Radiographics

Our medical research library holds 18 studies published in Radiographics (1989–2024). 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. 16 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 1 study 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: Radiological Society of North America
• Published: 1981 to the present, United States
• Language: English
• ISSN: 0271-5333 (print), 1527-1323 (electronic)
• Its record in the NLM Catalog

2020s

• Pictorial Review of Pleural Disease: Multimodality Imaging and Differential Diagnosis. A. Yamada, R. Taiji, Y. Nishimoto, et al. 2024;44(4):e230079. Review PubMed · Publisher

  Abstract

  The pleura is a thin, smooth, soft-tissue structure that lines the pleural cavity and separates the lungs from the chest wall, consisting of the visceral and parietal pleurae and physiologic pleural fluid. There is a broad spectrum of normal variations and abnormalities in the pleura, including pneumothorax, pleural effusion, and pleural thickening. Pneumothorax is associated with pulmonary diseases and is caused by iatrogenic or traumatic factors. Chest radiography and US help detect pneumothorax with various signs, and CT can also help assess the causes. Pleural effusion occurs in a wide spectrum of diseases, such as heart failure, cirrhosis, asbestos-related diseases, infections, chylothorax, and malignancies. Chest US allows detection of a small pleural effusion and evaluation of echogenicity or septa in pleural effusion. Pleural thickening may manifest as unilateral or bilateral and as focal, multifocal, or diffuse. Various diseases can demonstrate pleural thickening, such as asbestos-related diseases, neoplasms, and systemic diseases. CT, MRI, and fluorodeoxyglucose (FDG) PET/CT can help differentiate between benign and malignant lesions. Knowledge of these features can aid radiologists in suggesting diagnoses and recommending further examinations with other imaging modalities. The authors provide a comprehensive review of the clinical and multimodality imaging findings of pleural diseases and their differential diagnoses. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.

• Mesotheliomas and Benign Mesothelial Tumors: Update on Pathologic and Imaging Findings. A. Bonde, R. Singh, S.R. Prasad, et al. 2023;43(3):e220128. PubMed · Publisher

  Abstract

  A diverse spectrum of benign entities and malignant neoplasms originate from the monotonous mesothelium that lines the serosal membranes of the pleural, pericardial, and peritoneal cavities. The mesothelium of myriad sites shows a common origin from the lateral plate mesoderm; primary mesothelial tumors thus demonstrate similar pathogenesis, imaging findings, and treatment options. Significant changes have been made in the 2021 World Health Organization (WHO) classification schemata of the pleural and pericardial tumors on the basis of recent advances in pathology and genetics. While malignant mesotheliomas are biologically aggressive malignancies that occur primarily in patients exposed to asbestos with attendant poor survival rates, well-differentiated papillary mesothelial tumors and adenomatoid tumors charter a benign clinical course with an excellent prognosis. Mesothelioma in situ is a newly characterized entity represented by recurrent unexplained pleural effusions without any identifiable mass at imaging or thoracoscopy. Immunohistochemical markers based on BAP1, MTAP, CDKN2A, and TRAF7 gene mutations help differentiate diffuse mesotheliomas from benign mesothelial proliferations and localized mesotheliomas. Cross-sectional imaging modalities, including US, CT, MRI, and fluorine 18-fluorodeoxyglucose (FDG) PET/CT, permit diagnosis and play a major role in staging and assessing surgical resectability. Imaging studies are invaluable in providing noninvasive and quantitative assessment of tumor response in patients with unresectable disease. Owing to significant overlap in patient characteristics and pathomorphology, accurate diagnosis based on advanced histopathology techniques and genetic abnormalities is imperative for optimal management and prognostication. While patients with nonepithelioid pleural mesotheliomas benefit from immunotherapy, novel targeted therapies for CDKN2A-, NF2-, and BAP1-altered mesotheliomas are under consideration. © RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.

