Radiodiagnostik der Lunge

Abstract

Radiological cross-sectional imaging modalities, particularly computed tomography (CT) have become the mainstays for diagnosing lung disease in recent years. These enable morphological visualization of pathological processes with the greatest possible spatial resolution. Modern technical developments and complementary strategies have led to new applications and new functional assessments which need to be reviewed together with state-of-the-art techniques in nuclear imaging. The diagnosis of pulmonary embolism using spiral CT angiography and magnetic resonance (MR) angiography certainly belongs in this category. CT has become the an alternative modality of first choice, and it is also challenging pulmonary angiography as the gold standard. Direct visualization of patent pulmonary arteries and thromboembolic material is complemented by that of effects on the pulmonary parenchyma and right heart function; it also provides perfusion studies and MR-based flow measurement to assess hemodynamic compromise. Ventilation studies have long been a domain of nuclear imaging, and new techniques for the direct visualization of ventilation are emerging from recent developments in the field of MR imaging, for example, using hyperpolarized inert gases. New functional parameters of ventilation can be derived from these studies. For the diagnosis of metabolically active disease, such as tumor and pneumonia, CT offers very high sensitivity, for example, in screening for intrapulmonary nodules using low-dose CT and in the early detection of pulmonary infiltrates in high-risk patients. Especially for characterizing pulmonary nodules there is a need to combine nuclear medicine techniques, such as in positron-emission tomography.

Stereotactic body radiation therapy: The report of AAPM Task Group 101

“…CT is helpful in identifying pulmonary nodules, parenchymal diseases, and chest-wall involvement for superior sulcus tumors and lung disease. 55,56 Dynamic contrast-enhanced CT is the most sensitive study for the hepatic system. 57,58 MR is the gold standard for visualization of brain neoplasms and is increasingly used in SBRT applications including prostate, spinal tumors, chest, and solid abdominal tumors.…”

Die Ballon-Okklusionsangiographie der Pulmonalarterien bei chronischer pulmonaler Hypertonie

“…Andererseits kommt es bei 0,4 bis 5% der Patienten nicht zu einer vollständigen Thrombolyse (Kauczor et al, 2000). Dann wird das thrombembolische Material in die Gefäßwand eingebaut mit der Folge einer bleibenden Reduktion des Gesamtquerschnittes der Pulmonalisstrombahn.…”

Imaging Strategies in the Diagnostics of Colorectal Metastases

“…Other features of CT are the application of high‐resolution CT to detect lymphangitic carcinomatosis and the use of low dose CT for dose reduction. Recent studies have shown low‐dose spiral CT of the chest to be of high sensitivity in the detection of pulmonary nodules, making a dose minimization possible (42, 43).…”

“…FDG‐PET represents an important and accurate tool for detecting and diagnosing neoplastic disease of the lung (43). Both FDG‐PET and Tc99m‐SPECT present a high degree of sensitivity, specificity and overall accuracy in the diagnostics of patients with a solitary pulmonary nodule suspected for metastatic disease (46) and in the differential of viable tumor tissue.…”