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The novel grading system developed by the International Association for the Study of Lung Cancer (IASLC) for clinical stage IA lung adenocarcinomas has demonstrated remarkable prognostic capabilities. Notably, tumors classified as grade 3 have been associated with poor prognostic outcomes, thereby playing a crucial role in the formulation of personalized surgical strategies. The objective of this study is to develop a radiomics nomogram that utilizes the optimal volume of interest (VOI) derived from high-resolution CT (HRCT) scans to accurately predict the presence of grade 3 tumors in patients with clinical IA lung adenocarcinomas. In this multi-center, large-population study, clinical, pathological, and HRCT imaging data from 1418 patients who were pathologically diagnosed with lung adenocarcinomas were retrospectively collected. The data was obtained from four hospital databases between January 2018 and May 2022. From this patient cohort, 1206 individuals were screened from three databases and randomly divided into training and internal validation datasets in a 7:3 ratio. An additional dataset consisting of 212 individuals was used for external validation dataset. Radiomics features were extracted from HRCT images at various scales, including VOI−2mm, VOI entire, VOI +2mm, and VOI +4mm. To reduce dimensionality, select relevant features, and build radiomics signatures, the maximal redundancy minimal relevance (mRMR) and least absolute shrinkage and selection operator (LASSO) algorithm were utilized. Univariate and multivariate logistic regression analyses were conducted to identify independent clinic-radiological (Clin-Rad) predictors. Receiver operating characteristic (ROC) curves and corresponding area under the curve (AUC) were used to evaluate the diagnostic efficiency. A nomogram predicting the risk of grade 3 in clinical stage IA lung adenocarcinoma was constructed based on multivariate logistic regression, combining independent predictors and the optimal radiomics signatures. Multivariate logistic regression revealed that males exhibited a higher prevalence of grade 3 tumors, and solid nodules were frequently observed through radiological assessments. The utilization of radiomics features extracted from the VOI entire resulted in significant improvements in predictive performance, as evidenced by AUC values of 0.900 (0.880-0.942), 0.885 (0.824-0.946), and 0.888 (0.782-0.993) for the training, internal validation, and external validation datasets, respectively. Furthermore, the nomogram that combined VOI entire -based radiomics signatures and Clin-Rad characteristics, exhibited remarkable predictive performance. This was indicated by AUC values of 0.910(0.873-0.942), 0.891 (0.845-0.937), and 0.905 (0.846-0.964) for the training, internal validation, and external validation datasets, respectively. The extraction of radiomics features from both the indented and peri-tumoral regions does not offer any additional benefits in predicting grade 3 tumors according to the IASLC system. However, when combining the VOI entire-based radiomics model with Clin-Rad characteristics, the resulting integrated nomogram exhibited remarkable predictive performance. [ABSTRACT FROM AUTHOR]

Objective: To study the relationship between high-resolution CT (HRCT) typing and airway inflammation, immune function and clinical efficacy in patients with chronic obstructive pulmonary disease (COPD). Methods: 165 COPD patients admitted to the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from May 2020 to August 2023 were selected, and patients were divided into type A group (n=81), type E group (n=46) and type M group (n=38) according to HRCT imaging phenotype. Pulmonary function indexes[forced expiratory volume in the first second (FEV1), percentage of forced expiratory volume in the first second to predicted value (FEV1%), forced expiratory volume in the first second/forced vital capacity (FEV1/FVC), residual volume/total lung capacity (RV/TLC) ], airway inflammation indexes[C-reactive protein (CRP), interleukin-6 (IL-6) ], immune function indexes and clinical efficacy were compared in each group. Results: FEV1, FEV1% and FEV1/FVC in type E group and M group were lower than those in type A group, and type M group were lower than those of type E group (P＜0. 05). RV/TLC in type E group and type M group was higher than that in type A group, and RV/TLC in type M group was higher than that in type E group (P＜0. 05). The levels of CRP and IL-6 in type A group and type E group were lower than those in type M group, and type E group were lower than those of type A group (P＜0. 05). CD3+ and CD4+/CD8+ in type E group and type M group were lower than those in type A group, and type M group were lower than those of type E group (P＜0. 05). The total effective rate in group A was higher than that in type E group and type M group, and type E group was higher than that of type M group (P＜0. 05). Conclusion: There are great differences in airway inflammation, immune function and clinical efficacy among COPD patients with different HRCT types, this situation can be paid attention to in the process of diagnosis and treatment, so as to provide support for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective: To analyze the predictive value of high-resolution CT (HRCT) emphysema index combined with serum carcinoembryonic antigen (CEA), neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR) on the risk of non-small cell lung cancer (NSCLC) in patients with chronic obstructive pulmonary disease (COPD). Methods: Selected 120 patients with COPD complicated with NSCLC who were admitted to Xinjiang Uygur Autonomous Region Traditional Chinese Medicine Hospital from June 2020 to March 2023 were selected as combined group, 80 patients with NSCLC alone were selected as NSCLC group, and 80 patients with COPD alone were selected as COPD group. The HRCT emphysema indexes [emphysema index (EI), emphysema Goddard score], CEA, NLR, PLR were compared among three groups. The value of HRCT emphysema index, CEA, NLR and PLR in predicting the risk of NSCLC in COPD patients were analyzed by receiver operating characteristic (ROC) curve. Results: Serum levels of CEA, NLR, and PLR were greater in combined group than in NSCLC group and COPD group, with NSCLC group had higher levels than COPD group (P<0.05). The combined group's Goddard score and EI were greater than those in COPD group and NSCLC group, and COPD group was higher than NSCLC group (P<0.05). ROC curve showed that, the area under the ROC curve (AUC) of CEA, NLR, PLR, Goddard score, EI and the combination of the five in predicting the occurrence of COPD combined with NSCLC was 0.833, 0.835, 0.771, 0.824, 0.813 and 0.991, respectively. Conclusion: HRCT emphysema index and serum CEA, NLR and PLR are increase in COPD patients with NSCLC. HRCT emphysema index combined with CEA, NLR and PLR can effectively predict the occurrence of COPD combined with NSCLC. [ABSTRACT FROM AUTHOR]

