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103. Implementation of the Radiological Society of North America Expert Consensus Guidelines on Reporting Chest CT Findings Related to COVID-19: A Multireader Performance Study

Author

Som, Avik, primary, Lang, Min, additional, Yeung, Tristan, additional, Carey, Denston, additional, Garrana, Sherief, additional, Mendoza, Dexter P., additional, Flores, Efren J., additional, Li, Matthew D., additional, Sharma, Amita, additional, McDermott, Shaunagh, additional, Shepard, Jo-Anne O., additional, and Little, Brent P., additional

Published
2020
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106. Pulmonary Vascular Manifestations of COVID-19 Pneumonia

Author

Lang, Min, primary, Som, Avik, additional, Carey, Denston, additional, Reid, Nicholas, additional, Mendoza, Dexter P., additional, Flores, Efrén J., additional, Li, Matthew D., additional, Shepard, Jo-Anne O., additional, and Little, Brent P., additional

Published
2020
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118. A 51-year-old man with the adult respiratory distress syndrome

Author

Brusch, John L., Shepard, Jo-Anne O., Mark, Eugene J., and Jain, Bimal P.

Subjects
Acute respiratory distress syndrome -- Complications, Bacterial pneumonia -- Diagnosis, Streptococcal infections -- Complications
Abstract

A businessman with adult respiratory syndrome died of multiple organ failure caused by an atypical presentation of bacterial pneumonia. The 51-year-old man was hospitalized with a recent history of chills and breathing difficulties. His blood pressure dropped steadily while the heart beat accelerated. Urine output was minimal and chest X-rays revealed progressive lung disease. The patient died despite antibiotics and maximum drug therapy during the second episode of heart failure. Fibrous tissues in the heart and lungs, found at autopsy, indicated a fatal organ-conduction problem that worsened the course of the bacterial infection. The bacterium in question was group A beta-hemolytic streptococcus. Some bronchial scarring may have predisposed the patient to pneumonia, possibly related to having had sarcoidosis thirty years earlier.

Published
1996

119. Factors affecting patient adherence to lung cancer screening: A multisite analysis.

Author

Stowell, Justin T, Narayan, Anand K, Wang, Gary X, Fintelmann, Florian J, Flores, Efren J, Sharma, Amita, Petranovic, Milena, Shepard, Jo-Anne O, and Little, Brent P

Subjects
ACQUISITION of data methodology, CONFIDENCE intervals, MULTIPLE regression analysis, MEDICAL screening, LUNG tumors, RISK assessment, CANCER patients, MEDICAL records, DESCRIPTIVE statistics, PATIENT compliance, COMPUTED tomography, ODDS ratio, SMOKING
Abstract

Objective: To identify factors associated with delayed adherence to follow-up in lung cancer screening. Methods: Utilizing a data warehouse and lung cancer screening registry, variables were collected from a referred sample of 3110 unique participants with follow-up CT during the study period (1 January 2016 to 17 October 2018). Adherence was defined as undergoing chest CT within 90 days and 30 days of the recommended time for follow-up and was determined using proportions and multiple variable logistic regression models across the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS®) categories. Results: Of 1954 lung cancer screening participants (51.9% (1014/1954) males, 48.1% (940/1954) female; mean age 65.7 (range 45–87), smoking history median 40 pack-years, 60.2% and 44.5% did not follow-up within 30 and 90 days, respectively. Participants receiving Lung-RADS® category 1 or 2 presented later than those with Lung-RADS® category 3 at 90 days (coefficient −27.24, 95% CI −51.31, −3.16, p = 0.027). Participants with Lung-RADS® category 1 presented later than those with Lung-RADS® category 2 at both 90- and 30-days past due (OR 0.76 95% CI [0.59–0.97], p = 0.029 and OR 0.63 95% CI [0.48–0.83], p = 0.001, respectively). Conclusions: Adherence to follow-up was higher among participants receiving more suspicious Lung-RADS® results at index screening CT and among those who had undergone more non-lung cancer screening imaging examinations prior to index lung cancer screening CT. These observations may inform strategies aimed at prospectively identifying participants at risk for delayed or nonadherence to prevent potential morbidity and mortality from incident lung cancers. [ABSTRACT FROM AUTHOR]

