Radiologic clinics of North America
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Current guidelines endorse low-dose computed tomography (LDCT) screening for smokers and former smokers aged 55 to 74, with at least a 30-pack-year smoking history. Adherence to published algorithms for nodule follow-up is strongly encouraged. ⋯ Screening for lung cancer with LDCT has revealed that there are indolent lung cancers that may not be fatal. More research is necessary if the risk-benefit ratio in lung cancer screening is to be maximized.
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Radiol. Clin. North Am. · Jan 2014
ReviewThe idiopathic interstitial pneumonias: an update and review.
Idiopathic interstitial pneumonias (IIPs) are a group of disorders with distinct histologic and radiologic appearances and no identifiable cause. The IIPs comprise 8 currently recognized entities. ⋯ To be considered an IIP, the disease must be idiopathic; however, each pattern may be secondary to a recognizable cause, most notably collagen vascular disease, hypersensitivity pneumonitis, or drug reactions. The diagnosis of IIP requires the correlation of clinical, imaging, and pathologic features.
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In this review, we focus on the radiologic, clinical, and pathologic aspects primarily of solitary subsolid pulmonary nodules. Particular emphasis will be placed on the pathologic classification and correlative computed tomography (CT) features of adenocarcinoma of the lung. The capabilities of fluorodeoxyglucose positron emission tomography-CT and histologic sampling techniques, including CT-guided biopsy, endoscopic-guided biopsy, and surgical resection, are discussed. Finally, recently proposed management guidelines by the Fleischner Society and the American College of Chest Physicians are reviewed.
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Radiol. Clin. North Am. · Jan 2014
Multidetector computed tomographic imaging in chronic obstructive pulmonary disease: emphysema and airways assessment.
Chronic obstructive pulmonary disease (COPD) is a complex syndrome encompassing potentially overlapping diseases such as pulmonary emphysema, chronic bronchitis, and small airways disease. The management of COPD relies on distribution and severity of those processes, which clinically can manifest similarly. Relative contribution and severity of each of those pathologic changes can be assessed using qualitative and quantitative analysis of computed tomographic imaging data. Studies are under way to establish potential links among the imaging, clinical, and genetic manifestations of COPD.