2010s

• Mediastinal and Pleural MR Imaging in Daily Practice. A.M. Priola, A. Veltri, S.M. Priola. 2018;38(3):981-982. Comment PubMed · Publisher

• Benign Multicystic Peritoneal Mesothelioma: AIRP Best Cases in Radiologic-Pathologic Correlation. R. Lee, A. Tong, B. Kurtis, et al. 2016;36(2):407-11. Case report PubMed · Publisher

  Abstract

  RadioGraphics continues to publish radiologic-pathologic case material selected from the American Institute for Radiologic Pathology (AIRP) "best case" presentations. The AIRP conducts a 4-week Radiologic Pathology Correlation Course, which is offered five times per year. On the penultimate day of the course, the best case presentation is held at the American Film Institute Silver Theater and Cultural Center in Silver Spring, Md. The AIRP faculty identifies the best cases, from each organ system, brought by the resident attendees. One or more of the best cases from each of the five courses are then solicited for publication in RadioGraphics. These cases emphasize the importance of radiologic-pathologic correlation in the imaging evaluation and diagnosis of diseases encountered at the institute and its predecessor, the Armed Forces Institute of Pathology (AFIP).

• Digital tomosynthesis of the chest: current and emerging applications. S.H. Chou, G.A. Kicska, S.N. Pipavath, et al. 2014;34(2):359-72. PubMed · Publisher

  Abstract

  Digital tomosynthesis (DTS) of the chest is a technique whose basic components are similar to those of digital radiography, but that also provides some of the benefits of computed tomography (CT). The major advantages of DTS over conventional chest radiography are improved visibility of the pulmonary parenchyma and depiction of abnormalities such as pulmonary nodules. Calcifications, vessels, airways, and chest wall abnormalities are also much more readily visualized at DTS than at chest radiography. DTS could potentially be combined with chest radiography to follow up known nodules, confirm or rule out suspected nodules seen at radiography, or evaluate individuals who are at high risk for lung cancer or pulmonary metastases. DTS generates coronal "slices" through the chest whose resolution is superior to that of coronal reconstructed CT images, but it is limited by its suboptimal depth resolution and susceptibility to motion; consequently, potential pitfalls in recognizing lesions adjacent to the pleura, diaphragm, central vessels, and mediastinum can occur. However, the radiation dose and projected cost of chest DTS are lower than those of standard chest CT. Besides pulmonary nodule detection, specific applications of DTS that are under investigation include evaluation of pulmonary tuberculous and nontuberculous mycobacterial disease, cystic fibrosis, interstitial lung disease, and asbestos-related thoracic diseases. A basic understanding of chest DTS and of the emerging applications of this technique can prove useful to the radiologist. Online supplemental material is available for this article.

  ©RSNA, 2014.

• Multimodality imaging for characterization, classification, and staging of malignant pleural mesothelioma. L.T. Nickell, J.P. Lichtenberger, L. Khorashadi, et al. 2014;34(6):1692-706. Review PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma (MPM) is the most common primary malignancy of the pleura and is associated with asbestos exposure in approximately 80% of patients. The patient prognosis is poor, with a median survival of 9-17 months after diagnosis. However, improved survival and decreased morbidity and mortality have been demonstrated when the diagnosis is made in the early stages of disease and specific treatment strategies are implemented. A staging system that focuses on the extent of primary tumor (T), lymph node involvement (N), and metastatic disease (M) has been devised by the International Mesothelioma Interest Group and emphasizes factors related to overall survival. Radiologists should recognize the manifestations of MPM across multiple imaging modalities, translate these findings into the updated staging system, and understand the effects of appropriate staging on treatment and survival. Computed tomography (CT) remains the primary imaging modality used to evaluate MPM and efficiently demonstrates the extent of primary tumor, intrathoracic lymphadenopathy, and extrathoracic spread. However, additional imaging modalities, such as magnetic resonance (MR) imaging of the thorax and positron emission tomography (PET)/CT with fluorodeoxyglucose, have emerged in recent years and are complementary to CT for disease staging and evaluation of patients with MPM. Thoracic MR imaging is particularly useful for identifying invasion of the chest wall, mediastinum, and diaphragm, and PET/CT can accurately demonstrate intrathoracic and extrathoracic lymphadenopathy and metastatic disease.

