AJR. American Journal of Roentgenology

Our medical research library holds 37 studies published in AJR. American Journal of Roentgenology (1978–2020). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 29 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 5 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: American Roentgen Ray Society
• Published: 1976 to the present, United States
• Language: English
• ISSN: 0361-803X (print), 1546-3141 (electronic)
• Continues: The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine
• Its record in the NLM Catalog

2020s

• In Situ Pulmonary Artery Thrombosis: Unrecognized Complication of Radiation Therapy. J. Ahuja, G.S. Shroff, M.F. Benveniste, et al. 2020;215(6):1329-1334. PubMed · Publisher

  Abstract

  OBJECTIVE. The purpose of this study is to evaluate the CT and clinical characteristics of in situ pulmonary artery thrombosis (PAT) associated with radiation therapy (RT). MATERIALS AND METHODS. A database search was performed to identify patients who had PAT develop after receiving RT. The CT characteristics of PAT, including the number, location, and appearance of filling defects as well as the presence of associated lung fibrosis, were recorded. The terminology (in situ thrombosis vs acute or chronic pulmonary embolism) used by the interpreting radiologists to describe PAT, the time between the completion of RT and development of PAT, the change in the size of the PAT, and observation of any new thrombi and emboli on follow-up imaging, were also recorded. RESULTS. Of the 27 patients in the study cohort, 22 (81%) had lung cancer and five (19%) had mesothelioma. Most PATs were solitary (93%) and nonocclusive (96%) and formed an obtuse angle to the vessel wall (89%). All PATs were eccentric within the involved PA and were located within the RT volume. The time from completion of RT to initial diagnosis of PAT on CT ranged from 53 to 2522 days (mean, 675 days). Radiation-induced lung fibrosis was present in the ipsilateral lung in all patients. No evidence of additional PA filling defects that suggested embolization were seen on follow-up images of any of the patients, even those who did not receive anticoagulant therapy. CONCLUSION. In situ PAT associated with RT, which to our knowledge has not previously been described in the English literature, has imaging features different from those of acute pulmonary emboli and does not appear to embolize. Radiologist awareness of PAT can facilitate accurate diagnosis and impact management.

2010s

• Whole-Body MRI: Comparison of Its Capability for TNM Staging of Malignant Pleural Mesothelioma With That of Coregistered PET/MRI, Integrated FDG PET/CT, and Conventional Imaging. Y. Ohno, M. Yui, K. Aoyagi, et al. 2019;212(2):311-319. PubMed · Publisher

  Abstract

  Objective: The purpose of this study was to compare the diagnostic accuracy of whole-body MRI, coregistered FDG PET/MRI, integrated FDG PET/CT, and conventional imaging examination including bone scintigraphy, contrast-enhanced brain MRI, and CT for malignant pleural mesothelioma (MPM) staging according to the new International Association for the Study of Lung Cancer (IASLC) system.

  Subjects And Methods: The study subjects were 23 consecutively registered patients with MPM (15 men, eight women; mean age, 68 years for both sexes) who had prospectively undergone whole-body FDG PET/CT, whole-body MRI, conventional radiologic examination, surgical or conventional treatments, pathologic examination, and follow-up conventional imaging examinations between January 2011 and December 2017. TNM staging was evaluated by two independent readers. Kappa statistics and chi-square tests were used for evaluation agreements on each factor and clinical stage between each method and final diagnosis. The diagnostic accuracy of each method was statistically compared by use of McNemar test.

  Results: The kappa values for each factor between each method and final diagnosis were significant (p < 0.0001) and ranged between 0.33 and 0.91. Kappa values between final diagnosis and stage evaluation were also significant (p < 0.0001) and ranged between 0.57 and 0.91. The diagnostic accuracy of N and stage assessment of whole-body MRI and FDG PET/MRI was significantly higher than that of conventional imaging examination (N factor, p < 0.05; stage, p < 0.05).

  Conclusion: The diagnostic accuracy of whole-body MRI, FDG PET/MRI, and FDG PET/CT for TNM stage assessment based on the new IASLC MPM staging system is greater than that of conventional imaging examination.

• FDG PET/CT in the management of primary pleural tumors and pleural metastases. M. Kruse, S.J. Sherry, V. Paidpally, et al. 2013;201(2):W215-26. Review PubMed · Publisher

  Abstract

  OBJECTIVE. FDG PET/CT is emerging as an important modality in the evaluation of pleural tumors. PET/CT has an established role in the diagnosis and staging and shows promise in therapy planning, therapy response assessment, and providing prognostic information in patients with malignant pleural mesothelioma. This modality has distinct advantages in characterizing other primary pleural tumors and pleural metastases. CONCLUSION. FDG PET/CT is a useful imaging modality in the management of patients with primary pleural tumors and pleural metastases.

• Epithelial malignant pleural mesothelioma after extrapleural pneumonectomy: stratification of survival with CT-derived tumor volume. R.R. Gill, W.G. Richards, B.Y. Yeap, et al. 2012;198(2):359-63. PubMed · Publisher

  Abstract

  Objective: The purpose of this study was to assess the usefulness of CT-derived tumor volume, with control for other prognostic factors, for stratifying survival after surgery-based multimodality treatment of a large cohort of patients with epithelial malignant pleural mesothelioma.

