Login to your account

Username *
Password *
Remember Me

Blog With Right Sidebar

    Vous êtes ici :  
  1. Accueil
  2. Blog With Right Sidebar

Semiquantification and Classification of Local Pulmonary Function by V/Q Single Photon Emission Computed Tomography in Patients with Non-small Cell Lung Cancer: Potential Indication for Radiotherapy Planning.

Perfusion (Q) single photon emission computed tomography (SPECT) has been used to divert dose away from higher-functioning lung during radiation therapy (RT) planning.

This study aimed to

  1. study regional lung function through coregistered pulmonary ventilation/perfusion (V/Q)-SPECT-CT
  2. and classify these defects for its potential value in radiation planning in patients with non-small cell lung cancer (NSCLC).

METHODS:: Patients with stages I to III NSCLC requiring radiation-based therapy were eligible for this prospective study. V/Q-SPECT performed within 2 weeks before the start of radiation was interpreted by nuclear medicine physicians and then measured by a semiquantitative score. The potential mechanism of V and Q defects was analyzed; the potential impact of V/Q-SPECT over Q-SPECT alone was completed through classified applications (high-dose RT versus RT avoidance) during planning.

RESULTS:: Images of 51 consecutive patients were analyzed. The V and Q defects were matched, reverse mismatched (V defect > Q defect), and mismatched (Q defect > V defect) in 61, 31, and 8% of patients, respectively. Tumor was the leading cause of the defects of ipsilateral lung in 73% of patients. The defect scores of the ipsilateral lung were greater in patients with central primaries than those with peripheral primaries for both V-SPECT (2.3 ± 1.1 versus 1.5 ± 0.8, p = 0.017) and Q-SPECT (2.2 ± 0.8 versus 1.4 ± 0.6, p = 0.000). The patients with chronic obstructive pulmonary disease had greater defect scores in contralateral lung for both V-SPECT (1.5 ± 0.7 versus 1.0 ± 0.8, p = 0.006) and Q-SPECT (1.4 ± 0.6 versus 1.0 ± 0.4, p = 0.010). On assessing the potential value of SPECT on RT plan, 39% of patients could have their RT plan when applying V/Q-SPECT rather than Q-SPECT alone.

CONCLUSIONS:: V/Q-SPECT provides a more comprehensive functional assessment, may provide additional value over Q-SPECT alone in assessing local pulmonary function, and guide RT plan decisions in patients with NSCLC.

Pulmonary thin-section CT findings in acute Moraxella catarrhalis pulmonary infection.

Moraxella catarrhalis is an important pathogen in the exacerbation of chronic obstructive pulmonary disease. The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute M. catarrhalis pulmonary infection.

Methods: Thin-section CT scans obtained between January 2004 and March 2009 from 292 patients with acute M. catarrhalis pulmonary infection were retrospectively evaluated. Clinical and pulmonary CT findings in the patients were assessed. Patients with concurrent infection, including Streptococcus pneumoniae (n = 72), Haemophilus influenzae (n = 61) or multiple pathogens were excluded from this study.

Results: The study group comprised 109 patients (66 male, 43 female; age range 28-102 years; mean age 74.9 years). Among the 109 patients, 34 had community-acquired and 75 had nosocomial infections. Underlying diseases included pulmonary emphysema (n = 74), cardiovascular disease (n = 44) or malignant disease (n = 41). Abnormal findings were seen on CT scans in all patients and included ground-glass opacity (n = 99), bronchial wall thickening (n = 85) and centrilobular nodules (n = 79). These abnormalities were predominantly seen in the peripheral lung parenchyma (n = 99). Pleural effusion was found in eight patients. No patients had mediastinal and/or hilar lymph node enlargement.

Conclusions: M. catarrhalis pulmonary infection was observed in elderly patients, often in combination with pulmonary emphysema. CT manifestations of infection were mainly ground-glass opacity, bronchial wall thickening and centilobular nodules.

Lung Tumors Treated With Percutaneous Radiofrequency Ablation: Computed Tomography Imaging Follow-Up.

To describe the morphologic evolution of lung tumors treated with radiofrequency ablation (RFA) by way of computed tomography (CT) images and to investigate patterns of incomplete RFA at the site of ablation.

MATERIALS AND METHODS: One hundred eighty-nine patients with 350 lung tumors treated with RFA underwent CT imaging at 2, 4, 6, and 12 months. CT findings were interpreted separately by two reviewers with consensus. Five different radiologic patterns were predefined: fibrosis, cavitation, nodule, atelectasis, and disappearance. The appearance of the treated area was evaluated at each follow-up CT using the predefined patterns.

RESULTS: At 1 year after treatment, the most common evolutions were fibrosis (50.5%) or nodules (44.8%). Differences were noted depending on the initial size of the tumor, with fibrosis occurring more frequently for tumors <2 cm (58.6% vs. 22.9%, P = 1 × 10(-5)). Cavitation and atelectasis were less frequent patterns (2.4% and 1.4%, respectively, at 1 year). Tumor location (intraparenchymatous, with pleural contact <50% or >50%) was not significantly correlated with follow-up image pattern. Local tumor progressions were observed with each type of evolution. At 1 year, 12 local recurrences were noted: 2 cavitations, which represented 40% of the cavitations noted at 1 year; 2 fibroses (1.9%); 7 nodules (7.4%); and 1 atelectasis (33.3%).

CONCLUSION: After RFA of lung tumors, follow-up CT scans show that the shape of the treatment zone can evolve in five different patterns. None of these patterns, however, can confirm the absence of further local tumor progression at subsequent follow-up.

Smoking status in parents of children hospitalized with a diagnosis of respiratory system disorders.

The purpose of this study was to investigate the relationship between the statuses of hospitalized children with diagnosis of respiratory tract disease with cigarette use in the parents.

This descriptive study was conducted in a Gowerment Hospital in the Sakarya city center in Turkey between June 2007 and June 2008. The inclusion criterion was willingness of families with children hospitalized due to diagnosis of respiratory disease to participate in the study. Data were collected from 345 parents using the questionnaire prepared by researchers.

In our study parental smoking was observed in 42.3% of fathers, 7.8% mothers and for 20.9% both parents were smoking. It was found that the hospitalization rates were more than two times higher in children diagnosed with pneumonia and bronchitis and three times higher in children hospitalized for asthma whose parents smoke at home compared to those whose parents are non-smokers.

Health care professionals who take care of children need to discuss the harmful effects of smoking and the importance of reducing childhood exposure to secondhand smoke; parents should be educated and encouraged not to smoke.

Allergen-specific immunotherapy improves asthma symptoms compared with placebo, but the possibility of adverse effects should be considered.

Evid Based Med. 2010 Nov 25;

Authors: Rashid R, Frew AJ

Search

Search