Clinical Radiology

Our medical research library holds 18 studies published in Clinical Radiology (1976–2020). 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. 15 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Blackwell Scientific Publications Ltd
• Published: 1960 to the present, England
• Language: English
• ISSN: 0009-9260 (print), 1365-229X (electronic)
• Continues: Journal of the Faculty of Radiologists
• Its record in the NLM Catalog

2020s

• The role of imaging in malignant pleural mesothelioma: an update after the 2018 BTS guidelines. S. Sinha, A.J. Swift, M.A. Kamil, et al. 2020;75(6):423-432. Review PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma (MPM) is a primary malignancy of the pleura and is associated with a poor outcome. The symptoms and signs of malignant mesothelioma present late in the natural history of the disease and are non-specific, making the diagnosis challenging and imaging key. In 2018, the British Thoracic Society (BTS) updated the guideline on diagnosis, staging, and follow-up of patients with MPM. These recommendations are discussed in this review of the current literature on imaging of MPM. It is estimated MPM will continue to cause serious morbidity and mortality in the UK late into the 21st century, and internationally, people continue to be exposed to asbestos. We aim to update the reader on current and future imaging strategies, which could aid early diagnosis of pleural malignancy and provide an update on staging and assessment of tumour response.

  Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.

2010s

• Pleural tumours and tumour-like lesions. F. Aluja Jaramillo, F. Gutierrez, S. Bhalla. 2018;73(12):1014-1024. Review PubMed · Publisher

  Abstract

  There are various neoplasms and tumour-like conditions of the pleura. Mesothelioma is perhaps the most widely recognised; however, there are many others that are more common and should be considered. Understanding the similarities and differences can be helpful in managing the patient with a newly found pleural lesion. We will discuss clinical symptoms at presentation and describe the imaging findings associated with these tumours, starting with conventional radiology, and correlating with computed tomography and combined positron-emission tomography (PET)/computed tomography (CT). Finally, imaging characteristics that help differentiation between the benign and malignant varieties will be reviewed.

  Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

• Low-voltage chest CT: another way to reduce the radiation dose in asbestos-exposed patients. D. Macía-Suárez, E. Sánchez-Rodríguez, B. Lopez-Calviño, et al. 2017;72(9):797.e1-797.e10. PubMed · Publisher

  Abstract

  Aim: To assess whether low voltage chest computed tomography (CT) can be used to successfully diagnose disease in patients with asbestos exposure.

  Materials And Methods: Fifty-six former employees of the shipbuilding industry, who were candidates to receive a standard-dose chest CT due to their occupational exposure to asbestos, underwent a routine CT. Immediately after this initial CT, they underwent a second acquisition using low-dose chest CT parameters, based on a low potential (80 kV) and limited tube current. The findings of the two CT protocols were compared based on typical diseases associated with asbestos exposure. The kappa coefficient for each parameter and for an overall rating (grouping them based on mediastinal, pleural, and pulmonary findings) were calculated in order to test for correlations between the two protocols.

  Results: A good correlation between routine and low-dose CT was demonstrated for most parameters with a mean radiation dose reduction of up to 83% of the effective dose based on the dose-length product between protocols.

  Conclusions: Low-dose chest CT, based on a limited tube potential, is useful for patients with an asbestos exposure background. Low-dose chest CT can be successfully used to minimise the radiation dose received by patients, as this protocol produced an estimated mean effective dose similar to that of an abdominal or pelvis plain film.

  Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

• Commentary on: Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos-related pleuropulmonary disease. I. Vlahos. 2013;68(4):336-7. Comment PubMed · Publisher

• Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos-related pleuropulmonary disease. G. Lee, Y.J. Jeong, K.I. Kim, et al. 2013;68(4):376-82. PubMed · Publisher

  Abstract

  Aim: To compare chest digital tomosynthesis (DTS) with digital radiography for the detection of asbestos-related pleuropulmonary disease.

  Materials And Methods: The institutional review board approved this study and all participants gave informed consent. Forty-five participants with a history of asbestos exposure were examined with DTS and radiography. Low-dose multidetector computed tomography (CT) in the prone position served as the reference. Two observers evaluated all images for the presence of pleural abnormalities and asbestosis. Interobserver agreement was analysed by using the k statistic. Diagnostic performance of the two imaging methods was compared using McNemar's test.

  Results: Interobserver agreement regarding DTS findings was moderate to very good (k = 0.544-0.846) and superior to the radiographic findings (k = 0.236-1.000). Overall, the diagnostic accuracy of DTS for the lesion detection was significantly better than with radiography (all p < 0.05, except that for the comparison of diagnostic accuracy of DTS versus radiographic detection of left diaphragmatic plaques and asbestosis). DTS was more sensitive than radiography for the detection of asbestosis (82% versus 27%, p = 0.031).