  Materials And Methods: We retrospectively reviewed 338 patients with mesothelioma who underwent extrapleural pneumonectomy between 2001 and 2007. The study cohort comprised 88 patients with epithelial subtype tumors, DICOM-format CT scans, and data regarding neoadjuvant and adjuvant therapy. Tumor volume was calculated, and Kaplan-Meier survival and Cox regression analyses were performed to compare the estimated survival functions of patient subgroups based on volume and other covariates related to outcome (sex, age, preoperative platelet count, hemoglobin concentration, WBC count, clinical and pathologic TNM category, and administration of neoadjuvant and adjuvant therapy). A multivariate regression model was derived on the basis of the most significant univariate predictors.

  Results: The median estimated tumor volume was 319 cm(3) (range, 4-3256 cm(3)). In univariate analysis, tumor volume, hemoglobin concentration, platelet count, pathologic TNM category, and administration of adjuvant chemotherapy or radiation therapy met the criteria for inclusion in the reverse stepwise regression analysis. In the final model, tumor volume, hemoglobin concentration, and administration of adjuvant chemotherapy or radiotherapy were identified as independently associated with overall survival.

  Conclusion: With control of prognostic covariates, CT-derived tumor volume can be used to stratify survival of patients with epithelial mesothelioma after extrapleural pneumonectomy and should be included in prognostic evaluation of patients for whom resection is being considered.

• Diffusion-weighted MRI of malignant pleural mesothelioma: preliminary assessment of apparent diffusion coefficient in histologic subtypes. R.R. Gill, S. Umeoka, H. Mamata, et al. 2010;195(2):W125-30. PubMed · Publisher

  Abstract

  Objective: The purpose of this study was to prospectively assess, in the evaluation of patients with suspected malignant pleural mesothelioma (MPM), apparent diffusion coefficient (ADC) values derived from diffusion-weighted images obtained with a free-breathing single-shot spin-echo echo-planar imaging sequence and to correlate the ADC values with the three histologic subtypes of MPM.

  Subjects And Methods: Sixty-two patients with a known pleural abnormality and clinical findings suggestive of MPM underwent diffusion-weighted 3-T MRI and ADC calculation. The pathologic diagnosis was confirmed by surgical procedure. ADC values were correlated with the histologic subtypes of MPM. Statistical analysis was performed with analysis of variance and the Student's t test.

  Results: Fifty-seven patients had MPM. Forty of the tumors were epithelioid, 11 were biphasic, and six were sarcomatoid. The other five patients had pleural thickening (two patients), metastatic adenocarcinoma (one patient), chronic inflammation (one patient), and malignant lymphoma (one patient). Because of image distortion, the diffusion-weighted images and ADC maps were not satisfactory for assessment in seven cases. The ADC values of MPM were 1.31 +/- 0.15 x 10(-3) mm(2)/s for the epithelioid, 1.01 +/- 0.11 x 10(-3) mm(2)/s for the biphasic, and 0.99 +/- 0.07 x 10(-3) mm(2)/s for the sarcomatoid subtypes of MPM. The ADC of the epithelioid subtype was statistically significantly higher than that of the sarcomatoid subtype (p < 0.05). The ADC in the two cases of benign plaque was 0.85 +/- 0.17 x 10(-3) mm(2)/s.

  Conclusion: The ADC values of epithelioid mesothelioma are higher than those of sarcomatoid mesothelioma. There is no significant difference between the ACD values of biphasic and those of sarcomatoid MPM.

2000s

• Malignant pleural mesothelioma with osteoblastic heterologous elements: CT and MR imaging findings. G. Chave, L. Chalabreysse, G. Picaud, et al. 2002;178(4):949-51. Case report PubMed · Publisher

  Summary

  This case report described the CT and MR imaging findings in a rare histologic subtype of malignant pleural mesothelioma with osteoblastic heterologous elements. The authors noted that only 13 such cases had previously been reported and that MR findings had not been described before. A 59-year-old man with a history of smoking and asbestos exposure presented with right chest pain. A chest radiograph showed a right pleural effusion with focal pleural thickening, and the initial CT scan showed right focal pleural thickening. A thoracoscopic pleural biopsy showed epithelial cells and malignant spindle cells, and malignant pleural mesothelioma was diagnosed. He received intrapleural gamma interferon. Three years later he was admitted with Pancoast-Tobias syndrome. Unenhanced CT showed that the pleural thickening had grown and that pleural calcifications had appeared. MR imaging confirmed chest wall and apical extension of the tumor. Calcified areas gave no signal on T1- and T2-weighted images, and noncalcified tumor gave a bright T2 signal. MR imaging also excluded a suspected superior vena cava syndrome. A repeat biopsy showed foci of malignant osteoid tissue, and the diagnosis was revised to mesothelioma with osteoblastic heterologous elements. The patient received palliative treatment and died 3 years after the initial diagnosis. The authors concluded that, although pleural calcification usually suggests benign disease, it may rarely occur in this tumor.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Multicystic mesothelioma of the peritoneum. L.T. Bui-Mansfield, G. Kim-Ahn, L.K. O'Bryant. 2002;178(2):402. Case report PubMed · Publisher

