Focal dependent pleural thickening at MDCT: Pleural lesion or functional abnormality?

Claude-Desroches, M.; Bierry, Guillaume; Touitou-Gottenberg, D.; Grenier, P.

doi:10.1016/j.diii.2012.01.011

Cited by 9 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reaching a correct diagnosis of PPs requires a good knowledge of normal locoregional anatomy (transversus thoracic muscle, subcostal muscle, extrapleural fat, etc. ), different features of PPs, and common pitfalls in their diagnosis (focal dependent pleural thickening, pseudoplaques in sarcoidosis and silicosis) [18, 29, 30]. Last but not least, in order to reduce underestimation and to improve current reporting practices of PPs, technical approaches in chest CT execution should also be rigorous.…”

Section: Discussionmentioning

confidence: 99%

“…However, if the CTs are performed with the patient in a supine position, the presence of pleural thickening in the dorsal regions, in the absence of PPs in other regions of the pleura, requires an additional acquisition in prone position. This approach will differentiate a real plaque from reversible dependent pleural thickening [29]. According to a recent study by Kim et al [31], an interesting distribution of PPs was found, in particular: diaphragmatic plaques were distributed more commonly on the right side, since the right diaphragmatic dome has a large interface with the lung; mediastinal plaques were distributed more commonly on the left side due to anatomical and mechanical factors such as larger interface with the lung and the pulsating left ventricle pushing the left mediastinal pleura against the adjacent left lung with more mechanical stress than the right mediastinal pleura; chest wall pleural plaques more commonly involved both the basal sides due to combination of high ventilation and gravity in these lung regions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them—Asbestos Exposure Still Exists

Mazzei

Contorni

Gentili

et al. 2017

BioMed Research International

View full text Add to dashboard Cite

Pleural plaques (PPs) may be a risk factor for mortality from lung cancer in asbestos-exposed workers and are considered to be a marker of exposure. Diagnosing PPs is also important because asbestos-exposed patients should be offered a health surveillance that is mandatory in many countries. On the other hand PPs are useful for compensation purposes. In this study we aimed to evaluate the prevalence, as incidental findings, and the underreporting rate of PPs in chest CT scans (CTs) performed in a cohort of patients (1512) who underwent chest CT with a slice thickness no more than 1.25 mm. PPs were found in 76 out of 1482 patients (5.1%); in 13 out of 76 (17,1%) CTs were performed because of clinical suspicion of asbestos exposure and 5 of them (38%) were underreported by radiologist. In the remaining 63 cases (82.9%) there was no clinical suspicion of asbestos exposure at the time of CTs (incidental findings) and in 38 of these 63 patients (60.3%) PPs were underreported. Reaching a correct diagnosis of PPs requires a good knowledge of normal locoregional anatomy and rigorous technical approach in chest CT execution. However the job history of the patient should always be kept in mind.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them—Asbestos Exposure Still Exists

Mazzei

Contorni

Gentili

et al. 2017

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…And there might be false detection of pleural thickening on CT. The thick soft-tissue density at the chest wall–lung interface on the axial CT images sometimes do not truly suggest pleural thickening on CT. Physiological pleural fluid accumulation or dependent atelectasis can mimic the presence of pleural thickening or enhancement on CT [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Image Characteristics on Chest CT and Severe Pleural Adhesion during Lung Cancer Surgery

