P volumes demonstrated a high discriminatory ability for group 2 PH (area under the curve, 0.92; 95% CI, 0.870-0.968). Volumetric analysis of the cardiac chambers from nongated chest CT scans, particularly with findings of an enlarged left atrium, exhibited high discriminatory ability for identifying patients with PH due to left-sided heart disease. Copyright © 2017. Published by Elsevier Inc.

Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

International Nuclear Information System (INIS)

Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

2014-01-01

Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI vol and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose metrics

Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

Energy Technology Data Exchange (ETDEWEB)

Zhang, Yakun [Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Li, Xiang [Medical Physics Graduate Program, Department of Physics, Cleveland State University, Cleveland, Ohio 44115 (United States); Segars, W. Paul [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Samei, Ehsan, E-mail: samei@duke.edu [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Departments of Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University Medical Center, Durham, North Carolina 27705 (United States)

2014-02-15

Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI{sub vol} and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose

Evaluation of effective dose from CT scans for overweight and obese adult patients using the VirtualDose software

International Nuclear Information System (INIS)

Liang, Baohui; Gao, Yiming; Chen, Zhi; Xu, X. George

2017-01-01

This paper evaluates effective dose (ED) of overweight and obese patients who undergo body computed tomography (CT) examinations. ED calculations were based on tissue weight factors in the International Commission on Radiological Protection Publication 103 (ICRP 103). ED per unit dose length product (DLP) are reported as a function of the tube voltage, body mass index (BMI) of patient. The VirtualDose software was used to calculate ED for male and female obese phantoms representing normal weight, overweight, obese 1, obese 2 and obese 3 patients. Five anatomic regions (chest, abdomen, pelvis, abdomen/pelvis and chest/abdomen/pelvis) were investigated for each phantom. The conversion factors were computed from the DLP, and then compared with data previously reported by other groups. It was observed that tube voltage and BMI are the major factors that influence conversion factors of obese patients, and that ED computed using ICRP 103 tissue weight factors were 24% higher for a CT chest examination and 21% lower for a CT pelvis examination than the ED using ICRP 60 factors. For body CT scans, increasing the tube voltage from 80 to 140 kVp would increase the conversion factors by as much as 19-54% depending on the patient's BMI. Conversion factor of female patients was ∼7% higher than the factors of male patients. DLP and conversion factors were used to estimate ED, where conversion factors depended on tube voltage, sex, BMI and tissue weight factors. With increasing number of obese individuals, using size-dependence conversion factors will improve accuracy, in estimating patient radiation dose. (authors)

Characteristics of pulmonary cysts in Birt-Hogg-Dube syndrome: Thin-section CT findings of the chest in 12 patients

Energy Technology Data Exchange (ETDEWEB)

Tobino, Kazunori, E-mail: tobino@juntendo.ac.jp [Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Gunji, Yoko [Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Kurihara, Masatoshi [Pneumothorax Center, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Kunogi, Makiko; Koike, Kengo [Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Tomiyama, Noriyuki [Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 (Japan); Johkoh, Takeshi [Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Kurumazuka 3-1, Itami, Hyogo 664-0872 (Japan); Kodama, Yuzo [Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Iwakami, Shin-ichiro [Department of Respiratory Medicine, Juntendo University, Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295 (Japan); Kikkawa, Mika [Biochemical Research Center, Division of Proteomics and Biomolecular Sciences, Juntendo University, Graduate School of Medicine, Bunkyo-Ku, Tokyo (Japan); Takahashi, Kazuhisa [Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Seyama, Kuniaki [Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan)

2011-03-15

Purpose: To describe in detail the characteristic chest computed tomography (CT) findings of Birt-Hogg-Dube (BHD) syndrome. Materials and methods: Thin-section chest CT scans of consecutive 12 patients with genetically diagnosed BHD syndrome were retrospectively evaluated by two observers, especially about the characteristics (distribution, number, size, shape and relation to pleura) of pulmonary cysts. Interobserver agreement in the identification of abnormalities on the CT images was achieved using the {kappa} statistic, and the degree of interobserver correlation for the characterization of pulmonary cysts was assessed using the Spearman rank correlation coefficient. Results: Multiple pulmonary cysts were seen in all patients. The number of cysts in each patient was various (range, 29-407), and cysts of various sizes (from a few mm to 2 cm or more) were seen in all patient. 76.6% (mean) of cysts were irregular-shaped, and 40.5% (mean) of cysts were located along the pleura. The mean extent score of cysts was 13% of the whole lung, and the distribution of cysts was predominantly in the lower medial zone. Finally, cysts abutting or including the proximal portions of lower pulmonary arteries or veins were also seen in all patients. Conclusion: Multiple, irregular-shaped cysts of various sizes with lower medial lung zone predominance are characteristic CT findings of BHD syndrome. Cysts abutting or including the proximal portions of lower pulmonary arteries or veins may also exist in this syndrome in a high probability.

Characteristics of pulmonary cysts in Birt-Hogg-Dube syndrome: Thin-section CT findings of the chest in 12 patients

International Nuclear Information System (INIS)

Tobino, Kazunori; Gunji, Yoko; Kurihara, Masatoshi; Kunogi, Makiko; Koike, Kengo; Tomiyama, Noriyuki; Johkoh, Takeshi; Kodama, Yuzo; Iwakami, Shin-ichiro; Kikkawa, Mika; Takahashi, Kazuhisa; Seyama, Kuniaki

2011-01-01

Purpose: To describe in detail the characteristic chest computed tomography (CT) findings of Birt-Hogg-Dube (BHD) syndrome. Materials and methods: Thin-section chest CT scans of consecutive 12 patients with genetically diagnosed BHD syndrome were retrospectively evaluated by two observers, especially about the characteristics (distribution, number, size, shape and relation to pleura) of pulmonary cysts. Interobserver agreement in the identification of abnormalities on the CT images was achieved using the κ statistic, and the degree of interobserver correlation for the characterization of pulmonary cysts was assessed using the Spearman rank correlation coefficient. Results: Multiple pulmonary cysts were seen in all patients. The number of cysts in each patient was various (range, 29-407), and cysts of various sizes (from a few mm to 2 cm or more) were seen in all patient. 76.6% (mean) of cysts were irregular-shaped, and 40.5% (mean) of cysts were located along the pleura. The mean extent score of cysts was 13% of the whole lung, and the distribution of cysts was predominantly in the lower medial zone. Finally, cysts abutting or including the proximal portions of lower pulmonary arteries or veins were also seen in all patients. Conclusion: Multiple, irregular-shaped cysts of various sizes with lower medial lung zone predominance are characteristic CT findings of BHD syndrome. Cysts abutting or including the proximal portions of lower pulmonary arteries or veins may also exist in this syndrome in a high probability.

Lung involvement quantification in chest radiographs; Quantificacao de comprometimento pulmonar em radiografias de torax

Energy Technology Data Exchange (ETDEWEB)

Giacomini, Guilherme; Alvarez, Matheus; Oliveira, Marcela de; Miranda, Jose Ricardo A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Pina, Diana R.; Pereira, Paulo C.M.; Ribeiro, Sergio M., E-mail: giacomini@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem

2014-12-15

Tuberculosis (TB) caused by Mycobacterium tuberculosis, is an infectious disease which remains a global health problem. The chest radiography is the commonly method employed to assess the TB's evolution. The methods for quantification of abnormalities of chest are usually performed on CT scans (CT). This quantification is important to assess the TB evolution and treatment and comparing different treatments. However, precise quantification is not feasible for the amount of CT scans required. The purpose of this work is to develop a methodology for quantification of lung damage caused by TB through chest radiographs. It was developed an algorithm for computational processing of exams in Matlab, which creates a lungs' 3D representation, with compromised dilated regions inside. The quantification of lung lesions was also made for the same patients through CT scans. The measurements from the two methods were compared and resulting in strong correlation. Applying statistical Bland and Altman, all samples were within the limits of agreement, with a confidence interval of 95%. The results showed an average variation of around 13% between the two quantification methods. The results suggest the effectiveness and applicability of the method developed, providing better risk-benefit to the patient and cost-benefit ratio for the institution. (author)

Computer-assisted solid lung nodule 3D volumetry on CT. Influence of scan mode and iterative reconstruction. A CT phantom study

International Nuclear Information System (INIS)

Coenen, Adriaan; Honda, Osamu; Tomiyama, Noriyuki; Jagt, Eric J. van der

2013-01-01

The objective of this study was to evaluate the effect of high-resolution scan mode and iterative reconstruction on lung nodule 3D volumetry. Solid nodules with various sizes (5, 8, 10 and 12 mm) were placed inside a chest phantom. CT images were obtained with various tube currents, scan modes (conventional mode, high-resolution mode) and iterative reconstructions [0, 50 and 100% blending of adaptive statistical iterative reconstruction (ASiR) and filtered back projection]. The nodule volumes were calculated using semiautomatic software and compared with the assumed volume from the nodules. The mean absolute and relative percentage error improved when using iterative reconstruction especially when using the conventional scan mode; however, this effect was not significant. Significant reduction in volume overestimation was observed when using high-resolution scan mode (P=0.011). The high-resolution mode significantly reduces the volume overestimation of 3D volumetry. Iterative reconstruction shows a reduction in volume overestimation and error margin especially with the conventional scan mode; however, this effect was not significant. (author)

