Radiology

Our medical research library holds 33 studies published in Radiology (1955–2015). 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. 26 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 4 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: Radiological Society of North America
• Published: 1923 to the present, United States
• Language: English
• ISSN: 0033-8419 (print), 1527-1315 (electronic)
• Its record in the NLM Catalog

2010s

• Malignant pleural mesothelioma: visual assessment by using pleural pointillism at diffusion-weighted MR imaging. J. Coolen, F. De Keyzer, P. Nafteux, et al. 2015;274(2):576-84. PubMed · Publisher

  Abstract

  Purpose: To evaluate the diagnostic accuracy of the visual assessment of malignant pleural mesothelioma (MPM) on magnetic resonance (MR) images by using two known visual markers (mediastinal pleural thickness and shrinking of the lung) and a newly introduced one (pleural pointillism).

  Materials And Methods: With the approval of the local ethics committee, 100 consecutive patients (mean age, 61.4 years; age range, 18-87 years; 75 men, 25 women) suspected of having MPM pleural abnormalities underwent positron emission tomography/computed tomography and MR imaging, including diffusion-weighted (DW) MR imaging, followed by explorative thoracoscopy or guided biopsy with histopathologic confirmation. Because visual assessment is still the preferred method of image interpretation, the diagnostic accuracy of mediastinal pleural thickening, shrinking lung (hemithorax volume decrease due to fibrosis), and pleural pointillism were examined. Pleural pointillism was denoted by the presence of multiple, hyperintense pleural spots on high-b-value DW images. Histopathologic findings in the surgical specimen served as the reference standard. McNemar tests with Bonferroni correction were used to assess differences in accuracy among the three examined markers.

  Results: Of 100 patients, 33 had benign pleural alterations, and 67 had malignant pleural diseases (MPDs); 57 of 67 had MPM. A total of 78 patients received a correct diagnosis (benign vs malignant) on the basis of mediastinal pleural thickening (sensitivity, 81%; specificity, 73%; accuracy, 78%); and 66 patients, on the basis of shrinking lung (sensitivity, 60%; specificity, 79%; accuracy, 66%). The correct diagnosis was indicated on the basis of pleural pointillism in 88 patients (sensitivity, 93%; specificity, 79%; accuracy, 88%).

  Conclusion: Visual assessment of pleural pointillism on high-b-value DW images is useful to differentiate MPD from benign alterations, performing substantially better than mediastinal pleural thickness and shrinking lung, and might obviate unnecessary invasive procedures for MPM.

  © RSNA, 2014.

• Nonselective transarterial chemoperfusion: a palliative treatment for malignant pleural mesothelioma. T.J. Vogl, S. Lindemayr, N.N. Naguib, et al. 2013;266(2):649-56. PubMed · Publisher

  Abstract

  Purpose: To evaluate tumor response by means of volumetric assessment, survival, and changes in patient symptoms after the treatment of unresectable and/or recurrent pleural mesothelioma by using regional nonselective transarterial chemoperfusion as a palliative treatment option.

  Materials And Methods: This retrospective study was approved by the hospital ethical committee, and all patients signed an informed consent prior to treatment. Thirty-nine patients (mean age, 64.0 years; 10 women and 29 men) with unresectable pleural mesothelioma were treated with repetitive transarterial chemoperfusion between March 2007 and March 2010, with a mean of 2.9 sessions per patient at 4-week intervals. Transarterial chemoperfusion was performed by using mitomycin C, cisplatin, and gemcitabine. Computed tomography findings and patient symptoms were evaluated. Tumor response was evaluated by using Response Evaluation Criteria in Solid Tumors guidelines, and survival was assessed with the Kaplan-Meier method. The change in volume for the partial-response group was tested by using the Wilcoxon signed-rank test.

  Results: In 36% of treated tumors (14 of 39), partial response was achieved, and tumor volume decreased from a mean value ± standard deviation of 839.6 mL ± 590.3 (range, 3.9-1972.2 mL) to 137 mL ± 399.8 (range, 0.88-1131.4; P = .00012). In 49% of tumors (19 of 39), stable disease was noted. In 15% of tumors (six of 39), progressive disease was seen. Mean specific growth rate of the tumor was 0.00158% per day. The mean survival time was 14.2 months (range, 2.1-33.1 months) from the start of treatment. For patients with tumors that responded to treatment, mean survival time was 15 months (range, 4.5-33.1 months). Mean time to disease progression was 2.6 months for all tumors, 1.5 months for stable disease, and 1.3 months for progressive disease.