Mi Zhou,&ast; Xinyu Jiang,&ast; Yulin Kong, Xiaolin Liu Department of Occupational Disease, The Fifth People’s Hospital of Suzhou, Jiangsu, 215100, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaolin Liu, Department of Occupational Disease, The Fifth People’s Hospital of Suzhou, No. 10 of Guangqian Road, Xiangcheng District, Suzhou, Jiangsu, 215100, People’s Republic of China, Tel +86 13862098055, Email xiaolinliulxl@126.comBackground: Auxiliaries, a mixed chemicals, for printing and dyeing characterized by their diverse range and complex chemical compositions are commonly utilized in the textile industry. These chemicals can lead to environmental contamination and pose health risks to humans.Case Description: A 29-year-old man who worked in a printing and dyeing factory in Suzhou, China, reported having tightness in his chest and coughing. Despite seeking medical treatment at several hospitals, the initial diagnosis remained elusive. High-resolution chest CT scans showed multifocal lesions in both lungs. The patient had no significant medical history, and the respiratory symptoms only surfaced after exposure to dyeing auxiliaries. Physicians initially suspected chemical pneumonitis due to occupational exposure. However, a subsequent evaluation at a hospital specializing in occupational diseases led to a diagnosis of AIDS and pneumocystis pneumonia.Conclusion: This case underscores the importance of comprehensive clinical diagnosis to avoid biases and reduce the incidence of misdiagnosis.Keywords: chemical pneumonitis, high-resolution CT, misdiagnosis, pneumocystis pneumonia, printing and dyeing auxiliaries

Recent advancements in computed tomography (CT) scanning have improved the detection rates of peripheral pulmonary nodules, including those with ground-glass opacities (GGOs). This study focuses on part-solid pure ground-glass nodules (GGNs) and aims to identify imaging predictors that can reliably differentiate primary lung cancer from nodules with other diagnoses among part-solid GGNs on highresolution CT (HRCT). A retrospective study was conducted on 609 patients who underwent surgical treatment or observation for lung nodules. Radiological findings from pre-operative HRCT scans were reviewed and several CT imaging features of part-solid GGNs were examined for their positive predictive value to identify primary lung cancer. The proportions of the nodules with a final diagnosis of primary lung cancer were significantly higher in part-solid GGNs (91.9%) compared with solid nodules (70.3%) or pure GGNs (66.7%). Among CT imaging features of part-solid GGNs that were evaluated, consolidation-totumor ratio (CTR) < 0.5 (98.1%), pleural indentation (96.4%), and clear tumor border (96.7%) had high positive predictive value to identify primary lung cancer. When two imaging features were combined, the combination of CTR < 0.5 and a clear tumor border was identified to have 100% positive predictive values with a sensitivity of 40.8%. Thus we conclude that part-solid GGNs with a CTR < 0.5 accompanied by a clear tumor border evaluated by HRCT are very likely to be primary lung cancers with an acceptable sensitivity. Preoperative diagnostic procedures to obtain a pathological diagnosis may potentially be omitted in patients harboring such part-solid GGNs. [ABSTRACT FROM AUTHOR]

Objective Stratifying the risk of death in SSc-related interstitial lung disease (SSc-ILD) is a challenging issue. The extent of lung fibrosis on high-resolution CT (HRCT) is often assessed by a visual semiquantitative method that lacks reliability. We aimed to assess the potential prognostic value of a deep-learning–based algorithm enabling automated quantification of ILD on HRCT in patients with SSc. Methods We correlated the extent of ILD with the occurrence of death during follow-up, and evaluated the additional value of ILD extent in predicting death based on a prognostic model including well-known risk factors in SSc. Results We included 318 patients with SSc, among whom 196 had ILD; the median follow-up was 94 months (interquartile range 73–111). The mortality rate was 1.6% at 2 years and 26.3% at 10 years. For each 1% increase in the baseline ILD extent (up to 30% of the lung), the risk of death at 10 years was increased by 4% (hazard ratio 1.04, 95% CI 1.01, 1.07, P  = 0.004). We constructed a risk prediction model that showed good discrimination for 10-year mortality (c index 0.789). Adding the automated quantification of ILD significantly improved the model for 10-year survival prediction (P  = 0.007). Its discrimination was only marginally improved, but it improved prediction of 2-year mortality (difference in time-dependent area under the curve 0.043, 95% CI 0.002, 0.084, P  = 0.040). Conclusion The deep-learning–based, computer-aided quantification of ILD extent on HRCT provides an effective tool for risk stratification in SSc. It might help identify patients at short-term risk of death. [ABSTRACT FROM AUTHOR]

Background and purpose: Studies have shown that when high-grade histological patterns (micropapillary and solid patterns) are present, patients with lung adenocarcinoma have a significantly poorer prognosis and often require more aggressive treatment modalities, and preoperative determination of the presence of any high-grade patterns (HGP) in invasive lung adenocarcinoma can help predict patient prognosis and determine treatment strategies. The aim of the study was to establish a logistic regression model based on high-resolution CT signs to predict the HGP of stage ⅠA lung adenocarcinoma. Methods: The clinical, pathological and imaging data of 443 patients (445 lesions) with stage ⅠA lung adenocarcinoma confirmed by pathology diagnosis from First People's Hospital of Xiaoshan District (Oct. 2018 to Mar. 2021) and Zhongshan Hospital of Fudan University (Jan. 2018 to Dec. 2020) were retrospectively analyzed. The 445 lesions were divided into two groups according to the presence or absence of HGP in pathological findings: HGP (n=88) and non-HGP (n-HGP) (n=357). The clinical and pathological data of the patients included age, gender, smoking history, tumor location, stage and pathological growth pattern. On CT imaging, the size, density, shape, burr sign, lobulation sign, vacuole sign, air bronchus sign and pleural depression sign were observed. Mann-Whitney U test was used to compare quantitative parameters between the two groups, and χ2 test or Fisher's exact test was used for enumeration of data. The independent predictors were screened by univariate combined with multivariate logistic regression analysis, and the clinical model, CT model and clinical-CT model were constructed according to the results of multivariate logistic regression analysis. DeLong test was used to compare the diagnostic efficacy between models. Results: In the univariate analysis, there were significant differences in age, gender, smoking history, tumor size, density, shape, burr, lobulation sign and pleural traction between the HGP group and the n-HGP group (P

The atoll sign describes ring-shaped opacities surrounding central ground glass attenuation seen on chest CT and was first associated with organizing pneumonia. The name is derived from the Maldives' language, denoting a ring or crescentic-shaped coral reef island surrounding a central lagoon. Although biopsy is usually required for diagnosis, understanding some of the more common pathologies associated with the atoll sign may help narrow a differential and guide management. • The atoll sign on chest CT refers to ring shaped opacities surrounding central ground glass attenuation. • Originally described in organizing pneumonia, the atoll sign can be been seen in a wide variety of pulmonarypathologies. • Recognition of the atoll sign helps in narrowing the differential diagnosis,including in immunocompromised individuals. [ABSTRACT FROM AUTHOR]