Diagnostic value of axial CT scan

International Nuclear Information System (INIS)

Kiuchi, Sousuke

1983-01-01

Axial CT scan was used to investigate the radiological details of the temporal bone of 33 patients with chronic otitis media, secondary cholesteatoma, sensorineural hearing loss, Meniere disease, vertigo, facial spasm, and neoplasma. The axial scans showed anatomic details of the temporal bone, and at the same time clearly demonstrated the extent of the soft-tissue masses in the middle ears, as well as the destructions of the ossicles. Bone changes of the anterior walls of the epitympanum and external auditory meatus were more clearly demonstrated than by coronary CT scan. However, the axial scan had the disadvantages in demonstrating the stapes, crista transversa, and the mastoid portion of the facial canal. (author)

The CT diagnose of pleural metastasis tumour

International Nuclear Information System (INIS)

Chen Liqun; Han Kaibin; Pan Heng; Huang Xiaoru; Zhou Bingcao; Huang Yuehua

2007-01-01

Objective: To discuss the CT characteristic of pleural metastasis tumour,enhance the diagnostic level of pleural metastasis tumour. Methods: Review 30 cases which have been performed CT scan in our hospital during March 2002 to June 2003, which have been approved to pleural metastasis tumour by pathology and clinic. Make use of GE Hispeed.zx/i spiral CT,10mm thickness,10mm increment, l.5 pitch, some of them use 10mm or high resolution mode. All cases have been performed normal scan, 25 cases with contrast scan. Results: The CT representation of pleural metastasis tumour are encapsulated pleural effusion with irregular pleural thickening(56.6%), nodular pleural thickening(46.6%), pleural masses (13.3%), pneumothorax (3.3%), etc. Encapsulated pleural effusion and nodular pleural thickening are 76.6%, use contrast mode to scan pleural pathological changes enhance upon middle level, CT value increment > 20HU, there are 66.6% cases with other chest metastasis symptom, 73.3% primary lesion are pulmonary cancer, and 20% no primary lesion are found. Conclusion: Combine primary lesion history and other chest metastasis symptom, Spiral CT examination can differentiate most of pleural metastasis tumour, but it is difficult to differentiate the cases between with a little pleural effusion or light band pleural thickening and reactive alteration. (authors)

The “dirty chest”—correlations between chest radiography, multislice CT and tobacco burden

Science.gov (United States)

Kirchner, J; Goltz, J P; Lorenz, F; Obermann, A; Kirchner, E M; Kickuth, R

2012-01-01

Objectives Cigarette smoking-induced airway disease commonly results in an overall increase of non-specific lung markings on chest radiography. This has been described as “dirty chest”. As the morphological substrate of this condition is similar to the anthracosilicosis of coal workers, we hypothesised that it is possible to quantify the radiological changes using the International Labour Organization (ILO) classification of pneumoconiosis. The aims of this study were to evaluate whether there is a correlation between the extent of cigarette smoking and increased lung markings on chest radiography and to correlate the chest radiographic scores with findings on CT studies. Methods In a prospective analysis a cohort of 85 smokers was examined. The cigarette consumption was evaluated in pack years (defined as 20 cigarettes per day over 1 year). Film reading was performed by two board-certified radiologists. Chest radiographs were evaluated for the presence of thickening of bronchial walls, the presence of linear or nodular opacities, and emphysema. To correlate the smoking habits with the increase of overall lung markings in chest radiography, the ILO profusion score was converted to numbers ranging from zero to nine. Chest radiographs were rated according to the complete set of standard films of the revised ILO classification. Results 63/85 (74%) of the smokers showed an increase in overall lung markings on chest radiography; 32 (37%) had an ILO profusion score of chest radiography and the cigarette consumption quantified as pack years (r=0.68). The majority of the heavy smokers (>40 pack years) showed emphysema; there was no significant difference between the prevalence of emphysema as diagnosed by CT (62%) or chest radiography (71%) (pchest radiography. PMID:21937617

Early experiences with crowdsourcing airway annotations in chest CT

DEFF Research Database (Denmark)

Cheplygina, Veronika; Perez-Rovira, Adria; Kuo, Wieying

2016-01-01

Measuring airways in chest computed tomography (CT) images is important for characterizing diseases such as cystic fibrosis, yet very time-consuming to perform manually. Machine learning algorithms offer an alternative, but need large sets of annotated data to perform well. We investigate whether...... a number of further research directions and provide insight into the challenges of crowdsourcing in medical images from the perspective of first-time users....

Adaptive wiener filter based on Gaussian mixture distribution model for denoising chest X-ray CT image

International Nuclear Information System (INIS)

Tabuchi, Motohiro; Yamane, Nobumoto; Morikawa, Yoshitaka

2008-01-01

In recent decades, X-ray CT imaging has become more important as a result of its high-resolution performance. However, it is well known that the X-ray dose is insufficient in the techniques that use low-dose imaging in health screening or thin-slice imaging in work-up. Therefore, the degradation of CT images caused by the streak artifact frequently becomes problematic. In this study, we applied a Wiener filter (WF) using the universal Gaussian mixture distribution model (UNI-GMM) as a statistical model to remove streak artifact. In designing the WF, it is necessary to estimate the statistical model and the precise co-variances of the original image. In the proposed method, we obtained a variety of chest X-ray CT images using a phantom simulating a chest organ, and we estimated the statistical information using the images for training. The results of simulation showed that it is possible to fit the UNI-GMM to the chest X-ray CT images and reduce the specific noise. (author)

CT scan for the diagnosis of maxillary sinus carcinoma

International Nuclear Information System (INIS)

Kimura, Yo; Kato, Isao; Aoyagi, Masaru; Kikuchi, Akira; Koike, Yoshio; Suzuki, Hachiro.

1984-01-01

A comparative study between the conventional radiological examination and the computed tomographical examination for the diagnosis of maxillary sinus carcinoma was done. CT scan has been more appreciated to detect the tumor invasion in the pterygopalatine fossa, orbit, posterior ethmoid sinus and skull base than the conventional examination. CT scan was most usefull for the determination of size and location of the tumor. The prognosis by the stage-grouping was significantly separated by the new classification with CT scan. Therefore, new TNM classification of maxillary sinus carcinoma with CT scan should be taken into account. (author)

Nontuberculous Mycobacterial (NTM) Disease in Immunocompetent Patients: Expanding Image Findings on Chest CT

Energy Technology Data Exchange (ETDEWEB)

Shin, Hyo Hyun; Seon, Hyun Ju; Kim, Mok Hee; Choi, Song; Song, Sang Gook; Shin, Sang Soo; Kim, Yun Hyeon; Park, Jin Gyoon [Chonnam National University Hospital, Gwangju (Korea, Republic of)

2010-04-15

The aim of this study was to evaluate the chest CT features of nontuberculous mycobacterial (NTM) disease regardless of the specific organisms. This study included 74 consecutive patients (35 men, 39 women; mean age, 63 years; age range, 25-89 years) who were diagnosed with NTM disease according to the American Thoracic Society Guidelines (1997 and 2007) between January 2005 and July 2007. Chest CT images were randomly reviewed by two radiologists with consensus. The most common organism associated with NTM disease is M. avium-intracellulare complex (87.8%), followed by M. abscesses, M. kansasii, and M. chelonae. The most common chest CT finding was a nodular bronchiectatic lesion (n = 35, 46.7%), followed by a cavitary lesion of the upper lobe (n = 21, 28.0%), combined lesions of two prior subtypes (n = 6, 8.0%), consolidative lesion (s) (n = 5, 6.7%), a bronchogenic spreading pulmonary tuberculosis-like lesion (n = 5, 6.7%), a cavitary mass lesion with small satellite nodules (n = 2, 2.7%), and a miliary nodular lesion (n = 1, 1.3%). More than 5 segments were involved in 60 cases (81.1%). The nodular bronchiectatic lesion or cavitary lesion of upper lobe presents with multi-segmental involvement and the occurrence of combined consolidation is indicative of NTM disease

Body CT (CAT Scan)

Science.gov (United States)

... a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These ... other medical conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease or ...

OBLITERATION OF COSTOPHRENIC ANGTE IN A PLAIN X - RAY CHEST

Directory of Open Access Journals (Sweden)

Ramakrishna

2015-08-01

Full Text Available Obliteration of Costophrenicangle can be a pleural effusion in a majority of cases but other causes of mediastinal masses , aortic aneurysm , postpneumonectomy , lung and pleural masses and consolidation and collapse of the lung can cause shadows mimicking pleural effusion. It is always essential to take the help of later al and decubitus films , ultrasonography of chest and CT scan chest to come to a proper diagnosis. Inadvertent pleural aspiration basing on chest x - ray PA alone can have disastrous consequences

Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT.