  Conclusion: Transarterial chemoperfusion may have the potential to yield positive results and response in the treatment of recurrent and/or unresectable pleural mesothelioma. © RSNA, 2012.

• Taking a retrospective look at asbestos-related thoracic disease produces interesting results. E.B. Gottschall. 2010;255(3):681-2. Editorial · Comment PubMed · Publisher

• Workers with Libby amphibole exposure: retrospective identification and progression of radiographic changes. T.C. Larson, C.A. Meyer, V. Kapil, et al. 2010;255(3):924-33. PubMed · Publisher

  Abstract

  Purpose: To assess how early pleural and/or parenchymal abnormalities consistent with asbestos exposure could be ascertained and to identify factors associated with progression.

  Materials And Methods: Informed consent was obtained under an institutional review board-approved protocol. Multiple sequential chest radiographs obtained between 1955 and 2004 in 84 workers exposed to amphiboles associated with vermiculite in the town of Libby, Montana, were studied. A panel of three NIOSH B readers reviewed each worker's longitudinal chest radiograph series in reverse chronologic order and achieved a consensus reading for each radiograph. Measures of exposure were compared between workers with and those without progression of parenchymal and pleural abnormalities.

  Results: Because of the way the study was designed, all subjects had pleural (n = 84) and/or parenchymal (n = 26) abnormalities on the most recent chest radiograph. Compared with other investigations that used different methods, this investigation revealed shorter latency periods (defined as the interval between date of hire and date of earliest radiographic detection) for circumscribed pleural plaque (median latency, 8.6 years) and pleural calcification (median latency, 17.5 years). Pleural abnormalities progressed in 64 workers, while parenchymal abnormalities progressed in 14. No significant differences were found with regard to measures of exposure between workers with and those without progression.

  Conclusion: The latency period for the development of pleural plaques may be shorter than previously reported. Early plaques are subtle and may not be detectable except at retrospective review.

  Copyright RSNA, 2010

2000s

• Asbestos-induced and smoking-related disease: apportioning pulmonary function deficit by using thin-section CT. S.J. Copley, Y.C. Lee, D.M. Hansell, et al. 2007;242(1):258-66. PubMed · Publisher

  Abstract

  Purpose: To retrospectively correlate the extent of individual diseases seen at thin-section computed tomography (CT) with pulmonary function in an initial group of patients with asbestos-related parenchymal disease (asbestosis) and to test these findings in a subsequent group of patients whose CT scans were retrospectively identified.

  Materials And Methods: This retrospective study had Institutional Review Board approval; informed consent was not required. The study included 133 individuals who had been exposed to asbestos. In the initial study group (81 patients; 79 men, two women; median age, 67 years), two observers used a CT scoring system to quantify the extent of pulmonary fibrosis, diffuse pleural thickening, small-airways disease, and emphysema. Multivariate equations were formulated by using independent CT variables to predict changes in total lung capacity (TLC) and carbon monoxide diffusing capacity (Dlco). The validity of these equations was then tested in a subsequent group of patients (52 patients; all men; median age, 60 years).

  Results: At thin-section CT, the extent of asbestos-induced pleuropulmonary disease and emphysema correlated significantly with physiologic impairment (P<.001). Combined CT variables predicted 58% and 57% of the variability in TLC and Dlco, respectively, despite considerable variation in the proportion of coexisting pathologic conditions. When predictive equations with CT variables derived from the initial study group were applied to the subsequent study group, predicted TLC (rho=0.75, P<.001) and Dlco (rho=0.64, P<.001) correlated strongly with measured values.

  Conclusion: The proposed CT system provides a semiquantitative method for assessing the relative contribution of asbestos-induced pleuropulmonary disease and smoking-related emphysema to functional impairment.

  Copyright (c) RSNA, 2006.

• Asbestos-related pleuropulmonary diseases: evaluation with low-dose four-detector row spiral CT. M. Remy-Jardin, A. Sobaszek, A. Duhamel, et al. 2004;233(1):182-90. PubMed · Publisher

  Abstract

  Purpose: To evaluate the depiction of lung and pleural asbestos-related lesions with low-dose four-detector row spiral computed tomography (CT).

  Materials And Methods: Eighty-three male workers with a mean duration of occupational exposure to asbestos of 18 years underwent CT as part of a medicolegal investigation. CT examination included low-dose multi-detector row spiral CT of the entire thorax, with reconstruction of contiguous 5-mm-thick images, and thin-section CT, which served as the reference standard for the detection of pleural and parenchymal asbestos-related abnormalities. Two main groups of abnormalities were identified: (a) pleural plaques and diffuse pleural thickening and (b) thickened interstitial short lines, curvilinear subpleural lines, ground-glass opacity with or without bronchiectasis, and honeycombing. The frequencies of the depiction of these abnormalities on the low-dose multi-detector row images and the thin-section images were compared by using the McNemar test.