Background and purpose: Studies have shown that when high-grade histological patterns (micropapillary and solid patterns) are present, patients with lung adenocarcinoma have a significantly poorer prognosis and often require more aggressive treatment modalities, and preoperative determination of the presence of any high-grade patterns (HGP) in invasive lung adenocarcinoma can help predict patient prognosis and determine treatment strategies. The aim of the study was to establish a logistic regression model based on high-resolution CT signs to predict the HGP of stage ⅠA lung adenocarcinoma. Methods: The clinical, pathological and imaging data of 443 patients (445 lesions) with stage ⅠA lung adenocarcinoma confirmed by pathology diagnosis from First People's Hospital of Xiaoshan District (Oct. 2018 to Mar. 2021) and Zhongshan Hospital of Fudan University (Jan. 2018 to Dec. 2020) were retrospectively analyzed. The 445 lesions were divided into two groups according to the presence or absence of HGP in pathological findings: HGP (n=88) and non-HGP (n-HGP) (n=357). The clinical and pathological data of the patients included age, gender, smoking history, tumor location, stage and pathological growth pattern. On CT imaging, the size, density, shape, burr sign, lobulation sign, vacuole sign, air bronchus sign and pleural depression sign were observed. Mann-Whitney U test was used to compare quantitative parameters between the two groups, and χ2 test or Fisher's exact test was used for enumeration of data. The independent predictors were screened by univariate combined with multivariate logistic regression analysis, and the clinical model, CT model and clinical-CT model were constructed according to the results of multivariate logistic regression analysis. DeLong test was used to compare the diagnostic efficacy between models. Results: In the univariate analysis, there were significant differences in age, gender, smoking history, tumor size, density, shape, burr, lobulation sign and pleural traction between the HGP group and the n-HGP group (P＜0.05). Multivariate logistic regression analysis showed tumor size (P=0.04; OR=1.063, 95% CI: 1.003-1.126), density (P＜0.001; OR=8.249, 95% CI: 4.244-16.034), lobulation sign (P=0.001; OR=3.101, 95% CI: 1.598-6.021) were independent predictors of HGP, and the area under curve (AUC) values of clinical model, CT model and clinical-CT model for predicting HGP were 0.634, 0.838 and 0.834, respectively. Conclusion: Tumor size, density and lobulation sign are independent predictors of HGP in stage ⅠA lung adenocarcinoma. The logistic regression model based on high-resolution CT signs has good diagnostic performance and can provide a certain reference for clinical diagnosis and surgical treatment. [ABSTRACT FROM AUTHOR]

This article aims to explore the potential use of lung texture assessed in CT images in distinguishing between the usual interstitial pneumonia and the nonspecific interstitial pneumonia. A retrospective analysis of 96 cases of interstitial pneumonia was performed. Among these cases, there were 40 cases of usual interstitial pneumonia (UIP) and 56 cases of the nonspecific interstitial pneumonia (NSIP). All of the patients underwent computed tomography (CT) scans. A lung intelligence kit (LK) was utilized to perform lung segmentation and texture feature extraction. The significant variables were determined by variance analysis, least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression. Finally, a multivariate logistic regression model was established to distinguish between the two types of interstitial pneumonia. Receiver operating characteristic (ROC) curves, area under the curve (AUC) values, sensitivity, and specificity were used to evaluate the performance of the established model. A total of 100 texture features were extracted from the whole lung that was segmented by LK, and 8 features remained after feature reduction. The AUC, sensitivity, and specificity of the multivariate logistic regression model in the training group and the test group were 0.952 and 0.838, 0.821 and 0.667, and 0.949 and 0.824, respectively. It is possible to distinguish between UIP and NSIP using lung texture features obtained from CT images. [ABSTRACT FROM AUTHOR]

Purpose: We performed a retrospective qualitative and quantitative evaluation of the sutural changes during the physiological growth to define the age-related ossification stages of major and minor skull sutures or synchondroses. Methods: A total of 390 healthy subjects, examined for cranio-facial trauma and whose CT scans turned out to be normal, were clustered into homogenous age-matched groups ranged from birth to 90 years. High-resolution CT was used to assess the degree of sutural closure according to a 3-grade scoring system, the sutural pattern, the width, and the density of the gap calculated as the average of two or three ROIs along each suture/synchondrosis. Results: The identification of a definite pattern depended on the suture's type, the closure degree, and the width of the gap (p < 0.001). The interdigitation process was more intricate for most of vault sutures than the skull base sutures/synchondroses. Closing grades 1, 2, and 3 were associated to an identifiable sutural pattern and the cutoff value of 1.45 mm of the gap width allowed to detect an identifiable sutural pattern with the best combination of sensitivity (97%) and specificity (98%). Age and sutural closing degree were inversely related to gap width while positively related to the gap density (p < 0.001). Conclusion: The sutural ossification is an age-related process, distinctive for each suture, and synchondrosis; it occurs neither according to a predefined order along sutural arches nor following a sequential distribution in the cranial fossae, and some sutures continued their growth process during lifetime. [ABSTRACT FROM AUTHOR]

There is a well-known association between the connective tissue disorders (CTDs) and lung disease. In addition to interstitial lung disease, the CTDs may affect the air spaces and pulmonary vasculature. Imaging tests are important not only in diagnosis but also in management of these complex disorders. In the present review, key aspects of the imaging of CTD-reated diseases are discussed. [ABSTRACT FROM AUTHOR]

A projection X-ray microscope useful for industrial non-destructive inspections and various biological observations has been developed. By installing a Schottky type electron source, a nano focus X-ray source with 100 nm focal spot size that is easy to handle in various laboratories is successfully achieved at 20 to 80 kVp. An imaging system has been composed of a vertical type that can adjust a sample position on the optical axis, and high-resolution imaging can be achieved by using a high precision stage unit. A test chart with 200 nm line width can be clearly confirmed by a transmission image, and CT images with high spatial resolution were also obtained for a test sample of glass containing air micro-bubbles. Finally, we confirmed that the spatial resolution of the system estimated from the obtained CT images does not contradict the result of the evaluation formula of spatial resolution including the effect of X-rays diffraction. [ABSTRACT FROM AUTHOR]

Objective: To explore the predictive value of high-resolution computed tomography (CT) parameters and inflammatory markers for spread through air spaces (STAS) in lung cancer patients., Methods: A retrospective analysis was conducted on 72 lung cancer patients with STAS and 128 STAS-negative patients treated during the same period. Differences in high-resolution CT indicators and inflammatory markers between the two groups were assessed. Binary logistic regression was used to analyze the relationship between these indicators and STAS positivity. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive efficacy of these indicators for STAS positivity., Results: Patients in the STAS-positive group exhibited a higher prevalence of leaf signs, pleural traction signs, and blurred tumor-lung boundaries than the STAS-negative group (P<0.05). Additionally, the STAS-positive group had elevated levels of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), interleukin-6 (IL-6), and C-reactive protein (CRP), alongside a lower lymphocyte-to-monocyte ratio (LMR) (P<0.05). The combined predictive model incorporating pleural traction sign, LMR, NLR, PLR, SII, IL-6, and CRP yielded an area under the curve (AUC) of 0.977, with a sensitivity of 94.4% and a specificity of 90.8%., Conclusion: The integration of high-resolution CT parameters with inflammatory markers demonstrates significant value in predicting STAS positivity in lung cancer patients, with the combined predictive model showing superior performance., Competing Interests: None., (AJTR Copyright © 2024.)