Science.gov (United States)

Cho, S H; Sung, Y M; Kim, M S

2012-10-01

The objective of this study was to review the prevalence and radiological features of rib fractures missed on initial chest CT evaluation, and to examine the diagnostic value of additional coronal images in a large series of trauma patients. 130 patients who presented to an emergency room for blunt chest trauma underwent multidetector row CT of the thorax within the first hour during their stay, and had follow-up CT or bone scans as diagnostic gold standards. Images were evaluated on two separate occasions: once with axial images and once with both axial and coronal images. The detection rates of missed rib fractures were compared between readings using a non-parametric method of clustered data. In the cases of missed rib fractures, the shapes, locations and associated fractures were evaluated. 58 rib fractures were missed with axial images only and 52 were missed with both axial and coronal images (p=0.088). The most common shape of missed rib fractures was buckled (56.9%), and the anterior arc (55.2%) was most commonly involved. 21 (36.2%) missed rib fractures had combined fractures on the same ribs, and 38 (65.5%) were accompanied by fracture on neighbouring ribs. Missed rib fractures are not uncommon, and radiologists should be familiar with buckle fractures, which are frequently missed. Additional coronal imagescan be helpful in the diagnosis of rib fractures that are not seen on axial images.

Effect of CT scanning parameters on volumetric measurements of pulmonary nodules by 3D active contour segmentation: a phantom study

International Nuclear Information System (INIS)

Way, Ted W; Chan, H-P; Goodsitt, Mitchell M; Sahiner, Berkman; Hadjiiski, Lubomir M; Zhou Chuan; Chughtai, Aamer

2008-01-01

The purpose of this study is to investigate the effects of CT scanning and reconstruction parameters on automated segmentation and volumetric measurements of nodules in CT images. Phantom nodules of known sizes were used so that segmentation accuracy could be quantified in comparison to ground-truth volumes. Spherical nodules having 4.8, 9.5 and 16 mm diameters and 50 and 100 mg cc -1 calcium contents were embedded in lung-tissue-simulating foam which was inserted in the thoracic cavity of a chest section phantom. CT scans of the phantom were acquired with a 16-slice scanner at various tube currents, pitches, fields-of-view and slice thicknesses. Scans were also taken using identical techniques either within the same day or five months apart for study of reproducibility. The phantom nodules were segmented with a three-dimensional active contour (3DAC) model that we previously developed for use on patient nodules. The percentage volume errors relative to the ground-truth volumes were estimated under the various imaging conditions. There was no statistically significant difference in volume error for repeated CT scans or scans taken with techniques where only pitch, field of view, or tube current (mA) were changed. However, the slice thickness significantly (p < 0.05) affected the volume error. Therefore, to evaluate nodule growth, consistent imaging conditions and high resolution should be used for acquisition of the serial CT scans, especially for smaller nodules. Understanding the effects of scanning and reconstruction parameters on volume measurements by 3DAC allows better interpretation of data and assessment of growth. Tracking nodule growth with computerized segmentation methods would reduce inter- and intraobserver variabilities

Paper-thinned diaphragm: CT sign of diaphragmatic eventration

International Nuclear Information System (INIS)

Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Shim, Young Soo

1990-01-01

CT findings of total left hemidiaphragmatic eventration in two adult patients are described. Chest radiograph showed elevated left hemidiaphragm and left hilum. Paper-thinned muscular portion of the diseased diaphragm was clearly demonstrated with CT scan. With demonstration of paper-thinned diaphragm by CT scan, differentiation of the diaphragmatic eventration from recent onset phrenic nerve paralysis by tumor invasion or from post-traumatic diaphragmatic hernia can be made

Paper-thinned diaphragm: CT sign of diaphragmatic eventration

Energy Technology Data Exchange (ETDEWEB)

Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Shim, Young Soo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

1990-10-15

CT findings of total left hemidiaphragmatic eventration in two adult patients are described. Chest radiograph showed elevated left hemidiaphragm and left hilum. Paper-thinned muscular portion of the diseased diaphragm was clearly demonstrated with CT scan. With demonstration of paper-thinned diaphragm by CT scan, differentiation of the diaphragmatic eventration from recent onset phrenic nerve paralysis by tumor invasion or from post-traumatic diaphragmatic hernia can be made.

Ultrasound and supine chest radiograph in road traffic accident patients: a reliable and convenient way to diagnose pleural effusion

International Nuclear Information System (INIS)

Mumtaz, U.; Zahur, Z.; Raza, M.A.

2017-01-01

Background: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard. Methods: This study was conducted in PIMS and PAEC General Hospital, Islamabad from 1st January to 15th December 2015. The current study examined total of 80 trauma (blunt and penetrating) patients coming to emergency departments of both hospitals specifically those who had road traffic accident history. Their portable bed side ultrasound and supine chest radiograph were performed for assessing pleural effusion and subsequently CT scan chest was done for confirmation as it's a gold standard. Results: Using CT findings as gold standard the sensitivity, specificity, positive predictive value and negative predictive value was assessed for both ultrasonography and chest radiography and found to be 88.23%,100%, 100%, 40% and 77.94%, 100%, 100%, 55.55% respectively with diagnostic accuracy of ultrasound 90% as compared to 81.25% for supine chest x-rays when compared with gold standard. Conclusion: Ultrasound and chest x-ray can be used as a useful and suitable adjunct to CT in road traffic accident patients as these are easily available, non-invasive, no contrast required, can be performed on bed side and carries no or little radiation risk. (author)

SU-F-207-03: Dosimetric Effect of the Position of Arms in Torso CT Scan with Tube Current Modulation

International Nuclear Information System (INIS)

Liu, H; Gao, Y; Xu, X; Zhuo, W; Wu, J

2015-01-01

Purpose: To evaluate the patient organ dose differences between the arms-raised and arms-lowered postures in Torso multidetector computed tomography (MDCT) scan protocols with tube current modulation (TCM). Methods: Patient CT organ doses were simulated using the Monte Carlo method with human phantoms and a validated CT scanner model. A set of adult human phantoms with arms raised and arms lowered postures were developed using advanced BREP-based mesh surface geometries. Organ doses from routine Torso scan protocols such as chest, abdomen-pelvis, and CAP scans were simulated. The organ doses differences caused by two different posutres were investigated when tube current modulation (TCM) were applied during the CT scan. Results: With TCM applied, organ doses of all the listed organs of arms-lowered posture phantom are larger than those of arms raised phantom. The dose difference for most of the organs or tissues are larger than 50%, and the skin doses difference for abdomen-pelvis scan even reaches 112.03%. This is due to the fact that the tube current for patient with arms-lowered is much higher than for the arms raised posture. Conclusion: Considering CT scan with TCM, which is commonly applied clinically, patients who could not raise their arms will receive higher radiation dose than the arms raised patient, with dose differences for some tissues such as the skin being larger than 100%. This is due to the additional tube current necessary to penetrate the arms while maintaining consistent image quality. National Nature Science Foundation of China(No.11475047)

Radiographic, CT and MRI spectrum of hydatid disease of the chest: a pictorial essay

Energy Technology Data Exchange (ETDEWEB)

Sinner, W.N. von [Dept. of Radiology MBC28, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

1993-01-01

Thirty patients with thoracic hydatidosis (Echinococcus granulosus) were studied. The hydatid cysts were located in the lung parenchyma (70%), mediastinum (6.7%), inside the heart (10%), the pleurae (10%) and the chest wall (3.3%). Complications of thoracic hydatid cysts, such as rupture, infection, pleural involvement, spread and calcifications are presented. Computed tomography (CT) without and/or with contrast enhancement was performed in all patients (30). Findings from conventional chest radiographs were compared with CT and confirmed by pathology (30). In 10 cases (33.3%), magnetic resonance imaging was also performed. The diagnostic spectrum of hydatid cysts, including variations and developmental stages, is presented in this pictorial essay. (orig.)

Reducing Radiation Doses in Female Breast and Lung during CT Examinations of Thorax: A new Technique in two Scanners

Directory of Open Access Journals (Sweden)

Mehnati P.

2017-09-01

Full Text Available Background: Chest CT is a commonly used examination for the diagnosis of lung diseases, but a breast within the scanned field is nearly never the organ of interest. Objective: The purpose of this study is to compare the female breast and lung doses using split and standard protocols in chest CT scanning. Materials and Methods: The sliced chest and breast female phantoms were used. CT exams were performed using a single-slice (SS- and a 16 multi-slice (MS- CT scanner at 100 kVp and 120 kVp. Two different protocols, including standard and split protocols, were selected for scanning. The breast and lung doses were measured using thermo-luminescence dosimeters which were inserted into different layers of the chest and breast phantoms. The differences in breast and lung radiation doses in two protocols were studied in two scanners, analyzed by SPSS software and compared by t-test. Results: Breast dose by split scanning technique reduced 11% and 31% in SS- and MS- CT. Also, the radiation dose of lung tissue in this method decreased 18% and 54% in SS- and MS- CT, respectively. Moreover, there was a significant difference (p< 0.0001 in the breast and lung radiation doses between standard and split scanning protocols. Conclusion: The application of a split scan technique instead of standard protocol has a considerable potential to reduce breast and lung doses in SS- and MS- CT scanners. If split scanning protocol is associated with an optimum kV and MSCT, the maximum dose decline will be provided.

3D intrathoracic region definition and its application to PET-CT analysis

Science.gov (United States)

Cheirsilp, Ronnarit; Bascom, Rebecca; Allen, Thomas W.; Higgins, William E.

