Thoracic Imaging
I gratefully thank all the thoracic imaging experts who have contributed to this issue of Clinics in Chest Medicine devoted to thoracic imaging. The topics presented are relevant to the clinical care of patients with pulmonary diseases and emphasize newly gained knowledge, technological innovations, and imaging features integral to management guidelines across multiple disciplines. Over a short time, we have seen exciting technological advances in radiology that include deep learning, quantitative analysis, radiomics, multienergy dual-energy computed tomography (CT) imaging, chest MRI, and thoracic CT-guided lung biopsy, a...
Source: Clinics in Chest Medicine - April 5, 2024 Category: Respiratory Medicine Authors: Jane P. Ko Tags: Preface Source Type: research
Chest Intensive Care Unit Imaging
Imaging plays a major role in the care of the intensive care unit (ICU) patients. An understanding of the monitoring devices is essential for the interpretation of imaging studies. An awareness of their expected locations aids in identifying complications in a timely manner. This review describes the imaging of ICU monitoring and support catheters, tubes, and pulmonary and cardiac devices, some more commonly encountered and others that have been introduced into clinical patient care more recently. Special focus will be placed on chest radiography and potential pitfalls encountered. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - April 4, 2024 Category: Respiratory Medicine Authors: Geraldine Villasana, Danielle Toussie, Brian Kaufman, Jadranka Stojanovska, William Moore, Lea Azour, Leah Traube, Jane P. Ko Source Type: research
Neuromuscular Disorders in Pediatric Respiratory Disease
Respiratory sequelae are a frequent cause of morbidity and mortality in children with NMD. Impaired cough strength and resulting airway clearance as well as sleep disordered breathing are the two main categories of respiratory sequelae. Routine clinical evaluation and diagnostic testing by pulmonologists is an important pillar of the multidisciplinary care required for children with NMD. Regular surveillance for respiratory disease and timely implementation of treatment including pulmonary clearance techniques as well as ventilation can prevent respiratory related morbidity including hospital admissions and improve surviva...
Source: Clinics in Chest Medicine - April 3, 2024 Category: Respiratory Medicine Authors: Jane B. Taylor, David G. Ingram, Oren Kupfer, Reshma Amin Source Type: research
Interstitial Lung Abnormalities
Interstitial lung abnormalities (ILAs) are incidental findings on computed tomography scans, characterized by nondependent abnormalities affecting more than 5% of any lung zone. They are associated with factors such as age, smoking, genetic variants, worsened clinical outcomes, and increased mortality. Risk stratification based on clinical and radiological features of ILAs is crucial in clinical practice, particularly for identifying cases at high risk of progression to pulmonary fibrosis. Traction bronchiectasis/bronchiolectasis index has emerged as a promising imaging biomarker for prognostic risk stratification in ILAs....
Source: Clinics in Chest Medicine - April 2, 2024 Category: Respiratory Medicine Authors: Noriaki Wada, Gary M. Hunninghake, Hiroto Hatabu Source Type: research
Imaging of Small Airways Disease
Bronchiolitis refers to a small airways disease and may be classified by etiology and histologic features. In cellular bronchiolitis inflammatory cells involve the small airway wall and peribronchiolar alveoli and manifest on CT as centrilobular nodules of solid or ground glass attenuation. Constrictive bronchiolitis refers to luminal narrowing by concentric fibrosis. Direct CT signs of small airway disease include centrilobular nodules and branching tree-in-bud opacities. An indirect sign is mosaic attenuation that may be exaggerated on expiratory CT and represent air trapping. Imaging findings can be combined with clinic...
Source: Clinics in Chest Medicine - April 2, 2024 Category: Respiratory Medicine Authors: Karen Rodriguez, Lida P. Hariri, Paul VanderLaan, Gerald F. Abbott Source Type: research
Imaging in Lung Cancer Staging
Lung cancer remains one of the leading causes of mortality worldwide, as well as in the United States. Clinical staging, primarily with imaging, is integral to stratify patients into groups that determine treatment options and predict survival. The eighth edition of the tumor, node, metastasis (TNM-8) staging system proposed in 2016 by the International Association for the Study of Lung Cancer remains the current standard for lung cancer staging. The system is used for all subtypes of lung cancer, including non-small cell lung cancer, small cell lung cancer, and bronchopulmonary carcinoid tumors. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - March 28, 2024 Category: Respiratory Medicine Authors: Chad D. Strange, Taylor A. Strange, Lauren T. Erasmus, Smita Patel, Jitesh Ahuja, Girish S. Shroff, Rishi Agrawal, Mylene T. Truong Source Type: research
Lung Needle Biopsy and Lung Ablation
The clinical role and use of percutaneous transthoracic needle biopsy (TTNB) and ablation of lung tumors are evolving. Here we discuss important considerations for referring providers, including current and emerging indications supported by guidelines, critical aspects of pre and postprocedure patient management, and expected postprocedure imaging findings. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - March 28, 2024 Category: Respiratory Medicine Authors: Sharath K. Bhagavatula, Alexander Graur, Florian J. Fintelmann Source Type: research
Imaging of Lung Transplantation