  Results: No significant differences were observed between the low-dose and thin-section CT images in the depiction of either (a) parietal pleural fibrosis consisting of pleural plaques (identified in 67 [81%] vs 65 [78%] workers, P =.157), which appeared mainly as thick, calcified pleural linear structures; or (b) features of parenchymal fibrosis, which consisted of various combinations of intralobular and septal lines (identified in 12 [14%] vs 13 [16%] workers, P =.564), subpleural curvilinear lines (identified in 10 [12%] vs eight [10%] workers, P =.157), and ground-glass opacity with (identified in six [7%] vs six [7%] workers) or without (identified in five [6%] vs three [4%] workers, P =.317) traction bronchiectasis. A honeycombing pattern was depicted on only the thin-section CT images (P <.001). Emphysema (identified in 26 [31%] vs 14 [17%] workers at low-dose and thin-section CT, respectively; P <.001) and noncalcified nodules (identified in 18 [22%] workers vs one [1%] worker, P <.001) were depicted significantly more frequently on the low-dose images than on the thin-section images.

  Conclusion: Low-dose multi-detector row spiral CT accurately depicts asbestos-related disease.

  Copyright RSNA, 2004

• Thin-section CT abnormalities and pulmonary gas exchange impairment in workers exposed to asbestos. A. Sette, J.A. Neder, L.E. Nery, et al. 2004;232(1):66-74. PubMed · Publisher

  Abstract

  Purpose: To evaluate the relationship between abnormalities at thin-section computed tomography (CT) and indexes of pulmonary gas exchange impairment at rest and during moderate exercise in workers exposed to asbestos.

  Materials And Methods: Eighty-two workers with long-term exposure to asbestos and abnormal thin-section CT findings underwent respiratory physiologic measurements at rest (lung diffusing capacity, Dlco) and during exercise (oxygen uptake-corrected alveolar-arterial pressure difference for oxygen, DeltaP[A-a]O(2)/VO(2)). CT results were compared with physiologic measurements of impairment in gas exchange (Dlco < 70% predicted value and/or DeltaP[A-a]O(2)/VO(2) > 20 mm Hg. L. min(-1)). The CT findings were divided into five categories by using a previously described method. Odds ratios and 95% CIs for gas exchange defects were calculated for patients grouped according to CT findings. Logistic regression analysis was performed with gas exchange as the dependent response and CT abnormalities as independent variables.

  Results: A significant association was found between extent of disease at CT and impairment of gas exchange (P <.01). Probability of functional impairment was increased with multifocal (class II) and diffuse (class III) CT abnormalities, particularly when several lesion types were found concomitantly. Logistic regression analysis demonstrated significant association of parenchymal bands (odds ratio, 6.20; 95% CI: 1.99, 19.22) and subpleural nodules (odds ratio, 3.83; 95% CI: 1.23, 11.89) with functional impairment. Presence and number of pleural plaques did not improve model accuracy for gas exchange impairment prediction (P >.05).

  Conclusion: Thin-section CT grading of interstitial lung disease is useful in assessing the likelihood of pulmonary gas exchange impairment at rest (Dlco) and during exercise (DeltaP[A-a]O(2)/VO(2)) in workers with long-term asbestos exposure.

  Copyright RSNA, 2004

• Functional consequences of pleural disease evaluated with chest radiography and CT. S.J. Copley, A.U. Wells, M.B. Rubens, et al. 2001;220(1):237-43. PubMed · Publisher

  Abstract

  Purpose: To identify a system for the quantification of pleural thickening with an acceptable level of interobserver variation and good functional correlation in individuals with pleural disease.

  Materials And Methods: The extent of pleural thickening and plaques was assessed in 50 patients by using the following: (a) a radiographic score based on the International Labour Office system, (b) a subjective simple computed tomographic (CT) score, (c) a subjective comprehensive CT score, (d) an objective nonautomated method, and (e) an objective computer-aided semiautomated method.

  Results: Similar correlations between the extent of diffuse pleural thickening and forced vital capacity were seen for each system (objective CT, r = -0.72, P <.001; simple CT, r = -0.69, P <.001; radiographic, r = -0.67, P <.001; comprehensive CT, r = -0.66, P <.001). Comparable correlations were observed for total lung capacity. After controlling for extent of diffuse pleural thickening, pleural plaque scores were functionally irrelevant.

