Journal of Thoracic Imaging最新文献

{"title":"Analyzing Patient Characteristics and Lung Cancer Outcomes Pre and Post the 2021 USPSTF Lung Cancer Screening Guidelines: Experience From a Large Academic Institution.","authors":"Yannan Lin, Seyed Mohammad Hossein Tabatabaei, Ruiwen Ding, Tracey A Sanders, Denise R Aberle, William Hsu, Ashley E Prosper","doi":"10.1097/RTI.0000000000000838","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000838","url":null,"abstract":"<p><strong>Purpose: </strong>In 2021, the US Preventive Services Task Force (USPSTF) revised the guidelines for lung cancer screening (LCS). Numerous studies have examined the effects of the guideline changes on LCS eligibility. Yet, few have focused on their impact on participation and lung cancer outcomes within a clinical LCS cohort.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included individuals who underwent low-dose computed tomography (LDCT) screening between July 31, 2013, and August 25, 2023, at a large tertiary academic medical center. Patients were categorized into the preguideline and postguideline revision groups based on LCS eligibility and insurance status. Patient characteristics at baseline screening and lung cancer outcomes were compared.</p><p><strong>Results: </strong>Among 3929 patients, after implementing the new guidelines, the average monthly volume of new LCS patients nearly tripled (68 vs. 23, P<0.05). Notable reductions were observed in age (mean: 63 vs. 65, P<0.05), pack-years (mean: 35 vs. 44, P<0.05), and PLCOm2012 risk score (mean: 2.9% vs. 4.1%, P<0.05). The proportion of negative LDCT results increased (89.4% vs. 84.5%, P<0.05). The proportion of Black patients decreased (5.1% vs. 6.9%, P<0.05), while Hispanic patients increased from 5.5% to 7.6% (P<0.05). The lung cancer detection rate fell in the postguideline group (0.9% vs. 4.5%, P<0.05), with 8 lung cancers detected among 943 newly eligible patients.</p><p><strong>Conclusions: </strong>Disparities in LCS participation among racial and ethnic groups were observed following the 2021 USPSTF LCS guidelines, highlighting the need for active outreach and patient education, as guideline revisions alone increase eligibility but do not ensure participation.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological and Behavioral Factors in Lung Cancer Screening Uptake and Adherence: Challenges and Opportunities.","authors":"Chanel M Wood, Isabel O Cortopassi, Matthew R McCann, Patricia J Mergo, Justin T Stowell, Brent P Little","doi":"10.1097/RTI.0000000000000841","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000841","url":null,"abstract":"<p><p>Lung cancer screening participation and adherence are influenced by individual psychological and cognitive factors and behaviors that may have negative or positive effects on screening, and the screening process in turn has important psychological and behavioral consequences. A nuanced understanding of these factors and consequences is essential in creating and administering effective and humane lung cancer screening programs. Barriers to lung cancer screening, such as knowledge gaps, anxiety, stigma, cost and inconvenience, can be addressed through patient-centered best practices and a wide variety of educational and behavioral interventions. The potential positive psychological and behavioral effects of lung cancer screening can also be leveraged to maximize uptake and promote screening adherence and other positive behavioral outcomes. This comprehensive review summarizes the known psychological and behavioral factors relevant to lung cancer screening uptake and adherence and provides suggestions for overcoming psychological and cognitive obstacles to successful screening.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: A Comprehensive Review of Radiology and Pathology in Acute Lung Injury.","authors":"Ana P S Lima, Desiree A Marshall, Eric Morrell, Sudhakar N J Pipavath","doi":"10.1097/RTI.0000000000000837","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000837","url":null,"abstract":"<p><p>Acute respiratory distress syndrome (ARDS) is a life-threatening condition characterized by widespread inflammation in the lungs. It is associated with high mortality and morbidity in critically ill patients. ARDS are conditions that cause acute respiratory failure due to noncardiogenic pulmonary edema, leading to severe hypoxemia and diffuse, bilateral lung injury. These conditions represent a spectrum of lung injury with varying severity and complexity. ARDS is a more severe form of ALI. ALI can also describe a range of clinical and paraclinical findings that include one or both pathologic patterns of organizing pneumonia (OP) or diffuse alveolar damage (DAD). The pathologic correlate of ARDS is DAD. This damage can be triggered by various risk factors, including pneumonia, sepsis, trauma, and the inhalation of harmful substances. The alveolar capillary damage that accompanies DAD