• Primary pericardial tumors. C.S. Restrepo, D. Vargas, D. Ocazionez, et al. 2013;33(6):1613-30. Review PubMed · Publisher

  Abstract

  Primary pericardial tumors are rare and may be classified as benign or malignant. The most common benign lesions are pericardial cysts and lipomas. Mesothelioma is the most common primary malignant pericardial neoplasm. Other malignant tumors include a wide variety of sarcomas, lymphoma, and primitive neuroectodermal tumor. When present, signs and symptoms are generally nonspecific. Patients often present with dyspnea, chest pain, palpitations, fever, or weight loss. Although the imaging approach usually begins with plain radiography of the chest or transthoracic echocardiography, the value of these imaging modalities is limited. Cross-sectional imaging, on the other hand, plays a key role in the evaluation of these lesions. Computed tomography and magnetic resonance imaging allow further characterization and may, in some cases, provide diagnostic findings. Furthermore, the importance of cross-sectional imaging lies in assessing the exact location of the tumor in relation to neighboring structures. Both benign and malignant tumors may result in compression of vital mediastinal structures. Malignant lesions may also directly invade structures, such as the myocardium and great vessels, and result in metastatic disease. Imaging plays an important role in the detection, characterization, and staging of pericardial tumors; in their treatment planning; and in the posttreatment follow-up of affected patients. The prognosis of patients with benign tumors is good, even in the few cases in which surgical intervention is required. On the other hand, the length of survival for patients with malignant pericardial tumors is, in the majority of cases, dismal.

• Somatic and visceral solitary fibrous tumors in the abdomen and pelvis: cross-sectional imaging spectrum. A.K. Shanbhogue, S.R. Prasad, N. Takahashi, et al. 2011;31(2):393-408. Review PubMed · Publisher

  Abstract

  Solitary fibrous tumors (SFTs) are a unique group of mesenchymal neoplasms of fibroblastic or myofibroblastic origin. These tumors were originally described as "benign fibrous mesotheliomas" of the pleural cavity and were erroneously thought to be confined to the serosal surfaces (due to a putative mesothelial or submesothelial origin). It is now established that SFTs are ubiquitous neoplasms with both pleural and extrapleural distribution. Extrapleural SFTs commonly occur in middle-aged adults and manifest as asymptomatic, slow-growing, large tumors. Fewer than 5% of patients with SFTs present with symptomatic hypoglycemia. SFTs are histopathologically diverse with a variable admixture of fibroblasts or myofibroblasts, numerous thin-walled vessels, and dense fibrosis. Tumors previously categorized as hemangiopericytomas are now considered cellular variants of SFTs. At imaging, SFTs demonstrate remarkable heterogeneity, with variable degrees of enhancement, necrosis, or hemorrhage. Although most extrapleural SFTs have a benign clinical course, 10%-15% of these tumors demonstrate aggressive behavior in the form of recurrence or malignancy.

  © RSNA, 2011.

2000s

• From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation. A.D. Levy, J. Arnáiz, J.C. Shaw, et al. 2008;28(2):583-607; quiz 621-2. Review PubMed · Publisher

  Abstract

  Primary peritoneal tumors are uncommon lesions that arise from the mesothelial or submesothelial layers of the peritoneum. Primary malignant mesothelioma, multicystic mesothelioma, primary peritoneal serous carcinoma, leiomyomatosis peritonealis disseminata, and desmoplastic small round cell tumor are the most prominent of these rare lesions. Primary malignant mesothelioma is a highly aggressive malignancy that occurs most commonly in older men and that has a strong association with high levels of asbestos exposure. It manifests most often as diffuse sheetlike or nodular thickening of the peritoneal surfaces, but it may occasionally be a localized mass. Multicystic mesothelioma occurs most frequently in women and has benign or indolent biologic behavior in the majority of patients. It is a multilocular cystic mass that arises from the pelvic peritoneal surfaces. Primary peritoneal serous carcinoma occurs almost exclusively in women. It is histologically identical to ovarian serous carcinoma and may be indistinguishable from metastatic ovarian carcinoma at imaging studies. Leiomyomatosis peritonealis disseminata is a rare, benign proliferative process that also occurs exclusively in women and is characterized by multiple smooth muscle nodules throughout the peritoneum. Desmoplastic small round cell tumor is a highly aggressive malignancy of unknown origin that occurs most often in the peritoneal cavity of young men. This unusual group of tumors is linked together by a common site of origin and imaging manifestations that mimic those of peritoneal carcinomatosis. Knowledge of the spectrum of imaging findings in this group of primary peritoneal tumors, along with their clinical and pathologic characteristics, is important in the evaluation of patients with diffuse peritoneal disease.