  Conclusion: Comparable functional-morphologic correlations were achieved by using different CT and radiographic scoring systems for pleural disease. A subjective simple CT system had the advantages of ease of application and potential to aid in the accurate assessment of the lung parenchyma, which may be important in individuals exposed to asbestos.

1990s

• Malignant pleural mesothelioma: US-guided histologic core-needle biopsy. A. Heilo, A.E. Stenwig, O.P. Solheim. 1999;211(3):657-9. PubMed · Publisher

  Abstract

  Purpose: To assess the clinical use of ultrasonographically (US) guided core-needle biopsy, performed with a one-hand automatic sampling technique, in the diagnosis of malignant pleural mesothelioma (MPM).

  Materials And Methods: The authors reviewed the findings in 70 patients with a tentative diagnosis of MPM who underwent US-guided core-needle biopsy at our institution during the past 10 years.

  Results: Fifty-two of the 70 patients who underwent automatic high-speed core-needle biopsy at our institution had MPM; 18 had other disorders. The correct diagnosis was made in 56 patients. Twelve of 14 inadequate biopsy specimens were false-negative for MPM. There were no false-positive biopsy results. In the detection of MPM, US-guided core-needle biopsy had a sensitivity of 77%, specificity of 88%, accuracy of 80%, positive predictive value of 100%, and negative predictive value of 57%. There were no serious complications.

  Conclusion: US-guided core-needle biopsy is highly effective in the diagnosis of MPM. Owing to its simplicity, low cost, and few side effects, it could be the biopsy method of choice for detection of this condition.

• Imaging of the pleura. N.L. Müller. 1993;186(2):297-309. Review PubMed · Publisher

  Summary

  This review summarized the main pleural diseases, described their imaging appearances, and assessed the role of chest radiography, ultrasound, conventional and high-resolution computed tomography (CT), and magnetic resonance (MR) imaging in diagnosis and management. It divided pleural abnormalities into pleural effusion, empyema, focal pleural disease and diffuse pleural disease. The author stated that chest radiography remained the first examination and that MR imaging played a very limited role. For empyema, the reported success rate was 35%-71% with conventional chest tubes and 70%-90% with image-guided catheter drainage, which was recommended as the primary treatment. Pleural plaques were described as the most common manifestation of asbestos exposure. They were seen radiologically in 20%-60% of workers exposed to high concentrations of asbestos, with a latency of about 15 years. Using International Labour Office criteria, the sensitivity of radiography for plaques ranged from 30% to 80% and the specificity from 60% to 80%. High-resolution CT was the most accurate technique but was not recommended for screening because of its cost. About 80% of malignant mesotheliomas occurred in people exposed to asbestos. In a cited series of 74 patients, circumferential pleural thickening, nodular pleural thickening, parietal pleural thickening of more than 1 cm, and mediastinal pleural involvement had specificities of 88%-100% for malignant disease. The author stated that CT could play a major role in distinguishing malignant from benign diffuse pleural disease and in guiding biopsy.

  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.

• Early asbestosis: evaluation with high-resolution CT. M. Akira, K. Yokoyama, S. Yamamoto, et al. 1991;178(2):409-16. PubMed · Publisher

  Abstract

  To determine the earliest stage at which lesions in asbestosis can be diagnosed and to assess their progression, 23 asbestos-exposed patients with minimal or no abnormalities at plain radiography were examined with high-resolution computed tomography (HRCT) twice, with an interval of 12-37 months between examinations. In 21 of the patients, parenchymal abnormalities were found. Major parenchymal features seen at CT included thickened intralobular and interlobular lines, subpleural curvilinear lines, pleural-based nodular irregularities, hazy patches of increased attenuation, small cystic spaces, and small areas of low attenuation. At paired serial CT, subpleural isolated dots or branching structures connected with the most peripheral branch of the pulmonary artery started to appear in lower subpleural zones and then became confluent to create pleural-based nodular irregularities. CT-pathologic correlation led to the conclusion that the confluence of subpleural peribronchiolar fibrosis creates subpleural fibrosis.