2014-03-01

Recently developed integrated PET-CT scanners give co-registered multimodal data sets that offer complementary three-dimensional (3D) digital images of the chest. PET (positron emission tomography) imaging gives highly specific functional information of suspect cancer sites, while CT (X-ray computed tomography) gives associated anatomical detail. Because the 3D CT and PET scans generally span the body from the eyes to the knees, accurate definition of the intrathoracic region is vital for focusing attention to the central-chest region. In this way, diagnostically important regions of interest (ROIs), such as central-chest lymph nodes and cancer nodules, can be more efficiently isolated. We propose a method for automatic segmentation of the intrathoracic region from a given co-registered 3D PET-CT study. Using the 3D CT scan as input, the method begins by finding an initial intrathoracic region boundary for a given 2D CT section. Next, active contour analysis, driven by a cost function depending on local image gradient, gradient-direction, and contour shape features, iteratively estimates the contours spanning the intrathoracic region on neighboring 2D CT sections. This process continues until the complete region is defined. We next present an interactive system that employs the segmentation method for focused 3D PET-CT chest image analysis. A validation study over a series of PET-CT studies reveals that the segmentation method gives a Dice index accuracy of less than 98%. In addition, further results demonstrate the utility of the method for focused 3D PET-CT chest image analysis, ROI definition, and visualization.

Post-pneumonectomy empyema and dosimetric CT scan. Report of two cases and review of literature

International Nuclear Information System (INIS)

Latorzeff, I.; Bachaud, J.M.; Aziza, R.; Arboucalot, F.; Berjaud, J.; Dahan, M.; Giron, J.

1999-01-01

Following a pneumonectomy for cancer, the patients are classically observed by clinical examination and standard chest X-ray. However, torpid empyemas can be missed when they occur after the period of hospitalization and when they are not accompanied by a fever, At the time of postoperative radiotherapy, the dosimetric CT scan constitutes the first examination providing objective information of the endo-thoracic content. It is therefore necessary on this occasion to assure the normality of the post-pneumonectomy pleural space while checking that the substituted liquid is homogeneous and above all that the internal mediastinal part of the cavity has a concave appearance. If that is not the case, an empyema should be suspected. The diagnosis, confirmed by a cyto-bacteriological examination of the pleural fluid, constitutes a counter-indication of the radiotherapy. We present two cases of post-pneumonectomy pauci-symptomatic empyema which were diagnosed during the course of postoperative radiotherapy when the initial dosimetric CT scan was pathologic and could have allowed an earlier diagnosis. (author)

Methods of counting ribs on chest CT: the modified sternomanubrial approach

Energy Technology Data Exchange (ETDEWEB)

Yi, Kyung Sik; Kim, Sung Jin; Jeon, Min Hee; Lee, Seung Young; Bae, Il Hun [Chungbuk National University, Cheongju (Korea, Republic of)

2007-08-15

The purpose of this study was to evaluate the accuracy of each method of counting ribs on chest CT and to propose a new method: the anterior approach with using the sternocostal joints. CT scans of 38 rib lesions of 27 patients were analyzed (fracture: 25, metastasis: 11, benign bone disease: 2). Each lesion was independently counted by three radiologists with using three different methods for counting ribs: the sternoclavicular approach, the xiphisternal approach and the modified sternomanubrial approach. The rib lesions were divided into three parts of evaluation of each method according to the location of the lesion as follows: the upper part (between the first and fourth thoracic vertebra), the middle part (between the fifth and eighth) and the lower part (between the ninth and twelfth). The most accurate method was a modified sternomanubrial approach (99.1%). The accuracies of a xiphisternal approach and a sternoclavicular approach were 95.6% and 88.6%, respectively. A modified sternomanubrial approach showed the highest accuracies in all three parts (100%, 100% and 97.9%, respectively). We propose a new method for counting ribs, the modified sternomanubrial approach, which was more accurate than the known methods in any parts of the bony thorax, and it may be an easier and quicker method than the others in clinical practice.

Is sweat chloride predictive of severity of cystic fibrosis lung disease assessed by chest computed tomography?

Science.gov (United States)

Caudri, Daan; Zitter, David; Bronsveld, Inez; Tiddens, Harm

2017-09-01

Cystic Fibrosis (CF) lung disease is characterized by a marked heterogeneity. Sweat chloride-level is a functional marker of the CF Transmembrane Regulator (CFTR) protein and could be an important predictor of later disease severity. In this retrospective analysis children from the Rotterdam CF clinic with available sweat chloride level at diagnosis and at least one routine spirometry-controlled volumetric chest CT scan in follow-up were included. CT scans were scored using the CF-CT scoring system (% of maximum). Associations between sweat chloride-levels and CF-CT scores were calculated using linear regression models, adjusting for age at sweat test and age at follow-up. Because structural lung damage develops over the course of many years, effect modification by the age at follow-up CT-scan was tested for by age-stratification. In 59 children (30 male) sweat chloride was measured at diagnosis (median age 0.5 years, range 0-13) and later chest CT performed (median age 14 years, range 6-18). Sweat chloride was associated with significantly higher CT-CT total score, bronchiectasis score, and mucus plugging score. Stratification for age at follow-up in tertiles showed this association remained only in the oldest age group (range 15-18 years). In that subgroup associations were found with all but one of the CF-CT subscores, as well as with all tested lung functions parameters. Sweat chloride-level is a significant predictor of CF lung disease severity as determined by chest CT and lung function. This association could only be demonstrated in children with follow-up to age 15 years and above. © 2017 Wiley Periodicals, Inc.

The evaluation of cardiac tamponade risk in patients with pericardial effusion detected by non-gated chest CT.

Science.gov (United States)

Ohta, Yasutoshi; Miyoshi, Fuminori; Kaminou, Toshio; Kaetsu, Yasuhiro; Ogawa, Toshihide

2016-05-01

Although pericardial effusion is often identified using non-gated chest computed tomography (CT), findings predictive of cardiac tamponade have not been adequately established. To determine the findings predictive of clinical cardiac tamponade in patients with moderate to large pericardial effusion using non-gated chest CT. We performed a retrospective analysis of 134 patients with moderate to large pericardial effusion who were identified from among 4581 patients who underwent non-gated chest CT. Cardiac structural changes, including right ventricular outflow tract (RVOT), were qualitatively evaluated. The inferior vena cava ratio with hepatic (IVCupp) and renal portions (IVClow) and effusion size were measured. The diagnostic performance of each structural change was calculated, and multivariate analysis was used to determine the predictors of cardiac tamponade. Of the 134 patients (mean age, 70.3 years; 64 men), 37 (28%) had cardiac tamponade. The sensitivity and specificity were 76% and 74% for RVOT compression; 87% and 84% for an IVClow ratio ≥0.77; and 60% and 77% for an effusion size ≥25.5 mm, respectively. Multivariate logistic regression analysis demonstrated that RVOT compression, an IVClow ratio ≥0.77, and an effusion size ≥25.5 mm were independent predictors of cardiac tamponade. The combination of these three CT findings had a sensitivity, specificity, and accuracy of 81%, 95%, and 91%, respectively. In patients with moderate to large pericardial effusion, non-gated chest CT provides additional information for predicting cardiac tamponade. © The Foundation Acta Radiologica 2015.

PET-CT in the evaluation of metastatic breast cancer

International Nuclear Information System (INIS)

Sullivan, A.M.; Fulham, M.J.

2005-01-01

A 44-year-old woman underwent two PET-CT scans for the evaluation of metastatic breast cancer. A radical left mastectomy with axillary dissection (1 of 43 nodes positive) followed by chemotherapy, was performed in 1998. She represented in October 2003 with a left supraclavicular fossa mass. This was confirmed to be recurrent breast cancer on FNAB. She was considered for a radical neck dissection and the surgeon requested a PET scan. Other imaging at this time included a normal bone scan and CT brain. CT neck/chest/abdomen/pelvis showed soft tissue thickening in the left lower neck. The PET-CT scan showed multiple glucose avid lesions in the sternum, mediastinum and neck lymph nodes as well as a small lesion in the proximal left femur consistent with extensive metastatic disease. Surgery was cancelled and Femara chemotherapy commenced. Femara was stopped in March 2004 and the patient began alternative therapies. In October 2004 she presented to her surgeon with new back and chest pain. CT of the neck/chest/abdomen/pelvis showed a soft tissue mass in the upper sternum and a lymph node at the base of the neck highly suspicious for metastatic disease. There were also 2 suspicious lung nodules and a lesion in the proximal left femur reported as an osteoid osteoma. Wholebody PET-CT scans were performed on a Siemens LSO Biograph, 60mins after the injection of 350Mbq of Fl 8-Fag, with arms at the patient's side and head in the field-of-view. On both occasions the patient had to pay for the scan. On the 2004 PET-CT scan, the CT brain revealed multiple hyperdense lesions consistent with hemorrhagic metastases. In addition, there were innumerable glucose avid foci involving viscera, nodes and skeleton consistent with disseminated disease. Our case illustrates: (i) the value of PET in the management of metastatic breast cancer; (ii) the improved accuracy of PET-CT in delineating sites of disease; (iii) the issues of head movement in PET-CT and. (iv) the problem with lack of

Radiology of pulmonary disease. Chest radiography, computed tomography, and gallium scanning

International Nuclear Information System (INIS)

Golden, J.A.; Sollitto, R.A.

1988-01-01

A review of the radiologic manifestations of AIDS pulmonary diseases, with an emphasis on the utility of gallium scanning in the context of the normal or equivocal chest x-ray, is presented.99 references

ECG-triggered MDR-CT for the detection of pulmonary metastases

International Nuclear Information System (INIS)

Pauls, S.; Wahl, J.; Aschoff, A.J.; Brambs, H.J.; Fleiter, T.R.