• Pneumoconiosis: comparison of imaging and pathologic findings. S. Chong, K.S. Lee, M.J. Chung, et al. 2006;26(1):59-77. Review PubMed · Publisher

  Abstract

  Pneumoconiosis may be classified as either fibrotic or nonfibrotic, according to the presence or absence of fibrosis. Silicosis, coal worker pneumoconiosis, asbestosis, berylliosis, and talcosis are examples of fibrotic pneumoconiosis. Siderosis, stannosis, and baritosis are nonfibrotic forms of pneumoconiosis that result from inhalation of iron oxide, tin oxide, and barium sulfate particles, respectively. In an individual who has a history of exposure to silica or coal dust, a finding of nodular or reticulonodular lesions at chest radiography or small nodules with a perilymphatic distribution at thin-section computed tomography (CT), with or without eggshell calcifications, is suggestive of silicosis or coal worker pneumoconiosis. Magnetic resonance imaging is helpful for distinguishing between progressive massive fibrosis and lung cancer. CT and histopathologic findings in asbestosis are similar to those in idiopathic pulmonary fibrosis, but the presence of asbestos bodies in histopathologic specimens is specific for the diagnosis of asbestosis. Giant cell interstitial pneumonia due to exposure to hard metals is classified as a fibrotic form of pneumoconiosis and appears on CT images as mixed ground-glass opacities and reticulation. Berylliosis simulates pulmonary sarcoidosis on CT images. CT findings in talcosis include small centrilobular and subpleural nodules or heterogeneous conglomerate masses that contain foci of high attenuation indicating talc deposition. Siderosis is nonfibrotic and is indicated by a CT finding of poorly defined centrilobular nodules or ground-glass opacities.

  (c) RSNA, 2006.

• Asbestos: when the dust settles an imaging review of asbestos-related disease. H.D. Roach, G.J. Davies, R. Attanoos, et al. 2002;22 Spec No:S167-84. Review PubMed · Publisher

  Abstract

  Asbestos-related neoplastic and nonneoplastic diseases of the lungs and pleura range from pleural effusion and pleural plaques to lung cancer and malignant mesothelioma. Pleural effusions are typically hemorrhagic exudates of mixed cellularity but do not typically contain asbestos bodies. The classic distribution of pleural plaques seen on chest radiographs is the posterolateral chest wall between the seventh and tenth ribs, lateral chest wall between the sixth and ninth ribs, the dome of the diaphragm, and the mediastinal pleura. Computed tomographic (CT) findings support this distribution but also show anterior and paravertebral plaques not well shown at chest radiography. Imaging features of diffuse pleural thickening include a continuous sheet, often involving the costophrenic angles and apices, that rarely calcifies. The typical CT features of round atelectasis are of a round or oval mass that abuts the pleura, a "comet tail" of bronchovascular structures going into the mass, and thickening of the adjacent pleura. Features of asbestosis on chest radiographs include ground-glass opacification, small nodular opacities, "shaggy" cardiac silhouette, and ill-defined diaphragmatic contours. CT, however, is more sensitive in their detection. Chest radiography in patients with malignant mesothelioma may show an effusion, pleural thickening, and as the tumor progresses, a more lobulated outline. CT can help identify the disease in its early stages. Asbestos-related cancers can occur anywhere in the lungs. Recognition of the clinical, radiologic, and pathologic features of these diseases will be important for some years to come.