• Asbestosis: high-resolution CT-pathologic correlation. M. Akira, S. Yamamoto, K. Yokoyama, et al. 1990;176(2):389-94. PubMed · Publisher

  Abstract

  High-resolution computed tomography (HRCT) was performed in seven inflated and fixed postmortem lungs from seven asbestos-exposed patients with pathologically proved asbestosis. The parenchymal abnormalities seen at in vitro HRCT included thickened intralobular lines (n = 7), thickened interlobular lines (n = 7), pleural-based opacities (n = 7), parenchymal fibrous bands (n = 5), subpleural curvilinear shadows (n = 4), ground-glass appearance (n = 4), traction bronchiectasis (n = 4), and honeycombing (n = 2). The thickened intralobular lines were shown histologically to be due to peribronchiolar fibrosis. Thickened interlobular lines were due mainly to interlobular fibrotic thickening in four lungs and edema in three. The peribronchiolar fibrosis was most severe in the subpleural lung regions, creating curvilinear line shadows and pleural-based areas of opacity. Some subpleural fibrosis extended proximally along the bronchovascular sheath to create bandlike lesions. Areas of ground-glass appearance on HRCT scans were shown to be the result of mild alveolar wall and interlobular septal thickening due to fibrosis or edema. Postmortem HRCT findings were similar to premortem HRCT findings and correlated well with the pathologic findings of asbestosis.

1980s

• Costal pleura: appearances at high-resolution CT. J.G. Im, W.R. Webb, A. Rosen, et al. 1989;171(1):125-31. PubMed · Publisher

  Abstract

  The appearance of the costal pleura at high-resolution computed tomography (CT) was evaluated with a cadaver and 25 normal subjects. This was contrasted with the high-resolution CT appearance of the costal pleura in 15 patients with mild pleural thickening, 13 of whom had been exposed to asbestos. On high-resolution CT scans in the normal subjects, a 1-2-mm-thick line of soft-tissue attenuation at the point of contact between lung and chest wall represents the visceral and parietal pleura, pleural contents, endothoracic fascia, and innermost intercostal muscle. In a paravertebral location, the innermost intercostal muscle is lacking, and a thin line seen on high-resolution CT scans reflects pleura and endothoracic fascia. Transverse thoracic and subcostal muscles and extrapleural fat pads can be seen as tissue internal to a rib and may be confused with pleural thickening. In 13 of the 15 patients with mild pleural thickening, the 1-3-mm-thick pleura was separable from the underlying normal intercostal muscle by a layer of extrapleural fat. High-resolution CT was more sensitive than CT with 1-cm collimation in depicting this degree of pleural abnormality.

• Cystic mesothelioma of the peritoneum. J.D. O'Neil, P.R. Ros, B.L. Storm, et al. 1989;170(2):333-7. PubMed · Publisher

  Abstract

  Cystic mesothelioma (CM) of the peritoneum is a rare, benign neoplasm that occurs predominantly in women and tends to recur locally. It has received little attention (to our knowledge, a single case report) in the radiology literature. Five cases of CM are presented. Computed tomography (CT) was performed in three cases, ultrasound (US) in four cases, and magnetic resonance (MR) imaging in one case. Twenty-eight cases reported in the literature are reviewed for comparison. CM shows a clear predilection for the surfaces of the pelvic viscera but is seen in other areas of the peritoneum and retroperitoneum. The neoplasm was intraperitoneal in three cases and primarily retroperitoneal in the other two cases. In all CT and US studies performed, a single large, multilocular cystic mass was demonstrated. MR imaging, performed in one case, showed that the lesion had signal characteristics typical of a watery collection low in solute concentration. It is concluded that CM of the peritoneum has a nonspecific multilocular cystic appearance on images, which does not permit it to be differentiated from other cystic lesions.

• Asbestos-related focal lung masses: manifestations on conventional and high-resolution CT scans. D.A. Lynch, G. Gamsu, C.S. Ray, et al. 1988;169(3):603-7. PubMed · Publisher

  Abstract

  In 260 asbestos-exposed individuals evaluated by means of computed tomography (CT), 43 unsuspected pulmonary masses were found in 27 individuals. The masses included fissural pleural plaques (n = 10), dense fibrotic bands (n = 3), round atelectasis (n = 11), carcinomas (n = 3), and other presumed benign masses (n = 16). The most helpful features in the diagnosis of rounded atelectasis with CT were (a) contiguity to areas of diffuse pleural thickening, (b) a lentiform or wedge-shaped outline, (c) evidence of volume loss in the adjacent lung, and (d) a characteristic "comet tail" of vessels and bronchi sweeping into the margins of the mass. Less advanced areas of focal atelectasis had fewer classic features. Intrafissural pleural plaques were readily identified with high-resolution CT. In asbestos-related masses, the demonstration of stability over time is necessary. Careful interpretation of CT and high-resolution CT features and close surveillance can obviate the need for biopsy in the majority of instances.