  Conclusion: DTS is more accurate than radiography in the detection of pleural plaques and more sensitive than radiography in the detection of asbestosis. Interobserver agreements with respect to the DTS findings were superior to the radiographic findings.

  Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

2000s

• CT appearances of pleural tumours. H.M. Salahudeen, E.T. Hoey, R.J. Robertson, et al. 2009;64(9):918-30. Review PubMed · Publisher

  Abstract

  Computed tomography (CT) is the imaging technique of choice for characterizing pleural masses with respect to their location, composition, and extent. CT also provides important information regarding invasion of the chest wall and surrounding structures. A spectrum of tumours can affect the pleura of which metastatic adenocarcinoma is the commonest cause of malignant pleural disease, while malignant mesothelioma is the most common primary pleural tumour. Certain CT features help differentiate benign from malignant processes. This pictorial review highlights the salient CT appearances of a range of tumours that may affect the pleura.

• CT appearances of talc pleurodesis. S. Narayanaswamy, S. Kamath, M. Williams. 2007;62(3):233-7. PubMed · Publisher

  Abstract

  Aim: To report the computed tomography (CT) appearances of talc pleurodesis in the management of patients with pleural effusions and spontaneous pneumothorax.

  Materials And Methods: The post-pleurodesis CT studies of 16 patients obtained over a 5-year period were reviewed. The mean age was 63 years (range 41-79 years). Ten patients were male. After pleurodesis, nine patients underwent a single chest CT examination and seven patients underwent more than one.

  Results: The characteristic finding observed in all patients, except one, was the presence of high-density deposits in the posterior basal regions of the pleural space. These were typically linear in seven patients, nodular in two, and a combination of linear and nodular in six. In five patients talc deposits were present on both the visceral and parietal pleura separated by an effusion (a variant of the split pleura sign). Talc deposits extended into an interlobar fissure with associated fissural thickening in five patients. In patients who underwent more than one CT study, the appearances remained stable.

  Conclusions: The typical finding was the presence of high attenuation areas in the posterior basal regions of the pleural space. Two new appearances were observed: extension of talc deposits into the fissure and the presence of a variant of the split pleura sign. It is important to recognize these CT appearances so as not to confuse them with other conditions such as asbestos exposure.

• Asbestos-related benign pleural disease. S.K. Morcos. 2001;56(1):85. Letter PubMed · Publisher

• Asbestos-related benign pleural disease. C. Peacock, S.J. Copley, D.M. Hansell. 2000;55(6):422-32. Review PubMed · Publisher

  Abstract

  Benign pleural disease is the commonest manifestation of asbestos exposure encountered by radiologists. Benign pleural thickening can appear as circumscribed parietal pleural plaques or as more diffuse thickening of the visceral pleura. Benign-asbestos induced pleural effusions are a significant and under-recognized manifestation of asbestos exposure with important sequelae, such as diffuse pleural thickening which may be associated with functional impairment and for which compensation may be sought. This review concentrates on the strengths and weaknesses of chest radiography and computed tomography for the detection and characterization of benign asbestos-related pleural disease and the relevance of imaging abnormalities to compensation and functional impairment.Peacock, C. (2000). Clinical Radiology55, 422-432.

  Copyright 2000 The Royal College of Radiologists.

1990s

• Case report: asbestos related pericardial disease. M. Cooper, K. Johnson, D.J. Delany. 1996;51(9):656-7. Case report PubMed · Publisher

• Computed tomographic assessment of patients following radical surgery for malignant mesothelioma. H. Adams, E.G. Butchart. 1992;45(2):120-4. PubMed · Publisher

  Abstract

  Serial computed tomographic (CT) scans of the thorax and upper abdomen were performed in eight patients following radical surgery (pleuro-pneumonectomy) for diffuse malignant mesothelioma of the pleura. The post-operative appearances included a well defined membrane lining the pleuro-pneumonectomy space in seven cases; in two cases this resembled the original tumour. In six patients there was upward abdominal visceral displacement on the side of the surgery due to diaphragmatic resection; this resulted in contralateral mediastinal shift in four patients. One patient required a diaphragmatic prosthesis which produced a distinctive CT appearance. CT suggested recurrent mesothelioma in five cases. Although two patients had evidence of intrathoracic recurrence, in three patients the only feature was the non-specific finding of abdominal ascites. The normal CT appearances after pleuro-pneumonectomy should be recognized to facilitate radiological interpretation. With careful application CT is of value for the assessment of recurrent disease in patients following radical surgery for malignant mesothelioma.

