Direct Access Thoracic CT Scan: Impact of Change in Pathway on Wait Times

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 557A
Author(s):  
Jayanth Bhat ◽  
Javed Ibrahim ◽  
Subashini Chandrapalan ◽  
Ashwin Rajhan ◽  
Nick Watson ◽  
...  
Keyword(s):  
Ct Scan ◽  
Direct Access ◽  
Wait Times ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

Thoracic CT Scan vs PET-TC Imaging in the Diagnosis of Patients Suffering Exudative Pleural Effusions with Suspicion of Malignancy

2019 ◽  
Vol 55 (10) ◽  
pp. 546
Author(s):  
Marc Simó ◽  
Esther Pallisa ◽  
Alberto Jaúregui ◽  
Bruno Montoro ◽  
Ana Vázquez ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pleural Effusions ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

scholarly journals Impact of emergency physician experience on decision-making in patients with suspected community-acquired pneumonia and undergoing systematic thoracic CT scan

2019 ◽  
Vol 36 (8) ◽  
pp. 485-492
Author(s):  
Josselin Le Bel ◽  
Thierry Pelaccia ◽  
Patrick Ray ◽  
Charles Mayaud ◽  
Anne-Laure Brun ◽  
...  
Keyword(s):  
Ct Scan ◽  
Emergency Physician ◽  
Patient Management ◽  
Univariate Analysis ◽  
Community Acquired Pneumonia ◽  
Emergency Physicians ◽  
Thoracic Ct ◽  
Thoracic Ct Scan ◽  
Adjudication Committee ◽  
Diagnosis Classification

ObjectivesTo determine whether the impact of a thoracic CT scan on community-acquired pneumonia (CAP) diagnosis and patient management varies according to emergency physician’s experience (≤10 vs >10 years).MethodsEarly thoracic CT Scan for Community-Acquired Pneumonia at the Emergency Department is an interventional study conducted from November 2011 to January 2013 in four French emergency departments, and included suspected patients with CAP. We analysed changes in emergency physician CAP diagnosis classification levels before and after CT scan; and their agreement with an adjudication committee. We performed univariate analysis to determine the factors associated with modifying the diagnosis classification level to be consistent with the radiologist’s CT scan interpretation.Results319 suspected patients with CAP and 136 emergency physicians (75% less experienced with ≤10 years, 25% with >10 years of experience) were included. The percentage of patients whose classification was modified to become consistent with CT scan radiologist’s interpretation was higher among less-experienced than experienced emergency physicians (54.2% vs 40.2%; p=0.02). In univariate analysis, less emergency physician experience was the only factor associated with changing a classification to be consistent with the CT scan radiologist’s interpretation (OR 1.77, 95% CI 1.01 to 3.10, p=0.04). After CT scan, the agreement between emergency physicians and adjudication committee was moderate for less-experienced emergency physicians and slight for experienced emergency physicians (k=0.457 and k=0.196, respectively). After CT scan, less-experienced emergency physicians modified patient management significantly more than experienced emergency physicians (36.1% vs 21.7%, p=0.01).ConclusionsIn clinical practice, less-experienced emergency physicians were more likely to accurately modify their CAP diagnosis and patient management based on thoracic CT scan than more experienced emergency physicians.Trial registration numberNCT01574066

Chondrosarcoma in Mafucci’s syndrome – an interdisciplinary approach to a rare disease

2012 ◽  
Vol 153 (26) ◽  
pp. 1035-1038 ◽  
Author(s):  
Balázs Forgács
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Multidisciplinary Approach ◽  
Pulmonary Metastases ◽  
Interdisciplinary Approach ◽  
Thoracic Ct ◽  
Upper And Lower Extremities ◽  
The Right ◽  
Thoracic Ct Scan ◽  
Very High