Published
2021
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122. Clinical Utility of Rapid EGFR Genotyping in Advanced Lung Cancer

Author

Dagogo-Jack, Ibiayi, Azzolli, Christopher G., Fintelmann, Florian, Mino-Kenudson, Mari, Farago, Anna F., Gainor, Justin F., Jiang, Ginger, Piotrowska, Zofia, Heist, Rebecca S., Lennes, Inga T., Temel, Jennifer S., Mooradian, Meghan J., Lin, Jessica J., Digumarthy, Subba R., Batten, Julie M., Robinson, Hayley, Nose, Vania, Rivera, Miguel, Nardi, Valentina, Dias-Santagata, Dora, Le, Long P., Sequist, Lecia V., Pitman, Martha, Shepard, Jo-Anne O., Shaw, Alice T., Iafrate, A. John, and Lennerz, Jochen K.

Subjects
Article
Abstract

Purpose Targeted therapy is the cornerstone of treatment of advanced EGFR-mutant non–small-cell lung cancer (NSCLC). Next-generation sequencing (NGS), the preferred method for genotyping, typically requires several weeks. Here, we assessed workflows designed to rapidly identify patients with actionable EGFR mutations and reduce time to initiation (TTI) of epidermal growth factor receptor (EGFR)–directed therapy. Patients and Methods We performed rapid testing for EGFR L858R mutations and exon 19 deletions on paraffin-embedded or frozen section biopsy specimens from newly diagnosed patients with metastatic NSCLC by using an EGFR-specific assay (rapid test). To determine clinical utility, we assessed concordance with NGS results, turnaround time, and TTI of EGFR therapy, and we evaluated reimbursement data. Results Between January 2015 and September 2017, we performed 243 rapid EGFR tests and identified EGFR mutations in 43 patients (18%). With NGS results as a reference, sensitivity and specificity of the rapid EGFR polymerase chain reaction assay were 98% and 100%, respectively. The median turnaround time for NGS was 14 days, compared with 7 days for rapid testing (P < .001). In the rapid group, 95% of patients received an EGFR inhibitor in the first-line setting. The median TTI of EGFR therapy was significantly shorter in the rapid cohort when compared with 121 historical cases (22 v 37 days; P = .01). Escalation of the initiative into an interdisciplinary ultra-rapid next-day frozen-section workflow for highly symptomatic patients (n = 8) resulted in a reduction in the median (± standard deviation) turnaround time to 1 ± 0.4 days and allowed several patients to initiate therapy within 1 week of biopsy. An extended 9-month clinical evaluation phase confirmed operational sustainability (turnaround times: ultra-rapid, 0.81 ± 0.4 days; rapid, 3 ± 1.5 days), and a 63% reimbursement rate indicated financial sustainability. Conclusion Rapid genotyping facilitates earlier initiation of EGFR-directed therapies without compromising NGS workflows.

Published
2018

130. Needle localization of peripheral lung nodules for video-assisted thoracoscopic surgery

Author

Shepard, Jo-Anne O., Mathisen, Douglas J., Muse, Victorine V., Bhalla, Meenakshi, and McLoud, Theresa C.

Subjects
Thoracoscopy -- Methods, Biopsy, Needle -- Methods, Health, Methods
Abstract

Video-assisted thoracoscopic surgery provides an alternative to conventional thoracotomy for resection of peripheral lung nodules. To localize small peripheral lung nodules that may not be visible or palpable by the [...]

Published
1994

131. RadioGraphicsUpdate: The 10 Pillars of Lung Cancer Screening—Rationale and Logistics of a Lung Cancer Screening Program

Author

Adams, Scott J., Flores, Efren J., Little, Brent P., Sharma, Amita, Lennes, Inga T., Shepard, Jo-Anne O., and Fintelmann, Florian J.