Teaching Point: Pulmonary Langerhans cell histiocytosis (PLCH) has to be included in the differential diagnosis of cystic pulmonary lesions on chest computed tomography (CT). CT has important diagnostic value by demonstrating initial centrilobular nodules that in time cavitate and transform into cysts, typically sparing the costophrenic angles.

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background With the tremendous rise in COVID-19 infection and the shortage of real-time reverse transcription-polymerase chain reaction (RT-PCR) testing, we aimed to assess the role of CT in the detection of COVID-19 infection and the correlation with the patients’ management. A retrospective study was conducted on 600 patients who presented with symptoms suspicious for COVID-19 infection between March and the end of June 2020. The current study followed the RSNA recommendations in CT reporting and correlated with the RT-PCR. CT was reviewed and the severity score was correlated with the patient’s management. Results Four hundred sixty-six patients were included with a mean age of 46 + 14.8 years and 63.3 % were males. Three hundred forty patients were confirmed positive by RT-PCR. CT sensitivity was 92.6% while the RT-PCR was the reference. The CT specificity showed a gradual increase with the CT probability reaching 97.6% with high probability CT features. Ground-glass opacities (GGO) was the commonest findings 85.9% with a high incidence of bilateral, peripheral, and multilobar involvement (88%, 92.8%, and 92.8% respectively). Consolidation was found in 81.5% of the ICU patients and was the dominant feature in 66.7% of the ICU cases. CT severity score was significantly higher in ICU patients with a score of ≥ 14. Conclusions COVID-19 infection showed typical CT features which can be used as a rapid and sensitive investigation. Two CT phenotypes identified with the predominant consolidation phenotype as well as severity score can be used to determine infection severity and ICU need.

Background: Survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are at risk for pulmonary adverse events. Data on late-onset noninfectious pulmonary complications in long-term adult survivors of allo-HSCT are limited and incomplete. Objectives: This study aimed (1) to determine occurrence and degree of pulmonary sequelae in adult survivors of allo-HSCT and (2) to identify associations between pulmonary function, high-resolution CT (HRCT), and clinical characteristics. Method: In a nationwide, single-center cross-sectional study, 103 survivors (aged median [range] 35 [17–58] years, 53% females) were examined 17 (6–32) years after allo-HSCT and compared with healthy controls (n = 105). Methods included pulmonary function tests and HRCT. Results: Chronic graft-versus-host disease was diagnosed in 33% of survivors, including 12% with bronchiolitis obliterans syndrome (BOS). Mean lung volumes (TLC, FVC, and FEV1) and gas diffusing capacity were >80% of predicted for the survivors as a group, but significantly lower than in healthy controls. Pathological HRCT findings were detected in 48% of the survivors (71% airways disease, 35% interstitial lung disease, and 24% apical subpleural interstitial thickening). Air trapping (%) on HRCT correlated with % predicted FEV1, p < 0.001. In a multiple logistic regression model, both BOS and pathological findings on HRCT were associated with chemotherapy prior to allo-HSCT, p < 0.05. Conclusions: Long-term allo-HSCT survivors had significantly lower pulmonary function than age- and gender-matched healthy controls and nearly half had pathological findings on HRCT. Longitudinal data will determine if pulmonary sequelae will remain stable or progress. We recommend lifelong monitoring of pulmonary function in allo-HSCT survivors. HRCT provides additional information, but is not suited for surveillance. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the potentialities of radiomic analysis and develop radiomic models to predict the skull dysmorphology severity and post-surgical outcome in children with isolated sagittal synostosis (ISS). Materials and methods: Preoperative high-resolution CT scans of infants with ISS treated with surgical correction were retrospectively reviewed. The sagittal suture (ROI_entire) and its sections (ROI_anterior/central/posterior) were segmented. Radiomic features extracted from ROI_entire were correlated to the scaphocephalic severity, while radiomic features extracted from ROI_anterior/central/posterior were correlated to the post-surgical outcome. Logistic regression models were built from selected radiomic features and validated to predict the scaphocephalic severity and post-surgical outcome. Results: A total of 105 patients were enrolled in this study. The kurtosis was obtained from the feature selection process for both scaphocephalic severity and post-surgical outcome prediction. The model predicting the scaphocephalic severity had an area under the curve (AUC) of the receiver operating characteristic of 0.71 and a positive predictive value of 0.83 for the testing set. The model built for the post-surgical outcome showed an AUC (95% CI) of 0.75 (0.61;0.88) and a negative predictive value (95% CI) of 0.95 (0.84;0.99). Conclusion: Our results suggest that radiomics could be useful in quantifying tissue microarchitecture along the mid-suture space and potentially provide relevant biological information about the sutural ossification processes to predict the onset of skull deformities and stratify post-surgical outcome. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of COVID-19 patients with those of other community-acquired pneumonia (CAP) patients to differentiate CAP from COVID-19 before reverse transcription-polymerase chain reaction results are obtained.Methods: The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020.Results: 24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients, except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. In total, 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were affected most often, and all lesions were located in the peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients.Conclusion: Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward. [ABSTRACT FROM AUTHOR]