leads to a loss in barrier function and is associated with the accumulation of fluid into the alveolar space. This fluid accumulation (pulmonary edema), along with subsequent organization and scarring, impairs gas exchange, which leads to hypoxemia and respiratory failure. Despite advances in understanding the pathophysiology of ARDS and improvements in supportive care, the mortality rates from ARDS still range from 25% to 45%. It is crucial to recognize that radiographic and histologic findings in a patient with ARDS can vary significantly depending on the phase of the disease. This is because the pathophysiological processes underlying these conditions evolve over time, leading to changes in both clinical presentation and imaging findings. Misinterpretation of these findings could lead to incorrect diagnoses and inappropriate treatment strategies. Therefore, understanding the temporal evolution of this condition is essential for accurate diagnosis and effective management. Our paper seeks to examine the existing literature focusing on radiology and pathology at different phases of injury and resolution to enhance management of ARDS.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anomalies of the Brachiocephalic Vein: A Pictorial Review.","authors":"Thazhathu Veettil Sreelal, Niraj Nirmal Pandey","doi":"10.1097/RTI.0000000000000840","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000840","url":null,"abstract":"<p><p>Anomalies of the brachiocephalic or \"innominate\" vein, which may be of course or number, are rare. Previously, most cases were incidentally detected during surgery or in autopsy specimens. Doppler evaluation may also demonstrate these anomalies; however, the sensitivity is poor due to suboptimal visualization of the entire course. With the advent of multidetector CT angiography, these anomalies are increasingly being detected. Although majority of cases are incidentally detected on scans performed for evaluation of congenital heart defects, these anomalies assume clinical importance when central venous cannulation or pacemaker insertion is contemplated through the anomalous side. Prior knowledge of the anomalous anatomy is also important before cardiothoracic surgeries. In this article, we present a pictorial review of the anomalies of the brachiocephalic vein using multidetector CT angiography.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer-aided Nodule Detection in the Lung Apices in Head and Neck Computed Tomography Angiography: An Unexpected Opportunity.","authors":"Tamar Perel Kass, Jeffrey Chankowsky, Jacob Sosna, Benjamin Hyatt Taragin, Alla Khashper","doi":"10.1097/RTI.0000000000000836","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000836","url":null,"abstract":"<p><strong>Purpose: </strong>Computed tomography angiography (CTA) of the head and neck includes the pulmonary apices, a common location for pulmonary nodules. Computer-aided detection (CAD) is an adjunctive tool for the detection of lung nodules and is widely used in standard chest CT scans. We evaluated whether the available software can be applied to CTA head and neck examinations, which include the lung apices, resulting in improved accuracy for lung nodule detection.</p><p><strong>Materials and methods: </strong>In this retrospective single-center study, 191 previously reported head and neck CTA scans were re-evaluated for apical pulmonary nodules by 2 radiologists. Subsequently, CAD software (Syngo.via, Siemens Healthiness AG) was applied to the lung apices and the results were compared between CAD and research radiologists (first reading) or clinical radiologist (null reading). In addition, the CAD performance in limited lung fields was compared with the accepted CAD assessment applied to whole lungs.</p><p><strong>Results: </strong>Of the 191 patients, 110 (57.6%) were men, with a mean age of 68 years. In the 24 CT scans, the research radiologists detected 40 nodules. In the 180 scans evaluated by CAD, the software detected 39 nodules in 22 examinations, with a sensitivity of 60.8% and a PPV of 63.6%. In the remaining 158 examinations in which CAD did not detect nodules, the radiologists concurred in 149 scans, with a specificity of 94.9%, NPV of 94.3%, and accuracy of 90.6%.</p><p><strong>Conclusion: </strong>The study results indicate that CAD is an unexpected quick supportive tool for nodule detection, particularly for excluding clinically significant nodules in lung apices on CTA head and neck, showing similar results for partial and full lung fields.