Jin

Sung

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

The aim of this study was to investigate the association between image characteristics on preoperative chest CT and severe pleural adhesion during surgery in lung cancer patients. We included consecutive 124 patients who underwent lung cancer surgeries. Preoperative chest CT was retrospectively reviewed to assess pleural thickening or calcification, pulmonary calcified nodules, active pulmonary inflammation, extent of emphysema, interstitial pneumonitis, and bronchiectasis in the operated thorax. The extent of pleural thickening or calcification was visually estimated and categorized into two groups: localized and diffuse. We measured total size of pulmonary calcified nodules. The extent of emphysema, interstitial pneumonitis, and bronchiectasis was also evaluated with a visual scoring system. The occurrence of severe pleural adhesion during lung cancer surgery was retrospectively investigated from the electrical medical records. We performed logistic regression analysis to determine the association of image characteristic on chest CT with severe pleural adhesion. Localized pleural thickening was found in 8 patients (6.5%), localized pleural calcification in 8 (6.5%), pulmonary calcified nodules in 28 (22.6%), and active pulmonary inflammation in 22 (17.7%). There was no patient with diffuse pleural thickening or calcification in this study. Trivial, mild, and moderate emphysema was found in 31 (25.0%), 21 (16.9%), and 12 (9.7%) patients, respectively. Severe pleural adhesion was found in 31 (25.0%) patients. The association of localized pleural thickening or calcification on CT with severe pleural adhesion was not found (P = 0.405 and 0.107, respectively). Size of pulmonary calcified nodules and extent of emphysema were significant variables in a univariate analysis (P = 0.045 and 0.005, respectively). In a multivariate analysis, moderate emphysema was significantly associated with severe pleural adhesion (odds ratio of 11.202, P = 0.001). In conclusion, severe pleural adhesion might be found during lung cancer surgery, provided that preoperative chest CT shows substantial pulmonary calcified nodules or emphysema.

show abstract

“…All examinations were carried out on the same second-generation 320-row scanner ( Aquillion One Vision Edition , Toshiba, Japan). Patients were positioned prone with their arms above their heads [17], so as to avoid gravity dependent parenchymal abnormalities in the posterior regions [18, 19]. Both examinations were acquired with a collimation of 0.5mm*80, a pitch of 0.813 and were reconstructed with Iterative Reconstruction ( AIDR-3D , Toshiba, Japan) set in standard mode.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic Performance of Ultra-Low-Dose Computed Tomography for Detecting Asbestos-Related Pleuropulmonary Diseases: Prospective Study in a Screening Setting

Schaal¹,

Séverac

Labani

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

ObjectiveTo evaluate the diagnostic performance of Ultra-Low-Dose Chest CT (ULD CT) for the detection of any asbestos-related lesions (primary endpoint) and specific asbestos-related abnormalities, i.e. non-calcified and calcified pleural plaques, diffuse pleural thickening, asbestosis and significant lung nodules (secondary endpoints).Material and Methods55 male patients (55.7±8.1 years old) with occupational asbestos exposure for at least 15 years and where CT screening was indicated were prospectively included. They all underwent a standard unenhanced chest CT (120kV, automated tube current modulation), considered as the reference, and an ULD CT (135kV, 10mA), both with iterative reconstruction.Two chest radiologists independently and blindly read the examinations, following a detailed protocol. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and error rate of ULD CT were calculated using the exact method of Pearson with a confidence interval of 95%.ResultsRadiation dose was 17.9±1.2mGy.cm (0.25mSv) for the ULD-CT versus 288.8 ±151mGy.cm (4mSv); p <2.2e-16.Prevalence of abnormalities was 20%. The ULD CT’s diagnostic performance in joint reading was high for the primary endpoint (sensitivity = 90.9%, specificity = 100%, positive predictive value = 100%, negative predictive value = 97.8%), high for lung nodules, diffuse pleural thickening and calcified pleural plaques (sensitivity, specificity, PPV and NPV = 100%) and fair for asbestosis (sensitivity = 75%, specificity = 100%, PPV = 00%, NPV = 98.1%).Intra-reader accuracy between the ULD CT and the reference CT for the primary endpoint was 98% for the senior and 100% for the junior radiologist. Inter-reader agreement for the primary endpoint was almost perfect (Cohen’s Kappa of 0.81).ConclusionULD CT in the screening of asbestos exposure related diseases has 90.9% sensitivity and 100% specificity, and could therefore be proposed as a first line examination.

show abstract

Focal dependent pleural thickening at MDCT: Pleural lesion or functional abnormality?

Cited by 9 publications

References 14 publications

Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them—Asbestos Exposure Still Exists

Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them—Asbestos Exposure Still Exists

Association between Image Characteristics on Chest CT and Severe Pleural Adhesion during Lung Cancer Surgery

Diagnostic Performance of Ultra-Low-Dose Computed Tomography for Detecting Asbestos-Related Pleuropulmonary Diseases: Prospective Study in a Screening Setting

Contact Info

Product

Resources

About