Shuyi Qin,1,2,* Xinjuan Yu,1,2,* Qianli Ma,3,* Li Lin,4 Qinghai Li,1,2 Hong Liu,1,2 Lei Zhang,5 Shuguang Leng,6 Wei Han1,2 1Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong, People’s Republic of China; 2Respiratory Disease Key Laboratory of Qingdao, Qingdao Municipal Hospital, Qingdao, Shandong, People’s Republic of China; 3Department of Radiology, Qingdao Municipal Hospital, Qingdao, Shandong, People’s Republic of China; 4Department of Pulmonary Medicine, Shandong Provincial Chest Hospital, Jinan, Shandong, People’s Republic of China; 5Department of Hospital Infection, Qingdao Municipal Hospital, Qingdao, Shandong, People’s Republic of China; 6Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA*These authors contributed equally to this workCorrespondence: Wei HanDepartment of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, No. 5 Donghaizhong Road, Qingdao, Shandong, People’s Republic of ChinaTel +86 532 85937579Email hanw@qdu.edu.cnShuguang LengDepartment of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USATel +1 505 3489465Email sleng@salud.unm.eduPurpose: To explore a practical marker for quantitatively analyzing the small airway remodeling in COPD by HRCT.Patients and Methods: Twenty-four patients with COPD (GOLD I, n = 7; GOLD II, n = 8; GOLD III+IV, n = 9) and 14 healthy controls (7 normal pulmonary function; 7 small-airway disease (SAD)) were enrolled in the study as five groups, GOLD I, GOLD II, GOLD III+IV, normal and SAD. All subjects underwent HRCT and spirometry. With ISP 9.0, whole emphysema index (EI) and the airway parameters, including wall area (WA), lumen area (LA), airway area (AA) of the 3rd, 5th and 9th generations of bronchi, were measured successively. The ratio of LA/AA and WA/AA in the 3rd, 5th and 9th generations of bronchi were calculated and compared among groups.Results: For the five groups, EI was increased only in GOLD III+IV group (P < 0.05), while the ratio of LA/AA (9-LA/AA) and WA/AA (9-WA/AA) in 9th generation of bronchi have significantly changed since SAD group (P < 0.05). There were significant correlation between FEV1generations of bronchi (r3 = 0.429, r5 = 0.583, r9 = 0.592, respectively, P < 0.05); FEV1% and WA/AA (r3 = – 0.428, r5 = – 0.532, r9 = – 0.570, respectively, P < 0.05); as well as MMEF% and LA/AA (r3 = 0.421, r5 = 0.566, r9 = 0.610, respectively, P < 0.05); MMEF% and WA/AA (r3 = – 0.421, r5 = – 0.529, r9 = – 0.593, respectively, P < 0.05).Conclusion: Small airway remodeling has occurred in the early stage of COPD, while emphysema in the late stage of COPD. The 9-LA/AA and 9-WA/AA are accurate and practical markers for small airway remodeling of COPD.Keywords: COPD, high-resolution CT, emphysema index, pulmonary function test

To explore the quality of high-resolution CT images information in the evaluation of pulmonary nodule interface and internal structure of nodules in lung tissue, as well as the value of early diagnosis of lung cancer associated with infection, high-resolution CT images were used as the research object. Through the analysis of the computerized detection and diagnosis (Computer-Aided Diagnosis (CAD)) of lung cancer, the high-resolution CT was further explored in the process of clinical imaging doctors in the diagnosis of lung cancer, and more conditions were created for the application of medical image processing in the early diagnosis of lung cancer. The research results show that CAD can automatically and accurately complete the automatic segmentation of the lung region in the CT image by applying the automatic segmentation algorithm for a series of processing and analysis of the CT image, that is, generating high-resolution CT images. It can enhance the pulmonary nodules in CT images and improve the accuracy of lung nodule detection, which is of great value in the diagnosis of early lung cancer. CAD diagnosis of lung lesions based on high-resolution CT images is studied, which can provide reference for imaging physicians to diagnose early lung cancer. However, in the automatic identification of benign and malignant lesions in the lungs, it is necessary to further improve the analysis function of similar nodules, which will be an important step for humans in the diagnosis and treatment of diseases.

This paper discussed the value of pulmonary ultrasound in the diagnosis of interstitial diseases, and analyzed the difference between ultrasonography and high-resolution CT (HRCT) and its clinical application value. All patients received lung ultrasonography and HRCT examination. A total of 127 patients with connective tissue diseases were selected for clinical research. According to the clinical diagnosis results, the patients were divided into the interstitial lung disease group (97 cases) and the non-interstitial lung disease group (30 cases). The detection rate of B-line, pleural thickening and pleural surface roughness in the interstitial lung disease group was significantly higher than that in the non-interstitial lung disease group, and the difference was statistically significant (P<0.05). The sensitivity of lung ultrasound in diagnosing patients with interstitial lung disease was 85.57%, the specificity was 80.70%, and the AUC value was 0.831. The sensitivity of HRCT in the diagnosis of patients with interstitial lung disease was 93.81%, the specificity was 87.72%, and the AUC value was 0.908. The value of lung ultrasonography in diagnosing interstitial diseases is similar to that of HRCT, but it has the advantages of simple operation and good consistency in evaluating the condition of patients. [ABSTRACT FROM AUTHOR]

Lymphangioleiomyomatosis (LAM) is a rare disease characterized by cystic lung lesions, lymphatic abnormalities, and angiomyolipomas. It can take a significant amount of time to diagnose LAM due to the vague symptoms of fatigue, progressive dyspnea, pneumothorax, and pleural effusion. We present a case of a 29-year-old woman with recurrent spontaneous pneumothorax and progressive dyspnea who was initially misdiagnosed with asthma and was later found to have LAM. As with all rare diagnoses, there needs to be a suspicion of the disease in order for a further workup to be initiated. In patients with a compatible High-resolution CT scan of the chest, a high vascular endothelial growth factor-D (VEGF-D) value is diagnostic for LAM, and no other confirmatory test is needed.

Abstract Background Systemic sclerosis is a connective tissue disease that affects multiple systems and causes fibrosis of the skin and internal organs. There are two ways in which the lungs can be involved in patients with systemic sclerosis, either isolated pulmonary hypertension or interstitial lung fibrosis. The purpose of this study is to correlate the high resolution CT findings with pulmonary function tests in patients with systemic sclerosis to evaluate the severity of lung changes. Results Significant inverse correlations were found between the maximal extent radiological score, maximal severity radiological score as well as total (global) radiological score on one hand and the pulmonary function tests on the other hand Conclusion The combination of high resolution CT and pulmonary function tests are recommended for better assessment of the extent and severity of systemic sclerosis associated interstitial lung disease.

Abstract Background Lung ultrasound is a bedside non-irradiating tool for assessment and monitoring of lung diseases. A lung ultrasound score based on visualized artefacts allows reliable quantification of lung aeration, and is useful to monitor mechanical ventilation setting, fluid resuscitation and antibiotic response in critical care. In the context of interstitial lung diseases associated to connective tissue disorders, lung ultrasound has been integrated to computed tomography for diagnosis and follow-up monitoring of chronic lung disease progression. Case presentation This case describes a severe acute exacerbation of interstitial lung disease associated to dermatomyositis–polymyositis requiring prolonged extra-corporeal life support. Lung ultrasound score was performed daily and allowed monitoring and guiding both the need of advanced imaging as computed tomography and immunosuppressive therapy. Conclusions This case suggests lung ultrasound may be a useful monitoring tool for the response to immunosuppressive therapy in acute severe rheumatic interstitial lung disease, where chest X-ray is poorly informative, and transportation is at high risk.

Abstract Lymphangioleiomyomatosis (LAM) is an unusual lung disease which can be diagnosed by its characteristic appearance on a high‐resolution CT, and may not always require a biopsy.