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Spectrum of Mesenchymal Tumors of Lungs and Pleura.","authors":"Nivedita Chakrabarty, Ashu Seith Bhalla, Manisha Jana, Abhishek Mahajan","doi":"10.1097/RTI.0000000000000839","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000839","url":null,"abstract":"<p><p>This review covers World Health Organization classification and in-depth imaging of diverse adult and paediatric mesenchymal tumors of the thorax (lungs and pleura), highlighting their key imaging features predominantly on computed tomography (CT) including CT angiography (for intimal sarcoma), and also on other imaging modalities such as ultrasound, magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography CT (FDG PET-CT) wherever necessary. Although rare, it is essential to identify and differentiate these mesenchymal tumors from the common epithelial tumors of lungs on imaging, as their management is entirely different. Mesenchymal tumor should be suspected over epithelial tumor when the CT scan shows a large-sized, well-marginated tumor or a tumor containing fat and calcifications in adults, or a solid-cystic tumor in a relatively younger population. An algorithmic approach to diagnosing these tumors has been presented at the end based on age (children/adult), location (perihilar /intrapulmonary/ peripheral), nature of tumor (solid/solid-cystic), and content (calcification/fat), for the ease of evaluation by the radiologists.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT Features for Prognostic Assessment of Pulmonary Mucormycosis in Patients With Hematological Diseases.","authors":"Huiming Yi, Shuping Zhang, Jieru Wang, Chunhui Xu, Donglin Yang, Qingsong Lin, Xiaoxue Wang, Sizhou Feng","doi":"10.1097/RTI.0000000000000832","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000832","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the CT features in prognostic evaluations for pulmonary mucormycosis in patients with hematological diseases.</p><p><strong>Materials and methods: </strong>A retrospective analysis of clinical data and chest CT features of 53 HD patients with PM was conducted. Univariate and multivariate logistic regression analyses were used to determine the risk factors for death. The Cox regression model was used to analyze the factors affecting the survival rate.</p><p><strong>Results: </strong>A total of 30 patients with proven PM and 23 with probable PM were included. All 30 patients with proven PM underwent bronchoscopy-guided biopsy, among which 9 cases underwent surgical resection. Of the 23 patients with probable PM, 5 cases had positive results in sputum smear microscopy, 4 cases in sputum culture, 13 cases in bronchoalveolar lavage fluid (BALF) microscopy, and 1 case in BALF culture. All identification of pathogen genera and partial species was conducted by metagenomic next-generation sequencing (mNGS) testing. In the multivariate regression analysis, the CT feature of multiple lesions (≥2) on the initial CT scan was an independent risk factor for mortality (P=0.019). Cox survival analysis demonstrated a significantly lower survival rate (P=0.043) in patients exhibiting the CT feature of multiple lesions on the initial CT scan.</p><p><strong>Conclusions: </strong>The CT feature of multiple lesions (≥2) on the initial CT may serve as an independent risk factor for mortality in patients with hematologic disorders with pulmonary mucormycosis.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection, Classification, and Segmentation of Rib Fractures From CT Data Using Deep Learning Models: A Review of Literature and Pooled Analysis.","authors":"Stella Den Hengst, Noor Borren, Esther M M Van Lieshout, Job N Doornberg, Theo Van Walsum, Mathieu M E Wijffels, Michael H J Verhofstad","doi":"10.1097/RTI.0000000000000833","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000833","url":null,"abstract":"<p><strong>Purpose: </strong>Trauma-induced rib fractures are common injuries. The gold standard for diagnosing rib fractures is computed tomography (CT), but the sensitivity in the acute setting is low, and interpreting CT slices is labor-intensive. This has led to the development of new diagnostic approaches leveraging deep learning (DL) models. This systematic review and pooled analysis aimed to compare the performance of DL models in the detection, segmentation, and classification of rib fractures based on CT scans.</p><p><strong>Materials and methods: </strong>A literature search was performed using various databases for studies describing DL models detecting, segmenting, or classifying rib fractures from CT data. Reported performance metrics included sensitivity, false-positive rate, F1-score, precision, accuracy, and mean average precision. A meta-analysis was performed on the sensitivity scores to compare the DL models with clinicians.</p><p><strong>Results: </strong>Of the 323 identified records, 25 were included. Twenty-one studies reported on detection, four on segmentation, and 10 on classification. Twenty studies had adequate data for meta-analysis. The gold standard labels were provided by clinicians who were radiologists and orthopedic surgeons. For detecting rib fractures, DL models had a higher sensitivity (86.7%; 95% CI: 82.6%-90.2%) than clinicians (75.4%; 95% CI: 68.1%-82.1%). In classification, the sensitivity of DL models for displaced rib fractures (97.3%; 95% CI: 95.6%-98.5%) was significantly better than that of clinicians (88.2%; 95% CI: 84.8%-91.3%).