Follow-up Recommendations for Chest CT Scan Reports of Incidental Pulmonary Nodules

CHEST Journal ◽  
2012 ◽  
Vol 141 (1) ◽  
pp. 280-281
Author(s):  
Douglas B. Johnson ◽  
Mark A. Powers ◽  
Shiying Wu ◽  
Yuh-Chin T. Huang
Author(s):  
Mehrdad Nabahati ◽  
Soheil Ebrahimpour ◽  
Reza Khaleghnejad Tabari ◽  
Rahele Mehraeen

Abstract Background We aimed to prospectively assess the lung fibrotic-like changes, as well as to explore their predictive factors, in the patients who survived Coronavirus Disease 2019 (COVID-19) infection. In this prospective cross-sectional study, we recruited patients who had been treated for moderate or severe COVID-19 pneumonia as inpatients and discharged from Rohani hospital in Babol, northern Iran, during March 2020. The clinical severity of COVID-19 pneumonia was classified as per the definition by World Health Organization. We also calculated the CT severity score (CSS) for all patients at admission. Within the 3 months of follow-up, the next chest CT scan was performed. As the secondary outcome, the patients with fibrotic abnormalities in their second CT scan were followed up in the next 3 months. Results Totally, 173 COVID-19 patients were finally included in the study, of whom 57 (32.9%) were male and others were female. The mean age was 53.62 ± 13.67 years old. At 3-month CT follow-up, evidence of pulmonary fibrosis was observed in 90 patients (52.0%). Consolidation (odds ratio [OR] = 2.84), severe disease (OR 2.40), and a higher CSS (OR 1.10) at admission were associated with increased risk of fibrotic abnormalities found at 3-month CT follow-up. Of 62 patients who underwent chest CT scan again at 6 months of follow-up, 41 patients (66.1%) showed no considerable changes in the fibrotic findings, while the rest of 21 patients (33.9%) showed relatively diminished lung fibrosis. Conclusion Post-COVID-19 lung fibrosis was observed in about half of the survivors. Also, patients with severe COVID-19 pneumonia were at a higher risk of pulmonary fibrosis. Moreover, consolidation, as well as a higher CSS, in the initial chest CT scan, was associated with increased risk of post-COVID-19 lung fibrosis. In addition, some patients experienced diminished fibrotic abnormalities in their chest CT on 6-month follow-up, while some others did not.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. TPS7111-TPS7111
Author(s):  
Virginie Westeel ◽  
Fabrice Barlesi ◽  
Jean Domas ◽  
Philippe Girard ◽  
Pascal Foucher ◽  
...  

TPS7111 Background: There are no robust data published on the follow-up after surgery for non-small cell lung cancer (NSCLC). Current international guidelines are informed by expert opinion. Most of them recommend regular follow-up with clinic visit and thoracic imaging, either chest X-ray of Chest CT-scan. The IFCT-0302 trial addresses the question whether a surveillance program with chest CT-scan and fiberoptic bronchoscopy can improve survival compared to a follow-up only based on physical examination and chest x-ray. There is no such trial ongoing over the world. Methods: The IFCT-0302 trial is a multicenter open-label controlled randomized phase III trial. The objective of the trial is to compare two follow-up programs after surgery for stage I-IIIa NSCLC. The primary endpoint is overall survival. Patients are randomly assigned to arm 1, minimal follow-up, including physical examination and chest x-ray; or arm 2, a follow-up consisting of physical examination and chest x-ray plus chest CT scan and fiberoptic bronchoscopy (optional for adenocarcinomas). In both arms, follow-up procedures are performed every 6 months during the first two postoperative years, and every year between the third and the fifth years. The main eligibility criteria include: completely resected stage I-IIIA (6th UICC TNM classification) or T4 (in case of nodules in the same lobe as the tumor) N0 M0 NSCLC, surgery within the previous 8 weeks. Patients who have received and/or who will receive pre/post-operative chemotherapy and/or radiotherapy are eligible. Statistical considerations: 1,744 patients is required. Accrual status: 1,568 patients from 119 French centers had been included. The end of accrual can be expected for September 2012. Ancillary study: Blood samples are collected in 1000 patients for genomic high density SNP micro-array analysis. This collection will contribute to the French genome wide association study (gwas) of lung cancer gene susceptibility, and the genetic factors predictive of survival and lung cancer recurrence will be analyzed.