• Asbestos-related pleural and parenchymal fibrosis: detection with high-resolution CT. D.R. Aberle, G. Gamsu, C.S. Ray, et al. 1988;166(3):729-34. PubMed · Publisher

  Abstract

  Twenty-nine subjects with occupational asbestos exposure and clinical asbestosis were examined with high-resolution computed tomography (HRCT) to determine its sensitivity, relative to that of conventional computed tomography (CT), for detection of benign asbestos-related disease. Thin-section HRCT scans were obtained at five discrete levels through the mid and lower thorax in both prone and supine positions. The same technique was used in 34 age-similar control patients. Parenchymal abnormalities were seen most frequently in the posterior portion of the lung bases in the asbestos-exposed subjects. HRCT prone scans enabled basal structural abnormalities to be reliably distinguished from gravity-related physiologic phenomena in 25 asbestos-exposed subjects. HRCT was more sensitive than CT in detection of both pleural and parenchymal fibrosis. In subjects with clinical asbestosis, HRCT demonstrated parenchymal abnormality in 96%, compared with 83% for CT. Similarly, pleural thickening was shown in 100% of subjects at HRCT, compared with 93% at CT. HRCT could be an important adjunct in the evaluation of asbestos-related pleuroparenchymal fibrosis. An HRCT study including prone scans is a sensitive, reliable means of detecting thoracic abnormalities in asbestos-exposed individuals.

• The use of CT in the examination of asbestos-exposed persons. T.C. McLoud. 1988;169(3):862-3. Editorial PubMed · Publisher

• Changes on radiographs of wives of workers exposed to asbestos. L. Sider, E.A. Holland, T.M. Davis, et al. 1987;164(3):723-6. PubMed · Publisher

  Abstract

  Between January and March 1986, 117 wives of insulation workers exposed to asbestos were screened by means of chest radiography, pulmonary function testing, and a detailed questionnaire. The final study group included 93 women over 40 years of age. Eighteen of these (19.4%) demonstrated pleural changes consistent with asbestos exposure, including pleural plaque (88.9%), diaphragm plaque (27.8%), pleural calcification (16.6%), and diffuse pleural thickening (5.5%). In statistical correlation between the groups with normal and abnormal radiographs, the only factor that proved significant was the year of first exposure (the duration of the latent period). Finally, radiographs of the husbands were compared for 17 of the 18 wives with radiographic abnormalities. Fourteen of the husbands (82%) demonstrated more severe radiographic changes than their wives.

• Cardiophrenic angle adenopathy: update of causes and significance. P. Vock, J. Hodler. 1986;159(2):395-9. PubMed · Publisher

  Abstract

  Of 21 cases of cardiophrenic angle adenopathy (CAA) detected on computed tomography (CT) examination, 12 were due to malignant lymphomas, seven to carcinomas, and two to mesotheliomas. Of the nine lesions that were not malignant lymphomas, four were of supradiaphragmatic and five of infradiaphragmatic origin. On average, CAA was detected 4.6 years after the primary neoplasm was diagnosed. Only 29% of the patients were alive 14 months after CAA was detected on CT scans. Radiography was inferior to CT in the detection of CAA, with only 35% of radiography results clearly positive. Malignant lymphoma is a major but not exclusive cause of CAA, and it must be differentiated from lymphatic seeding of supradiaphragmatic and infradiaphragmatic malignancies. Unilateral CAA may point to supradiaphragmatic neoplasms or, if right-sided, to ovarian carcinoma, and bilateral CAA may indicate another neoplasm of infradiaphragmatic origin.

• Pulmonary asbestosis: CT study of subpleural curvilinear shadow. Work in progress. H. Yoshimura, M. Hatakeyama, H. Otsuji, et al. 1986;158(3):653-8. PubMed · Publisher

  Abstract

  High-resolution computed tomographic scans of 19 patients with pulmonary asbestosis revealed a subpleural curvilinear shadow (SCLS) parallel to the inner chest wall in the lungs of 15 (78.9%) patients. Most (46.7%) SCLS measured greater than 5 cm but less than 10 cm in length and occurred less than 1 cm from the inner chest wall in all cases. SCLS was distributed mainly in the lower lobe in patients with mild pulmonary fibrosis and in segments where fibrosis was mild in patients with honeycomb shadows. This may reflect initiation of pulmonary fibrosis leading to the formation of a honeycomb shadow. Radiologic-pathologic correlation, achieved in one postmortem specimen, seemed to indicate that SCLS was associated with the initial change of fibrosing bronchioloalveolitis, which is characteristic of pulmonary asbestosis.