Lung transplantation is the only curative treatment for end-stage lung disease, which is caused by a wide variety of pathologies and encountered in a diverse range of patients. Potential recipients, as well as donors are carefully evaluated by imaging prior to transplant for contraindications to the transplant. After transplantation, recipients are imaged in the immediate, early, intermediate, and late periods for complications that may arise and require intervention. Radiography and computed tomography are the 2 most commonly used imaging modalities used to evaluate the chest after lung transplantation. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - March 28, 2024 Category: Respiratory Medicine Authors: Stacy J. Kim, Ryan G. Short, Michael A. Beal, Derek E. Byers, Cylen Javidan, Demetrios Raptis Source Type: research
Respiratory Aspects of Primary Ciliary Dyskinesia
This review article explores the respiratory aspects of primary ciliary dyskinesia (PCD), a rare, heterogenous, genetic disorder characterized by impaired motile ciliary function. It discusses the clinical diagnosis and management strategies for PCD-related respiratory disease, including chronic sinusitis, otitis media with effusion, recurrent pneumonia, and bronchiectasis. The review emphasizes the need for a multidisciplinary approach to optimize care and clinical trials to improve outcomes in individuals with PCD, highlighting the importance of accurate diagnosis. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - March 28, 2024 Category: Respiratory Medicine Authors: Wilfredo De Jes ús-Rojas, Adam J. Shapiro, Amelia Shoemark Source Type: research
Advocacy and Health Equity
This article provides an overview of selected advocacy topics related to health equity and provides key examples that can improve child respiratory health in the clinical encounter and beyond. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - March 28, 2024 Category: Respiratory Medicine Authors: Sara Christy Sadreameli, Anne Coates, Beverley J. Sheares Source Type: research
The Role of the Microbiome in Pediatric Respiratory Diseases
Numerous studies have examined the role of the microbiome and microbiome-based therapeutics in many childhood airway and lung diseases. In this narrative review, the authors first give a brief overview of the current methods used in microbiome research. The authors then review the literature linking the microbiome with (1) early-life acute respiratory infections due to respiratory syncytial virus, (2) childhood asthma onset, (3) cystic fibrosis, and (4) bronchopulmonary dysplasia, focusing on recent studies that have used culture-independent methods to characterize the respiratory or gut microbiome in the pediatric populat...
Source: Clinics in Chest Medicine - March 28, 2024 Category: Respiratory Medicine Authors: Edith T. Zemanick, Christian Rosas-Salazar Source Type: research
Imaging of the Spectrum of Acute Lung Injury
Organizing pneumonia, acute fibrinous and organizing pneumonia, and diffuse alveolar damage, represent multi-compartment patterns of lung injury. The initial region of injury in all remains the same and is centered on the fused basement membrane (BM) between the capillary endothelium and type I pneumocyte. Injury leads to cellular death, BM denudation, increased cellular permeability, and BM structural damage, which leads to exudation, organization, and attempts at repair. When acute lung injury does lead to fibrosis, in some instances it can lead to histologic and/or radiologic usual interstitial pneumonia or nonspecific ...
Source: Clinics in Chest Medicine - March 27, 2024 Category: Respiratory Medicine Authors: Seth Kligerman Source Type: research
Radiation Therapy for Lung Cancer
Radiation therapy is part of a multimodality treatment approach to lung cancer. The radiologist must be aware of both the expected and the unexpected imaging findings of the post –radiation therapy patient, including the time course for development of post– radiation therapy pneumonitis and fibrosis. In this review, a brief discussion of radiation therapy techniques and indications is presented, followed by an image-heavy differential diagnostic approach. The review focu ses on computed tomography imaging examples to help distinguish normal postradiation pneumonitis and fibrosis from alternative complications, such as ...
Source: Clinics in Chest Medicine - March 26, 2024 Category: Respiratory Medicine Authors: Danielle Toussie, Luke A. Ginocchio, Benjamin T. Cooper, Lea Azour, William H. Moore, Geraldine Villasana Gomez, Jane P. Ko Source Type: research
Imaging of Large Airway Disorders
Large airway disorders encompass a large variety of diseases and pathology, with broad categories including anatomic variants, congenital abnormalities, acquired abnormalities, inflammatory/infiltrative causes, infection, and tumors. The most common diseases in each category are discussed with a focus on the salient imaging findings. Pitfalls to beware of are discussed through the article, and concludes with a general method to approaching large airways pathology that should provide the reader with a basic framework and understanding of this complex topic. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - March 26, 2024 Category: Respiratory Medicine Authors: Anupama Gupta Brixey, Raluca McCallum Source Type: research
Pericardial Recesses on Computed Tomography
The pericardium comprises a double-walled fibrous-serosal sac that encloses the heart. Reflections of the serosal layer form sinuses and recesses. With advances in multidetector computed tomography (CT) technology, pericardial recesses are frequently detected with thin-section CT. Knowledge of pericardial anatomy on imaging is crucial to avoid misinterpretation of fluid-filled pericardial sinuses and recesses as adenopathy/pericardial metastasis or aortic dissection, which can impact patient management and treatment decisions. The authors offer a comprehensive review of pericardial anatomy and its variations observed on CT...
Source: Clinics in Chest Medicine - March 24, 2024 Category: Respiratory Medicine Authors: Hanna Dalla Pria Ferreira, Lauren T. Erasmus, Taylor A. Strange, Jitesh Ahuja, Rishi Agrawal, Girish S. Shroff, Smita Patel, Mylene T. Truong Source Type: research