2003-01-01

Purpose: Comparison of multidetector-row CT (MDR-CT) of the chest with and without ECG triggering for the detection of pulmonary metastases. Materials and Methods: Fifty patients with malignant tumors underwent CT of the chest. The unenhanced phase was performed with ECG-triggered MDR-CT and the contrast-enhanced phase with helical MDR-CT. The ECG-triggered and standard helical scans were interpreted in separate sessions, with the analysis determining the number and demarcation of the intrapulmonary nodules and the delineation of the mediastinal structure (rated 1 = excellent to 5 = poor). Results: ECG-MDR-CT images detected 38% more pulmonary nodules than MDR-CT. The detection rate for tumors [de

F-18 FDG PET scan findings in patients with pulmonary involvement in the hypereosinophilic syndrome

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Lee, Jae Hoon; Kim, Tae Hoon; Yun, Mi Jin [College of Medicine, Yonsei University, Seoul (Korea, Republic of)] (and others)

2005-08-15

Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs including the lung. F-18 2-fluoro-2-deoxyglucose (F-18 FDG) may accumulate at sites of inflammation or infection, making interpretation of whole body PET scan difficult in patients with cancer. This study was to evaluate the PET findings of HES with lung involvement and to find out differential PET features between lung malignancy and HES with lung involvement. F-18 FDG PET and low dose chest CT scan was performed for screening of lung cancer. Eight patients who showed ground-glass attenuation (GGA) and consolidation on chest CT scan with peripheral blood eosinophilia were included in this study. The patients with history of parasite infection, allergy and collagen vascular disease were excluded. CT features and FDG PET findings were meticulously evaluated for the distribution of GGA and consolidation and nodules on CT scan and mean and maximal SUV of abnormalities depicted on F-18 FDG PET scan. In eight patients, follow-up chest CT scan and FDG PET scan were done one or two weeks after initial study. F-18 FDG PET scan identified metabolically active lesions in seven out of eight patients. Maximal SUV was ranged from 2.8 to 10.6 and mean SUV was ranged from 2.2 to 7.2. Remaining one patient had maximal SUV of 1.3. On follow-up FDG PET scan taken on from one to four weeks later showed decreased degree of initially noted FDG uptakes or migration of previously noted abnormal FDG uptakes. Lung involvement in the HES might be identified as abnormal uptake foci on FDG PET scan mimicking lung cancer. Follow-up FDG PET and CT scan for the identification of migration or resolution of abnormalities and decrement of SUV would be of help for the differentiation between lung cancer and HES with lung involvement.

F-18 FDG PET scan findings in patients with pulmonary involvement in the hypereosinophilic syndrome

International Nuclear Information System (INIS)

Lee, Jae Hoon; Kim, Tae Hoon; Yun, Mi Jin

2005-01-01

Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs including the lung. F-18 2-fluoro-2-deoxyglucose (F-18 FDG) may accumulate at sites of inflammation or infection, making interpretation of whole body PET scan difficult in patients with cancer. This study was to evaluate the PET findings of HES with lung involvement and to find out differential PET features between lung malignancy and HES with lung involvement. F-18 FDG PET and low dose chest CT scan was performed for screening of lung cancer. Eight patients who showed ground-glass attenuation (GGA) and consolidation on chest CT scan with peripheral blood eosinophilia were included in this study. The patients with history of parasite infection, allergy and collagen vascular disease were excluded. CT features and FDG PET findings were meticulously evaluated for the distribution of GGA and consolidation and nodules on CT scan and mean and maximal SUV of abnormalities depicted on F-18 FDG PET scan. In eight patients, follow-up chest CT scan and FDG PET scan were done one or two weeks after initial study. F-18 FDG PET scan identified metabolically active lesions in seven out of eight patients. Maximal SUV was ranged from 2.8 to 10.6 and mean SUV was ranged from 2.2 to 7.2. Remaining one patient had maximal SUV of 1.3. On follow-up FDG PET scan taken on from one to four weeks later showed decreased degree of initially noted FDG uptakes or migration of previously noted abnormal FDG uptakes. Lung involvement in the HES might be identified as abnormal uptake foci on FDG PET scan mimicking lung cancer. Follow-up FDG PET and CT scan for the identification of migration or resolution of abnormalities and decrement of SUV would be of help for the differentiation between lung cancer and HES with lung involvement

Inferior hilar window on lateral chest radiographs

International Nuclear Information System (INIS)

Park, C.K.; Webb, W.R.; Klein, J.S.

1990-01-01

This paper determines the accuracy of lateral chest radiography in the detection of masses in the inferior hilar window, a normally avascular hilar region anterior to the lower lobe bronchi. Fifty patients with normal thoracic CT scans and 25 with hilar masses/adenopathy were selected retrospectively. The 75 corresponding lateral chest radiographs were blindly evaluated for visibility of the anterior walls of the lower lobe bronchi and the presence and laterality of abnormal soft tissue (>1 cm) in the inferior hilar window. Only a 7 x 7-cm square of the lateral radiograph was viewed

Clinical and CT scan pictures of cerebral cysticercosis

Energy Technology Data Exchange (ETDEWEB)

Singounas, E.G.; Krassanakis, K.; Karvounis, P.C. (Evangelismos Hospital, Athens (Greece))

1982-01-01

The clinical presentations and CT scan pictures of four patients harbouring big cysticercus cysts are described. The value of CT scanning in detecting these cysts is emphasized, and also the fact that these cysts can behave as space-occyping lesions, which must be differentiated from other cystic formations.

Which Iodine concentration in chest CT? - A prospective study in 300 patients

Energy Technology Data Exchange (ETDEWEB)

Muehlenbruch, Georg [RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Aachen (Germany); University Hospital, RWTH Aachen University, Aachen (Germany); Behrendt, Florian F.; Eddahabi, Mohammed A.; Das, Marco; Guenther, Rolf W.; Mahnken, Andreas H. [RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Aachen (Germany); Knackstedt, Christian [RWTH Aachen University Hospital, Department of Cardiology, Pulmonology and Angiology, Aachen (Germany); Stanzel, Sven [RWTH Aachen University Hospital, Institute of Medical Statistics, Aachen (Germany); Seidensticker, Peter [Bayer Schering Pharma AG, Berlin (Germany); Wildberger, Joachim E. [University Hospital Maastricht, Department of Radiology, Maastricht (Netherlands)

2008-12-15

In computed tomography(CT) several contrast media with different iodine concentrations are available. The aim of this study is to prospectively compare contrast media with iodine concentrations of 300, 370 and 400 mg iodine/ml for chest- CT. 300 consecutive patients were prospectively enrolled, under a waiver of the local ethics committee. The first (second, third) 100 patients, received contrast medium with 300(370, 400)mg iodine/ml. Injection protocols were adapted for an identical iodine delivery rate(1.3 mg/s) and total iodine load(33 g) for all three groups. Standardized MDCT of the chest (16 x 0.75 mm, 120 kVp, 100 mAseff.) was performed. Intravascular attenuation values were measured in the pulmonary trunk and the ascending aorta; subjective image quality was rated on a 3-point-scale. Discomfort during and after injection was evaluated. There were no statistically significant differences in contrast enhancement comparing the three contrast media at the pulmonary trunk(p = 0.3198) and at the ascending aorta(p = 0.0840). Image quality(p = 0.0176) and discomfort during injection(p = 0.7034) were comparable for all groups. General discomfort after injection of contrast media with 300 mg iodine/ml was statistically significant higher compared to 370 mg iodine/ml(p = 0.00019). Given identical iodine delivery rates of 1.3 g/s and iodine loads of 33 g, contrast media with concentrations of 300, 370 and 400 mg iodine/ml do not result in different intravascular enhancement in chest-CT. (orig.)

A Study for Reappearance According to the Scan Type, the CT Scanning by a Moving Phantom

International Nuclear Information System (INIS)

Choi, Jae Hyock; Jeong, Do Hyeong; Choi, Gye Suk; Jang, Yo Jong; Kim, Jae Weon; Lee, Hui Seok

2007-01-01

CT scan shows that significant tumor movement occurs in lesions located in the proximity of the heart, diaphragm, and lung hilus. There are differences concerning three kinds of type to get images following the Scan type called Axial, Helical, Cine (4D-CT) mode, when the scanning by CT. To know how each protocol describe accurately, this paper is going to give you reappearance using the moving phantom. To reconstruct the movement of superior-inferior and anterior-posterior, the manufactured moving phantom and the motor following breathing were used. To distinguish movement from captured images by CT scanning, a localizer adhered to the marker on the motor. The moving phantom fixed the movement of superior-inferior upon 1.3 cm /1 min. The motor following breathing fixed the movement of anterior-posterior upon 0.2 cm /1 min. After fixing each movement, CT scanning was taken by following the CT protocols. The movement of A localizer and volume-reappearance analyzed by RTP machine. Total volume of a marker was 88.2 cm 3 considering movement of superior-inferior. Total volume was 184.3 cm 3 . Total volume according to each CT scan protocol were 135 cm 3 by axial mode, 164.9 cm 3 by helical mode, 181.7 cm 3 by cine (4D-CT) mode. The most closely describable protocol about moving reappearance was cine mode, the marker attached localizer as well. CT scan should reappear concerning a exact organ-description and target, when the moving organ is being scanned by three kinds of CT protocols. The cine (4D-CT) mode has the advantage of the most highly reconstructible ability of the three protocols in reappearance of the marker using a moving phantom. The marker on the phantom has always regular motion but breathing patients don't move like a phantom. Breathing education and devices setting patients were needed so that images reconstruct breathing as exactly as possible. Users should also consider that an amount of radiation to patients is being bombed.