  Summary

  This radiologic–pathologic conference report, from Madigan Army Medical Center in Tacoma, Washington, described a case of multicystic mesothelioma of the peritoneum. A 44-year-old woman was found to have an abdominal mass during a pelvic examination. Pelvic sonography showed a complex multiseptate cystic mass. MR imaging showed a 15 × 9 × 7 cm mass arising from the uterine fundus, with intermediate and high signal intensity on T2-weighted images and fine septations in the cystic component. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. The specimen showed an irregular multilocular cystic mass attached to the uterine fundus. Microscopy found multiple mesothelium-lined cysts surrounded by fibrovascular stroma with adenomatoid changes. Drawing on published literature, the authors described multicystic mesothelioma as an intermediate form between benign adenomatoid mesothelioma and diffuse epithelial mesothelioma. They stated that it occurs mainly (84% of cases) in young or middle-aged women and chiefly affects the pelvic peritoneum. They stated that, unlike the malignant form of mesothelioma, it has no association with asbestos exposure. They summarized its sonographic, CT and MR appearances and its differential diagnoses, and noted that a correct preoperative diagnosis is almost never made because of its rarity. They reported that the tumor is not chemo- or radiosensitive, and that treatment is total surgical excision for localized lesions and debulking for more extensive ones.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Epithelioid hemangioendothelioma of the pleura: clinical and radiologic features. E.J. Crotty, H.P. McAdams, J.J. Erasmus, et al. 2000;175(6):1545-9. PubMed · Publisher

  Abstract

  Objective: The purpose of our study was to describe the clinical and radiologic features of epithelioid hemangioendothelioma of the pleura.

  Conclusion: Pleural epithelioid hemangioendothelioma is an uncommon malignancy that typically affects older men, who present with chest pain and dyspnea. This lesion manifests on chest radiographs and CT scans with unilateral pleural fluid and nodular pleural thickening and appears similar to diffuse pleural carcinomatosis or mesothelioma.

1990s

• Rounded atelectasis and mesothelioma. R.F. Munden, H.I. Libshitz. 1998;170(6):1519-22. PubMed · Publisher

  Abstract

  Objective: The purpose of this article is to report the coexistence of rounded atelectasis with malignant pleural mesothelioma as revealed by radiography and CT.

  Conclusion: Our five cases show the coexistence of rounded atelectasis and malignant mesothelioma. If rounded atelectasis is associated with a pleural effusion, a pleural mass with or without chest-wall invasion, or thickened pleura not adjacent to the rounded atelectasis, malignant mesothelioma should be strongly considered.

• Benign fibrous mesothelioma of the pleura: MR imaging findings. G.N. Harris, A. Rozenshtein, M.J. Schiff. 1995;165(5):1143-4. Case report PubMed · Publisher

• CT for asbestosis: value and limitations. D.A. Lynch. 1995;164(1):69-71. Comment PubMed · Publisher

  Abstract

  CT is more sensitive than clinical evaluation for the detection of asbestosis but is inevitably less sensitive and less specific than pathologic evaluation. For the asbestos-exposed individual, CT is useful for the evaluation of suspected lung masses, particularly rounded atelectasis [15], for identifying pleural plaques, and for confirming unequivocal asbestosis (grade 2 or grade 3 [8]). CT also will identify and quantify emphysema as a cause of physiologic impairment. Because clinicians commonly use CT to resolve clinical uncertainties, radiologists often feel pressured to categorize disease as unequivocally present or absent. Gamsu et al. [8] show that the borderline between normal and abnormal is not always sharply defined. In the absence of pathologic proof, the diagnosis of asbestosis must be based on a thoughtful evaluation of the likelihood of asbestosis by use of all available clinical, physiologic, and radiologic information. The scoring systems used by Gamsu et al. [8] offer a practical approach to defining the likelihood of asbestosis based on CT appearances.

• Performing high-resolution computed tomography in asbestos-exposed patients. T.C. McLoud. 1995;164(3):761-2. PubMed · Publisher

• Specificity of high-resolution CT findings in pulmonary asbestosis: do patients scanned for other indications have similar findings?. C.J. Bergin, R.A. Castellino, N. Blank, et al. 1994;163(3):551-5. PubMed · Publisher

  Abstract

  Objective: High-resolution CT findings in patients with asbestosis include subpleural curvilinear densities, subpleural density in dependent portions of the lung, parenchymal bands, thickened septal lines, and honeycomb lung. Our objective was to examine the prevalence of these CT findings in a random group of patients scanned for a variety of clinical reasons not specifically related to occupational exposure.

  Materials And Methods: One hundred sixty-eight CT studies of the thorax were performed at six levels in 168 patients examined for a variety of clinical indications. The scans were evaluated by two radiologists for the presence of subpleural curvilinear densities, subpleural density in dependent locations, parenchymal bands, thickened septal lines, and honeycomb lung.

  Results: CT scans of 11 patients showed pleural plaques suggesting previous exposure to asbestos. Among the 157 studies showing no evidence of pleural plaques, CT scans showed subpleural curvilinear densities in dependent areas in 32 (20%); subpleural curvilinear densities in nondependent areas in 19 (12%); parenchymal bands in 47 (30%); thickened septal lines in dependent areas in 93 (59%), and septal lines in nondependent areas in 67 (43%); subpleural density in dependent areas in 66 (42%); and honeycomb lung in five (3%).

  Conclusion: Subpleural curvilinear densities, subpleural density in dependent locations, parenchymal bands, and thickened septal lines occur as isolated and as combined CT findings in patients with a variety of underlying diseases or conditions unrelated to asbestosis and by themselves are nonspecific findings. Their occurrence, even in patients with CT evidence of pleural plaques, does not necessarily indicate the presence of asbestosis.

• Malignant pleural mesothelioma caused by environmental exposure to asbestos or erionite in rural Turkey: CT findings in 84 patients. A.A. Sahin, L. Cöplü, Z.T. Selçuk, et al. 1993;161(3):533-7. PubMed · Publisher

  Abstract

  Objective: Malignant pleural mesothelioma in rural Turkey frequently results from environmental exposure to tremolite asbestos or fibrous zeolite (erionite). The aim of this study was to determine the CT features of malignant pleural mesothelioma in patients exposed to asbestos or erionite.