• Best cases from the AFIP. Malignant peritoneal mesothelioma. J.M. Busch, J.B. Kruskal, B. Wu, et al. 2002;22(6):1511-5. Case report PubMed · Publisher

  Summary

  This article, from the Armed Forces Institute of Pathology 'Best Cases' series, reported one case of malignant peritoneal mesothelioma and correlated the imaging and pathology. A 70-year-old retired male food broker had several weeks of intermittent, poorly localized abdominal discomfort and a 15-pound weight loss. Abdominal CT showed a single large heterogeneous mass in the left upper quadrant with a small amount of ascites and no pleural or pulmonary abnormalities. Percutaneous biopsy showed mostly spindle cells, consistent with the desmoplastic variant of malignant mesothelioma. The patient had no known exposure to asbestos. Repeat CT after referral showed a 20 by 7 cm enhancing mass replacing much of the omentum. It had invaded the colon and spleen, surrounded the stomach fundus, and extended into the liver, with enhancing peritoneal plaques and nodules and moderate ascites. He underwent debulking omentectomy and partial colectomy. The resected specimen weighed 1,740 g. Histology showed malignant mesothelioma with epithelial and sarcomatoid components. Tumor cells were positive for keratin and calretinin and negative for B72.3, carcinoembryonic antigen and Leu-M1. The discussion reviewed epidemiology, clinical patterns, CT features, differential diagnosis, immunohistochemistry and treatment. It noted that asbestos exposure, mainly crocidolite, has been implicated, and that about half of reported cases have no history of asbestos exposure. The authors concluded that the diagnosis should be considered when solid peritoneal masses are present, that percutaneous sampling should be done to confirm it, and that CT is critical for preoperative assessment.

  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.

• Imaging of occupational lung disease. K.I. Kim, C.W. Kim, M.K. Lee, et al. 2001;21(6):1371-91. Review PubMed · Publisher

  Abstract

  Occupational lung disease comprises a wide variety of disorders caused by the inhalation or ingestion of dust particles or noxious chemicals. These disorders include pneumoconiosis, asbestos-related pleural and parenchymal disease, chemical pneumonitis, occupational infection, hypersensitivity pneumonitis, and organic dust toxic syndrome. Most of these disorders produce diffuse lung disease. Although many of the disorders can be detected at chest radiography, high-resolution computed tomography (CT) has been shown to be superior to chest radiography in depicting parenchymal, airway, and pleural abnormalities. Some occupational lung diseases have characteristic radiologic features suggesting the correct diagnosis, whereas in others, a combination of clinical features, related occupational history, radiologic findings, and literature supporting an association between the exposure and the disease process is required for diagnosis. With advances in chest radiology, including high-resolution CT, radiologists play a key role in the clinical evaluation of occupational lung diseases and should continue their involvement in the diagnosis and treatment of these diseases.

• Unusual radiologic findings in the thorax after radiation therapy. B. Mesurolle, S.D. Qanadli, M. Merad, et al. 2000;20(1):67-81. Review PubMed · Publisher

  Abstract

  Radiation therapy is used to treat many intrathoracic and chest wall malignancies. A variety of changes may occur after radiation therapy to the thorax. Radiation therapy produces dramatic effects in the lung. Pulmonary necrosis is an uncommon, severe, late complication of adjuvant postoperative radiation therapy. Bronchiolitis obliterans with organizing pneumonia is a distinct clinicopathologic entity characterized by patchy, migratory, peripheral air-space infiltrates. Radiation therapy can also cause spontaneous pneumothorax, mesothelioma, and lung cancer. In the mediastinum, radiation therapy may cause thymic cysts, calcified lymph nodes, and esophageal injuries. Cardiovascular complications of radiation therapy are often delayed and insidious. Premature coronary artery stenosis occurs after radiation therapy to the mediastinum. Radiation therapy may also give rise to calcifications of the ascending aorta, pericardial disease, valvular injuries, and conduction abnormalities. Women who undergo thoracic irradiation before the age of 30 years have a high risk of developing a second breast cancer. Radiation-induced sarcomas are an infrequent but well-recognized complication of radiation therapy. Other chest wall injuries due to radiation therapy are osteochondroma and rib or clavicle fractures. Knowledge of the imaging features of injuries caused by radiation therapy can prevent misinterpretation as recurrent tumor and may facilitate further treatment.