</p><p><strong>Conclusions: </strong>DL models for rib fracture detection and classification achieved promising results. With better sensitivities than clinicians for detecting and classifying displaced rib fractures, the future should focus on implementing DL models in daily clinics.</p><p><strong>Level of evidence: </strong>Level III-systematic review and pooled analysis.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world Evaluation of Computer-aided Pulmonary Nodule Detection Software Sensitivity and False Positive Rate.","authors":"Raquelle El Alam, Khushboo Jhala, Mark M Hammer","doi":"10.1097/RTI.0000000000000835","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000835","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate the false positive rate (FPR) of nodule detection software in real-world use.</p><p><strong>Materials and methods: </strong>A total of 250 nonenhanced chest computed tomography (CT) examinations were randomly selected from an academic institution and submitted to the ClearRead nodule detection system (Riverain Technologies). Detected findings were reviewed by a thoracic imaging fellow. Nodules were classified as true nodules, lymph nodes, or other findings (branching opacity, vessel, mucus plug, etc.), and FPR was recorded. FPR was compared with the initial published FPR in the literature. True diagnosis was based on pathology or follow-up stability. For cases with malignant nodules, we recorded whether malignancy was detected by clinical radiology report (which was performed without software assistance) and/or ClearRead.</p><p><strong>Results: </strong>Twenty-one CTs were excluded due to a lack of thin-slice images, and 229 CTs were included. A total of 594 findings were reported by ClearRead, of which 362 (61%) were true nodules and 232 (39%) were other findings. Of the true nodules, 297 were solid nodules, of which 79 (27%) were intrapulmonary lymph nodes. The mean findings identified by ClearRead per scan was 2.59. ClearRead mean FPR was 1.36, greater than the published rate of 0.58 (P<0.0001). If we consider true lung nodules <6 mm as false positive, FPR is 2.19. A malignant nodule was present in 30 scans; ClearRead identified it in 26 (87%), and the clinical report identified it in 28 (93%) (P=0.32).</p><p><strong>Conclusion: </strong>In real-world use, ClearRead had a much higher FPR than initially reported but a similar sensitivity for malignant nodule detection compared with unassisted radiologists.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Society of Thoracic Radiology Mentorship Program: A Paradigm for Professional Societies.","authors":"Georgeann McGuinness, Linda B Haramati, Chi Wan Koo, Baskaran Sundaram","doi":"10.1097/RTI.0000000000000834","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000834","url":null,"abstract":"<p><p>The Society of Thoracic Radiology (STR) membership enthusiastically embraced the launch of its mentorship program, with peaks in participation and engagement after annual meetings and during the COVID pandemic. The program provides a valuable resource for early to mid-career thoracic radiologists, especially those lacking local resources. This report describes the program's inception and design, and summarizes the program's successes and challenges at 5 years, based on a 2023 mentorship survey. STR mentees, spanning early to mid-career stages, most frequently sought mentorship in career development, graduate medical education, research portfolio development, publishing, cardiac imaging, grant funding, and artificial intelligence. Mentors offered expertise in these areas, plus lung cancer screening, career development, and workplace navigation. The committee prioritized creating dyads based on mutual interest and expertise, achieving mutual top-choice match rates of 70% to 97%. Enduring dyads flourished as the program matured. At 5 years, a survey of participants was fielded. Mentees reported moderate to high program impact on scholarly activities, leadership, networking, clinical service, education, and career satisfaction. Mentors described satisfaction in their roles, highlighting networking, career satisfaction, and the opportunity to influence upcoming generations of cardiothoracic radiologists, thereby impacting the field's future. Most participants expressed high career satisfaction. Descriptive comments further enriched findings. Survey results confirmed that strengthening dyad formation and enhancing mentoring outcomes remain pivotal. Remote mentorship, while valuable, presents challenges-personal connections and contextual familiarity, considered essential to successful mentorship relationships, are typically absent in these settings. Activities to potentially enhance the STR mentorship program are offered.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}