AbstractText: Results from retrospective studies indicate that selecting individuals for low-dose CTlung cancer screening on the basis of a highly predictive risk model is superior to using criteria similar to those used in the National Lung Screening Trial (NLST; age, pack-year, and smoking quit-time. We designed the Pan-Canadian Early Detection of Lung Cancer (PanCan) study ...
... by 2.8 mm (median, IQR:2.2-3.7 mm), so above the 1.5 mm cutoff for nodule growth used in LungCT Screening Reporting and Data System (Lung-RADS... Thus, size of indeterminate nodules is poorly represented by diameter AbstractText: Pre-results, ISRCTN63545820 Keyword: imaging/CT MRI etc. Keyword: lung cancer.
CT measures of lung density might reflect lung tissue changes; however, longitudinal data regarding the effects of CTlung tissue on FEV1 in smokers with and without COPD are scarce AbstractText: The 15th percentile of CTlung density was obtained from the scans of 3,390 smokers ... presence might influence the interpretation of future studies that use CTlung density as an intermediate study end point for a decline ...
Chronic Obstructive Pulmonary Disease (5), Emphysema (1), more mentions
Abstract: Emphysema on CT is associated with accelerated lung function decline in heavy smokers and patients with COPD; however, in the general population, it is not known whether greater emphysema-like lung on CT is associated with incident COPD. We used data from 2045 adult participants without initial prebronchodilator airflow limitation, classified by FEV1/FVC upper limit of normal, was ...
OBJECTIVE: The purpose of this study was to investigate the incidence and natural history of incidentally found and untreated pulmonary embolism (PE) at coronary CT angiography after coronary artery bypass grafting.
MATERIALS AND METHODS: We retrospectively reviewed the records of 353 patients consecutively registered between January 1, 2010, and November 11, 2015, who underwent coronary artery bypass grafting followed within 2 weeks by coronary CT angiography. All patients received 100 mg of aspirin and 75 mg of clopidogrel after surgery. We collected relevant clinical and CT data, including total follow-up duration after coronary artery bypass grafting, follow-up CT findings, mortality, and incidence of any recurrent PE.
RESULTS: PE was diagnosed in 22 of the 353 patients (6.2%) who remained in the study after the exclusion criteria were applied. Most of the PEs occurred at the segmental or subsegmental level. All patients were in hemodynamically stable condition, had no symptoms, and underwent follow-up for a median of 53 months (range 19-74 months). Twenty of the 22 patients did not receive anticoagulation, and all but one of these patients had complete resolution of PE at second follow-up coronary CT angiography (median, 149 days after surgery). There was no associated mortality or recurrent PE.
CONCLUSION: Incidental PE after coronary artery bypass grafting is found in approximately 6% of patients undergoing postoperative coronary CT angiography, and most PEs resolve spontaneously without anticoagulation. No patient in this study died or had recurrent PE during a median follow-up period of 53 months.
BACKGROUND: Pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot provides symptomatic benefit and right ventricular (RV) volume reduction. However, data on the rate of ventricular structural and functional adaptation are scarce. We aimed to assess immediate and midterm post-PVR changes and predictors of reverse remoeling.
METHODS: Fifty-seven patients with repaired tetralogy of Fallot (age ≥16 y; mean age, 35.8±10.1 y; 38 male) undergoing PVR were prospectively recruited for cardiovascular magnetic resonance performed before PVR (pPVR), immediately after PVR (median, 6 d), and midterm after PVR (mPVR; median, 3 y).
RESULTS: There were immediate and midterm reductions in indexed RV end-diastolic volumes and RV end-systolic volumes (RVESVi) (indexed RV end-diastolic volume pPVR versus immediately after PVR versus mPVR, 156.1±41.9 versus 104.9±28.4 versus 104.2±34.4 mL/m(2); RVESVi pPVR versus immediately after PVR versus mPVR, 74.9±26.2 versus 57.4±22.7 versus 50.5±21.7 mL/m(2); P<0.01). Normal postoperative diastolic and systolic RV volumes (the primary end point) achieved in 70% of patients were predicted by a preoperative indexed RV end-diastolic volume ≤158 mL/m(2) and RVESVi ≤82 mL/m(2). RVESVi showed a progressive decrease from baseline to immediate to midterm follow-up, indicating ongoing intrinsic RV functional improvement after PVR. Left ventricular ejection fraction improved (pPVR versus mPVR, 59.4±7.6% versus 61.9±6.8%; P<0.01), and right atrial reverse remodeling occurred (pPVR versus mPVR, 15.2±3.4 versus 13.8±3.6 cm(2)/m(2); P<0.01). Larger preoperative RV outflow tract scar was associated with a smaller improvement in post-PVR RV/left ventricular ejection fraction. RV ejection fraction and peak oxygen uptake predicted mortality (P=0.03) over a median of 9.5 years of follow-up.
CONCLUSIONS: Significant right heart structural reverse remodeling takes place immediately after PVR, followed by a continuing process of further biological remodeling manifested by further reduction in RVESVi. PVR before RVESVi reaches 82 mL/m(2) confers optimal chances of normalization of RV function.
Tetralogy of Fallot (5), Ventricular Remodeling (2), more mentions
AbstractText: Clinicians rely heavily on fluorodeoxyglucose F18-labeled positron emission tomography (FDG-PET) imaging to evaluate lung nodules suspicious for cancer... varying cancer prevalence AbstractText: To determine the performance of FDG-PET/computed tomography (CT) in diagnosing lung malignancy across different populations with varying cancer prevalence AbstractText: Multicenter retrospective cohort study ...
In multivariable models, pulmonary function and CT characteristics defining COPD were associated with mortality in PLWH: those with airflow obstruction (FEV1/FVC 10% burden) had 2.4 times the risk of death (HR 2.4 [95% CI 1.1-5.5]) compared to those with ≤10% emphysema. In uninfected subjects, pulmonary variables were not significantly associated with mortality, which may reflect fewer deaths limiting ...
Chronic Obstructive Pulmonary Disease (10), Emphysema (2), more mentions
... evidence on whether, for a fixed level of spending, doctors allocate resources to patients with the highest expected returns. We assess both sources of inefficiency exploiting variation in rates of negative imaging tests for pulmonary embolism. We document enormous across-doctor heterogeneity in testing conditional on patient population, which explains the negative relationship between physicians' testing rates and test yields.