Thoracic Applications of Spectral CT Scan

Moore, Jonathan; Remy, Jacques; Altschul, Erica; Chusid, Jesse; Flohr, Thomas; Raoof, Suhail; Remy-Jardin, Martine

doi:10.1016/j.chest.2023.07.4225

CHEST

2024

DOI: 10.1016/j.chest.2023.07.4225

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Thoracic Applications of Spectral CT Scan

Jonathan Moore,

Jacques Remy,

Erica Altschul

et al.

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2024

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Cited by 3 publications

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Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Nardone,

Minichetti,

Sauro

et al. 2024

J Med Imaging Intervent Radiol

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According to the 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines, a right heart catheterization-derived mean pulmonary arterial pressure (mPAP) > 20 mmHg at rest defines pulmonary hypertension (PH). As PH can ultimately lead to death, multidisciplinary early diagnosis, proper framework, and prompt management are crucial. ESC/ERS PH classification encompasses five groups, each sharing pathogenesis, hemodynamics, and management, i.e., group I, pulmonary arterial hypertension; II, left heart disease; III, lung disease and/or hypoxia; IV, chronic thromboembolic PH; and V, with unclear and/or multifactorial mechanisms. Chest CT is pivotal in PH grouping, comprehensively evaluating the lung, heart, pulmonary vessels, and mediastinum. In this review, we synoptically illustrate the chest CT findings of PH and provide a CT-based logical framework suggesting a PH group hypothesis. Improving knowledge of PH CT features and their combination empowers radiologists to contribute valuably to the PH multidisciplinary clinical discussion.

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Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Nardone,

Minichetti,

Sauro

et al. 2024

J Med Imaging Intervent Radiol

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Spatial lung imaging in clinical and translational settings

Mahmutovic Persson,

Bozovic,

Westergren-Thorsson

et al. 2024

Breathe

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For many severe lung diseases, non-invasive biomarkers from imaging could improve early detection of lung injury or disease onset, establish a diagnosis, or help follow-up disease progression and treatment strategies. Imaging of the thorax and lung is challenging due to its size, respiration movement, transferred cardiac pulsation, vast density range and gravitation sensitivity. However, there is extensive ongoing research in this fast-evolving field. Recent improvements in spatial imaging have allowed us to study the three-dimensional structure of the lung, providing both spatial architecture and transcriptomic information at single-cell resolution. This fast progression, however, comes with several challenges, including significant image file storage and network capacity issues, increased costs, data processing and analysis, the role of artificial intelligence and machine learning, and mechanisms to combine several modalities. In this review, we provide an overview of advances and current issues in the field of spatial lung imaging.

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Combined Use of External Iliac Lymph Node Count and Bone Scintigraphy for PJI Diagnosis: A Prospective Study

Zhou,

Yang,

et al. 2024

Diagnostics

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Background: The reactive enlargement of external iliac lymph nodes and increased blood flow in the infected region are commonly observed in lower limb infections. We aimed to differentiate between aseptic loosening and periprosthetic joint infection (PJI) after joint replacement surgery by quantifying the number of enlarged external iliac lymph nodes and using bone scintigraphy to monitor blood flow. Methods: We recruited 124 patients undergoing revision surgery for aseptic loosening or PJI. All the patients underwent preoperative dual-energy computed tomography (DECT) imaging for external iliac lymph nodes and bone scintigraphy. The diagnostic value was evaluated using ROC curve analysis. Results: The number of enlarged external iliac lymph nodes was significantly higher in the PJI group than in the aseptic failure group (4.0 versus. 1.0, p value < 0.001). The median affected/unaffected side ratio in the blood pool phase of ECT in the PJI group was 1.49, significantly higher than the aseptic failure group’s median ratio of 1.04 (p value < 0.001). The AUC for diagnosing PJI using the number of enlarged lymph nodes alone was 0.91, and when using the bone scintigraphy blood pool phase alone, the AUC was 0.89. When both metrics were combined, the AUC increased to 0.95, which was higher than the AUCs for the ESR (AUC = 0.83), CRP (AUC = 0.76), and synovial fluid PMN% (AUC = 0.62). Conclusions: Combining the enlargement of the lymph node count with the bone scintigraphy blood pool phase is a promising approach for diagnosing PJI.

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Thoracic Applications of Spectral CT Scan

Cited by 3 publications

References 62 publications

Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Noninvasive assessment of pulmonary hypertension: key insights to maximize chest computed tomography

Spatial lung imaging in clinical and translational settings

Combined Use of External Iliac Lymph Node Count and Bone Scintigraphy for PJI Diagnosis: A Prospective Study

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