Interpretation of chest radiographs

2018 ◽  
Vol 11 (3) ◽  
pp. 155-161
Author(s):  
Ramona-Rita Barbara ◽  
Eryl A Thomas
Keyword(s):  
General Practice ◽  
Junior Doctor ◽  
Chest Radiographs ◽  
Patient Treatment ◽  
X Ray ◽  
Chest X Ray

It is vital that every junior doctor has a thorough knowledge of the fundamentals of interpreting chest radiographs. Frequently, hospital-based trainees in general practice need to make a decision regarding patient treatment on an unreported chest X-ray. This article covers the basic interpretation of chest radiographs and the most common pathologies encountered.

Is a routine chest X-ray indicated before discharge following paediatric cardiac surgery?

2009 ◽  
Vol 19 (4) ◽  
pp. 370-371 ◽  
Author(s):  
Kerstin Bosse ◽  
Thomas Krasemann
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Clinical Impact ◽  
Chest Radiographs ◽  
X Ray ◽  
Paediatric Cardiac Surgery ◽  
Routine Basis ◽  
Chest X Ray ◽  
Routine Chest

AbstractIn many paediatric cardiosurgical units, a chest X-ray is routinely performed before discharge. We sought to evaluate the clinical impact of such routine radiographs in the management of children after cardiac surgery.Of 100 consecutive children, a chest X-ray was performed in 71 prior to discharge. Of these, 38 were clinically indicated, while 33 were performed as a routine. Therapeutic changes were instituted on the basis of the X-ray in 4 patients, in all of whom the imaging had been clinically indicated. No therapeutic changes followed those radiographs performed on a routine basis.Conclusion: Routine chest radiographs can be omitted prior to discharging patients after paediatric heart surgery.

Comparison of Baseline, Bone-Subtracted, and Enhanced Chest Radiographs for Detection of Pneumothorax

2020 ◽  
pp. 084653712090885
Author(s):  
Fatemeh Homayounieh ◽  
Subba R. Digumarthy ◽  
Jennifer A. Febbo ◽  
Sherief Garrana ◽  
Chayanin Nitiwarangkul ◽  
...  
Keyword(s):  
False Negative ◽  
Tension Pneumothorax ◽  
Area Under The Curve ◽  
Ground Truth ◽  
Chest Radiographs ◽  
Detection Rates ◽  
X Ray ◽  
Institutional Review ◽  
Type Area ◽  
Chest X Ray

Purpose: To assess and compare detectability of pneumothorax on unprocessed baseline, single-energy, bone-subtracted, and enhanced frontal chest radiographs (chest X-ray, CXR). Method and Materials: Our retrospective institutional review board–approved study included 202 patients (mean age 53 ± 24 years; 132 men, 70 women) who underwent frontal CXR and had trace, moderate, large, or tension pneumothorax. All patients (except those with tension pneumothorax) had concurrent chest computed tomography (CT). Two radiologists reviewed the CXR and chest CT for pneumothorax on baseline CXR (ground truth). All baseline CXR were processed to generate bone-subtracted and enhanced images (ClearRead X-ray). Four radiologists (R1-R4) assessed the baseline, bone-subtracted, and enhanced images and recorded the presence of pneumothorax (side, size, and confidence for detection) for each image type. Area under the curve (AUC) was calculated with receiver operating characteristic analyses to determine the accuracy of pneumothorax detection. Results: Bone-subtracted images (AUC: 0.89-0.97) had the lowest accuracy for detection of pneumothorax compared to the baseline (AUC: 0.94-0.97) and enhanced (AUC: 0.96-0.99) radiographs ( P < .01). Most false-positive and false-negative pneumothoraces were detected on the bone-subtracted images and the least numbers on the enhanced radiographs. Highest detection rates and confidence were noted for the enhanced images (empiric AUC for R1-R4 0.96-0.99). Conclusion: Enhanced CXRs are superior to bone-subtracted and unprocessed radiographs for detection of pneumothorax. Clinical Relevance/Application: Enhanced CXRs improve detection of pneumothorax over unprocessed images; bone-subtracted images must be cautiously reviewed to avoid false negatives.