Objective: To study the relationship between serum carcinoembryonic antigen (CEA), neurospecific purified enzyme (NSE) and cytokeratin 19 fragment (Cyfra21-1) levels and nodule diameter in patients with Solitary Pulmonary Nodules (SPN) and the diagnostic value of combined high-resolution CT. Methods: 154 patients with SPN who were admitted to the hospital from March 2017 to March 2020 were included in the study. According to the results of postoperative pathological examination, the patients were divided into malignant nodules group with 104 cases and benign nodules group with 50 cases. All patients underwent high-resolution CT chest enhanced scan, and CT imaging manifestations of different tuberculous patients were compared. In addition, serum CEA, NSE and Cyfra21-1 levels of patients with different nodules were detected and compared, and the relationship between serum CEA, NSE and Cyfra21-1 and the nodule diameter were analyzed. Serum CEA, NSE, CYFRA21-1 levels and the effectiveness of high-resolution CT in the diagnosis of benign and malignant SPN were analyzed by receiver operating characteristic (ROC) curves. Results: The proportion of patients with malignant pulmonary nodules showing burr sign, deep lobulation sign, pleural depression sign, vascular collection sign and spinous process sign on chest CT imaging were higher than those of benign nodules, while the proportion of calcification sign was lower than that of benign nodules (all P<0.05). The serum CEA, NSE and Cyfra21-1 levels of patients with malignant pulmonary nodules were significantly higher than those of patients with benign nodules (all P<0.05). Serum CEA of patients with the nodule maximum diameter >2.0 cm was significantly higher than that of patients with the nodule maximum diameter 1.0~2.0 cm, while serum CEA of patients with the nodule maximum diameter 1.0~2.0 cm was significantly higher than that of patients with the nodule maximum diameter <1.0 cm (all P<0.05). Spearman correlation analysis showed that serum CEA level was positively correlated with nodule diameter in SPN patients, while serum NSE, Cyfra21-1 levels were not correlated with nodule diameter in SPN patients. The ROC curve analysis showed that the area under the curve, sensitivity and specificity of serum CEA, NSE and Cyfra21-1 combined with high-resolution CT in the diagnosis of benign and malignant SPN were significantly higher than those of the above serological indexes and high-resolution CT alone. Conclusion: Serum CEA level of SPN patients is positively correlated with nodule diameter, while Serum NSE and Cyfra21-1 levels are not significantly correlated with nodule diameter. The value of serum CEA, NSE and Cyfra21-1 combined with high-resolution CT in the diagnosis of benign and malignant SPN is relatively high. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Myositis-related interstitial lung disease presents with a wide variety of lesions, ranging from chronic to acute. It can be divided into two main forms by the types of onsets, namely, chronic to subacute type showing nonspecific interstitial pneumonia (NSIP) or NSIP with an organizing pneumonia (OP)/fibrosing OP (FOP) pattern and acute type showing acute lung injury (ALI) to diffuse alveolar damage (DAD) pattern. Anti-aminoacyl tRNA Synthetase antibody-positive cases mainly show an NSIP or FOP pattern, whereas anti-melanoma differentiation-associated gene 5 antibody-positive cases show ALI to DAD pattern. Bilateral consolidation with or without groundglass opacification with lower lobe predominance is common as a major pattern in all types, but the distribution or extent is sometimes different. The early detection of findings that indicate a rapid progressive course is vital. Diffuse cranio-caudal distribution and multiple ground-glass opacifications with random distribution might indicate a poorer prognosis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to quantify location and direction‐dependent variations in the 3D modulation transfer function (MTF) of a high‐resolution CT scanner with selectable focal spot sizes and resolution modes. Methods: The Aquilion Precision CT scanner (Canon Medical Systems) has selectable 0.25 mm or 0.5 mm detectors (by binning) in both the axial (x‐y) and detector array width (z) directions. For the x‐y and z orientations, detectors are configured (x–y) = 0.5 mm/(z) = 0.5 mm for normal resolution (NR), 0.25/0.5 mm for high resolution (HR), and 0.25/0.25 mm for super high resolution (SHR). Six focal spots (FS1‐FS6) range in size from 0.4 (x‐y) × 0.5 mm (z) for FS1 to 1.6 × 1.4 mm for FS6. Phantoms fabricated from spherical objects were positioned at radial distances of 0, 4.0, 7.5, 11.0, 14.5, and 18.5 cm. Axial and helical acquisitions were utilized and reconstructed using filtered back projection with the FC18 "Body," FC30 "Bone," and FC81 "Bone Sharp" kernels. The reconstructions were used to measure a 1D slice of the 3D MTF by oversampling the 3D ESF in the axial plane [MTF(fr); φ = 0°)], 45° out of the axial plane [MTF(fr); φ = 45°)], in the longitudinal direction [MTF(fr); φ = 80°)], and along the radial and azimuthal directions within the axial plane. Results: The MTF(fr); φ = 45°) drops to 10% (f10) at 1.20, 1.45, and 2.06 mm−1 for NR, HR, and SHR, respectively, for a helical acquisition with FS1, FC30, and r = 4 cm from the isocenter. The MTF(fr); φ = 45°) includes contributions of both the axial‐plane MTF (f10 = 1.10, 2.04, and 2.01 mm−1) and the longitudinal MTF (f10 = 1.17, 1.18, and 1.82 mm−1) for the NR, HR, and SHR modes, respectively. For SHR, the axial scan mode showed a 15–25% improvement over helical mode in the longitudinal resolution. Helical pitch, ranging from 0.569 to 1.381, did not appreciably affect the 3D resolution (<2%). The radial MTFs across the axial field of view (FOV) showed dependencies on the focal spot length in z; for example, for SHR with FS2 (0.6 × 0.6 mm), f10 at r = 11 cm was within 17% of the value at r = 4 cm, but for SHR with FS3 (0.6 × 1.3), the reduction in f10 was 46% from 4 to 11 cm from the isocenter. The azimuthal MTF also decreased as r increased but less so for longer gantry rotation times and smaller focal spot dimensions in the axial plane. The longitudinal MTF was minimally affected (<11%) by position in the FOV and was principally affected by the focal spot length in the z‐dimension. Conclusions: The 3D MTF was measured throughout the FOV of a high‐resolution CT scanner, quantifying the advantages of different resolution modes and focal spot sizes on the axial‐plane and longitudinal MTF. Reconstruction kernels were shown to impact axial‐plane resolution, imparting non‐isotropic 3D resolution characteristics. Focal spot size (both in x‐y and in z) and gantry rotation time play important roles in preserving the high‐resolution characteristics throughout the field of view for this new high‐resolution CT scanner technology. [ABSTRACT FROM AUTHOR]