2020 ◽  
Author(s):  
Wangjia Li ◽  
Liangbo Hu ◽  
Junhao Huang ◽  
Fajin Lv ◽  
Binjie Fu ◽  
...  

Abstract Background: Pulmonary spherical ground-glass opacities (GGOs) are commonly detected on initial chest CT scan in patients with coronavirus disease 2019 (COVID-19).We aimed to investigate the evolution of spherical GGOs to better understand their clinical significance.Materials and Methods:A retrospective study of 33 consecutive patients with confirmed COVID-19 and pulmonary spherical GGOs was performed from January 21, 2020, to March 6, 2020. The initial and follow-up CT images and clinical data were reviewed. The initial CT manifestations of spherical GGOs and their subsequent changes were mainly evaluated. Results:A total of 101 pulmonary spherical GGOs, including 38 with and 63 without consolidation, were found in 33 patients. Of the 101 spherical GGOs, 71 (70.3%) and 30 (29.7%) showed progression and direct absorption on follow-up CT images, respectively. GGOs with consolidation were more likely to progress than those without (84.2% vs. 61.9%, p = 0.017). The 71 progressed lesions mainly showed an increase in size and/or density and most (70.4%) of them extended toward the pleura and developed from spherical to patchy. Internal consolidation appeared and increased in 18 (25.4%) and 22 (31.0%) lesions, respectively. During absorption, all the previous progressed and directly absorbed lesions exhibited a simultaneous decrease in size and density. On each patient’s final CT, more lesions with progression had a residual mixed GGO (40.8% vs. 6.7%, p = 0.002) and fewer had pure GGO (39.4% vs. 60.0%, p = 0.016) than those with direct absorption.Conclusion: In patients with COVID-19, most pulmonary spherical ground-glass opacities would progress, especially those with consolidation, and develop into patchy, subpleural lesions.


2021 ◽  
pp. 106384
Author(s):  
Guido Giovannetti ◽  
Lucrezia De Michele ◽  
Michele De Ceglie ◽  
Paola Pierucci ◽  
Alessandra Mirabile ◽  
...  

2020 ◽  
Author(s):  
Liqa A Rousan ◽  
Eyhab Elobeid ◽  
Musaab Karrar ◽  
Yousef Khader

Abstract Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.


2020 ◽  
Author(s):  
Qiulian Sun ◽  
Xinjian Xu ◽  
Hai Yang ◽  
Guanliang Wang ◽  
Jingjing Li ◽  
...  

Abstract Objective: To investigate the evolution and characteristics of "fibrosis-like" strips on chest CT in patients with COVID-19 pneumonia. Methods: From January 17, 2020, to February 27, 2020, inpatients diagnosed with COVID-19 pneumonia in Enze Hospital, Taizhou, Zhejiang Province, were selected. The chest CT data of the patients were collected, and patients were included in the present study according to the predefined inclusion criteria. The dynamic evolution process and outcome of "fibrosis-like" strips on chest CT were analyzed.Results: A total of 36 patients (20 males and 16 females) with COVID-19 were included in the study, all of whom were diagnosed with mild or common COVID-19; "fibrosis-like" strips were observed in 29 patients (80.6%) on the first chest CT scan, and "fibrosis-like" strips were observed in 7 patients (19.4%) on the second chest CT scan, Repeated chest CT during the course of treatment showed that all patients with "fibrosis-like" strips had varying degrees of absorption. "Fibrosis-like" strips in 15 patients demonstrated a trend of first increasing in number, and then decreasing in number; "fibrosis-like" strips in 3 patients demonstrated a trend of first decreasing in number first, followed by an increase in number and then a decrease in number; and "fibrosis-like" strips in 18 patients demonstrated a trend of a gradual decrease in number. Follow-up chest CT after treatment showed that "fibrosis-like" strips in 15 patients completely disappeared in both lungs, and "fibrosis-like" strips completely disappeared in unilateral lung of 8 cases.Conclusion: In the present study, we observed that "fibrosis-like" strips in COVID-19 patients had characteristics of early appearance and rapid morphological changes as well as rapid absorption, suggesting that "fibrosis-like" strips may be a sign of subsegmental atelectasis rather than fibrotic changes.