scholarly journals ChestXthon: An algorithm for Abnormality Detection in Chest Radiographs

2018 ◽  
Vol 7 (4) ◽  
pp. 2528
Author(s):  
N. Sarada ◽  
K. Thirupathi Rao ◽  
K. V. Ramana
Keyword(s):  
Heart Failure ◽  
Lung Tumor ◽  
Chest Radiographs ◽  
Abnormality Detection ◽  
X Ray ◽  
Lung Tuberculosis ◽  
Chest X Ray ◽  
Critical Consideration

Chest illnesses like heart failure, lung tumor or lung tuberculosis, and so on is frequently in view of chest X-ray images (CXR). The ailments are treatable on the off chance that they are recognized in their beginning times. Analyzing CXR is a tedious procedure. Now and again, therapeutic specialists had ignored the illnesses in their first examinations on CXR, and when the pictures were reevaluated, the malady signs could be detected. Furthermore, the quantity of CXR to look at is various and a long ways past the capacity of accessible therapeutic staff, particularly in creating nations. A PC supported finding (CAD) framework can check presumed zones on CXR for cautious examination by restorative specialists, and can give caution in the cases that need critical consideration. This paper reports our persistent work on developing an algorithm that aids the radiologists for the diagnosis of chest radiographs.  

scholarly journals Coronavirus Disease-2019 Pneumonia

2021 ◽  
Author(s):  
Rashid S. Al Umairi ◽  
Ishaq Al Salmi ◽  
Jokha Al Kalbani ◽  
Atheel Kamona ◽  
Saqar Al Tai ◽  
...  
Keyword(s):  
Ground Glass Opacity ◽  
Chest Radiographs ◽  
Ground Glass ◽  
Common Finding ◽  
Radiographic Examination ◽  
Type I ◽  
Lung Field ◽  
X Ray ◽  
Type Iv ◽  
Chest X Ray

Objectives: The aim of this study is to assess the correlation between the severity of the initial chest x-ray abnormalities in patients with confirmed diagnosis of coronavirus disease 2019 (COVID-19) and the final outcomes. Methods: Retrospectively, we identified serial chest radiographs of 64 patients (57 men, 7 women, with mean age of 50 years) admitted to the Royal Hospital between March 15, 2020 and May 30, 2020 with confirmed diagnosis of COVID-19. The chest radiographs were examined for presence, extent, distribution and progression pattern of radiological abnormalities. Each lung field was divided into 3 zones on each CXR and a score was allocated for each zone. The scores (0 [normal], 1 [mild] to 4 [severe]) for all six zones per chest radiographic examination were summed to provide a cumulative chest radiographic score (range, 0–24). Results: The initial CXR was abnormal in 60 patients (93.8%). The most common finding was ground glass opacity (58/64, 90.6%), followed by consolidation (50/64, 78.1%). The majority of the patients had bilateral (51/64, 85%), multifocal (57/64 95%) combined central and peripheral (36/64, 60%) lung abnormalities. The median score of initial CXR for deceased patients was significantly higher than those who recovered (17 vs 11 respectively; P = 0.009). Five CXR evolution patterns were identified: type I (initial radiograph deteriorates then improves), type II (fluctuate), type III (static), type IV (progressive deterioration) and type V (progressive improvement). Conclusion: Higher baseline chest radiograph score is associated with higher mortality rate and poor prognosis in those with COVID-19 pneumonia. Keywords: SARS-CoV-2; COVID-19; Chest X-ray; Scoring System; Pneumonia; Prognosis; Outcome; Severity; Consolidation; Ground-glass.

scholarly journals Challenges of Irradiation on Extrathoracic and Non-Thoracic Organs in Portable Neonatal Chest Radiography: Do We Need Mandatory Protective Rules?