Poster — Thur Eve — 06: Dose assessment of cone beam CT imaging protocols as part of SPECT/CT examinations

Energy Technology Data Exchange (ETDEWEB)

Tonkopi, E; Ross, AA [Department of Diagnostic Imaging, Queen Elizabeth II Health Sciences Centre, CDHA (Canada); Department of Radiology, Dalhousie University (Canada)

2014-08-15

Purpose: To assess radiation dose from the cone beam CT (CBCT) component of SPECT/CT studies and to compare with other CT examinations performed in our institution. Methods: We used an anthropomorphic chest phantom and the 6 cc ion chamber to measure entrance breast dose for several CBCT and diagnostic CT acquisition protocols. The CBCT effective dose was calculated with ImPACT software; the CT effective dose was evaluated from the DLP value and conversion factor, dependent on the anatomic region. The RADAR medical procedure radiation dose calculator was used to assess the nuclear medicine component of exam dose. Results: The entrance dose to the breast measured with the anthropomorphic phantom was 0.48 mGy and 9.41 mGy for cardiac and chest CBCT scans; and 4.59 mGy for diagnostic thoracic CT. The effective doses were 0.2 mSv, 3.2 mSv and 2.8 mSv respectively. For a small patient represented by the anthropomorphic phantom, the dose from the diagnostic CT was lower than from the CBCT scan, as a result of the exposure reduction options available on modern CT scanners. The CBCT protocols used the same fixed scanning techniques. The diagnostic CT dose based on the patient data was 35% higher than the phantom dose. For most SPECT/CT studies the dose from the CBCT component was comparable with the dose from the radiopharmaceutical. Conclusions: The patient radiation dose from the cone beam CT scan can be higher than that from a diagnostic CT and should be taken into consideration in evaluating total SPECT/CT patient dose.

Improved assessment of mediastinal and pulmonary pathologies in combined staging CT examinations using a fast-speed acquisition dual-source CT protocol

Energy Technology Data Exchange (ETDEWEB)

Braun, Franziska M.; Holzner, Veronica; Meinel, Felix G.; Armbruster, Marco; Brandlhuber, Martina; Ertl-Wagner, Birgit; Sommer, Wieland H. [University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

2017-12-15

To demonstrate the feasibility of fast Dual-Source CT (DSCT) and to evaluate the clinical utility in chest/abdomen/pelvis staging CT studies. 45 cancer patients with two follow-up combined chest/abdomen/pelvis staging CT examinations (maximally ±10 kV difference in tube potential) were included. The first scan had to be performed with our standard protocol (fixed pitch 0.6), the second one using a novel fast-speed DSCT protocol (fixed pitch 1.55). Effective doses (ED) were calculated, noise measurements performed. Scan times were compared, motion artefacts and the diagnostic confidence rated in consensus reading. ED for the standard and fast-speed scans was 9.1 (7.0-11.1) mSv and 9.2 (7.4-12.8) mSv, respectively (P = 0.075). Image noise was comparable (abdomen; all P > 0.05) or reduced for fast-speed CTs (trachea, P = 0.001; ascending aorta, P < 0.001). Motion artefacts of the heart/the ascending aorta (all P < 0.001) and breathing artefacts (P < 0.031) were reduced in fast DSCT. The diagnostic confidence for the evaluation of mediastinal (P < 0.001) and pulmonary (P = 0.008) pathologies was improved for fast DSCT. Fast DSCT for chest/abdomen/pelvis staging CT examinations is performed within 2 seconds scan time and eliminates relevant intrathoracic motion/breathing artefacts. Mediastinal/pulmonary pathologies can thus be assessed with high diagnostic confidence. Abdominal image quality remains excellent. (orig.)

CORK Study in Cystic Fibrosis: Sustained Improvements in Ultra-Low-Dose Chest CT Scores After CFTR Modulation With Ivacaftor.

Science.gov (United States)

Ronan, Nicola J; Einarsson, Gisli G; Twomey, Maria; Mooney, Denver; Mullane, David; NiChroinin, Muireann; O'Callaghan, Grace; Shanahan, Fergus; Murphy, Desmond M; O'Connor, Owen J; Shortt, Cathy A; Tunney, Michael M; Eustace, Joseph A; Maher, Michael M; Elborn, J Stuart; Plant, Barry J

2018-02-01

Ivacaftor produces significant clinical benefit in patients with cystic fibrosis (CF) with the G551D mutation. Prevalence of this mutation at the Cork CF Centre is 23%. This study assessed the impact of cystic fibrosis transmembrane conductance regulator modulation on multiple modalities of patient assessment. Thirty-three patients with the G551D mutation were assessed at baseline and prospectively every 3 months for 1 year after initiation of ivacaftor. Change in ultra-low-dose chest CT scans, blood inflammatory mediators, and the sputum microbiome were assessed. Significant improvements in FEV 1 , BMI, and sweat chloride levels were observed post-ivacaftor treatment. Improvement in ultra-low-dose CT imaging scores were observed after treatment, with significant mean reductions in total Bhalla score (P < .01), peribronchial thickening (P = .035), and extent of mucous plugging (P < .001). Reductions in circulating inflammatory markers, including interleukin (IL)-1β, IL-6, and IL-8 were demonstrated. There was a 30% reduction in the relative abundance of Pseudomonas species and an increase in the relative abundance of bacteria associated with more stable community structures. Posttreatment community richness increased significantly (P = .03). Early and sustained improvements on ultra-low-dose CT scores suggest it may be a useful method of evaluating treatment response. It paralleled improvement in symptoms, circulating inflammatory markers, and changes in the lung microbiota. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Quality criteria in computerized tomography of the chest

International Nuclear Information System (INIS)

Doehring, W.

1985-01-01

The quality of thoracical computerized tomography (CT) - like any other CT examination - depends from the quality of the equipment used, from the skill of the examinor and the properties of the patient. Concerning computerized chest tomograms, rapid scan equipment should be used only and slow translation - rotation systems should not be used any more. Whereas the quality of computerized tomograms may be influenced by the patient in the scanning process only, the examining physician will decisively influence the possible informative value of the examination also in the reconstruction of the CT value matrix, in single demonstration of CT values and, possibly, in additional measurement value processing as well as in the interpretation of findings. Use of equipment should always consider the technical potential provided by the equipment to be oriented to the clinical issue, and the conditions preset by the patient. (orig.) [de

Dense volumetric detection and segmentation of mediastinal lymph nodes in chest CT images

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Oda, Hirohisa; Roth, Holger R.; Bhatia, Kanwal K.; Oda, Masahiro; Kitasaka, Takayuki; Iwano, Shingo; Homma, Hirotoshi; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Schnabel, Julia A.; Mori, Kensaku

2018-02-01

We propose a novel mediastinal lymph node detection and segmentation method from chest CT volumes based on fully convolutional networks (FCNs). Most lymph node detection methods are based on filters for blob-like structures, which are not specific for lymph nodes. The 3D U-Net is a recent example of the state-of-the-art 3D FCNs. The 3D U-Net can be trained to learn appearances of lymph nodes in order to output lymph node likelihood maps on input CT volumes. However, it is prone to oversegmentation of each lymph node due to the strong data imbalance between lymph nodes and the remaining part of the CT volumes. To moderate the balance of sizes between the target classes, we train the 3D U-Net using not only lymph node annotations but also other anatomical structures (lungs, airways, aortic arches, and pulmonary arteries) that can be extracted robustly in an automated fashion. We applied the proposed method to 45 cases of contrast-enhanced chest CT volumes. Experimental results showed that 95.5% of lymph nodes were detected with 16.3 false positives per CT volume. The segmentation results showed that the proposed method can prevent oversegmentation, achieving an average Dice score of 52.3 +/- 23.1%, compared to the baseline method with 49.2 +/- 23.8%, respectively.

Chest ultrasound in the evaluation of complicated pneumonia in the ICU patients: Can be viable alternative to CT?

Directory of Open Access Journals (Sweden)

Hesham El Sheikh

2014-06-01

Conclusion: Chest US provides an accurate evaluation of the pleural and parenchymal abnormalities associated with complicated pneumonia in the ICU patients. Considering that chest US is a bedside and avoids transportation of the patient outside ICU, free of radiation exposure and easily repeatable, chest US appears to be an attractive alternative to CT.