• Peritoneal mesothelioma: the role of computed tomography in diagnosis and follow up. P.J. Guest, R.H. Reznek, D. Selleslag, et al. 1992;45(2):79-84. PubMed · Publisher

  Abstract

  Computed tomography (CT) was performed on 15 patients with proven peritoneal mesothelioma. Eight of these patients underwent follow-up CT. It was found that a discrete and measurable mass is unusual in comparison with the common occurrence of ascites and that therefore CT has little role in quantifying the disease. Ascites is usually a prominent feature. Other features (e.g. omental infiltration) were evaluated and these could be used to assess disease progression.

• The prevalence of enlarged mediastinal lymph nodes in asbestos-exposed individuals: a CT study. C. Sampson, D.M. Hansell. 1992;45(5):340-2. PubMed · Publisher

  Abstract

  Patients with cryptogenic fibrosing alveolitis have a higher prevalence of enlarged mediastinal lymph nodes compared with the normal population. To determine whether or not this observation applies to individuals with asbestos-induced pulmonary fibrosis the high resolution computed tomography (CT) scans of 14 patients with definite asbestosis and 11 age-matched cases with benign asbestos-induced pleural disease, but no lung disease, were re-imaged on soft tissue settings. The site, size and number of mediastinal lymph nodes equal to, or greater than, 1.2 cm were recorded. In the asbestosis group 14 out of 14 patients had at least one enlarged lymph node with an average number per individual of four (range 1-10). In the control group two out of 11 patients each had one minimally enlarged lymph node. We conclude that mediastinal lymph node enlargement occurs frequently in asbestosis: awareness of this is important in the investigation of malignant disease in patients with asbestosis.

1980s

• Computed tomography in the assessment of malignant mesothelioma of the pleura. M.R. Law, A. Gregor, J.E. Husband, et al. 1982;33(1):67-70. PubMed · Publisher

  Abstract

  Computed tomography (CT) and plain radiography have been performed on 32 patients with malignant mesothelioma of the pleura, in order to assess the extent of disease and suitability for radical treatment. A comparison of the assessments by the two techniques is reported, with confirmation from either thoracotomy or post-mortem findings available in 16 cases. CT was found to be more sensitive than plain radiology in the detection of pleural effusions, although routine lateral decubitus radiographs has not been performed. The two techniques were equally effective in detecting involvement by tumour of the lateral chest wall, mediastinum and lung, with no false positive assessments by either technique, and few false negative assessments. Disease was shown to be extensive and gross at presentation in mesothelioma, so that the greater sensitivity of CT was of no advantage. Diaphragmatic involvement by tumour was accurately assessed by plain radiology but there were frequent false negative assessments by CT, possibly due to difficulty of interpretation of the curved diaphragm on the cross-sectional CT image. In this study CT offered little advantage over conventional radiology.

• Rib destruction: a neglected finding in malignant mesothelioma. R.M. Steiner, M.W. Cooper, H. Brodovsky. 1982;33(1):61-5. Case report PubMed · Publisher

  Abstract

  Malignant mesothelioma is extensively described in the radiological literature, but the incidence and importance of rib destruction has not been emphasised. In this communication, four patients with extensive mesothelioma and contiguous rib destruction are described. They represent 12% of the collected series of 36 patients. The differential diagnosis of a pleural mass with rib destruction is discussed.

• Peritoneal mesothelioma. J.R. Young, E.R. Reddy. 1980;31(3):243-7. Case report PubMed · Publisher

  Abstract

  The clinical and radiological features of peritoneal mesothelioma in four patients with an industrial history of asbestos exposure are described. The radiological features of intestinal obstruction, soft tissue masses and displacement and infiltration of bowel are stressed. A normal chest radiograph does not exclude the diagnosis. More sensitive diagnostic imaging and perhaps the use of laparoscopy may help to improve the accuracy of pre-mortem diagnosis.

1970s

• Computed tomography in pulmonary asbestosis. D. Katz, L. Kreel. 1979;30(2):207-13. PubMed · Publisher

  Abstract

  Attention is drawn to the signs of asbestosis on computed axial tomography and comparison made with findings in conventional radiology in 36 patients. CT was found to be significantly more sensitive in the detection of both pleural and parenchymal disease apart from thickened fissures. A possible sign of early mesothelioma is mentioned and an encasing variety of pleural thickening described. Perfusion changes which may represent a 'pre-radiological' interstitial fibrosis are discussed.

• Spontaneous pneumothorax and pulmonary malignant disease--a syndrome sometimes associated with cavitating tumours. Report of nine new cases, four with metastases and five with primary bronchial tumours. F.W. Wright. 1976;27(2):211-22. Case report PubMed · Publisher

  Abstract

  Tumours of the lung, primary or secondary, may occasionally be complicated by a pneumothorax, and on rare occasions this may be the presenting feature. Metastatic tumours associated with pneumothorax arise usually from bone or soft tissue sarcomas and hence are more common in the young.

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