Abstract

Editor's Note.—RadioGraphicsUpdate articles supplement or update information found in full-length articles previously published in RadioGraphics. These updates, written by at least one author of the previous article, provide a brief synopsis that emphasizes important new information such as technological advances, revised imaging protocols, new clinical guidelines involving imaging, or updated classification schemes.

Published
2024
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132. Feasibility and accuracy of CT-guided percutaneous needle biopsy of cavitary pulmonary lesions.

Author

Kiranantawat, Nantaka, Petranović, Milena, McDermott, Shaunagh, Gilman, Matthew, Digumarthy, Subba R., Shepard, Jo-Anne O., and Sharma, Amita

Subjects
NEEDLE biopsy, HEMOTHORAX, CHEST tubes, METASTASIS, DISEASE risk factors, COMPUTED tomography, CORE needle biopsy, LUNG microbiology, BIOPSY, HEMOPTYSIS, LUNGS, LUNG tumors, PNEUMOTHORAX, PILOT projects, DISEASE prevalence, RETROSPECTIVE studies, CHEST (Anatomy)
Abstract

Purpose: We aimed to evaluate the feasibility, accuracy, and complications of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) of cavitary lesions.Methods: Consecutive PTNB procedures in an academic institution over a 4-year period were reviewed, 53 of which were performed on patients with cavitary lesions. The demographic data of patients, lesion characteristics, biopsy technique and complications, initial pathologic results, and final diagnosis were reviewed. A final diagnosis was established through surgical correlation, microbiology or clinico-radiologic follow-up for at least 18 months after biopsy.Results: The overall accuracy of PTNB was 81%. In 33 patients (62%) the cavitary lesion was found to be malignant (23 lung cancers and 10 metastases). The sensitivity and specificity for malignancy was 91% and 100%, respectively. In 20 patients (38%) a benign etiology was established (16 infections and 4 noninfectious etiologies), with PTNB demonstrating a sensitivity of 81% and specificity of 100% for infection. Wall thickness at the biopsy site, lesion in lower lobe, and malignancy were significant independent risk factors for diagnostic success. Minor complications occurred in 28% of cases: 13 pneumothoraces (5 requiring chest tube), 1 small hemothorax, and 1 mild hemoptysis. A nonsignificant higher chest tube insertion rate was seen in cavities with a thinner wall.Conclusion: PTNB of cavitary lesions provides high accuracy, sensitivity, and specificity for both malignancy and infection and has an acceptable complication rate. Wall thickness at the biopsy site, lesion in lower lobe, and malignancy were significant independent risk factors for diagnostic success. Samples for microbiology should be obtained in all patients, especially in the absence of on-site cytology, due to the high prevalence of infection in cavitary lesions. [ABSTRACT FROM AUTHOR]

Published
2019
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139. Lung Cancer Screening

Author

Fintelmann, Florian J., primary, Gottumukkala, Ravi V., additional, McDermott, Shaunagh, additional, Gilman, Matthew D., additional, Lennes, Inga T., additional, and Shepard, Jo-Anne O., additional

Published
2017
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140. Contributors