• Asbestos-related pleural thickening: effect of threshold criteria on interpretation. R. Greene, C. Boggis, H. Jantsch. 1984;152(3):569-73. PubMed · Publisher

  Abstract

  Radiographic evidence of pleural thickening was evaluated in 1,216 shipyard workers (high-risk group) and 214 executives (low-risk group) and classified according to two threshold levels: low (any detectable thickening) and high (thickening less than or equal to 2 mm excluded). Results were markedly different, affecting the low-risk group more than the high-risk group. Changing from the high to the low threshold markedly increased pleural findings and scores as well as inter-reader correlation while reducing both differences between risk groups and detection of additional findings on supplementary oblique views. When data on prevalence and extent of pleural thickening were combined, differences between risk groups were maximized; however, when only prevalence was considered, such differences were minimized, particularly with a low threshold. These findings indicate that different or ambiguous threshold criteria produce divergent results in screening surveys for asbestos-related disease. The authors recommend that explicit minimal pleural threshold criteria be adopted.

• Subpleural fat pads in patients exposed to asbestos: distinction from non-calcified pleural plaques. E.N. Sargent, W.D. Boswell, P.W. Ralls, et al. 1984;152(2):273-7. PubMed · Publisher

  Abstract

  Thirty patients with known asbestos dust exposure were studied because of uncertainty as to whether or not the pleural changes observed on the radiographs were due to plaques or subpleural fat. The CT scans confirmed that the changes were due to subpleural fat in 14 cases (48%). Characteristic subpleural fat shadows on radiographs and CT scans are described, and the importance of differentiating fat from plaques for medico-legal reasons is emphasized.

• A comparative study of mesothelioma and asbestosis using computed tomography and conventional chest radiography. J.G. Rabinowitz, S.C. Efremidis, B. Cohen, et al. 1982;144(3):453-60. PubMed · Publisher

  Abstract

  A comparative study using computed tomography and conventional posteroanterior radiography was performed on 27 patients with mesothelioma and 13 patients with advanced asbestosis. The major pathologic features of both asbestosis and mesothelioma were well demonstrated by both modalities; computed tomography demonstrated the findings more frequently and in greater detail. No distinguishing features could be established based on configuration and size of the lesion. Many pleural plaques associated with advanced asbestosis were large and irregular and resembled those associated with mesothelioma. However, nodular involvement of the pleural fissures, pleural effusion, and ipsilateral volume loss with a fixed mediastinum were features predominating in mesothelioma. Growth determination of the plaques associated with asbestosis may be of minimal value since such plaques also undergo growth due to active inflammatory changes.

• Calcified interlobar pleural plaques: visceral pleural involvement due to asbestos. E.N. Sargent, J.S. Felton, L.T. Barnes. 1981;140(3):634. Case report PubMed · Publisher

  Abstract

  Visceral pleural involvement, seen as interlobar thickening and bilateral calcified plaques in the major interlobar fissures, was observed as a result of exposure to asbestos dust. This is in contrast to the parietal pleural involvement seen in most cases.

• Rounded atelectasis and its association with asbestos-induced pleural disease. R.A. Mintzer, R.M. Gore, R.L. Vogelzang, et al. 1981;139(3):567-70. PubMed · Publisher

  Abstract

  Rounded atelectasis (RA) is an unusual form of peripheral lobar collapse which may present as a juxtapleural mass simulating a pulmonary neoplasm. Seven cases of RA were recently encountered in patients with asbestos-induced pleural disease. Since asbestos exposure is associated with mesothelioma, bronchogenic carcinoma, and other tumors, differentiation of RA from these neoplasms is essential in avoiding unnecessary thoracotomy. The radiographic features of RA are sufficiently characteristic, so that in the presence of chronic pleural thickening due to asbestos exposure, the diagnosis can be made with assurance and further work-up avoided.

• Ultrasonography and computed tomography of peritoneal mesothelioma. H.C. Yeh, A.P. Chahinian. 1980;135(3):705-12. PubMed · Publisher

  Abstract

  Eleven patients with malignant peritoneal mesothelioma were examined with ultrasonography. Four of them were also examined with computed tomography (CT). A sheetlike mass was seen in seven patients and a localized irregular mass was seen in four. No nodular or globular masses were seen. Ascites was present in all patients except one, and an omental mass in addition to a peritoneal mass was found in two. Extremely rapid progression of mesothelioma occurred in one patient, and disappearance of mesothelioma and ascites occurred in another. Ultrasonography was, in general, superior to CT in demonstrating peritoneal masses, especially in the presence of ascites.