New Methods for Imaging Evaluation of Chest Wall Deformities

Directory of Open Access Journals (Sweden)

Ana Lain

2017-12-01

Full Text Available AimThe purpose of this study is to describe the development of an external 3-dimensional (3D scanner as a noninvasive method for imaging chest wall deformities. It allows objective assessment, reconstruction of the area of interest, and evaluation of the severity of the deformity by using external indexes.External 3D scanning systemThe OrtenBodyOne scanner (Orten, Lyon, France uses depth sensors to scan the entire 3D external body surface of a patient. The depth sensors combine structured light with two classic computer vision techniques: depth from focus and depth from stereo. The data acquired are processed and analyzed using the Orten-Clinic software.Materials and methodsTo investigate the performance of the device, a preliminary prospective study (January 2015–March 2016 was carried out in patients attending our hospital chest wall deformities unit. In total, 100 patients (children and young adults with pectus excavatum or pectus carinatum, treated by surgery or non-operative methods were included. In patients undergoing non-operative treatment, external 3D scanning was performed monthly until complete correction was achieved. In surgically treated patients, scanning was done before and after surgical correction. In 42 patients, computed tomography (CT was additionally performed and correlations between the Haller index calculated by CT and the external Haller index using external scanning were investigated using a Student’s test (r = 0.83.ConclusionExternal scanning is an effective, objective, radiation-free means to diagnose and follow-up patients with chest wall deformities. Externally measured indexes can be used to evaluate the severity of these conditions and the treatment outcomes.

3D Convolutional Neural Network for Automatic Detection of Lung Nodules in Chest CT.

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Hamidian, Sardar; Sahiner, Berkman; Petrick, Nicholas; Pezeshk, Aria

2017-01-01

Deep convolutional neural networks (CNNs) form the backbone of many state-of-the-art computer vision systems for classification and segmentation of 2D images. The same principles and architectures can be extended to three dimensions to obtain 3D CNNs that are suitable for volumetric data such as CT scans. In this work, we train a 3D CNN for automatic detection of pulmonary nodules in chest CT images using volumes of interest extracted from the LIDC dataset. We then convert the 3D CNN which has a fixed field of view to a 3D fully convolutional network (FCN) which can generate the score map for the entire volume efficiently in a single pass. Compared to the sliding window approach for applying a CNN across the entire input volume, the FCN leads to a nearly 800-fold speed-up, and thereby fast generation of output scores for a single case. This screening FCN is used to generate difficult negative examples that are used to train a new discriminant CNN. The overall system consists of the screening FCN for fast generation of candidate regions of interest, followed by the discrimination CNN.

CT of the chest with model-based, fully iterative reconstruction: comparison with adaptive statistical iterative reconstruction.

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Ichikawa, Yasutaka; Kitagawa, Kakuya; Nagasawa, Naoki; Murashima, Shuichi; Sakuma, Hajime

2013-08-09

The recently developed model-based iterative reconstruction (MBIR) enables significant reduction of image noise and artifacts, compared with adaptive statistical iterative reconstruction (ASIR) and filtered back projection (FBP). The purpose of this study was to evaluate lesion detectability of low-dose chest computed tomography (CT) with MBIR in comparison with ASIR and FBP. Chest CT was acquired with 64-slice CT (Discovery CT750HD) with standard-dose (5.7 ± 2.3 mSv) and low-dose (1.6 ± 0.8 mSv) conditions in 55 patients (aged 72 ± 7 years) who were suspected of lung disease on chest radiograms. Low-dose CT images were reconstructed with MBIR, ASIR 50% and FBP, and standard-dose CT images were reconstructed with FBP, using a reconstructed slice thickness of 0.625 mm. Two observers evaluated the image quality of abnormal lung and mediastinal structures on a 5-point scale (Score 5 = excellent and score 1 = non-diagnostic). The objective image noise was also measured as the standard deviation of CT intensity in the descending aorta. The image quality score of enlarged mediastinal lymph nodes on low-dose MBIR CT (4.7 ± 0.5) was significantly improved in comparison with low-dose FBP and ASIR CT (3.0 ± 0.5, p = 0.004; 4.0 ± 0.5, p = 0.02, respectively), and was nearly identical to the score of standard-dose FBP image (4.8 ± 0.4, p = 0.66). Concerning decreased lung attenuation (bulla, emphysema, or cyst), the image quality score on low-dose MBIR CT (4.9 ± 0.2) was slightly better compared to low-dose FBP and ASIR CT (4.5 ± 0.6, p = 0.01; 4.6 ± 0.5, p = 0.01, respectively). There were no significant differences in image quality scores of visualization of consolidation or mass, ground-glass attenuation, or reticular opacity among low- and standard-dose CT series. Image noise with low-dose MBIR CT (11.6 ± 1.0 Hounsfield units (HU)) were significantly lower than with low-dose ASIR (21.1 ± 2.6 HU, p standard-dose FBP CT (16.6 ± 2.3 HU, p 70%, MBIR can provide

Diagnosis of pituitary adenoma by dynamic CT scanning

International Nuclear Information System (INIS)

Tanabe, Sumiyoshi; Uede, Teiji; Daibo, Masahiko; Niwa, Jun; Hashi, Kazuo

1988-01-01

The advantage of high resolution CT in the diagnosis of pituitary microadenomas has been established, but the diagnosis becomes more difficult when the pituitary microadenoma is less than 5 mm in diameter. We have studied the usefulness of dynamic CT scans particularly for diagnosis of small microadenomas. The dynamic CT scans were performed for 61 normal pituitary glands and 68 pituitary adenomas (36 microadenomas, 32 macroadenomas) with a GECT/T 9800 scanner. Coronal sections of 1.5 mm thickness were taken at the plane just in front of the pituitary stalk of the pituitary gland. Following a bolus intra-venous injection of 40 - 60 ml of contrast media using an automatic injector, ten consecutive CT scans of 2 seconds scan time were obtained, beginning 2 seconds from the start of intravenous injection. The first seven scans were taken with an interval of 2.3 seconds, and the last three scans with an interval of 10 seconds. Then, time-density curves were obtained at the ROI which were set on the anterior pituitary gland, the vascular bed of the pituitary gland, the pituitary stalk and the area of the pituitary adenoma respectively. In a normal pituitary gland, the density increases gradually and makes an S shaped curve, then attains the maximum density value (92.3 CT number) approximately 60 seconds after the administration of contrast media. The pituitary vascular bed is located in midline on the upper surface of the pituitary gland, and shows a symmetrical square, triangular or rhomboid shape. In case of pituitary adenoma, the time-density curve makes a plateau curve and attains the maximum density value (60.1 CT number) approximately 60 seconds after the administration of contrast media. In microadenoma, the pituitary vascular bed is either deformed or compressed, showing an asymmetrical shape. (author)

Chest X-ray and chest CT findings in patients diagnosed with pulmonary tuberculosis following solid organ transplantation: a systematic review.

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Giacomelli, Irai Luis; Schuhmacher Neto, Roberto; Marchiori, Edson; Pereira, Marisa; Hochhegger, Bruno

2018-04-01

The objective of this systematic review was to select articles including chest X-ray or chest CT findings in patients who developed pulmonary tuberculosis following solid organ transplantation (lung, kidney, or liver). The following search terms were used: "tuberculosis"; "transplants"; "transplantation"; "mycobacterium"; and "lung". The databases used in this review were PubMed and the Brazilian Biblioteca Virtual em Saúde (Virtual Health Library). We selected articles in English, Portuguese, or Spanish, regardless of the year of publication, that met the selection criteria in their title, abstract, or body of text. Articles with no data on chest CT or chest X-ray findings were excluded, as were those not related to solid organ transplantation or pulmonary tuberculosis. We selected 29 articles involving a collective total of 219 patients. The largest samples were in studies conducted in Brazil and South Korea (78 and 35 patients, respectively). The imaging findings were subdivided into five common patterns. The imaging findings varied depending on the transplanted organ in these patients. In liver and lung transplant recipients, the most common pattern was the classic one for pulmonary tuberculosis (cavitation and "tree-in-bud" nodules), which is similar to the findings for pulmonary tuberculosis in the general population. The proportion of cases showing a miliary pattern and lymph node enlargement, which is most similar to the pattern seen in patients coinfected with tuberculosis and HIV, was highest among the kidney transplant recipients. Further studies evaluating clinical data, such as immunosuppression regimens, are needed in order to improve understanding of the distribution of these imaging patterns in this population.

CT findings of foreign bodies in the chest: a pictorial essay

International Nuclear Information System (INIS)

Park, Sang Hyun; Kim, Young Tong; Jou, Sung Shick; Shin, Hyung Cheol

2008-01-01

The most common causes of tracheobronchial foreign bodies are peanuts in children, and meat and dentures in adults. The most common causes of esophageal foreign bodies are coins in children and meat in adults. It is passable to diagnose a foreign body by visualization on a chest radiograph, if the foreign bodies are radio opaque. However, if the foreign bodies are radiolucent and the patients do not remember the history of aspiration, it is important to evaluate CT findings for foreign bodies and their complications. We describe the CT findings of various thoracic foreign bodies in children and adults

CT findings of foreign bodies in the chest: a pictorial essay

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Park, Sang Hyun; Kim, Young Tong; Jou, Sung Shick; Shin, Hyung Cheol [Cheonan Hospital, Soonchunhyang University, Cheonan (Korea, Republic of)

2008-05-15

The most common causes of tracheobronchial foreign bodies are peanuts in children, and meat and dentures in adults. The most common causes of esophageal foreign bodies are coins in children and meat in adults. It is passable to diagnose a foreign body by visualization on a chest radiograph, if the foreign bodies are radio opaque. However, if the foreign bodies are radiolucent and the patients do not remember the history of aspiration, it is important to evaluate CT findings for foreign bodies and their complications. We describe the CT findings of various thoracic foreign bodies in children and adults.