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Alireza Mahmoudabadi ◽  
Mohammad Keshtkar ◽  
Majid Sadeghi Moghadam
Keyword(s):  
Retrospective Study ◽  
Chest Radiography ◽  
Pediatric Patients ◽  
Chest Radiographs ◽  
Costal Margin ◽  
X Ray ◽  
Reduce Radiation Exposure ◽  
Chest X Ray ◽  
The Given ◽  
The Ideal

Background: A chest X-ray (CXR) is known as the most common radiography used for adult and pediatric patients worldwide. Improper X-ray field collimation can result in excessive radiation dose on non-thoracic organs in chest radiographs. Objectives: This study was to investigate X-ray field collimation quality in neonatal chest radiography. Methods: A total of 213 chest radiographs of neonates from three hospitals were analyzed for collimation quality assessment in a retrospective study. Accordingly, ideal imaging field (IIF) and current imaging field (CIF) were initially defined. The margins of the IIF included acromioclavicular (AC) level to lower costal margin (i.e. top to bottom) and one centimeter beyond the broadest area of the chest on each side (that is, right to left). The CIF size was also defined as the square borders of collimators. Results: The findings revealed that the area of the CIF was 1.65 ± 0.39 times to the ideal imaging firlddd (IIF) for three hospitals, suggesting that collimation quality in neonatal chest radiographs was not accurate and it had defects. According to the results, acceptable collimation percentage (36.6%) in Hospital A was more than that in two other centers, and the given center also provided the lowest radiation due to the exposure of non-thoracic structures to primary beams. Conclusions: It was concluded that training radiographers and using patient immobilization devices and stabilizers were of important points that could reduce radiation exposure to non-thoracic organs in pediatric CXR.

scholarly journals Incidental diagnosis of a gastric mass on chest radiographs

2003 ◽  
Vol 7 (3) ◽  
pp. 30-32
Author(s):  
W. F.C. Gelderen
Keyword(s):  
Bowel Obstruction ◽  
Chest Radiographs ◽  
Subphrenic Abscess ◽  
Case Histories ◽  
Incidental Diagnosis ◽  
X Ray ◽  
Gastric Tumour ◽  
Free Air ◽  
Gastric Mass ◽  
Chest X Ray

Careful inspection of the infradiaphragmatic area on chest radiographs may lead to diagnosis of different conditions such as gastric fundal masses, sub-diaphragmatic free air, subphrenic abscess, bowel obstruction, etc. Case histories are presented for 4 patients in whom the diagnosis of a gastric tumour was made on chest X-ray. The importance of including the infradiaphragmatic area as a review area of the chest X-ray is emphasised.

scholarly journals Cost of a population-based programme of chest x-ray screening for lung cancer

2015 ◽  
Vol 79 (2) ◽  
Author(s):  
L. Dominioni ◽  
N. Rotolo ◽  
A. Poli ◽  
M. Castiglioni ◽  
M. Mangini ◽  
...  
Keyword(s):  
Lung Cancer ◽  
General Practice ◽  
High Risk ◽  
Usual Care ◽  
Direct Cost ◽  
Screening Programme ◽  
Population Based ◽  
Practice Setting ◽  
X Ray ◽  
Chest X Ray

Background. After the implementation of a population- based programme of chest x-ray (CXR) screening on smokers in Varese, Italy, lung cancer (LC) mortality was significantly reduced. Analysis of the incremental costs due to this type of screening programme is needed to evaluate its economic impact on the healthcare system. Methods. In July 1997 a population-based cohort, consisting of all high-risk smokers (n=5,815) identified among 60,000 adult residents from the Varese province, was invited to a LC screening programme (an annual CXR for five years) in a general practice setting, and was observed through 2006. Invitees received National Health Service (NHS) usual care, with the addition of CXRs in screening participants. At the end of observation, among the 245 LCs diagnosed in the entire screening-invited cohort the observed LC deaths were 38 fewer than expected. To estimate the incremental direct cost due to screening in the invited cohort for the period July 1997-2006, we compared the direct cost of screening administration, CXR screens and LC management in the invited cohort and in the uninvited and unscreened controls in NHS usual care setting. Results. Over the 9.5 years, the total incremental direct healthcare costs (including screening organization/administration, CXR screens, additional procedures prompted by false-positive tests, overdiagnosed LCs) were estimated to range from € 607,440 to € 618,370 (in euros as of 2012), equating to between € 15,985- € 16,273 per patient out of the 38 LC deaths averted. Conclusions. In a general practice setting, the incremental cost for a CXR screening programme targeted at all high-risk smokers in a population of 60,000 adults was estimated to be about €65,000 per annum, approx. €16,000 for each LC death averted.