  Materials And Methods: The CT scans of 84 patients with proved malignant pleural mesothelioma were retrospectively evaluated. Twenty patients (24%) had been exposed to erionite and 64 patients (76%) had been exposed to asbestos. The CT scans were interpreted by seven observers who did not know the clinical or pathologic findings.

  Results: CT scans showed either unilateral pleural thickening or pleural nodules/masses in all patients. Pleural nodules were present in 25 patients (30%) and pleural masses in 44 patients (52%). Pleural effusion was found in 61 patients (73%), mediastinal pleural involvement in 78 (93%), pleural calcifications in 52 (62%), involvement of the interlobar fissures in 64 (76%), and volume contraction in 61 (73%). Reduced size of the hemithorax was significantly correlated with chest wall involvement. On the basis of CT findings, the preassigned staging was changed in 21 patients (25%), including 44% of the patients with disease that had been classified as stage I. CT findings were not significantly different between the patients exposed to erionite and those exposed to asbestos.

  Conclusion: The most common CT findings in cases of malignant pleural mesothelioma were unilateral pleural thickening or pleural nodules/masses with or without effusion. CT provided valuable information on the extent of the disease, which was important for staging. Although the CT features are not pathognomonic, they provide valuable clues to the diagnosis in patients who have been exposed to mineral fibers.

• CT findings in benign fibrous mesothelioma of the pleura: pathologic correlation in nine patients. K.S. Lee, J.G. Im, K.O. Choe, et al. 1992;158(5):983-6. PubMed · Publisher

  Abstract

  The CT findings in cases of benign fibrous mesothelioma of the pleura have been described previously, but little attention has been given to a correlation of these findings with the pathologic appearance of the tumors. Accordingly, we analyzed the CT scans in nine proved cases in which pathologic studies were available and compared the pathologic findings with the CT appearance of the tumors. On enhanced CT scans (available in eight patients), the lesions showed significant enhancement in all cases. Pathologic examination showed that the enhancement could be explained by the vascularity of the tumor. Areas of myxoid (n = 7) or cystic (n = 3) degeneration and hemorrhage (n = 3) seen in the pathologic specimens correlated with round or tubular low-attenuation areas on unenhanced and enhanced CT scans. On unenhanced CT scans (n = 3), the tumor density was the same as that of the surrounding musculature. Calcification was seen in one patient. Large lesions showed lobulated borders, but no invasion into the lung parenchyma and chest wall was noted. There was no pleural effusion. Our experience suggests that intense enhancement of the tumors occurs because of the vascularity of the tumors. Areas of low attenuation in the tumors on CT were due to foci of myxoid or cystic degeneration and hemorrhage in the lesion.

• Malignant pleural mesothelioma: value of CT and MR imaging in predicting resectability. E.F. Patz, K. Shaffer, D.R. Piwnica-Worms, et al. 1992;159(5):961-6. PubMed · Publisher

  Abstract

  Objective: Our objective was to determine if CT or MR imaging findings could be used to accurately predict resectability in patients with biopsy-proved malignant pleural mesotheliomas.

  Subjects And Methods: CT and MR findings in 41 consecutive patients with malignant mesotheliomas who were referred to the thoracic surgery clinic for extrapleural pneumonectomy were studied by thoracic radiologists before surgery. Review of radiologic studies focused on local invasion of three separate regions: the diaphragm, chest wall, and mediastinum. Results of all imaging examinations were carefully correlated with intraoperative, gross, and microscopic pathologic findings.

  Results: After radiologic and clinical evaluation, 34 patients (83%) had thoracotomy; 24 of these had tumors that were resectable. The sensitivity was high (> 90%) for both CT and MR in each region. Specificity, however, was low, probably because of the small number of patients with unresectable tumors.

  Conclusion: CT and MR provided similar information on resectability in most cases. Sensitivity was high for both procedures. Because CT is more widely available and used, we suggest it as the initial study when determining resectability. In difficult cases, important complementary anatomic information can be derived from MR images obtained before surgical intervention.

• Chest CT combined with artificial pneumothorax: value in determining origin and extent of tumor. A. Watanabe, K. Shimokata, H. Saka, et al. 1991;156(4):707-10. PubMed · Publisher

  Abstract

  To determine the presence of chest wall and mediastinal invasion by lung cancer and to establish the origin of chest tumors, we studied 12 patients with intrathoracic tumors by using chest CT combined with artificial pneumothorax. Six patients had primary lung cancer, two had metastases, and one each had neurofibroma, pericardial cyst, chondroma of the rib, and malignant mesothelioma. All 12 tumors abutted the chest wall or mediastinum and could not be separated by conventional CT. Between 400 and 800 ml of air was injected into the pleural space before a second CT scan was obtained. No invasion was found at surgery in cancers that were separated from chest wall or mediastinum on CT scans. Surgery revealed chest wall invasion in three patients in whom the CT scans showed that the tumor was not separated from the chest wall. Only one patient with a tumor that was not separated from the mediastinum on CT did not have mediastinal invasion: in this case, only adhesions were found at surgery. Thus, in the eight patients with primary lung cancer and metastasis, sensitivity, specificity, and accuracy were 100%, 80%, and 88%, respectively. In four patients with mediastinal or pleural tumor, CT combined with pneumothorax was useful for establishing the origin of tumors. In all, 11 of the 12 patients were correctly evaluated by using this method. No complications occurred, except for mild chest discomfort in one patient. This study suggests that chest CT combined with artificial pneumothorax is useful for the evaluation of the extension of lung cancer into the chest wall and mediastinum and for the diagnosis of the site of origin of intrathoracic tumors.