2020 ◽  
Author(s):  
Qiulian Sun ◽  
Xinjian Xu ◽  
Hai Yang ◽  
Guanliang Wang ◽  
Jingjing Li ◽  
...  

Abstract Objective: To investigate the evolution and characteristics of "fibrosis-like" strips on chest CT in patients with COVID-19 pneumonia.Methods: From January 17, 2020, to February 27, 2020, inpatients diagnosed with COVID-19 pneumonia in Enze Hospital, Taizhou, Zhejiang Province, were selected. The chest CT data of the patients were collected, and patients were included in the present study according to the predefined inclusion criteria. The dynamic evolution process and outcome of "fibrosis-like" strips on chest CT were analyzed.Results: A total of 36 patients (20 males and 16 females) with COVID-19 were included in the study, all of whom were diagnosed with mild or common COVID-19; "fibrosis-like" strips were observed in 29 patients (80.6%) on the first chest CT scan, and "fibrosis-like" strips were observed in 7 patients (19.4%) on the second chest CT scan, Repeated chest CT during the course of treatment showed that all patients with "fibrosis-like" strips had varying degrees of absorption. "Fibrosis-like" strips in 15 patients demonstrated a trend of first increasing in number, and then decreasing in number; "fibrosis-like" strips in 3 patients demonstrated a trend of first decreasing in number first, followed by an increase in number and then a decrease in number; and "fibrosis-like" strips in 18 patients demonstrated a trend of a gradual decrease in number. Follow-up chest CT after treatment showed that "fibrosis-like" strips in 15 patients completely disappeared in both lungs, and "fibrosis-like" strips completely disappeared in unilateral lung of 8 cases.Conclusion: In the present study, we observed that "fibrosis-like" strips in COVID-19 patients had characteristics of early appearance and rapid morphological changes as well as rapid absorption, suggesting that "fibrosis-like" strips may be a sign of subsegmental atelectasis rather than fibrotic changes.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Latif Panahi ◽  
Abolfazl Etebarian Khorasgani ◽  
Marzieh Amiri ◽  
Somaye Pouy

Background: Management of Covid-19 patients is key to control the pandemic. In this line, access to chest Computed Tomography (CT) scan findings and investigating changes during initial diagnosis until recovery is of crucial importance. Objectives: The present study aimed to investigate the chest CT-scan findings of patients with a definitive diagnosis of Covid-19 in Guilan, Iran. Methods: In this retrospective study, 1000 patients with a definitive diagnosis of Covid-19, from 20 April to 30 July 2020, were enrolled. Their first and follow-up chest CT-scans were obtained. Total lung involvement was determined by the number of lobes involved and by scoring 0 to 5 for each lobe (5 lobes, lowest score: 0, and highest score: 25). Results: In this study, three CT-scans of all 1000 patients were studied. Patients were classified into 4 stages according to their hospitalization duration (ranging from 0 to 30 days): stage 1 or primary (0 to 7 days): ground-glass opacities (n = 178 or 89%), stage 2 or progressive (8 to 15 days): increased crazy-paving pattern (n = 89 or 44.5%), stage 3 or peak involvement (16 to 22 days): consolidation (n = 78 or 89%), and stage 4 or decreased pulmonary involvement severity (greater than 23 Day): the gradual resolution of consolidation (n = 178 or 89%). Conclusions: Chest CT-scan findings revealed that patients with Covid-19 had a high rate of pulmonary involvement, on average, for the first 15 days, which then declined.


2021 ◽  
Vol 123 (4) ◽  
pp. 815-822
Author(s):  
Joanne Guerlain ◽  
Fabienne Haroun ◽  
Alexandra Voicu ◽  
Charles Honoré ◽  
Franck Griscelli ◽  
...  

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.


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