Chronic diffuse infiltrative lung disease: comparison of diagnostic accuracy of CT and chest radiography.

Mathieson, John; Mayo, John R.; Staples, C A; Müller, N L

doi:10.1148/radiology.171.1.2928513

Cited by 397 publications

(204 citation statements)

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“…Various studies have calculated the accuracy of thoracic HRCT in fibrotic lung diseases [5][6][7], evaluated interobserver agreement for the diagnosis of different thoracic HRCT patterns (e.g. ground-glass and reticular pattern) [8,9] in patients with biopsy-proven nonspecific interstitial pneumonia (NSIP) or UIP [3], or in different forms of interstitial lung disease [10,11]. Studies on interobserver agreement amongst pathologists are sparse [12], and only one study with a multicentric prospective design has addressed the issue of diagnostic accuracy in UIP in relation to both radiologist and pathologist [7].…”

mentioning

confidence: 99%

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Thomeer¹,

Demedts²,

Behr³

et al. 2007

Eur Respir J

140

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The purpose of the present study was to evaluate the accuracy of the diagnosis of idiopathic pulmonary fibrosis (IPF) by respiratory physicians in six European countries, and to calculate the interobserver agreement between high-resolution computed tomography reviewers and histology reviewers in IPF diagnosis.The diagnosis of usual interstitial pneumonia (UIP) was assessed by a local investigator, following the American Thoracic Society/European Respiratory Society consensus statement, and confirmed when a minimum of two out of three expert reviewers from each expert panel agreed with the diagnosis. The level of agreement between readers within each expert panel was calculated by weighted kappa.The diagnosis of UIP was confirmed by the expert panels in 87.2% of cases. A total of 179 thoracic high-resolution computed tomography scans were independently reviewed, and an interobserver agreement of 0.40 was found. Open or thoracoscopic lung biopsy was performed in 97 patients, 82 of whom could be reviewed by the expert committee. The weighted kappa between histology readers was 0.30.It is concluded that, although the level of agreement between the readers within each panel was only fair to moderate, the overall accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis in expert centres is good (87.2%).

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mentioning

confidence: 99%

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Thomeer¹,

Demedts²,

Behr³

et al. 2007

Eur Respir J

140

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“…Cadela Poodle com 11 anos de idade (animal nº5) 23 . Essas alterações que por vezes não são indentificadas ao exame radiográfico 26,27 podem representar um quadro de linfangite carcinomatosa, a qual tem sido associada aos carcinomas mamários em cadelas 4,5,10,15,24,25 . No caso desta paciente, foi descrito um quadro intersticial discreto ao exame radiográfico acometendo especialmente lobos caudais ao passo que, o quadro observado ao exame tomográfico era evidente e acometia principalmente lobos craniais.…”

Section: Materials E Métodounclassified

“…Essa forma tem sido descrita em cães, associada a carcinomas mamários 4,5,10,15,24,25 e o exame tomográfico é considerado mais acurado que o exame radiográfico para o diagnóstico da linfangite carcinomatosa 26,27 . Pelo exame tomográfico de alta resolução ela pode ser observada como nódulos perilinfáticos que predominam nas superfícies pleurais, ao redor de grandes vasos e brônquios, nos septos interlobulares e em regiões centrilobulares 23 29 acredita que a tomografia de tórax deva ser feita quando as radiografias torácicas mostrarem apenas um nódulo, quando o achado não for conclusivo e em pacientes portadores de neoplasia malignas extratorácicas com radiografias torácicas normais.…”

Section: Introductionunclassified

Tomografia computadorizada do tórax de cadelas portadoras de neoplasias malignas: II - Avaliação dos campos pulmonares

Pinto

Iwasaki

Figueiredo

et al. 2007

Braz. J. Vet. Res. Anim. Sci.

