Thoracic cases
Lt Col Edward Sellon, David C Howlett, Nick Taylor in Radiology for Medical Finals, 2017
Appearances of lung metastases on CXR include (see Table 5.4):Cannonball appearance.Ill-defined ‘snowstorm’ appearance (Figure 5.4C).Solitary lung nodule (+/- cavity).Multiple lung nodules (+/- cavities, Figure 5.4D, page 70).Miliary nodularity (military = seed = fine and small, 1–3 mm).Lymphangitis carcinomatosa.
Single-Lung Transplant Recipient with Primary Carcinoma Metastasis from Native Lung to Donor Lung Allograft
Wickii T. Vigneswaran in Thoracic Surgery, 2019
During follow-up of the left single-lung transplant, a chest CT at four months showed a soft tissue density measuring 2.2 × 1.4 cm in the right lung base, suspected as scar, pleural thickening, or atelectasis. Examination at another four months later reported the finding as stable chronic appearing interstitial opacity of right lung base. However, a CT scan at an additional six months later showed growth of the right lower lung mass and an additional new lung nodule in the middle lobe (1.6 × 1.2 cm) and in the left (donor, 0.7 cm) upper lobe. In retrospect, the mass that was favored as fibrotic or infective change was a missed growth in the right lower lobe that was masked by the pre-existing fibrotic changes in the bases due to pulmonary fibrosis. The right lower lobe showed a mass that was now 7.7 × 6.7 cm (Figures 49.1 through 49.3). A 7-mm nodule was also noted in the left upper lobe. A PET-CT showed abnormal fluoro-deoxyglucose (FDG) accumulation along the periphery with a central area of necrosis and a Standardized Uptake Value (SUV) max of 18.9 in the right base. A right middle lobe nodule showed an SUV max of 12.6, and the left upper lobe also showed a mass of 7 mm with a SUV max of 5.8 and a subcarinal lymph node (1.1 cm) with an SUV of 9.5. A brain MRI showed an enhancing left frontal lobe mass (1.6 × 1.0 cm) extending to the dura with moderate local edema and sulcal effacement. Pulmonary fine-needle biopsies were subsequently obtained and reported metastatic carcinoma consistent with metastatic squamous cell carcinoma from the lung.
Computer-Aided Diagnosis Systems for Prostate Cancer Detection
Ayman El-Baz, Gyan Pareek, Jasjit S. Suri in Prostate Cancer Imaging, 2018
Computer vision has given rise to many promising solutions, but instead of focusing on fully automatic computerized systems, researchers have aimed at providing computer image analysis techniques to aid radiologists in their clinical decisions [49]. In fact, these investigations brought about both concepts of computer-aided detection (CADe) and computer-aided diagnosis (CADx) grouped under the acronym CAD. Since those first steps, evidence has shown that CAD systems enhance the diagnosis performance of radiologists. Chan et al. reported a significant 4% improvement in breast cancer detection [51], which has been confirmed in later studies [52]. Similar conclusions have been drawn in the case of lung nodule detection [53], colon cancer [54], or CaP as well [50]. Chan et al. also hypothesized that CAD systems will be even more efficient assisting inexperienced radiologists than senior radiologists [51]. That hypothesis has been tested by Hambrock et al. and confirmed in case of CaP detection [50]. In this particular study, inexperienced radiologists obtained equivalent performance to senior radiologists, both using CAD whereas the accuracy of their diagnosis was significantly poorer without CAD’s help.
A 3D Lung Nodule Tool Improves Patient Distress Following LDCT
Published in Oncology Issues, 2021
After numerous LDCT shared decision‐making consults with anxious and distressed patients, Roelke conceptualized the idea of a 3D tool that that could be used to better educate patients about their lung nodules and cancer risks. After developing the design on paper, Roelke reached out to the Maine College of Art in Portland to discuss partnership opportunities. The college connected Roelke to a student, William Kittredge, with expertise in 3D modeling and printing. Working together, Roelke and Kittredge created a nylon and resin prototype with lung nodules of different features and sizes. As a starting point, they used an existing tool of unknown origin and began a process of diagramming and prototyping iterations. The final prototype 3D lung nodule tool represented lung nodules of increasing diameter and with varying physical features.
Robot-assisted radical nephrectomy for primary renal mesenchymal chondrosarcoma: case report and literature review
Published in Renal Failure, 2019
Wen Deng, Jinxiu Zhou, Xiaoqiang Liu, Luyao Chen, Guanghua Guo, Bin Fu
A 62-year-old man, with no significant medical history, was hospitalized with left loin pain and intermittent gross hematuria. Nothing except for mild costovertebral angle tenderness was found abnormal on routine physical examination. The laboratory tests including hematologic studies and urinalysis are shown in Table 1. Abdominal contrast-enhanced CT scan revealed a 14 cm × 11 cm × 8 cm heterogeneous lobulated mass, which involved most of the left renal parenchyma, with the calcification foci and cystic spaces. Multiple patchy dense calcifications occupying the expanded renal pelvis and bar filling defect in left renal vein were also detected in the CT scan (Figure 1). A 0.7 cm lung nodule was identified at the left upper lobe on the chest X-ray. In a bone scan, nuclide was distributed evenly and meristicly over the body except for the 7th thoracic vertebra, which was considered as a metastatic lesion.
Stereotactic body radiotherapy for synchronous early stage non-small cell lung cancer
Published in Acta Oncologica, 2021
Cole R. Steber, Ryan T. Hughes, Michael H. Soike, Corbin A. Helis, Karina Nieto, Travis Jacobson, Moeko Nagatsuka, Hamilton S. McGinnis, C. Marc Leyrer, Michael K. Farris
Ten patients (28%) were found to develop an additional new primary NSCLC after SBRT for SPLC and were subsequently treated with localized therapy including SBRT and radiofrequency ablation. We distinguished patients with new primaries for this cohort of patients with SPLC as separate entities than patients that have a truly metastatic disease process present. Rationale for this was based on the fact that these patients were treated with a local definitive therapy option for the new lung nodule and not with systemic therapy. Only 1 patient had a biopsy of the new primary and the rest were treated empirically. Two of the patients with new primaries went on to have an eventual metastatic disease process. The patients that developed a new primary had similar outcomes to those patients that did not, suggesting that salvage therapies (including repeat SBRT) are effective in treating subsequent, metachronous lung primary tumors after treatment of SPLC which has already been reported in multiple studies [11–14,27]. In the studies which specifically compared patients with metachronous NSCLC and SPLC there are conflicting conclusions in terms of survival outcomes. In two studies it was found that patients with metachronous NSCLC had improved PFS and OS compared to patients with SPLC [11,13]. In contrast, another study found patients treated with synchronous SBRT had similar OS and freedom from progression compared to patients treated for single lesion NSCLC [14].
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