• Malignant fibrous histiocytoma of the lung in a patient with a history of asbestos exposure. A.C. Reifsnyder, H.J. Smith, T.J. Mullhollan, et al. 1990;154(1):65-6. Case report PubMed · Publisher

  Summary

  The authors reported a case of primary malignant fibrous histiocytoma of the lung, a rare tumour, in a patient with a history of asbestos exposure, and reviewed the clinical and radiographic findings in the literature. A 49-year-old man presented with fatigue and hemoptysis. He had smoked 3-4 packs of cigarettes per day for 35 years and had been exposed to asbestos during military service 30 years earlier. Chest radiographs and CT showed a large noncalcified mass in the right lung base and pleural plaques, some calcified. Fine-needle aspiration suggested squamous cell carcinoma, and a technetium-99m methylene diphosphonate bone scan showed increased soft-tissue uptake at the right lung base. After right middle and lower lobectomy, microscopic and ultrastructural studies showed a poorly differentiated mesenchymal tumour consistent with malignant fibrous histiocytoma; epithelial tumours and malignant mesothelioma were excluded. Biopsy of the pleural plaques showed hyalinized fibrous scar. The patient was clinically free of disease 10 months later. To the authors' knowledge, this was the first documented case in a patient with asbestos exposure; they noted that no causal association between smoking or asbestos exposure and this tumour had been described. They concluded that, when primary pulmonary malignant fibrous histiocytoma is suspected, a careful search for tumour elsewhere must be made to exclude a metastasis.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Malignant pleural mesothelioma: CT manifestations in 50 cases. A. Kawashima, H.I. Libshitz. 1990;155(5):965-9. PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma, a rare and usually fatal neoplasm that is associated with asbestos exposure, is being encountered with increasing frequency. Pretreatment CT findings from 50 patients with malignant pleural mesothelioma are illustrated. Pleural thickening was found in 46 (92%) of the 50 patients, thickening of the pleural surfaces of the interlobar fissures in 43 (86%), pleural calcifications in 10 (20%), and pleural effusions in 37 (74%). The volume of the involved hemithorax varied appreciably. Contractions of the involved hemithorax was noted in 21 (42%) of 50 patients and contralateral mediastinal shift in seven (14%). Disease beyond the parietal pleura was found in the chest wall (nine patients), mediastinum, lymph nodes, and diaphragm.

1980s

• Cardiac masses: assessment by MR imaging. J.T. Lund, R.L. Ehman, P.R. Julsrud, et al. 1989;152(3):469-73. PubMed · Publisher

  Abstract

  The purpose of this study was to assess the role of MR imaging for evaluating suspected cardiac tumors or paracardiac masses involving the heart. Sixty-one patients with clinical or radiologic evidence of cardiac masses were imaged with ECG-gated MR at 1.5 T (22 patients) or 0.15 T (39 patients). Fifty-one patients had echocardiography previously. Among the tissue diagnoses were myxoma (six); fibroma, rhabdomyoma, plasma cell granuloma, lipomatous hypertrophy of the atrial septum, mesothelioma, and thymoma (two each); and leiomyosarcoma, lymphoma, metastatic carcinoid, melanoma, malignant fibrous histiocytoma, hemangiopericytoma, and lung spindle cell sarcoma (one each). MR imaging demonstrated masses in 50 patients (82%); they were centered in the heart in 32, pericardial in nine, and juxtacardiac in nine. MR imaging provided diagnostic information that affected clinical management or surgical planning in 53 patients (87%), including 11 (18%) in whom cardiac mass was excluded by MR. The ability to provide a global view of cardiac anatomy and other unique capabilities of MR imaging give the procedure an important role in the diagnosis and preoperative assessment of cardiac masses.

• Asbestos-related pleural disease and asbestosis: a comparison of CT and chest radiography. A.C. Friedman, S.B. Fiel, M.S. Fisher, et al. 1988;150(2):269-75. PubMed · Publisher

  Abstract

  High-resolution CT (HRCT) has the ability to demonstrate both asbestos-related pleural disease and parenchymal abnormalities consistent with asbestosis. The role of CT in the diagnosis of asbestosis can be defined by comparing it with radiography. We evaluated 60 men who had a history of occupational exposure to asbestos and whose outside chest radiographs were considered abnormal. Chest radiographs (inside films) and HRCT were performed in all patients at our institution and were interpreted independently by experienced radiologists. Outside film results were compiled from the submitted reports. The final conclusion regarding the interpretation of the radiologic examinations was determined by consensus when disagreements existed. Positive predictive values (the likelihood that a positive report is correct) for pleural disease were: outside films 56%, inside films 79%, HRCT 100%. The positive predictive values for parenchymal disease were: outside films 51%, inside films 83%, HRCT 100%. The addition of HRCT to chest radiography is most useful in eliminating false-positive diagnoses of asbestos-related pleural disease caused by subpleural fat and false-positive diagnoses of parenchymal asbestosis in patients with extensive plaques or emphysema obscuring lung detail. The interpretation of chest radiographs in patients exposed to asbestos is often extremely difficult and subjective, and we recommend that positive findings (except calcified plaques) be confirmed with HRCT.