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ResumoVisto a importância das neoplasias mamárias na clínica médico-veterinária e as novas perspectivas do diagnóstico por imagem, o presente trabalho visou comparar o exame tomográfico contrastado com o exame radiográfico simples dos campos pulmonares de cadelas portadoras de tumores mamários malignos. Para tanto, foram realizados exames de tomografia computadorizada contrastada da cavidade torácica de vinte fêmeas da espécie canina, de diferentes raças e idades, portadoras de neoplasias mamárias malignas encaminhadas ao Serviço de Diagnóstico por Imagem do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo pelos Serviços de Obstetrícia e Ginecologia e de Cirurgia de Pequenos Animais da mesma instituição. Concluiu-se que, o exame tomográfico se mostrou um importante complemento do exame radiográfico na pesquisa de metástases de neoplasias mamárias em cadelas no que se refere à avaliação do interstício pulmonar. Palvras-chave:Tomografia computadorizada. Pulmão. Neoplasia mamária. Cadelas. IntroduçãoO exame radiográfico ainda é a modalidade diagnóstica de eleição para a avaliação inicial da cavidade torácica de pequenos animais 1,2,3 . Por permitir um estudo conjunto dos campos pulmonares, estruturas mediastinais, pleuras, espaço pleural, arcabouço ósseo e partes moles da parede torácica, o exame radiográfico tem sido o exame de escolha para a pesquisa de metástases no tórax 4,5 , para tanto, segundo Miles et al. 6 , deve ser realizado precocemente nos animais com neoplasias primárias.Contudo, por meio do exame radiográfico, até 13% de falsos negativos têm sido apontados quando da pesquisa de nódulos pulmonares em cães 5 . Lang et al. 7 advertem que vários fatores interferem na detecção de massas pulmonares ressaltando os inerentes às formações pulmonares, além daqueles relacionados à técnica radiográfica e os ligados à interpretação dos exames. Eles, assim como Forrest 8 , acreditam que quando a análise dos filmes for realizada por apenas um leitor, três projeções radiográficas devam ser obtidas a fim de aumentar a acurácia da análise. Barthez et al. 9 , todavia, recomendam duas projeções radiográficas perpendiculares entre si para a pesquisa de metástases pulmonares e, em casos duvidosos até três projeções. Para Jakovljevic e Morrison 10 e Rogers 11 a visibilização da lesão metastática pelo exame radiográfico depende da qualidade do equipamento radiográfico, do tamanho das formações neoplásicas, do número de nódulos, da sobreposição e somação de nódulos e de sua localização no pulmão. Apesar dos aspectos de nódulos ou de massas intersticiais sólidos, múltiplos e bem definidos serem os achados radiográficos mais comuns na doença pulmonar metastática 5,10,11,12,13,14 , também são observados outros padrões como nódulos pulmonares solitários, nódulos cavitários, consolidação alveolar lobar 10,11,15,16 , nódulos mal definidos e aumento da radiopacidade intersticial difuso

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“…These include diseases that are primarily broncho-or bronchiolocentric, angiocentric, perilymphatic, septal, diffuse interstitial and other distributions of disease that are also recognizable on HRCT [1][2][3]. By demonstrating the pattern and distribution of these abnormalities, HRCT often allows for a confident diagnosis to be made [4][5][6].…”

Section: High-resolution Computed Tomographymentioning

confidence: 99%

“…MATHIESON et al [4] compared the accuracy of conventional and HRCT with that of chest radiographs in making specific diagnoses in 118 consecutive patients who had chronic diffuse lung disease. The CT scans and radiographs were reviewed independently by three observers who listed their most likely diagnoses and their degree of confidence in these diagnoses.…”

Section: Diagnosis Of Bronchiectasismentioning

confidence: 99%

Computed tomography and magnetic resonance imaging: past, present and future

Nl¹

2002

Eur Respir J

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The aims of this paper are to summarize the current recommendations for the use of computed tomography (CT) and magnetic resonance imaging (MRI) in the chest and to suggest some possible future developments.The main developments of CT in the chest have been the introduction of highresolution CT (HRCT), spiral CT and, more recently, multidetector spiral CT.HRCT is defined as thin-section CT (1-to 2-mm collimation scans), optimized by using a high-spatial resolution (edge-enhancing) algorithm. Several studies have shown that HRCT closely reflects macroscopic (gross) pathological findings. HRCT currently has the best sensitivity and specificity of any imaging method used for the assessment of focal and diffuse lung diseases.The advent of spiral CT and, more recently, multidetector CT scanners, has allowed for major improvements in the imaging of airways, pulmonary and systemic vessels, and lung nodules. Spiral CT facilitates multiplanar and three-dimensional display of structures and visualization of pulmonary and systemic vessels, with a level of detail that is comparable to that of conventional angiography. With the use of graphics-based software programs, spiral CT enables depiction of the luminal surface of the airways with images that resemble those of bronchoscopy (virtual bronchoscopy) or bronchography (virtual bronchography). Several studies have shown a high sensitivity and specificity for spiral CT in the diagnosis of acute pulmonary embolism. Therefore, spiral CT is rapidly becoming the imaging modality of choice in the diagnosis of pulmonary embolism.Like the radiograph, signal intensity on computed tomography is mainly due to a single parameter: electron density. The signal intensity of the magnetic resonance image depends on four parameters: nuclear density, two relaxation times called T1 and T2, and motion of the nuclei within the imaged lung volume. Abnormal soft tissue can be identified more easily through measurement of these four parameters than through use of computed tomography. Furthermore, because the spatial orientation of the image is determined by manipulation of magnetic fields, scans can be performed in any plane. The main indications for magnetic resonance in the chest have been in the evaluation of the heart, major vessels, mediastinum, and hilar structures because of the natural contrast provided by flowing blood. Of particular interest for the respirologist has been the recent development of magnetic resonance angiography. This technique consists of three-dimensional single breath-hold images obtained using gadolinium-based contrast agents. This is a promising technique for the diagnosis of acute and chronic pulmonary embolism. Eur Respir J 2002; 19: Suppl. 35, 3s- For many years, the plain chest radiograph was the only imaging modality used in the diagnosis of lung disease. With the advent of computed tomography (CT) came the first opportunity to assess gross lung structure. Conventional 8-to 10-mm collimation scans allowed better assessment of the lung parenchyma than was...

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Chronic diffuse infiltrative lung disease: comparison of diagnostic accuracy of CT and chest radiography.

Cited by 397 publications

References 0 publications

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis

Tomografia computadorizada do tórax de cadelas portadoras de neoplasias malignas: II - Avaliação dos campos pulmonares

Computed tomography and magnetic resonance imaging: past, present and future

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