The precise extent of acute cellulitis and the presence of necrotizing soft-tissue infections can be determined with MR imaging, particularly on T2-weighted images.
Immune checkpoint inhibitors are promising new therapies for advanced cancers. In particular, antibodies against programmed cell death 1 (PD-1), such as nivolumab and pembrolizumab, increase anti-tumour T cell responses by blocking the interaction between PD-1 on T cells and its ligand PD-L1 on cancer cells [1]. Enhanced T-cell responses resulting from checkpoint inhibition can lead to an unusual spectrum of side effects called immune-related adverse events, which involve numerous organs, particularly the skin, liver, and gastrointestinal and endocrine systems [2–11]. Pneumonitis is a potentially lethal side effect of immune checkpoint inhibition, occurring in 1–5% of patients enrolled in trials [2–11]. However, little is known about the clinical and radiological features of checkpoint inhibitor-induced lung disease. Here, we report three cases of pembrolizumab-induced acute interstitial lung disease (ILD). The medical data of the patients presented below were collected in accordance with French regulations, none of which was opposed to their uses.
After a decade of preclinical testing, photon-counting computed tomography (PCCT) has now entered daily routine, enabling radiologists to start investigating thoracic disorders in unprecedented conditions. The improved spatial resolution of the ultra-high-resolution (UHR) scanning mode is a major step for the analysis of bronchopulmonary disorders, making abnormalities at the level of small anatomical structures such as secondary pulmonary lobules accessible to radiologists. Distal divisions of pulmonary and systemic vessels also benefit from UHR protocols as alterations of lung microcirculation were previously excluded from confident analysis with energy-integrating detector CT. Although noncontrast chest CT examinations were the initial target of UHR protocols, the clinical value of this mode is also applicable to chest CT angiographic examinations with improved morphological evaluation and higher-quality lung perfusion imaging. The clinical benefits of UHR have been evaluated in initial studies, allowing radiologists to foresee the field of future applications, all combining high diagnostic value and radiation dose reduction. The purpose of this article is to highlight the technological information relevant to daily practice and to review the current clinical applications in the field of chest imaging.
Nongated multidetector CT can be used to diagnose high-grade shunts through a PFO, with 91% sensitivity and 98% specificity. Thus, PFO detection, in addition to routine CT evaluation of the lungs, could be indicated in patients with unexplained hypoxemia.
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