Mafucci’s syndrome is a rare genetic but non-hereditary disorder, characterized by multiple enchondromas (enchondromatosis), hemangiomas and, rarely, lymphangiomas. The risk for malignant transformation of enchondromas is very high, and chondrosarcomas can develop which mainly metastatize to the lungs. A case report of a 61-years-old male, whose enchondromatosis developed at his age of 10 years, is described. The initial diagnosis had been Ollier’s disease at that time, and it was modified to Mafucci’s syndrome only in 1995 when hemangiomatosis developed on the right hand. He had a unilateral disorder affecting his right upper and lower extremities. In 2010, a chondrosarcoma developed on his right leg and amputation was performed. In 2012, a thoracic CT scan revealed pulmonary metastases on both sides. This case report underlines the importance of the multidisciplinary approach and cooperation between various specialties in diagnosing and early detecting this type of cancer. Orv. Hetil., 2012, 153, 1035–1038.

scholarly journals Pulmonary Artery Diameter on Thoracic CT Scan and Its Relationship to Pulmonary Artery Pressure

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 823A
Author(s):  
Mohammad Khalid ◽  
Sarfraz Saleemi ◽  
Abdullah AlDalaan ◽  
Mohammad Zeitouni ◽  
Abdullah Mobeireek ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Ct Scan ◽  
Pulmonary Artery Pressure ◽  
Artery Pressure ◽  
Thoracic Ct ◽  
Thoracic Ct Scan ◽  
Pulmonary Artery Diameter

Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan?

1995 ◽  
Vol 152 (2) ◽  
pp. 524-530 ◽  
Author(s):  
F Brunet ◽  
D Jeanbourquin ◽  
M Monchi ◽  
J P Mira ◽  
L Fierobe ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ct Scan ◽  
Blood Gases ◽  
Lung Mechanics ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

scholarly journals Circulating Vitamin D levels status and clinical prognostic indices in COVID-19 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Ricci ◽  
Alessandra Pagliuca ◽  
Michela D’Ascanio ◽  
Marta Innammorato ◽  
Claudia De Vitis ◽  
...  
Keyword(s):  
Vitamin D ◽  
T Lymphocytes ◽  
Immune Responses ◽  
Ct Scan ◽  
Vitamin D Deficiency ◽  
Plasma Levels ◽  
Cd8 T Lymphocytes ◽  
Thoracic Ct ◽  
Vitamin D Levels ◽  
Thoracic Ct Scan

Abstract Background Several immune mechanisms activate in COVID-19 pathogenesis. Usually, coronavirus infection is characterized by dysregulated host immune responses, interleukine-6 increase, hyper-activation of cytotoxic CD8 T lymphocytes. Interestingly, Vitamin D deficiency has been often associated with altered immune responses and infections. In the present study, we evaluated Vitamin D plasma levels in patients affected with different lung involvement during COVID-19 infection. Methods Lymphocyte phenotypes were assessed by flow cytometry. Thoracic CT scan involvement was obtained by an image analysis program. Results Vitamin D levels were deficient in (80%) of patients, insufficient in (6.5%) and normal in (13.5%). Patients with very low Vitamin D plasma levels had more elevated D-Dimer values, a more elevated B lymphocyte cell count, a reduction of CD8 + T lymphocytes with a low CD4/CD8 ratio, more compromised clinical findings (measured by LIPI and SOFA scores) and thoracic CT scan involvement. Conclusions Vitamin D deficiency is associated with compromised inflammatory responses and higher pulmonary involvement in COVID-19 affected patients. Vitamin D assessment, during COVID-19 infection, could be a useful analysis for possible therapeutic interventions. Trial registration: 'retrospectively registered'.

scholarly journals Unusual Presentation of a Rare Chest Wall Tumor: Giant Cell Tumor of Bone

2019 ◽  
Vol 6 (R) ◽  
Author(s):  
Yassine BAIZ ◽  
Oussama Abdessalam AFANDI ◽  
Hicham FENNANE ◽  
Yassine MSOUGAR
Keyword(s):  
Ct Scan ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Chest Wall ◽  
Cell Tumor ◽  
Chest Wall Tumor ◽  
Giant Cell Tumors ◽  
Anterior Arch ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

