Postoperative follow-up of lung cancer: Randomized trial comparing two follow-up programs in completely resected non-small cell lung cancer (IFCT-0302).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. TPS7111-TPS7111
Author(s):  
Virginie Westeel ◽  
Fabrice Barlesi ◽  
Jean Domas ◽  
Philippe Girard ◽  
Pascal Foucher ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Physical Examination ◽  
Ct Scan ◽  
Fiberoptic Bronchoscopy ◽  
Chest Ct ◽  
Small Cell Lung ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

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.

scholarly journals Chest X-Ray Findings and Temporal Lung Changes in Patients with COVID-19 Pneumonia

2020 ◽  
Author(s):  
Liqa A Rousan ◽  
Eyhab Elobeid ◽  
Musaab Karrar ◽  
Yousef Khader
Keyword(s):  
Ct Scan ◽  
Chest Ct ◽  
Common Finding ◽  
X Rays ◽  
Radiographic Findings ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

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.

scholarly journals (F)utility of computed tomography of the chest in the presence of pleural effusion

2017 ◽  
Vol 2 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Tilak Pathak ◽  
Malvinder S. Parmar
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Ct Scan ◽  
Clinical Management ◽  
Chest Ct ◽  
X Ray ◽  
Contrast Enhanced ◽  
Plain Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.

Ultrasound Detection of Pneumothorax Compared with Chest X-Ray and Computed Tomography Scan

2011 ◽  
Vol 77 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Khanjan Nagarsheth ◽  
Stanley Kurek
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Chest Ct ◽  
Trauma Patients ◽  
X Rays ◽  
Thoracic Ultrasound ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

Pneumothorax after trauma can be a life threatening injury and its care requires expeditious and accurate diagnosis and possible intervention. We performed a prospective, single blinded study with convenience sampling at a Level I trauma center comparing thoracic ultrasound with chest X-ray and CT scan in the detection of traumatic pneumothorax. Trauma patients that received a thoracic ultrasound, chest X-ray, and chest CT scan were included in the study. The chest X-rays were read by a radiologist who was blinded to the thoracic ultrasound results. Then both were compared with CT scan results. One hundred and twenty-five patients had a thoracic ultrasound performed in the 24-month period. Forty-six patients were excluded from the study due to lack of either a chest X-ray or chest CT scan. Of the remaining 79 patients there were 22 positive pneumothorax found by CT and of those 18 (82%) were found on ultrasound and 7 (32%) were found on chest X-ray. The sensitivity of thoracic ultrasound was found to be 81.8 per cent and the specificity was found to be 100 per cent. The sensitivity of chest X-ray was found to be 31.8 per cent and again the specificity was found to be 100 per cent. The negative predictive value of thoracic ultrasound for pneumothorax was 0.934 and the negative predictive value for chest X-ray for pneumothorax was found to be 0.792. We advocate the use of chest ultrasound for detection of pneumothorax in trauma patients.

Small-Cell Lung Cancer: Importance of Fiberoptic Bronchoscopy in the Evaluation of Complete Remission

1989 ◽  
Vol 75 (3) ◽  
pp. 266-268 ◽  
Author(s):  
Maurizio Tondini ◽  
Adriano Rizzi
Keyword(s):  
Lung Cancer ◽  
Complete Remission ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fiberoptic Bronchoscopy ◽  
Small Cell ◽  
Small Cell Lung ◽  
X Ray ◽  
Chest X Ray

The authors report their eight-year experience on the methodical of fiberbronchoscopy in the evaluation of complete remission in 140 patients affected by small-cell lung cancer. The higher reliability of fiberbronchoscopy than of standard chest X-ray is emphasized.