Background: The classic chest CT imaging features of COVID-19 pneumonia have low specificity due to their similarity with a number of other conditions. So, the goal of the present study is to learn from the pathophysiology of COVID-19 clinical features, laboratory results, and high-resolution CT manifestations in different stages of disease severity to provide significant reference values for diagnosis, prevention, and treatment. Methods: This was a multicentered study that included 128 patients. Demographic, clinical, and laboratory data, in addition to chest HRCT findings, were evaluated. According to chest HRCT features, radiologic scoring were grade 1 and 2 for mild grades of the disease, 3 and 4 for moderate grades of the disease, and 5 and 6 for severe grades of the disease. Results: Patient clinical symptoms ranged between fever, dry cough, muscle ache (myalgia)/fatigue, dyspnea, hyposomia, sore throat, and diarrhea. Lymphocytes and WBCs were significantly lower in patients with severe COVID-19. A significant negative correlation was found with WBCs (r = − 0.245, P = 0.005), lymphocytes% (r = − 0.586, P < 0.001), RBCs (r = − 0.2488, P = 0.005), Hb (gm/dl) (r = − 0.342, P < 0.001), and HCT (r = − 0.377, P < 0.001). Transferrin and CRP were significantly higher in moderate and severe COVID-19 than mild degree and showed a significant positive correlation with CT score (r = 0.356, P < 0.001) and (r = 0.429, P < 0.001), respectively. The most common CT features were peripheral pulmonary GGO and air space consolidation. Conclusion: Clinical features, laboratory assessment, and HRCT imaging had their characteristic signs and performances. Correlating them can make it possible for physicians and radiologists to quickly obtain the final diagnosis and staging of the COVID-19 pneumonia. [ABSTRACT FROM AUTHOR]

Copyright of CT Theory & Applications is the property of Editorial Department of CT Theory & Applications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: With the tremendous rise in COVID-19 infection and the shortage of real-time reverse transcription-polymerase chain reaction (RT-PCR) testing, we aimed to assess the role of CT in the detection of COVID-19 infection and the correlation with the patients' management. A retrospective study was conducted on 600 patients who presented with symptoms suspicious for COVID-19 infection between March and the end of June 2020. The current study followed the RSNA recommendations in CT reporting and correlated with the RT-PCR. CT was reviewed and the severity score was correlated with the patient's management. Results: Four hundred sixty-six patients were included with a mean age of 46 + 14.8 years and 63.3 % were males. Three hundred forty patients were confirmed positive by RT-PCR. CT sensitivity was 92.6% while the RT-PCR was the reference. The CT specificity showed a gradual increase with the CT probability reaching 97.6% with high probability CT features. Ground-glass opacities (GGO) was the commonest findings 85.9% with a high incidence of bilateral, peripheral, and multilobar involvement (88%, 92.8%, and 92.8% respectively). Consolidation was found in 81.5% of the ICU patients and was the dominant feature in 66.7% of the ICU cases. CT severity score was significantly higher in ICU patients with a score of ≥ 14. Conclusions: COVID-19 infection showed typical CT features which can be used as a rapid and sensitive investigation. Two CT phenotypes identified with the predominant consolidation phenotype as well as severity score can be used to determine infection severity and ICU need. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of orbital proptosis and sutural synostosis pattern along the coronal ring in craniofaciosynostosis patients with or without fibroblastic growth factor receptor 2 (FGFR2) mutation. Methods: High-resolution computer tomography was used to assess, in children with or without FGFR2 mutation, the early synostotic involvement of the "major" and "minor" sutures/synchondroses of the coronal arch along with the following orbital parameters: interorbital angle, bone orbital cavity volume, globe volume, ventral globe volume, ventral globe index. Results: Infants with FGFR2 mutation showed an increased number of closed minor sutures/synchondroses along the posterior coronal branch while both groups showed a comparable synostotic involvement of the minor sutures of the anterior coronal branch. FGFR2 infants with posterior coronal branch synostotic involvement showed a higher degree of proptosis due to both reduced bony cavity volume and increased globe volume (p<0.05). Conclusions: Our data show that FGFR2 mutation together with posterior coronal branch synostotic involvement has a synergic effect in causing a more severe degree of orbital proptosis. [ABSTRACT FROM AUTHOR]

To explore the quality of high-resolution CT images information in the evaluation of pulmonary nodule interface and internal structure of nodules in lung tissue, as well as the value of early diagnosis of lung cancer associated with infection, high-resolution CT images were used as the research object. Through the analysis of the computerized detection and diagnosis (Computer-Aided Diagnosis (CAD)) of lung cancer, the high-resolution CT was further explored in the process of clinical imaging doctors in the diagnosis of lung cancer, and more conditions were created for the application of medical image processing in the early diagnosis of lung cancer. The research results show that CAD can automatically and accurately complete the automatic segmentation of the lung region in the CT image by applying the automatic segmentation algorithm for a series of processing and analysis of the CT image, that is, generating high-resolution CT images. It can enhance the pulmonary nodules in CT images and improve the accuracy of lung nodule detection, which is of great value in the diagnosis of early lung cancer. CAD diagnosis of lung lesions based on high-resolution CT images is studied, which can provide reference for imaging physicians to diagnose early lung cancer. However, in the automatic identification of benign and malignant lesions in the lungs, it is necessary to further improve the analysis function of similar nodules, which will be an important step for humans in the diagnosis and treatment of diseases. [ABSTRACT FROM AUTHOR]

The long-term sequelae of coronavirus disease 2019 (COVID-19) are still unknown. Lessons from past viral epidemics reveal that, after recovery, patients with viral pulmonary infections can suffer from irreversible pulmonary dysfunction and demonstrate residual imaging or functional abnormalities. Residual ground glass opacities, consolidations, reticular and linear opacities, residual crazy paving pattern, melted sugar sign, and parenchymal fibrotic bands are several features found in the late or remission stages of COVID-19. These radiologic findings have been observed weeks after symptom onset, even after hospital discharge, and they may or may not correlate with clinical manifestations. High-resolution CT may be indicated to establish new baselines and track changes in residual impairments. In our previous review, we observed significant pulmonary sequelae in some COVID-19 survivors at follow-up. In this update, we review the current literature on the clinical and radiologic manifestations of post-recovery COVID-19 toward the end of hospital admission and after discharge. [ABSTRACT FROM AUTHOR]