Introduction: Giant cell tumours account 5% of all bone tumours. However, the anterior chest wall is rarely involved . Clinical case: This is a 68-year-old housewife who has been thyroidectomized, for 11 years and is under hormone replacement therapy, and hysterectomized for 6 years after a uterine tumor. She is present for the onset of a 5 month old hard submammary mass on the left associated with left anterior chest pain under mammals. The clinical examination had found an irregular hard mass under left mammary which is fixed to the anterior arch of the 4th left rib. A thoracic x-ray showed a limited left hilo-axillary with an homogenously dense opacity. The thoracic CT scan showed the presence of a thoracic parietal mass of osteolytic tissue density centered on the anterior arch of the 4th left rib; without contrast agent, the surgical exploration through thoracotomy revealed a thoracic parietal tumoral process at the expense of the anterior arch of the 4th limb pushing the corresponding lung inwards. Surgical excision allowed ablation of the whole tumor in monobloc towards a healthy zone. The anatomopathological study of the operative specimen showed a morphological and histopathological aspect compatible with a costal tumor with giant cells. The postoperative recovery was marked by a good clinical and radiological improvement. The last check up after the surgery revealed that the patient was still asymptomatic. Good clinical, biological and radiological improvement was noted with a decline of 8 months. Conclusion: Giant cell tumors are aggressive bone tumors, yet histologically benign. The chosen examination is a thoracic CT scan with surgical treatment. A clinical and radiological monitoring is necessary. The recurrence is rare, but it usually necessitates a second surgery. The objective of this clinical observation is to highlight the possibility, although rare, of a giant cell tumor in case of the swelling of the soft parts, and a lytic lesion of the anterior part of a rib. Therefore, this tumor must be added to the list of diagnoses to be mentioned in this situation.

scholarly journals Influence of breathing state on the accuracy of automated patient positioning in thoracic CT using a 3D camera for body contour detection

2021 ◽  
Author(s):  
Ronald Booij ◽  
Marcel van Straten ◽  
Andreas Wimmer ◽  
Ricardo P. J. Budde
Keyword(s):  
Ct Scan ◽  
Patient Positioning ◽  
Contour Detection ◽  
Body Contour ◽  
Positioning Accuracy ◽  
Thoracic Ct ◽  
3D Camera ◽  
The Mean ◽  
Thoracic Ct Scan ◽  
The Ideal

Abstract Objective To assess the influence of breathing state on the accuracy of a 3D camera for body contour detection and patient positioning in thoracic CT. Materials and methods Patients who underwent CT of the thorax with both an inspiratory and expiratory scan were prospectively included for analysis of differences in the ideal table height at different breathing states. For a subgroup, an ideal table height suggestion based on 3D camera images at both breathing states was available to assess their influence on patient positioning accuracy. Ideal patient positioning was defined as the table height at which the scanner isocenter coincides with the patient’s isocenter. Results The mean (SD) difference of the ideal table height between the inspiratory and the expiratory breathing state among the 64 included patients was 10.6 mm (4.5) (p < 0.05). The mean (SD) positioning accuracy, i.e., absolute deviation from the ideal table height, within the subgroup (n = 43) was 4.6 mm (7.0) for inspiratory scans and 7.1 mm (7.7) for expiratory scans (p < 0.05) when using corresponding 3D camera images. The mean (SD) accuracy was 14.7 mm (7.4) (p < 0.05) when using inspiratory camera images on expiratory scans; vice versa, the accuracy was 3.1 mm (9.5) (p < 0.05). Conclusion A 3D camera allows for accurate and precise patient positioning if the camera image and the subsequent CT scan are acquired in the same breathing state. It is recommended to perform an expiratory planning image when acquiring a thoracic CT scan in both the inspiratory and expiratory breathing state. Key Points • A 3D camera for body contour detection allows for accurate and precise patient positioning if the camera image and the subsequent CT scan are acquired in the same breathing state. • It is recommended to perform an expiratory planning image when acquiring a thoracic CT scan in both the inspiratory and expiratory breathing state.

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