scholarly journals Time from presentation to pre-diagnostic chest X-ray in symptomatic lung cancer patients: a cohort study using electronic patient records

2020 ◽  
pp. bjgp20X714077
Author(s):  
Kirsten Deanne Arendse ◽  
Fiona M. Walter ◽  
Mark Pilling ◽  
Yin Zhou ◽  
William Hamilton ◽  
...  
Keyword(s):  
Lung Cancer ◽  
General Practice ◽  
Cancer Diagnosis ◽  
Older Patients ◽  
Test Interval ◽  
National Guidelines ◽  
X Ray ◽  
Lung Cancer Patients ◽  
Lung Cancer Diagnosis ◽  
Chest X Ray

Abstract Background: National guidelines in England recommend prompt chest X-ray (within 14-days) in patients presenting in General Practice with unexplained symptoms of possible lung cancer, including persistent cough, shortness of breath or weight loss. Aim: To examine time to chest X-ray in symptomatic patients in English General Practice prior to lung cancer diagnosis and explore variation by demographics. Design and Setting: Retrospective cohort study using routinely collected General Practice, cancer registry and imaging data from England. Method: Patients with lung cancer who presented symptomatically in General Practice in the year pre-diagnosis and had a pre-diagnostic chest X-ray were included. Time from presentation to chest X-ray (presentation-test interval) was determined and intervals classified based on national guideline recommendations as concordant (≤14 days) or non-concordant (>14 days). Variation in intervals was examined by age, sex, smoking status and deprivation. Results: In a cohort of 2102 lung cancer patients, the median presentation-test interval was 49 days (interquartile range, IQR:5-172). 727 (35%) patients had presentation-test intervals of <14 days (median:1 day; IQR:0-6) and 1375 (65%) had presentation-test intervals of >14 days (median:128 days; IQR:52-231). Intervals were longer among smokers than non-smokers (63% longer; p<0.001), older patients (7% longer for every 10-years; p=0.013) and females (12% longer than males; p=0.016). Conclusion: In symptomatic primary care patients who underwent chest X-ray before lung cancer diagnosis, only 35% were tested within the timeframe recommended by national guidelines. Smokers, older patients and females experienced longer intervals. These findings could help guide initiatives aimed at improving timely lung cancer diagnosis.

scholarly journals The mysterious needle in the heart: a case report

2020 ◽  
Vol 4 (3) ◽  
pp. 1-4
Author(s):  
Ciara Mahon ◽  
Peter Gatehouse ◽  
John Baksi ◽  
Raad H Mohiaddin
Keyword(s):  
Ferromagnetic Material ◽  
Patient Treatment ◽  
Unexpected Finding ◽  
Coronary Angiogram ◽  
Atypical Chest Pain ◽  
Bundle Branch Block ◽  
X Ray ◽  
Case Summary ◽  
Chest X Ray ◽  
New Diagnosis

Abstract Background A 53-year-old female with dyspnoea and atypical chest pain. Her electrocardiogram demonstrated a left bundle branch block, transthoracic echocardiogram demonstrated a mildly impaired left ventricle ejection fraction, and coronary angiogram revealed unobstructed coronary arteries. She was referred for cardiovascular magnetic resonance (CMR) for structural and functional assessment. Her imaging revealed an unexpected finding of an off-resonance artefact within the ventricle wall. This material was secondary to a ferromagnetic material. Case summary Chest X ray and computer tomography confirmed a needle-shaped structure in the ventricle wall. Understanding the basis of this off-resonance artefact aided in a new diagnosis, raised questions on the origin of the material, patient safety, and implementation of corrective strategies to optimize image acquisition. Discussion The continued development of CMR is revolutionizing our ability to establish diagnosis and guide patient treatment. The CMR sequences can be prone to artefact. This case highlights the importance of understanding the basis of CMR artefacts.

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