Adenosine-stress dynamic real-time myocardial perfusion CT and adenosine-stress first-pass dual-energy myocardial perfusion CT for the assessment of acute chest pain: Initial results

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Weininger, Markus [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC (United States); Ramachandra, Ashok [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Fink, Christian [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany); Rowe, Garrett W.; Costello, Philip [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Henzler, Thomas [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany)

2012-12-15

Purpose: Recent innovations in CT enable the evolution from mere morphologic imaging to dynamic and functional testing. We describe our initial experience performing myocardial stress perfusion CT in a clinical population with acute chest pain. Methods and materials: Myocardial stress perfusion CT was performed on twenty consecutive patients (15 men, 5 women; mean age 65 ± 8 years) who presented with acute chest pain and were clinically referred for stress/rest SPECT and cardiac MRI. Prior to CT each patient was randomly assigned either to Group A or to Group B in a consecutive order (10 patients per group). Group A underwent adenosine-stress dynamic real-time myocardial perfusion CT using a novel “shuttle” mode on a 2nd generation dual-source CT. Group B underwent adenosine-stress first-pass dual-energy myocardial perfusion CT using the same CT scanner in dual-energy mode. Two experienced observers visually analyzed all CT perfusion studies. CT findings were compared with MRI and SPECT. Results: In Group A 149/170 myocardial segments (88%) could be evaluated. Real-time perfusion CT (versus SPECT) had 86% (84%) sensitivity, 98% (92%) specificity, 94% (88%) positive predictive value, and 96% (92%) negative predictive value in comparison with perfusion MRI for the detection of myocardial perfusion defects. In Group B all myocardial segments were available for analysis. Compared with MRI, dual-energy myocardial perfusion CT (versus SPECT) had 93% (94%) sensitivity, 99% (98%) specificity, 92% (88%) positive predictive value, and 96% (94%) negative predictive value for detecting hypoperfused myocardial segments. Conclusion: Our results suggest the clinical feasibility of myocardial perfusion CT imaging in patients with acute chest pain. Compared to MRI and SPECT both, dynamic real-time perfusion CT and first-pass dual-energy perfusion CT showed good agreement for the detection of myocardial perfusion defects.

Adenosine-stress dynamic real-time myocardial perfusion CT and adenosine-stress first-pass dual-energy myocardial perfusion CT for the assessment of acute chest pain: Initial results

International Nuclear Information System (INIS)

Weininger, Markus; Schoepf, U. Joseph; Ramachandra, Ashok; Fink, Christian; Rowe, Garrett W.; Costello, Philip; Henzler, Thomas

2012-01-01

Purpose: Recent innovations in CT enable the evolution from mere morphologic imaging to dynamic and functional testing. We describe our initial experience performing myocardial stress perfusion CT in a clinical population with acute chest pain. Methods and materials: Myocardial stress perfusion CT was performed on twenty consecutive patients (15 men, 5 women; mean age 65 ± 8 years) who presented with acute chest pain and were clinically referred for stress/rest SPECT and cardiac MRI. Prior to CT each patient was randomly assigned either to Group A or to Group B in a consecutive order (10 patients per group). Group A underwent adenosine-stress dynamic real-time myocardial perfusion CT using a novel “shuttle” mode on a 2nd generation dual-source CT. Group B underwent adenosine-stress first-pass dual-energy myocardial perfusion CT using the same CT scanner in dual-energy mode. Two experienced observers visually analyzed all CT perfusion studies. CT findings were compared with MRI and SPECT. Results: In Group A 149/170 myocardial segments (88%) could be evaluated. Real-time perfusion CT (versus SPECT) had 86% (84%) sensitivity, 98% (92%) specificity, 94% (88%) positive predictive value, and 96% (92%) negative predictive value in comparison with perfusion MRI for the detection of myocardial perfusion defects. In Group B all myocardial segments were available for analysis. Compared with MRI, dual-energy myocardial perfusion CT (versus SPECT) had 93% (94%) sensitivity, 99% (98%) specificity, 92% (88%) positive predictive value, and 96% (94%) negative predictive value for detecting hypoperfused myocardial segments. Conclusion: Our results suggest the clinical feasibility of myocardial perfusion CT imaging in patients with acute chest pain. Compared to MRI and SPECT both, dynamic real-time perfusion CT and first-pass dual-energy perfusion CT showed good agreement for the detection of myocardial perfusion defects.

Overview of two years of clinical experience of chest tomo-synthesis at Sahlgrenska university hospital

International Nuclear Information System (INIS)

Johnsson, Aa. A.; Vikgren, J.; Svalkvist, A.; Zachrisson, S.; Flinck, A.; Boijsen, M.; Kheddache, S.; Maansson, L. G.; Baath, M.

2010-01-01

Since December 2006, ∼ 3800 clinical chest tomo-synthesis examinations have been performed at our department at Sahlgrenska Univ. Hospital. A subset of the examinations has been included in studies of the detectability of pulmonary nodules, using computed tomography (CT) as the gold standard. Visibility studies, in which chest tomo-synthesis and CT have been compared side-by side, have been used to determine the depiction potential of chest tomo-synthesis. Comparisons with conventional chest radiography have been made. In the clinical setting, chest tomo-synthesis has mostly been used as an additional examination. The most frequent indication for chest tomo-synthesis has been suspicion of a nodule or tumour. In visibility studies, tomo-synthesis has depicted over 90% of the nodules seen on the CT scan. The corresponding figure for chest radiography has been <30%. In the detection studies, the lesion-level sensitivity has been ∼ 60% for tomo-synthesis and 20% for chest radiography. In one of the detection studies, an analysis of all false-positive nodules was performed. This analysis showed that all findings had morphological correlates on the CT examinations. The majority of the false-positive nodules were localised in the immediate sub-pleural region. In conclusion, chest tomo-synthesis is an improved chest radiography method, which can be used to optimise the use of CT resources, thereby reducing the radiation dose to the patient population. However, there are some limitations with chest tomo-synthesis. For example, patients undergoing tomo-synthesis have to be able to stand still and hold their breath firmly for 10 s. Also, chest tomo-synthesis has a limited depth resolution, which may explain why pathology in the sub-pleural region is more difficult to interpret and artefacts from medical devices may occur. (authors)

CT findings of chronic eosinophilic pneumonia

International Nuclear Information System (INIS)

Kigami, Yusuke; Nishizawa, Sadahiko; Kuroda, Yasumasa

1992-01-01

CT scans in 11 cases of chronic eosinophilic pneumonia (CEP) were reviewed. Peripheral dense opacities suggesting air-space consolidation were the most peculiar findings seen in 9 patients on CT, but 7 on chest radiographs. Five patients showed broad plate-like opacities parallel to the pleura, which were the results of resolution from the periphery of the consolidation. Diffuse interstitial opacities suggesting alveolitis were the predominant finding in 3 patients, one of which also had peripheral air-space consolidation. Follow-up CT showed no residual abnormality except one who had DIP concomitant with CEP. CT scans are useful tool for both diagnosis and follow-up of CEP. (author)

Individualized volume CT dose index determined by cross-sectional area and mean density of the body to achieve uniform image noise of contrast-enhanced pediatric chest CT obtained at variable kV levels and with combined tube current modulation

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Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

2011-07-15

A practical body-size adaptive protocol providing uniform image noise at various kV levels is not available for pediatric CT. To develop a practical contrast-enhanced pediatric chest CT protocol providing uniform image noise by using an individualized volume CT dose index (CTDIvol) determined by the cross-sectional area and density of the body at variable kV levels and with combined tube current modulation. A total of 137 patients (mean age, 7.6 years) underwent contrast-enhanced pediatric chest CT based on body weight. From the CTDIvol, image noise, and area and mean density of the cross-section at the lung base in the weight-based group, the best fit equation was estimated with a very high correlation coefficient ({gamma}{sup 2} = 0.86, P < 0.001). For the next study, 177 patients (mean age, 7.9 years; the CTDIvol group) underwent contrast-enhanced pediatric chest CT with the CTDIvol determined individually by the best fit equation. CTDIvol values on the dose report after CT scanning, noise differences from the target noise, areas, and mean densities were compared between these two groups. The CTDIvol values (mean{+-}standard deviation, 1.6 {+-} 0.7 mGy) and the noise differences from the target noise (1.1 {+-} 0.9 HU) of the CTDIvol group were significantly lower than those of the weight-based group (2.0 {+-} 1.0 mGy, 1.8 {+-} 1.4 HU) (P < 0.001). In contrast, no statistically significant difference was found in area (317.0 {+-} 136.8 cm{sup 2} vs. 326.3 {+-} 124.8 cm{sup 2}), mean density (-212.9 {+-} 53.1 HU vs. -221.1 {+-} 56.3 HU), and image noise (13.8 {+-} 2.3 vs. 13.6 {+-} 1.7 HU) between the weight-based and the CTDIvol groups (P > 0.05). Contrast-enhanced pediatric chest CT with the CTDIvol determined individually by the cross-sectional area and density of the body provides more uniform noise and better dose adaptation to body habitus than does weight-based CT at variable kV levels and with combined tube current modulation. (orig.)

Optical-CT scanning of polymer gels

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