• High-resolution CT of benign asbestos-related diseases: clinical and radiographic correlation. D.R. Aberle, G. Gamsu, C.S. Ray. 1988;151(5):883-91. PubMed · Publisher

  Abstract

  We prospectively analyzed benign asbestos-related pleural and parenchymal abnormalities on high-resolution CT scans and correlated them with clinical diagnoses in 100 asbestos-exposed workers. All subjects had high-resolution CT scans in conjunction with conventional CT at the time of clinical evaluation. To evaluate for asbestosis, we ranked high-resolution CT scans as high, intermediate, or low probability of asbestosis on the basis of the multiplicity and extent of observed parenchymal changes. By linear regression analysis, the most distinctive high-resolution CT features of asbestosis included thickened nondependent interstitial short lines and parenchymal bands. In 45 subjects satisfying clinical criteria of asbestosis, high-resolution CT probability of asbestosis was high in 38 (84%), intermediate in five (11%), and low in two (4%). In 20 (36%) of 55 subjects without clinical asbestosis, parenchymal abnormalities indicative of a high probability of asbestosis were observed on high-resolution CT. High-resolution CT probability scores had a strong positive correlation with chest radiographic profusion scores (p less than .0001) and asbestos-related pleural thickening (p less than .0001). Significant inverse correlations were seen with forced vital capacity (p less than .006) and single-breath diffusing capacity (p less than .03), both functional measures of restrictive interstitial lung disease. Neither clubbing nor rales were sufficiently prevalent to have statistical correlation with high-resolution CT scores. High-resolution CT is sensitive in detecting both pleural and parenchymal abnormalities in the asbestos-exposed subject. Asbestos-related pleural changes are observed more frequently on high-resolution CT than on conventional CT or chest radiography. The probability of asbestosis based on high-resolution CT parenchymal features has a significant correlation with existing clinical determinants of disease, and high-resolution CT can detect abnormality when other methods are not diagnostic.

• Talc: understanding its manifestations in the chest. D.S. Feigin. 1986;146(2):295-301. PubMed · Publisher

  Abstract

  Four distinct forms of pulmonary disease caused by talc have been defined. The first form, talcosilicosis, is caused by talc mined with high-silica-content mineral. Findings in this form are identical with those of silicosis. Talcoasbestosis closely resembles asbestosis and is produced by crystalline talc, generally inhaled with asbestos fibers. Pathologic and radiographic abnormalities are virtually identical with those of asbestosis, including calcifications and malignant tumor formation. The third form, talcosis, caused by inhalation of pure talc, may include acute or chronic bronchitis as well as interstitial inflammation; radiographically, it appears as interstitial reticulations or small, irregular nodules, typical of small-airway obstruction. The fourth form, due to intravenous administration of talc, is usually associated with abuse of oral medications and production of vascular granulomas manifested by consolidations, large nodules, and masses. Radiographic abnormalities associated with talc can be predicted when there is sufficient history of the nature of exposure, including the region of origin of the talc in cases of inhalation. Radiographic changes, such as diaphragmatic plaques, often attributed to both talc and asbestos have not been documented to be caused by talc alone. The author provides review of 18 well-documented cases.

• Computed tomography of localized pleural mesothelioma. C.G. Dedrick, T.C. McLoud, J.A. Shepard, et al. 1985;144(2):275-80. PubMed · Publisher

  Abstract

  The computed tomographic (CT) features of six pathologically proven cases of fibrous mesothelioma were reviewed. There were no pathognomonic CT characteristics, but in all cases CT suggested or supported the preoperative diagnosis. CT findings included well delineated, often lobulated, noncalcified soft-tissue masses in close relation to a pleural surface, associated crural thickening, and absence of chest wall invasion. An obtuse angle of the mass with respect to the pleural surface was not particularly useful. Rather, a smoothly tapering margin was more characteristic of a pleural lesion.

• Computed tomography of retrocrural spaces: normal, anatomic variants, and pathologic conditions. M.S. Shin, L.L. Berland. 1985;145(1):81-6. PubMed · Publisher

  Summary

  This pictorial essay described the computed tomography (CT) appearance of the retrocrural space, the area behind the diaphragmatic crura. It covered normal anatomy, anatomic variants and disease. The authors drew on thoracic and abdominal CT scans of about 18,000 cases at the University of Alabama between 1978 and 1983, together with other radiologic studies and clinical data. The scans were obtained on GE 8800 or Philips Tomoscan 310 machines, generally at 10-mm intervals, usually with intravenous contrast given as a bolus. The essay described the normal crura and the structures within the space, including the aorta, azygos veins, lymph nodes, cisterna chyli and thoracic duct. Normal variants could mimic disease: lobulated or large crura could simulate enlarged lymph nodes, and a normal lung tip, seen in about 3% of patients, could mimic retroperitoneal air. Illustrated diseases included lymph node enlargement from noncaseating granulomata, fluid from acute pancreatitis, metastatic colon cancer, and clinically unsuspected metastatic mesothelioma. Others were bleeding after a vertebral compression fracture, steroid-induced fat deposits, varices with liver cirrhosis or superior vena caval obstruction by seminoma, and a ruptured aortic aneurysm. The authors noted that pleural mesothelioma may occasionally extend into the retrocrural space and that CT can help detect such spread and stage the disease. They concluded that radiologists should be familiar with the normal anatomy, variants and diseases of this small region.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Diffuse pleural thickening in an asbestos-exposed population: prevalence and causes. T.C. McLoud, B.O. Woods, C.B. Carrington, et al. 1985;144(1):9-18. PubMed · Publisher