Author

Abbara, Suhny, Abbott, Gerald F., Ackman, Jeanne B., Agarwal, Saurabh, Agrawal, Mukta D., Bang, Tami J., Baruah, Dhiraj, Batra, Kiran, Bernheim, Adam, Bhalla, Sanjeev, Bolen, Michael, Brown, Christopher G., Capobianco, Julia, Carter, Brett W., Chakrala, Nihara, Champlin, Jay, Chansakul, Thanissara, Chung, Jonathan H., Ciet, Pierluigi, Cox, Christian W., Digumarthy, Subba R., Dorbala, Sharmila, Edwards, Rachel, Elicker, Brett M., El-Sherief, Ahmed H., Fattouch, Tony Hany, Fintelmann, Florian J., Fisher, Stephen, François, Christopher J., Ghoshhajra, Brian B., Gilman, Matthew, Goodman, Lawrence R., Hassani, Cameron, Hedgire, Sandeep S., Heidinger, Benedikt H., Henry, Travis S., Hobbs, Stephen B., Hochhegger, Bruno, Isaacson, Jared, Jeong, Daniel, Joodi, Robert, Jordan, Kirk, Kalra, Mannudeep K., Kalva, Sanjeeva P., Kanne, Jeffrey P., Kicska, Gregory A., Kligerman, Seth, Kovoor, Jerry, Lee, Christopher, Levesque, Marie-Helene, Litmanovich, Diana, Little, Brent P., Lu, Michael T., Madan, Rachna, Malguria, Nagina, Meirelles, Gustavo, Moy, Matthew P., Murugan, Venkatesh Arumugam, Nagle, Scott K., Nagpal, Prashant, Ordovas, Karen, Padole, Atul, Pillai, Anil K., Pipavath, Sudhakar, Rajiah, Prabhakar, Ramakrishna, Rishi, Raptis, Constantine, Reddy, Guatham P., Renapurkar, Rahul, Rojas, Carlos A., Saboo, Sachin S., Sarwar, Mohammad, Schoepf, U. Joseph, Shahir, Kaushik, Sharma, Amita, Shepard, Jo-Anne O., Shroff, Girish S., Sirajuddin, Arlene, Staziaki, Pedro Vinícius, Suranyi, Pal Spruill, Tabari, Azadeh, Tóth, Attila, Tseng, Hsiang-Jer, Varga-Szemes, Akos, Veeranna, Vikas, von Herrmann, Paul, Walker, Christopher M., Walkoff, Lara A., Wang, Yingbing, White, Charles S., Wichmann, Julian L., Wright, Lindsay E., Wu, Carol C., Zangan, Steven, and Zucker, Evan James

Published
2020
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146. Contributors

Author

Abbott, Gerald F., Ackman, Jeanne B., Avery, Laura L., Carter, Brett W., Chung, Jonathan, Digumarthy, Subba R., Fintelmann, Florian J., Flores, Efren J., Gilman, Matthew D., Guo, Lan Qian (Lancia), Gutschow, Susan, Hossain, Rydhwana, Kalra, Mannudeep, Keimig, Thomas, Kovacina, Bojan, Loomis, Suzanne, McDermott, Shaunagh, Muse, Victorine V., Nance, John W., Natcheva, Hristina, Otrakji, Alexi, Petranovic, Milena, Price, Melissa, Sharma, Amita, Shepard, Jo-Anne O., Sabloff, Bradley S., Stowell, Justin, Truong, Mylene T., Walker, Christopher M., and Wu, Carol C.

Published
2019
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147. An overview of lung surgeries: postoperative ct findings and complications

Author

Nachiappan, Arun C., Digumarthy, Subba R., Sharma, Amita, Muse, Victorine V., Lanuti, Michael, and Shepard, Jo-Anne O.

Subjects
Pneumothorax -- Diagnosis, Pneumothorax -- Care and treatment, Radiologists -- Practice, CT imaging -- Usage, CT imaging -- Health aspects, Chest -- Surgery, Chest -- Health aspects, Chest -- Patient outcomes, Health
Abstract

There are various types of surgeries performed on the lungs, airways, pleura, and chest wall. As radiologists, it is imperative to understand the various surgeries, their expected post-operative imaging appearance and possible complications. The thoracic surgeries are broadly divided into two categories: open surgery and minimally invasive surgery. This article is a multi-modality review of open and minimally-invasive surgeries performed on the lung, pleura, trachea and chest wall. Computed tomography (CT) images, positron emission tomography (PET) images and radiographs, as well as intra-operative photographs and original illustrations of surgeries are provided to enhance understanding. Keywords: Thoracic Surgery | Pneumonectomy | Thoracic Radiography | Pleurodesis | Trachea | Tomography | Spiral Computed, Introduction Thoracic surgeons perform a variety of procedures depending on the indication, extent of disease and the health of the patient. Thoracic surgery interventions can be broadly classified into open [...]

Published
2010

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