1970s

• The serratus anterior muscle on chest radiographs. D. Gilmartin. 1979;131(3):629-35. PubMed · Publisher

  Abstract

  The radiographic appearance of the serratus anterior muscle shadow is analyzed. In frontal and near-frontal views, it produces a "bowling-pin" silhouette. When the muscle is well developed, the medial edge of this silhouette may be superimposed upon the air shadow of the lung in a variety of ways. When it overlies the apex of the lung, it gives rise to the companion shadow; when overlying the midlateral lung edge and costophrenic angle it may mimic pleural and/or extrapleural disease. Recognition of the various possible patterns is important to prevent overdiagnosis of disease, particularly asbestosis.

• Peritoneal mesothelioma. M.P. Banner, V.K. Gohel. 1978;129(3):637-40. PubMed · Publisher

  Abstract

  Five cases of malignant peritoneal mesothelioma are reported. Its radiographic manifestations consisted of a desmoplastic mesenteric process with or without a localized mass displacing gastrointestinal structures. Appreciation of the nature of this tumor permits pathologic-radiologic correlation and an understanding of the radiographic changes. Though numerous conditions may produce similar findings, combining a history of asbestos exposure or chest radiograph findings of asbestosis with gastrointestinal findings of desomplasia should narrow the diagnostic possibilities.

• Ultrasonography in ascites. H.C. Yeh, B.S. Wolf. 1977;124(3):783-90. PubMed · Publisher

  Abstract

  Ascites is usually not difficult to detect with ultrasonography because of its characteristic lack of echoes. However, minimal or lobulated collections of fluid or unusual distributions due to anatomical variations or associated pathological processes may create problems in diagnosis. Differentiation from an intraperitoneal abscess, hematoma, lymphocele, or cystic mass is of considerable clinical importance.

• Pulmonary needle aspiration biopsy in the diagnosis of Pancoast tumors. W.J. Walls, J.R. Thornbury, B. Naylor. 1974;111(1):99-102. PubMed · Publisher

  Abstract

  Twenty-seven patients with Pancoast tumors underwent fluoroscopically guided pulmonary needle aspiration biopsy, a diagnostic procedure which provided a cellular aspirate rather than a core of tissue. Diagnoses were made by cytologic rather than histologic techniques. A diagnosis of carcinoma was made in 26 of the 27 cases. The remaining tumor was a locally invasive pleural fibrous mesothelioma. Pulmonary needle aspiration biopsy gave diagnostic results far superior to those obtained by bronchoscopic biopsy, cytology of sputum or bronchial washings, or biopsy of scalene or supraclavicular lymph nodes.

  PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

1960s

• Villous tumors of the stomach and duodenum; report of three cases. A.D. Meltzer, B.I. Ostrum, H.J. Isard. 1966;87(3):511-3. Case report PubMed · Publisher

• Intrathoracic mesothelioma. W.B. Hutchinson, M.J. Friedenberg. 1963;80:937-45. PubMed · Publisher

  Abstract

  The clinical, radiographic, and pathologic findings in 20 cases of intrathoracic mesothelioma are reported. Benign mesotheliomas occasionally contain calcification, are rarely associated with pleural effusion, and never destroy or erode bone. They vary considerably in size, the large ones often displacing the heart and mediastinum. Malignant mesothelioma is characterized by thickening and fixation of the involved serosal surface and in our series was not associated with significant shift of the heart or mediastinum in spite of the great propensity for rapid re-accumulation of fluid following thoracentesis or pericardiocentesis.

  PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

1950s

• Roentgen aspects of pleural mesothelioma. N. Finby, I. Steinberg. 1955;65(2):169-82. PubMed · Publisher

  Abstract

  Five cases of localized pleural mesothelioma and 7 of diffuse pleural mesothelioma are presented. Localized pleural mesothelioma is usually a benign disease but may prove to be the early stage of the diffuse malignant type. Roentgenographically, it is manifest as a circumscribed lobulated mass in the plane of the pleura which cannot be differentiated from other intrathoracic tumors. Angiocardiography aids in demonstrating pericardial and great vessel involvement. Clinically, osteoarthropathy is a common feature. The diagnosis can be made only after thoracotomy and microscopic study of the tumor. Prompt surgical therapy with complete removal of the tumor may be curative. Diffuse pleural mesothelioma, on the other hand, is always a malignant disease. Roentgenographically, it often appears initially as a massive pleural effusion. Pneumothorax, after removal of the serosanguineous fluid, permits visualization of the nodular pleural densities, an important diagnostic feature. Pleural thickening and rapid recurrence of the pleural exudate, associated with fixation of the mediastinum, are other characteristic roentgen features. Angiocardiography aids the recognition of pericardial and cardiovascular involvement.

  PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

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