  Abstract

  Two types of pleural reaction have been described in association with asbestos exposure: pleural plaques and diffuse pleural thickening. This study was undertaken to determine the prevalence and causes of diffuse thickening in asbestos-exposed persons. Serial chest radiographs in 1373 exposed individuals and 717 controls were interpreted according to the ILO scheme by two B readers. Diffuse pleural thickening was defined as a smooth, noninterrupted pleural density extending over at least one-fourth of the chest wall, with or without costophrenic angle obliteration. Among the exposed group, plaques and diffuse thickening occurred with almost equal frequency, 16.5% and 13.5%, respectively. Of the 185 cases with diffuse thickening, the radiographic appearance was most often due to the residual of a benign asbestos effusion (31.3%) or confluent plaques (25.4%). The most commonly held explanation of diffuse thickening, an extension of pulmonary fibrosis to the visceral and parietal pleura, was actually infrequent (10.2%). Among the group with diffuse thickening without asbestosis, the forced vital capacity and single-breath diffusing capacity were significantly lower than those of comparable normal persons and those with confluent plaques.

• Gallium scanning in peritoneal mesothelioma. R.R. Armas, S.J. Goldsmith. 1985;144(3):563-5. PubMed · Publisher

  Abstract

  Gallium scans in seven cases of pathologically proven primary peritoneal mesothelioma were reviewed and correlated with clinical, radiologic, and surgical findings. Although five patients gave a history of asbestos exposure, only two showed chest film findings typical of asbestosis. Most had abdominal discomfort, ascites, and abdominal masses. Five of the seven had positive gallium scans; three showed a large single focus of uptake and two showed diffuse abdominal uptake. Although these patterns correspond to the two main gross pathologic types described in peritoneal mesothelioma, there was not complete agreement with clinical, radiographic, and surgical findings, and the focal pattern tended to underestimate the extent of the disease. Although gallium uptake can be seen in a variety of other neoplastic and inflammatory conditions, it may be useful in the diagnosis and follow-up of peritoneal mesothelioma.

• Angiography of omental mesothelioma. K. Marini, J.F. Walter. 1984;143(5):1075-7. Case report PubMed · Publisher

  Abstract

  Angiographic features of three cases of omental mesothelioma are presented. These lesions appeared mildly or moderately hypervascular without arteriovenous shunting or arterial encasement. The predominant feeding arteries were the right and left gastroepiploics. Since arteriography may be performed in the evaluation of the often nonspecific presenting symptoms of patients with abdominal mesothelioma, radiologists should be aware of these abnormalities.

• CT of malignant pleural mesothelioma. S. Mirvis, J.P. Dutcher, P.J. Haney, et al. 1983;140(4):665-70. PubMed · Publisher

  Abstract

  The CT scans, plain films, and clinical courses of nine patients with malignant pleural mesothelioma were reviewed to assess the value of computed tomography (CT) in the initial evaluation and follow-up of this malignancy. The initial pretreatment scans showed a typical lobulated rind of pleural tumor encasing the lung associated with variable amounts of pleural fluid. Local invasion of the mediastinum, pericardium, diaphragm, and contralateral thorax were well depicted on CT; unsuspected abdominal extension of tumor was demonstrated on CT scans of five patients. Serial scans during treatment provided objective evidence of either regression or growth of tumor mass, even when the patients' clinical status and plain films appeared stable.

• Diagnosis of peritoneal mesothelioma: computed tomography, sonography, and fine-needle aspiration biopsy. K. Reuter, V. Raptopoulos, F. Reale, et al. 1983;140(6):1189-94. PubMed · Publisher

  Abstract

  The diagnosis of peritoneal mesothelioma was made prospectively and noninvasively in four patients with the use of sonography, computed tomography, and sonographically guided fine-needle aspiration biopsy. The imaging methods revealed information similar to the operative findings, with clear superiority of computed tomography over sonography. These noninvasive methods may be used as screening tools, especially among groups or in regional areas with a high risk for asbestos exposure. The findings included soft-tissue masses with invariable involvement of the omentum; small intraperitoneal nodules; thickened peritoneum, mesentery, and bowel wall; pleural plaques; and usually minimal, if any, ascites. Since the differential diagnosis from peritoneal carcinomatosis may be difficult, sonographically (or CT) guided aspiration biopsy is needed to produce diagnostic cytologic specimens. The use of this type of biopsy should obviate surgical exploration.

• Arteriography in the localization of massive pleural tumors. P.F. Hahn, R.A. Novelline, E.J. Mark. 1982;139(4):814-7. Case report PubMed · Publisher

• Asbestos exposure and upper lobe involvement. G. Hillerdal. 1982;139(6):1163-6. PubMed · Publisher

  Abstract

  In a study of 1,251 persons with asbestos-related pleural and parenchymal changes, 16 had slowly progressive changes of the upper lobes, involving both pleura and parenchyma, with shrinkage of the lobes. In addition there were 41 cases with less advanced apical changes. Tuberculosis and other possible causes were excluded. It is hypothesized that the changes rate due to asbestos disease.