Objective: To investigate clinical relevance of performing lung ultrasound (LUS) in patients with connective tissue disease (CTD)-associated interstitial lung disease (ILD) in comparison with high-resolution computed tomography (HRCT)., Methods: This single-centre study enrolled eligible patients with CTD-ILD from the prospective LUS registry. Total B-lines were detected by assessment at 14 sites via LUS. Forced vital capacity, diffusing lung capacity for carbon monoxide (DLCO), DLCO/alveolar volume, 6-minute walking distance, and the ILD-GAP index were used as ILD prognostic parameters. Correlations were examined using single and multiple regression analyses., Results: Sixty-seven patients were enrolled, including 29 with idiopathic inflammatory myopathy or anti-synthetase syndrome, 25 with systemic sclerosis (SSc), 10 with rheumatoid arthritis, and 3 with mixed connective tissue disease. The total number of B-lines correlated with ILD extent on HRCT in patients with CTD-ILD (r = 0.66; P < 0.001), particularly in patients with SSc-ILD (r = 0.78; P < 0.001). Total B-lines and ILD extent on HRCT showed comparable correlations with prognostic parameters, while multiple regression analysis revealed the limited benefit of performing LUS in addition to HRCT in predicting correlations with prognostic factors., Conclusions: LUS serves as an alternative tool for assessing the severity and prognosis of patients with CTD-ILD., (© Japan College of Rheumatology 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Recent advancements in computed tomography (CT) scanning have improved the detection rates of peripheral pulmonary nodules, including those with ground-glass opacities (GGOs). This study focuses on part-solid pure ground-glass nodules (GGNs) and aims to identify imaging predictors that can reliably differentiate primary lung cancer from nodules with other diagnoses among part-solid GGNs on high-resolution CT (HRCT). A retrospective study was conducted on 609 patients who underwent surgical treatment or observation for lung nodules. Radiological findings from pre-operative HRCT scans were reviewed and several CT imaging features of part-solid GGNs were examined for their positive predictive value to identify primary lung cancer. The proportions of the nodules with a final diagnosis of primary lung cancer were significantly higher in part-solid GGNs (91.9%) compared with solid nodules (70.3%) or pure GGNs (66.7%). Among CT imaging features of part-solid GGNs that were evaluated, consolidation-to-tumor ratio (CTR) < 0.5 (98.1%), pleural indentation (96.4%), and clear tumor border (96.7%) had high positive predictive value to identify primary lung cancer. When two imaging features were combined, the combination of CTR < 0.5 and a clear tumor border was identified to have 100% positive predictive values with a sensitivity of 40.8%. Thus we conclude that part-solid GGNs with a CTR < 0.5 accompanied by a clear tumor border evaluated by HRCT are very likely to be primary lung cancers with an acceptable sensitivity. Preoperative diagnostic procedures to obtain a pathological diagnosis may potentially be omitted in patients harboring such part-solid GGNs.

Objective: To investigate the predictive value of temporal bone high-resolution CT（HRCT） multiplanar reconstruction（MPR） for cerebrospinal fluid（CSF） gusher during cochlear implantation in patients with inner ear malformation. Methods: The clinical data of 33 patients（36 ears） with inner ear malformation who underwent cochlear implantation were retrospectively analyzed. The predictive value of HRCT for cerebrospinal fluid gusher during cochlear implantation was evaluated. Results: The width of the cochlear foramen（ P =0.024, OR =1.735） and the diameter of the inner auditory meatus（ P =0.022, OR =6.119） were independent risk factors for CSF gusher during cochlear implantation. The area under the curve（AUC） of cochlear foramen width in predicting intraoperative gusher was 0.851, the sensitivity was 93.33%, and the specificity was 61.90%. The AUC of the upper and lower diameter of the internal auditory canal for predicting intraoperative gusher was 0.848, the sensitivity was 80.00%, and the specificity was 80.95%. The AUC of cochlear foramen width combined with the upper and lower diameters of the internal auditory meatus for predicting intraoperative gusher was 0.930, the sensitivity was 80.00%, and the specificity was 95.24%. Conclusion: Based on temporal bone HRCT, the prediction model of cochlear foramen width combined with the upper and lower diameter of the internal auditory canal has crucial predictive value for the "gusher" during cochlear implantation in patients with inner ear malformation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Teaching Point: Pulmonary Langerhans cell histiocytosis (PLCH) has to be included in the differential diagnosis of cystic pulmonary lesions on chest computed tomography (CT). CT has important diagnostic value by demonstrating initial centrilobular nodules that in time cavitate and transform into cysts, typically sparing the costophrenic angles. [ABSTRACT FROM AUTHOR]

Objective Idiopathic inflammatory myositis-associated interstitial lung disease (IIM-ILD) significantly increases morbidity and mortality. Lung ultrasound B-lines and Krebs von den Lungen-6 (KL-6) are identified as new sonographic and serum markers of ILD, respectively. The aim of our work was to assess the role of B-lines and KL-6 as markers of the severity of IIM-ILD. For this purpose, the correlation among B-lines score, serum KL-6 levels, high-resolution CT (HRCT) score, and pulmonary function tests were investigated in IIM-ILD patients. Methods Thirty-eight patients with IIM-ILD underwent chest HRCT scans, lung ultrasound and pulmonary function tests (independently performed within 1 week) examination. To assess severity and extent of ILD at HRCT, the Warrick score was used. The B-lines score denoting the extension of ILD was calculated by summing the number of B-lines on a total of 50 scanning sites. Serum KL-6 levels (U/ml) was measured by chemiluminescent enzyme immunoassay. Results A significant correlation was found between the B-lines score and serum KL-6 levels (r  = 0.43, P  < 0.01), and between the Warrick score and serum KL-6 levels (r  = 0.45, P  < 0.01). A positive correlation between B-lines score and the Warrick score (r  = 0.87, P  < 0.0001) was also confirmed. Both B-lines score and KL-6 levels inversely correlated to diffusion capacity for carbon monoxide (r  = −0.77, P  < 0.0001 and r  = −0.42, P  < 0.05, respectively) and total lung capacity (r  = −0.73, P  < 0.0001 and r  = −0.36, P  < 0.05, respectively). Moreover, B-lines correlated inversely with forced vital capacity (r  = −0.73, P  < 0.0001), forced expiratory volume in 1 s (r  = −0.69, P  < 0.0001). Conclusion B-lines score and serum KL-6 levels correlate with HRCT findings and pulmonary function tests, supporting their use as measures of IIM-ILD severity. [ABSTRACT FROM AUTHOR]

Lymphangioleiomyomatosis (LAM) is a rare disease characterized by cystic lung lesions, lymphatic abnormalities, and angiomyolipomas. It can take a significant amount of time to diagnose LAM due to the vague symptoms of fatigue, progressive dyspnea, pneumothorax, and pleural effusion. We present a case of a 29-year-old woman with recurrent spontaneous pneumothorax and progressive dyspnea who was initially misdiagnosed with asthma and was later found to have LAM. As with all rare diagnoses, there needs to be a suspicion of the disease in order for a further workup to be initiated. In patients with a compatible High-resolution CT scan of the chest, a high vascular endothelial growth factor-D (VEGF-D) value is diagnostic for LAM, and no other confirmatory test is needed. [ABSTRACT FROM AUTHOR]