CLINICAL CORRELATION AND AGREEMENT BETWEEN THE CHEST CT SCAN AND CHEST X-RAY FINDINGS IN TUBERCULIN-POSITIVE CHILDREN: A PROSPECTIVE CROSS SECTIONAL STUDY

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 40S
Author(s):  
Beverly D. Delacruz ◽  
Nerissa A. Deleon ◽  
Milagros S. Bautista ◽  
Fernando Ayuyao ◽  
Teresita Deguia
Keyword(s):  
Ct Scan ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Clinical Correlation ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

Annual lung cancer screening by chest X ray to avoid further examinations.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19124-e19124
Author(s):  
Tatsuo Kimura ◽  
Shinya Fukumoto ◽  
Hideki Fujii ◽  
Akemi Nakano ◽  
Yuji Nadatani ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Ct Scan ◽  
Screening Program ◽  
Chest Ct ◽  
Medical Checkup ◽  
Specialty Clinic ◽  
Chest X Ray ◽  
Health Screening Program ◽  
First Time ◽  
Chest Ct Scan

e19124 Background: Chest X ray (CXR) has been the most common screen procedure for detection of lung cancer. However, if patients had old inflammatory shadows such as tuberculosis, calcification and fibrotic changes, it would become increasingly difficult to detect the lung cancer. In that case, a comparative review of the CXR to the previous one helps the detection of new shadows. We examined whether the repeat participants (pts) who received the medical checkup annually, may have a profit for the lung cancer detection screening. Methods: Our clinic “MedCity21” is a university outpatient clinic to undergo a complete medical checkup in private health screening program. The pts with abnormalities detected in CXR were announced by call request and invited to our specialty clinic for chest CT scan as further examination. We examined the varieties of abnormal shadows by CXR and CT scans, and compared the differences between the repeat and the first-time pts using the chi-square tests, in 2018 and 2019 respectively. Results: In 2018, a total of 12540 with repeat / first-time pts of 6898/5642 pts (55/45%) were enrolled. The CXR abnormalities requiring further examinations were a total of 335 (2.6%) with those of 138/188 pts (p < 0.01). After the call requests, a total of 239 (71.3%) with those of 109/130 pts in 2018 received chest CT scan in our specialty clinic. In 2019, a total of 13690 pts with those of 7748/5942 (56.6/43.4%) were enrolled. The CXR abnormalities requiring further examinations were a total of 323 (2.4%) with those of 137/186 pts (p < 0.01). After the call requests, a total of 224 (69.3%) pts with those of 104/120 pts received chest CT scan in our specialty clinic. The varieties of abnormal shadows by CT scans showed that 8.3/20.8% (p < 0.01) in 2018 and 11.5/21.7% (p = 0.04) in 2019 of old inflammatory shadows, 11.0/6.9% (p = 0.27) in 2018 and 14.4/1.7% (p < 0.01) in 2019 of acute inflammatory shadows, respectively. The nodule was detected in 11.9/11.5% in 2018 and 8.7/10.8% in 2019 with no significant differences. Lung cancer was detected in 3/3 pts in 2018, and 1/3 pts in 2019. Conclusions: The repeat pts in each year, had significantly lower rate of CXR abnormalities detection, and had lower rate of the detection of old inflammatory changes as significant. In private health screening program, the repeat pts may have higher profits for the avoidance of further examination for lung cancer detection than the first-time pts.

scholarly journals ADULT BOCHDALEK HERNIA: AN UNUSUAL PRESENTATION AND DIAGNOSTIC DILEMMA.

2015 ◽  
Vol 1 (2) ◽  
pp. 111
Author(s):  
Nikhil S Shetty ◽  
Vijay P Agrawal ◽  
Ashwin Narasimhaprasad
Keyword(s):  
Pleural Effusion ◽  
Physical Examination ◽  
Rare Condition ◽  
Chest Ct ◽  
Delayed Presentation ◽  
Bochdalek Hernia ◽  
Diagnostic Dilemma ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

Bochdalek hernia is a rare condition in adult and usually diagnosis is missed. It is usually mistakenly diagnosed as TB, pleural effusion, empyema, lung cyst and pneumothorax. Delayed presentation is not uncommon. We present a case of 18 year old male patient who was misdiagnosed as having left sided pleural effusion with TB and associated gastritis for three days and later referred to our institution. Diagnosis was established by physical examination, chest x-ray and chest CT- scan. Per operatively a gangrenous ileal segment was seen of about 10 cms which was later resected. The Hernia was later closed with Prolene sutures.

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