• CT of abdominal tuberculosis. B.M. Epstein, J.H. Mann. 1982;139(5):861-6. PubMed · Publisher

  Abstract

  Intraabdominal tuberculosis (TB) presents with a wide variety of clinical and radiologic features. Besides the reported computed tomographic (CT) finding of high-density ascites in tuberculous peritonitis, this report describes additional CT features highly suggestive of abdominal tuberculosis in eight cases: (1)irregular soft-tissue densities in the omental area; (2) low-density masses surrounded by thick solid rims; (3) a disorganized appearance of soft-tissue densities, fluid, and bowel loops forming a disorganized appearance of soft-tissue densities, fluid, and bowel loops forming a poorly defined mass; (4) low-density lymph nodes with a multilocular appearance after intravenous contrast administration; and (5) possibly high-density ascites. The differential diagnosis of these features include lymphoma, various forms of peritonitis, peritoneal carcinomatosis, and peritoneal mesothelioma. It is important that the CT features of intraabdominal tuberculosis be recognized in order that laparotomy be avoided and less invasive procedures (e.g., laparoscopy, biopsy, or a trail of antituberculous therapy) be instituted.

• CT of peritoneal mesothelioma: analysis of eight cases. N.O. Whitley, D.E. Brenner, K.H. Antman, et al. 1982;138(3):531-5. PubMed · Publisher

  Abstract

  In order to define the computed tomographic appearance of mesothelioma, eight patients with histologically proven peritoneal mesotheliomas had computed tomography (CT) performed during the course of their disease. CT findings for all cases were analyzed for evidence of tumor involvement in the peritoneum, mesentery, liver, bone, lymph nodes, and lower pleural space, and for ascitic and pleural fluid. CT findings included evidence of peritoneal involvement (7/8 patients, 88%), ascites (6/8, 75%), mesenteric involvement (6/8, 75%), pleural involvement (4/7, 57%), bone destruction (2/8, 25%), peritoneal mass (1/8, 12%), and retroperitoneal lymph node involvement (1/8, 12%). On the basis of diffuse mesenteric and peritoneal involvement and high incidence of ascites, CT may suggest the diagnosis of peritoneal mesothelioma; however, it may be difficult to differentiate from carcinomatosis, gastrointestinal malignancies, ovarian carcinomas, and, rarely, lymphomas. It is important to suggest the diagnosis of peritoneal mesothelioma because special stains and electron microscopy are necessary for pathologic diagnosis. Experience suggests that CT may be useful in suggesting the diagnosis and biopsy site, and after response to therapy of peritoneal mesothelioma.

• CT of malignant pleural mesothelioma. E. Alexander, R.A. Clark, D.P. Colley, et al. 1981;137(2):287-91. Case report PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma is a rare tumor. Although the chest film findings of pleural mesothelioma are well described, there are few descriptions of the findings of computed tomography (CT). This report describes the CT findings in five cases of pleural mesothelioma. In each case the CT showed an extensive, irregular, pleural-based mass surrounding the lung, spreading into the fissures, and extending into the mediastinum. In two cases there was also extension into the contralateral chest, and in one case each there was extension into the abdomen and chest wall. In each case the chest radiographs underestimated the extent of disease, when compared to CT. When an irregular, pleural-based mass involving most of the hemithorax is identified on CT, the diagnosis of mesothelioma can be suggested and at the same time the extent of the tumor may be evaluated. This is important because the diagnosis of mesothelioma is difficult and because treatment and prognosis may depend on the extent of the disease.

• Peritoneal mesothelioma: CT, sonography, and gallium-67 scan. J. Dach, N. Patel, S. Patel, et al. 1980;135(3):614-6. Case report PubMed · Publisher

  Summary

  The authors described what they stated was the first case correlating computed tomography (CT), sonography and gallium-67 scanning in a patient with primary peritoneal mesothelioma. A 61-year-old white man, a sheet metal worker with a 20-year history of alcohol abuse and moderate cigarette use, was admitted with abdominal distension and pain. Attempts at paracentesis at two hospitals yielded no fluid. Tissue fragments obtained earlier had been reported as poorly differentiated adenocarcinoma. A chest radiograph showed no pleural or parenchymal calcification. Sonography showed an anechoic zone around the liver and spleen that suggested ascites but lacked acoustic enhancement, as well as hypoechoic masses in the pelvis and along the anterior abdominal wall. CT appeared to show ascitic fluid, but its mean density was +14 CT units, compared with 0 ± 4 for a water phantom. CT also showed a large pelvic mass. Gallium scanning showed increased uptake in both flanks, around the liver and spleen, and deep in the pelvis. Laparotomy biopsies showed primary peritoneal mesothelioma. The patient died 11 days after surgery. At autopsy, a diffuse, mainly epithelial tumor encased the spleen and involved the peritoneal side of the diaphragm, with no intrathoracic involvement. The authors noted possible occupational asbestos exposure, but iron stains of lung tissue showed no asbestos bodies. They reported this as the first case of gallium uptake in peritoneal mesothelioma. They suggested that a lack of acoustic enhancement and a CT density above that of water may indicate solid tumor mimicking ascites.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

1970s

• Bilateral pleural thickening: a manifestation of asbestos dust exposure. E.N. Sargent, J. Gordonson, G. Jacobson, et al. 1978;131(4):579-85. PubMed · Publisher

  Abstract

  Bilateral pleural thickening in a relatively asymptomatic patient without evidence of pulmonary disease is frequently a manifestation of asbestos dust exposure, particularly when it is localized or in the form of a noncalcified pleural plaque. Bilateral pleural thickening will be discovered with increasing frequency if specifically searched for on every radiograph. This radiographic finding is suggested as a more realistic indication of asbestos dust exposure, particularly when correlated with a complete occupational history.

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