1990s

• From the archives of the AFIP. Malignant pleural mesothelioma: radiologic-pathologic correlation. B.H. Miller, M.L. Rosado-de-Christenson, A.C. Mason, et al. 1996;16(3):613-44. Review PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma (MPM) is a rare malignant neoplasm that typically affects individuals occupationally exposed to asbestos through a variety of industries. The patients experience an insidious onset of symptoms, including dyspnea, chest pain, cough, malaise, and weight loss. The pathologic diagnosis of MPM is difficult, and special stains or immunohistochemical or ultrastructural analysis may be required to differentiate MPM from metastatic adenocarcinoma. The tumor affects both the parietal and visceral pleural surfaces and progresses to encase the lung and invade the lung, mediastinum, and chest wall. Radiologically, MPM manifests as unilateral pleural effusion, pleural nodules, or pleural masses. Imaging studies are useful for diagnosis and staging in patients who are potential surgical candidates. Although a variety of multimodality therapies are available and radical surgical procedures have been developed, the prognosis remains dismal.

• Imaging manifestations of pleural tumors. M.C. Dynes, E.M. White, W.A. Fry, et al. 1992;12(6):1191-201. Review PubMed · Publisher

  Abstract

  Although radiologic assessment of pleural tumors may be accomplished with several imaging modalities, the standard noninvasive techniques include chest radiography and computed tomography (CT). These examinations may be supplemented with magnetic resonance imaging and occasionally with ultrasound. Depending on the location, size, and underlying histologic features, pleural tumors may produce a spectrum of findings. CT is particularly useful in defining the location and extent of these masses. The authors present a review of basic pleural anatomy and imaging features of both benign and malignant pleural neoplasms. The pleural may be involved by one of several primary or metastatic tumors. Specific cell types are diffuse malignant mesothelioma (the most common plain radiographic findings are unilateral pleural effusion and pleural thickening), localized fibrous tumor (circumscribed, spherical or ovoid, noncalcified lesions arising in the pleural surface), metastatic disease (radiographic findings may mimic those of malignant mesothelioma), and uncommon neoplasms including thymoma and lymphoma. Among these various pleural tumors, metastatic disease represents the most common neoplasm.

• Neoplastic and inflammatory processes of the peritoneum, omentum, and mesentery: diagnosis with CT. J.E. Hamrick-Turner, M.V. Chiechi, P.L. Abbitt, et al. 1992;12(6):1051-68. Review PubMed · Publisher

  Abstract

  Disease processes in the peritoneum, omentum, and mesentery occasionally are not recognized at radiologic examination. The authors have used computed tomography (CT) to categorize the radiologic appearances of the more common abnormalities into three basic patterns: (a) solid but relatively well-defined masses, (b) cystic-appearing masses, and (c) ill-defined or infiltrative processes. The most common solid masses to affect these anatomic regions are secondary neoplasms, which are associated with enhancement of the peritoneum on contrast material-enhanced CT scans and, typically, ascites. The various cystic-appearing masses (including cystic lymphangioma, cystic mesothelioma, teratoma, and loculated ascites) and infiltrating masses (such as peritoneal mesothelioma, retractile mesenteritis, desmoid, and carcinoid) must be differentiated on the basis of clinical findings and additional imaging findings (eg, CT depiction of fat and calcium in teratomas and the radiating appearance of carcinoids). Although the CT appearances of some of the abnormalities overlap, classifying them by pattern is helpful in narrowing the range of the differential diagnosis.

1980s

• Conventional and high resolution computed tomography in the diagnosis of asbestos-related diseases. D.A. Lynch, G. Gamsu, D.R. Aberle. 1989;9(3):523-51. PubMed · Publisher

  Abstract

  High resolution CT (HRCT) can image the fine structures of the lung parenchyma and the pleura. Analysis of supine and prone HRCT scans in 300 patients with asbestos exposure shows that asbestosis is characterized the following findings; (1) parenchymal bands, (2) increased interlobular septa, (3) increased intralobular core structures, (4) subpleural lines, and (5) dependent opacity. Pleural disease is well displayed on HRCT scans. Correlated studies with whole lung sections confirm the HRCT findings. Masses in asbestosis may be benign or malignant, and CT helps in their differentiation. HRCT correlates well with radiographic and clinical criteria for asbestosis and is more sensitive than either in detecting abnormalities.

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